bluuebunny/crossref_metadata_2025_split huggingface dataset:
CNN for a Regression Machine Learning Algorithm for Predicting Cognitive Impairment using qEEG
Authors: Simfukwe Chanda , Youn Young Chul 
Published: December 2023

AbstractBackgroundElectroencephalogram (EEG) signals give detailed information on the electrical brain activities occurring in the cerebral cortex. They are used to study brain‐related disorders such as mild cognitive impairment (MCI), and dementia. Brain signals obtained using an EEG machine can be a neurophysiological biomarker for early diagnosis of dementia through quantitative EEG (qEEG) analysis. This paper proposes a machine learning methodology to detect MCI and dementia from qEEG time‐frequency (TF) images of the subjects in an eyes‐closed resting state (ECR).MethodThe dataset consisted of 16,910 TF images from 890 subjects: 269 healthy controls (HC), 356 MCI, and 265 dementia. First, EEG signals were transformed into TF images using a Fast Fourier Transform (FFT) containing different event‐rated changes of frequency sub‐bands preprocessed from the EEGlab toolbox in the MATLAB R2021a environment software. The preprocessed TF images were applied in a convolutional neural network (CNN) with adjusted parameters. For classification, the computed image features were concatenated with age data and went through the feed‐forward neural network (FFN).ResultThe trained models’, HC vs. MCI, HC vs. dementia, and HC vs. CASE (MCI + dementia), performance metrics were evaluated based on the test dataset of the subjects. The accuracy, sensitivity, and specificity were evaluated: HC vs. MCI was 83%, 93%, and 73%, HC vs. dementia was 81%, 80%, and 83%, and HC vs. CASE (MCI + dementia) was 88%, 80%, and 90%, respectively.ConclusionThe proposed models trained with TF images and age can be used to assist clinicians as a biomarker in detecting cognitively impaired subjects at an early stage in clinical sectors.
Remote assessment of functional impairment in Alzheimer’s disease: results of the RADAR‐AD study
Authors: Muurling Marijn , de Boer Casper , Vairavan Srinivasan , Curcic Jelena , Scebba Gaetano , Atreya Alankar , Hinds Chris , Conde Pauline , Grammatikopoulou Margarita , Lazarou Ioulietta , Nikolopoulos Spiros , Brem Katy , Coello Neva , Narayan Vaibhav A , Wittenberg Gayle , Aarsland Dag , Visser Pieter Jelle ,   the RADAR‐AD consortium
Published: December 2023

AbstractBackgroundRemote monitoring technologies (RMTs), such as smartphone apps and smartwatches, are changing the way functional and cognitive performance are measured in Alzheimer’s disease (AD). Due to their sensitivity, objectivity, and the option of long‐term and continuous measurement, RMTs have the potential to detect a subtle decline in the earliest stages of AD. Here, we present the results of the European RADAR‐AD project (Remote Assessment of Disease and Relapse – Alzheimer’s disease), which aims to test feasibility, acceptability and validity of RMT measures across all stages of AD, from cognitively normal to mild dementia.MethodFour study groups (amyloid negative healthy controls, and amyloid positive preclinical AD, prodromal AD, mild‐to‐moderate AD) were included in this cross‐sectional study (N = 175). During 8 weeks, participants wore two activity trackers (Fitbit and Axivity) measuring physical activity, heart rate and sleep continuously, and used two interactive smartphone apps (Mezurio and Altoida’s research algorithm: DNS‐MCI) measuring cognition daily/weekly. At baseline, participants underwent extensive neuropsychological, physical examinations, and did two sensor‐based tests (banking app and walk test). Features were extracted for all RMTs (Figure 1) and compared across groups using ANCOVA, with adjustment for relevant confounders. This study is part of an ongoing investigation into high‐end multimodal analyses for real‐world functional performance of continuous RMT data streams.ResultCompliance was high, but decreased with cognitive impairment (feasibility). User experience did not differ between groups but was lower for smartwatches compared to interactive smartphone apps (Table 1) (acceptability). Various individual sensors discriminated symptomatic AD participants from asymptomatic participants (p<0.05), for example the two active apps, but did not discriminate preclinical AD from healthy controls (Table 1) (validity).ConclusionThe RADAR‐AD study provides unique insights in the feasibility, acceptability, and validity of remote monitoring of functional abilities in AD and their potential to differentiate between syndromic stages.
This work has received support from the EU/EFPIA Innovative Medicines Initiative Joint Undertaking (grant No 806999) and their associated partners. www.imi.europa.eu. This communication reflects the views of the RADAR‐AD consortium and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein.
Primary care training needs about dementia. A Qualitative study
Authors: Leon Tomas , Troncoso Deiza , Barria Soledad , Slachevsky Andrea 
Published: December 2023

AbstractIntroductionThe prevalence of dementia in Chile is 1.06%, and it is expected to triple in the next 30 years. The current regulations establish that over 80% of the people living with dementia and their care partners should receive care in primary care with only the hard or atypical cases. However, the knowledge and confidence of primary care teams are low, and there is no current training scheme for them.ObjectivesTo identify the training needs of primary care teams, people living with dementia and their care partners, gathering information to create a course on dementia for primary care teams.MethodologyQualitative research methods were used, including focus group interviews for health professionals and individual interviews for people living with dementia and their care partners. A complete analysis of the recorded interviews was performed.ResultsDisregarding their previous training or background, all primary care professionals recognise the importance of continuous instruction. There is also a lack of preparation for interpersonal skills, like providing bad news and empathy. Caregivers and people living with dementia highlight a lack of continuity in their care team, being unaware of their diagnosis and low support.ConclusionsOur study supports the need for training for primary care on dementia. Even more, it finds some areas, like interpersonal skills, that are usually not covered in dementia education. Adding the patient’s and care partners' voices will allow our course to be adapted to their reality and expectations.
Variations in metabolic risk factors for dementia do not affect APOE‐mediated cognitive or functional decline in patients with Alzheimer’s disease from São Paulo, Brazil
Authors: Oliveira Fabricio Ferreira , Chen Elizabeth Suchi , Smith Marilia Arruda Cardoso , Bertolucci Paulo Henrique Ferreira 
Published: December 2023

AbstractBackgroundMidlife cerebrovascular risk, low education and copies of APOE‐ε4 are risk factors for Alzheimer’s disease (AD), whereas metabolic derangements have been associated with dementia onset. This prospective study aimed to explore the impacts of variations in metabolic risk factors on progression of AD in São Paulo, Brazil.MethodsOutpatients with late‐onset AD according to National Institute on Aging – Alzheimer’s Association criteria were assessed for APOE haplotypes (rs7412 & rs429358 genotyped by way of TaqMan® Real‐Time Polymerase Chain Reaction technology) and variations in one year of the following potential metabolic predictors: fasting glycemia, TSH, free T4, vitamin B12, and folic acid. Metabolic variations were assessed in accordance with concurrent variations in the Clinical Dementia Rating Sum‐of‐Boxes, the Index of Independence in Activities of Daily Living, Lawton’s Scale for Instrumental Activities of Daily Living, and the Mini‐Mental State Examination in multiple linear regression models for all patients, and after stratification according to APOE‐ε4 carrier status, with the threshold of significance set at p<0.05.ResultsOf 122 patients, there were 81 women (66.4%) and 41 men (33.6%), 69 APOE‐ε4 carriers (56.5%) and 53 APOE‐ε4 non‐carriers (43.5%). The mean estimated age at AD onset was 73.13±7.1 years‐old. Overall, 120 patients used a cholinesterase inhibitor (98.4%), and 90 patients used Memantine (73.8%). All test scores were significantly different at the end of one year (p<0.01), except for the Mini‐Mental State Examination (p = 0.13). None of the potential metabolic predictors varied significantly after one year (p>0.16), and no variations in metabolic risk factors were concurrently associated with variations in the Clinical Dementia Rating Sum‐of‐Boxes (p>0.17), the Index of Independence in Activities of Daily Living (p>0.09), Lawton’s Scale for Instrumental Activities of Daily Living (p>0.22), or the Mini‐Mental State Examination (p>0.40), neither for APOE‐ε4 carriers (p>0.28), nor for APOE‐ε4 non‐carriers (p>0.07).ConclusionsLifetime metabolic risk factors may affect onset of AD, but concurrent variations in metabolic parameters seem to have no associations with cognitive or functional decline in such patients, regardless of APOE‐ε4 carrier status. (Supported by FAPESP grant #2015/10109‐5)
Carer Assessment of medicaTion management guidanCe for people living with dementia at Hospital discharge (CATCH): A national cross‐sectional survey
Authors: Sawan Mouna J , Clough Alexander J , Mirzaei Ardalan J , Jeon Yun‐Hee , Schneider Carl R , Gnjidic Danijela , Chen Timothy 
Published: December 2023

AbstractIntroductionTransitions of care are a major contributing factor to medication‐related adverse events in people with dementia. There is limited knowledge on how well guidance on medication management is provided to carers at hospital discharge, and there is no tool that comprehensively reports on medication management guidance at discharge. The study aim was to evaluate carers’ experiences of medication management guidance for people with dementia at hospital discharge and explore the underlying factors of the CATCH tool as preliminary validation of the tool.MethodsA cross‐sectional survey of the CATCH tool was distributed across Australia between March and November 2022. The CATCH tool contained 30 Likert‐type items and three dichotomous (yes/no) items. The results of the survey were analysed descriptively, and exploratory factor and regression analyses were performed.ResultsA total of 185 survey responses were completed (completion rate 66.8%). Most respondents were informal carers (n = 116, 62.7%), and were predominantly provided medication management guidance on the day of discharge (n = 79, 42.7%). One‐third (n = 61, 33.0%) responded that medication management guidance could be improved. Regarding the safe use of medications, respondents felt information was not well provided on: medications that may interact with each other (n = 30, 17.6%), possible side‐effects of medications (n = 28,16.1%), and medications that might act on the brain (n = 27, 15.8%). Thirty respondents (17.8%) reported that they were not included in decisions by hospital staff about medications for people with dementia. The CATCH tool contained two factors: 1) person‐centred guidance in the safe use of medications during and after discharge; and 2) support of carers in medication management. Internal consistency of all factors were acceptable with Cronbach’s alpha (>0.8). The carer reported measure of how medication management guidance is provided is positively related to their confidence in management of medications post‐discharge and satisfaction (p< 0.05 for both).ConclusionOpportunities to improve delivery of person‐focused medication management guidance involve provision of information on the safe use of medications to the carer and engagement in medication decisions. The CATCH tool is the first scale developed that evaluates person‐centred medication management guidance and support provided to carers of people with dementia at discharge.
Day care program for older adults with dementia: A multidiscipilinary approach for patients and family caregivers from Argentina
Authors: Feldberg Carolina , Tartaglini María Florencia , Guyet Gisela , Vilas Silvia , Jacoboni Marina , Buttazzi Melina , Kasten Sergio , Teran Claudio , Astudillo Manuel , Garcia Susana , Gimenez Ariel 
Published: December 2023

AbstractBackgroundDay care programs for older adults with dementia is an effective strategy that allows prolonging the functionality of the elderly, their support and that of their family reducing home care costs and delaying the institutionalization of patients with cognitive impairment. The aim of the present work is to describe the main goals and the implementation of a multidisciplinary day care program for patients with dementia and their family caregivers in Argentina.MethodSubjects: 22 patients and their family caregivers, who attend a day care program in Argentina. Instruments: socio‐demographic and psychosocial questionnaire of both patient and caregiver (built ad hoc) Patient: MMSE, GDS, HAD‐A, PANAS‐VRARG, EQ‐5D and instrumental and basic habilites of daily living. Family caregiver: Zarit Burden Interview. Procedure: The intervention for patients consists of two different lines of work, one for the patient, and another for the family member. The activities are coordinated by a multidisciplinary group of professionals. Regarding the caregiver, individual orientation interviews and therapeutic group spaces and psycho‐educational material are offered.ResultPreliminary data of 22 patients and caregivers, who have taken part in the program so far, indicate that: Patient: median age was years 75,27 old (ds = 9,28), % 63,6 of which are woman. The values obtain in the instrument are: MMSE 22,45 (ds = 4,78) GDS 4,47 (ds = 3,73), HAD‐A 3,66 (ds = 3,39), (PANAS ‐E‐VRARG) Negative ítems 7,70 (ds = 3,11) (PANAS ‐E‐VRARG) Positive ítems 18,7 (ds = 3,13), EQ‐5D 77,35 (ds = 16,21) and BHDL 93,63 (ds = 13,10), IHDL 9,1 (ds = 3,31) . And for family caregivers the mean age was 65,27 old (ds = 11,37), % 66,71 of which are woman. Caregivers Zarit Burden Interview mean score was 40,18 (ds = 11,35).ConclusionOur findings concur with those presented in scientific literature and support the WHO recommendations regarding the need to implement multidisciplinary programs for patients with dementia and family caregivers, in order to moderate the impact that providing care for an elderly relative with a neurological disease has on them.
Dementia care navigation: A systematic review on different models and their prevalence
Authors: Giebel Clarissa , Reilly Siobhan , Gabbay Mark , Dickinson Julie , Tetlow Hilary , Hogan Hayley , Griffiths Alys Wyn , Cooper Claudia 
Published: December 2023

AbstractBackgroundDementia Care Navigators (DCNs) are professionals without clinical training, who provide individualised emotional and practical support to people living with dementia, working alongside clinical services. Navigator services have been implemented widely but the service offered vary without a consistent overview provided. The aim of this narrative systematic review was to describe and compare existing models, and to synthesise evidence regarding their implementation and impacts.MethodsThe review was registered on PROSPERO [CRD42021292518]. Three electronic databases were searched and included studies reported on a DCN model, defined as a service in which non‐clinically trained workers provide personalised advice and support to people with dementia and/or carers in the community. Two independent reviewers screened abstracts and titles and read through full papers for inclusion. Risk of bias was assessed using the Standard Quality Assessment QualSyst.ResultsWe included 13 papers (six studies). All models were US‐based and only varied by integration and training provided. Studies reported different degrees of impact on service utilisation and on symptoms and mental well‐being of people with dementia and their carers, with too little evidence to draw substantial/meaningful conclusions. One study evidenced greater impacts on people with more advanced dementia compared to earlier stages.ConclusionsDCN models have the potential to effectively provide non‐clinical support to people with dementia and carers from the point of diagnosis. Further research from countries other than the USA, focusing on the impact on social care and social support service access and utilisation, and utilising similar stablished outcome measures are required.
Application of Wavelet Leader Based Analysis to characterize different neurodegenerative disease
Authors: Azizi Tahmineh 
Published: December 2023

AbstractBackgroundNeuro‐degenerative diseases influence significantly the gait behavior and the ability to move.MethodTo explore the etiology of neuro‐degenerative disease, it would be useful to characterize gait dynamics. The purpose of this study is to classify different neuro‐degenerative diseases using fractal geometry.ResultWe noticed that neither SPD nor FD alone were sufficient to separate different classes of patients and healthy people. In addition, when WLM and scaling exponent were used as a classifier, the three classes could not be well separated. However, this study revealed that we have a wide range of exponents for some of the recordings which indicates they have multifractal structure and need to be indexed by different exponents as decomposed into different subsets. In other words, these multifractal subjects require much more exponents to characterize their scaling properties compared to monofractal gait recordings which their spectrum displays a narrow width of scaling exponent.ConclusionAlthough SPD, FD and WLM may not be able to classify gait recordings, however, they can be used as comprehensive frameworks to characterize the fractal behavior of gait recordings of different neuro‐degenerative diseases.
The Effectiveness of Reminiscence Therapy in Improving Cognitive Functions And Psychological Wellbeing in Older Adults With Early Dementia ‐ The Randomized Control Trial
Authors: Ho‐Yin Lai Frank 
Published: December 2023

AbstractBackgroundReminiscence therapy (RT) is a trending type of non‐pharmacological intervention in dementia care. RT is using life histories recalling and re‐experiencing the life events in older people in order to improve their psychological well‐being through the volitional or non‐volitional process of recollecting memories from their past.MethodParticipants' selection inclusion criteria are: (a) aged 65 or above, (b) early stage of dementia that was screened by the Montreal Cognitive Assessment (MoCA) with scoring of 17‐19, and (c) can read written instruction and consent. Participants were randomly assigned by block randomization with randomized block procedure. The participants attended eight group sessions, with each session lasting for 60 minutes. Sessions were administered two times a week over a 4‐week period. Participants' depressive symptoms were evaluated by Geriatric Depression Scale (GDS), Subjective well‐being (the cognitive components) was measured by Satisfaction With Life Scale (SWLS), mood change as measured by Visual Analogue Mood Scale (VAMS). All these evaluation were conducted baseline, mid‐way evaluation and post‐evaluation by a registered Occupational Therapist.ResultForty older people (29 male and 11 female) were eligible for the study. There was significant difference on depressive symptoms (p = .02, t = ‐2.38), mood change (p = .03, t = ‐3.38), but marginally significant in subjective well‐being (p = .05, t = ‐1.03) between intervention and control group. Further analyses were conducted whether depressive symptoms and mood change effect individuals' subjective well‐being. A two‐way ANOVA revealed that there was not a statistically significant interaction between the effects of depressive symptoms and mood change (F(3, 16) = 1.242, p = .311). Simple main effects analysis showed that depressive symptoms did not have a statistically significant effect on subjective well‐being (p = .975). Simple main effects analysis showed that mood change did have a statistically significant effect on subjective well‐being (p < .000).ConclusionThe findings of this study affirmed the benefit of RT to older people with early stage of dementia through improving depressive symptoms, mood and marginally on their subjective well‐being. The research data available support the inclusion of a structured RT as a part of the routine care given to older people. There are some limitations of our study.
The association of bone mineral density and dementia: the Rotterdam Study
Authors: Xiao Tian , Ghatan Samuel , Mooldijk Sanne S. , Trajanoska Katerina , Oei Ling , Gomez M. Medina , Ikram M. Kamran , Rivadeneira Fernando , Ikram M. Arfan 
Published: December 2023

AbstractBackgroundLow bone mineral density and dementia commonly co‐occur in the elderly, with bone loss accelerating in dementia patients due to physical inactivity and poor nutrition. However, uncertainty persists over the extent to which bone loss already exists prior to the onset of dementia. Therefore, we investigated how dementia risk was affected by bone mineral density at various skeletal regions in community‐dwelling older adults.MethodIn a prospective population‐based cohort study, bone mineral density at the femoral neck, lumbar spine, and total body and the trabecular bone score were obtained using dual‐energy X‐ray absorptiometry (DXA) in 3,651 participants free from dementia between 2002‐2005. Persons at risk of dementia were followed up until 1 January 2020. For analyses of the association between bone mineral density at baseline and the risk of incident dementia, we used Cox proportional‐hazards regression analyses, adjusting for age, sex, educational attainment, physical activity, smoking status, body mass index, systolic blood pressure, diastolic blood pressure, cholesterol level, high‐density lipoprotein cholesterol, history of comorbidities (stroke and diabetes mellitus), and APOE genotype.ResultAmong the 3,651 participants (median age 72.3±10.0 years, 57.9% women), 688 (18.8%) developed incident dementia during a median of 11.1 years, of whom 528 (76.7%) developed Alzheimer’s disease. During the whole follow‐up, participants with lower bone mineral density at the femoral neck (per SD decrease) were more likely to develop all‐cause dementia (Hazard ratio [HR] total follow‐up: 1.12, 95% Confidential interval [CI]: 1.02‐1.23) and Alzheimer’s disease (HR total follow‐up: 1.14, 95% CI: 1.02‐1.28). Within the first ten years following baseline, the risk of dementia was greatest for groups with the lowest tertile of bone mineral density (femoral neck bone mineral density, HR0‐10years 2.03; 95% CI, 1.39–2.96; total body bone mineral density, HR0‐10years 1.42; 95% CI, 1.01‐2.02; trabecular bone score, HR0‐10years 1.59; 95% CI, 1.11‐2.28).ConclusionIn conclusion, participants with low femoral neck and total body bone mineral density and low trabecular bone score were more likely to develop dementia. Further studies should focus on the predictive ability of bone mineral density for dementia.