bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and risk of dementia in people with Anxiety over 50 years old – an electronic health records study
Authors: Nimmons Danielle , Bazo‐Alvarez Juan Carlos , Petersen Irene , Walters Kate , Schrag Anette 
Published: December 2023

AbstractBackgroundDepression is a well‐established risk factor for dementia, but we know far less about the links between Anxiety and future dementia risk in older people. The aim was therefore to investigate the incidence of dementia in people with and without Anxiety above the age of 50 years over a 10‐year period.MethodThe Health Improvement Network (THIN) was used, a large UK primary care dataset, that includes approximately 15.6 million patients, which is representative of the UK population. All people between 1st January 2008 and 31 December 2018 who had new onset Anxiety over the age of 50 years were identified. At the time of the first record of Anxiety, each person was individually matched to 4 unexposed persons based on their sex and age and Exposure Density Sampling was used, creating a dynamic cohort. Weibull survival regression models were fitted and hazard ratios (HR) were estimated for modelling time‐to‐dementia in those with and without Anxiety; and when determining the risk of developing dementia in those with Anxiety. Hazard ratio estimates were adjusted for sociodemographic and lifestyle factors, and relevant physical and mental health conditions.ResultIn this cohort study, there were 37,824 men and 68,761 women diagnosed with a first episode of Anxiety. Of those who had Anxiety, 2,792 people developed dementia during the follow up period, compared to 19,000 people in the non‐Anxiety group. The incidence of dementia in those with and without Anxiety was 7.21 (95% CI 6.94‐7.48) and 3.22 (95% CI 3.18‐3.28) respectively per 1,000 person‐years. The risk of dementia was increased 2.47‐fold [HR 2.47 (CI 2.37‐ 2.57)] in the Anxiety group when compared to the non‐Anxiety group after adjustment for age, sex, social deprivation, alcohol, smoking, BMI, diabetes mellitus, cardiovascular diseases, learning disabilities, HIV, multiple sclerosis, brain injury and hearing impairment.ConclusionThe incidence of dementia was greater in those with Anxiety and the risk of developing dementia was more than doubled in people with Anxiety compared to those without. This provides further evidence that Anxiety is a potential risk factor for dementia.
Nuclear Shuttling of IGF1R/INSR in Alzheimer’s disease and its corresponding role in regulation of neurodegeneration
Authors: Sengupta Priyanka , Mukhopadhyay Debashis 
Published: December 2023

AbstractBackgroundAlzheimer’s disease (AD) has been long associated with ageing and Insulin dysregulation. The receptors and ligands of the Insulin family including Insulin, IGF1, INSR, and IGF1R mainly has been explored over the years. However, their differential distribution in terms of compartmentalization and trafficking requires investigation.MethodWe started this study with SHSY5Y cells and checked for differential distribution in nucleus and cytoplasm in case of AD model. We repeated the study in N2A cells. To understand the nuclear shuttling better, we extended our study in differentiated SHSY5Y (into the Acetylcholinergic lineage) and exploited super resolution microscopy for imaging and trafficking. We fractionated the cellular compartments for biochemical evidence. To ascertain the partners and forms of protein that shuttles, antibody based assays were performed. For validation of this phenomena as of uniform occurrence, mice brain tissues and human primary neurons were utilized for imaging studies.ResultLigand independent shuttling into the nucleus occurs in case of AD models in presence of amyloid beta (1‐42). There is a 6.4 fold increase in phosphorylation in cytosolic pIGF1R/INSR in case of AD and a 2.5 fold increase in nuclear fractions. The occurrence correlated with the increase in Cyclin D1 production as suggested by ChIP studies. Upon treatment with Sumoylation inhibitor which blocks IGF1R transit into the nucleus, Cyclin D1 levels lowered validating transcriptional control of Cyclin D1 by IGF1R in AD scenario. Thus cell cycle can be directly influenced through interaction of IGF1R with binding partners LEF and TCF in AD.ConclusionCanonical ligand independent shuttling of phosphorylated IGF1R/INSR influences the cell cycle in AD thus triggering cell cycle through a direct control mechanism.
Results of a post‐diagnostic intervention for people with dementia and their family carers
Authors: Prins Marleen , Kroezen Marieke , van der Kuil Milan N.A. , van Belzen Elsemieke , van der Roest Henriëtte G. , Draisma Stasja 
Published: December 2023

AbstractBackgroundSupport directly after the diagnosis dementia is often experienced as inadequate by people with dementia and their family carers. Often, available support is focused on practical matters and not on the emotional impact of the diagnosis. The innovative intervention SHARE [Support, Health, Activities, Resources, Education] was developed in the USA for dyads (i.e. person with dementia and their family carer) dealing with early‐stage dementia. Its primary goal is to enhance communication between members of the dyad and to prepare them for the future. The intervention has been adjusted and pilot‐tested in the Netherlands, with positive results. The aim of this study was to investigate the impact of the intervention on dyads on a number of primary and secondary outcome measures.MethodA pre‐post study with three measurements (T0; pre‐ intervention, T1; post‐ intervention, and T2; six months post‐intervention) was conducted. Additionally, a process evaluation took place and qualitative data were collected. Primary outcomes were the quality of life of the person with dementia and self‐efficacy of the family carer. Secondary outcomes were stress, quality of the relationship, confidence in the future, usability and applicability of the intervention and (for family carers only) empathy. Data was collected through structured questionnaire research among 50 dyads, structured interviews with 18 dyads, 19 psychologists and 31 referring professionals, analysis of 55 intervention logs and a group discussion with case managers.ResultNo significant effects were found on the primary and secondary outcomes. However, qualitative results demonstrated the added value of the intervention for dyads, psychologists and referring professionals. Usability, acceptability and applicability of the intervention were all positively assessed.ConclusionAs no significant effects were found, we theorize that the intervention protects dyads. Usually, with a progressive disease like dementia, scores on the primary and secondary outcome measures decline, as time and hence the disease progresses. Our findings may indicate a protective effect of the intervention, among others on a further decline in quality of life of the person with dementia, and it may help maintain a stable level of self‐efficacy for the family carer.
Development of a cognitive composite for preclinical Alzheimer’s disease (CPAD) in Korean older adults
Authors: Kim Minjae , Yi Dahyun , Byun Min Soo , Ahn Hyejin , Jung Joon Hyung , Kong Nayeong , Jung Gijung , Lee Dong Young ,   KBASE research group
Published: December 2023

AbstractBackgroundAs tracking subtle cognitive declines in the preclinical stage of Alzheimer’s disease (AD) is difficult with traditional individual outcome measures, need for cognitive composite for preclinical AD is widely recognized. We aimed to develop culturally appropriate cognitive composite that sensitively identifies subtle cognitive decline of preclinical AD in Korean older adults.MethodA total 225 cognitively normal elderly individuals, who completed baseline and 2‐year follow‐up evaluation including clinical assessments and comprehensive neuropsychological tests and baseline amyloid positron emission tomography (PET) in the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE), were included. Tests of episodic memory, orientation, and executive function were carefully selected through review of previously established composite scores. Three candidate composites including Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) word list recall (WLR), logical memory (LM) II, and Mini‐mental status examination (MMSE) in common, and letter fluency test, category fluency test, or Stroop color and word test, were selected.ResultStudent t‐tests demonstrated that only the composite composed of WLR, LM II, MMSE, and LF (Composite 1) showed a significant difference in score decline over two‐year follow‐up period between Aβ positive and negative group (P = 0.03). Linear mixed model analyses also showed that the Aβ x time interaction effect was significant only for Composite 1 (P = 0.026). In contrast, we did not find any significant results for other two candidate composites (Composite 2 and 3). Based on the results, Composite 1 was chosen as the final CPAD.ConclusionCPAD can be used to assess subtle cognitive decline of preclinical AD in clinical research settings, especially in clinical trials with Korean older adults with preclinical AD. It also may be used for monitoring progression or treatment benefits in clinical practices.
NT‐proBNP and changes in cognition and brain structure: the Rotterdam Study
Authors: Xiao Tian , Van der Velpen Isabelle , Niessen Wiro J. , Tilly Martijn J. M , Kavousi Maryam , Ikram M. Arfan , Ikram M. Kamran , Vernooij Meike W 
Published: December 2023

AbstractBackgroundTo investigate the association between NT‐proBNP and changes in cognition and brain structure.MethodIn the Rotterdam Study, baseline NT‐proBNP was assessed at baseline from 1997 to 2008. Between 1997‐2016, participants without dementia or stroke at baseline (n = 9,566) had repeated cognitive tests (every 3‐6 years) for global cognitive function, executive cognitive function, fine manual dexterity, and memory. Magnetic resonance imaging of the brain was performed repeatedly at re‐examination visits between 2005 and 2015 for 2,607 participants to obtain brain volumes, focal brain lesions, and white matter microstructural integrity as measures of brain structure.ResultAmong 9,566 participants (mean age 65.1±9.8 years), 5,444 (56.9%) were women, and repeated measures of cognition were performed during a median follow‐up time of 5.5 years (range = 1.1‐17.9). For participants with brain imaging data at baseline (mean age 56.8±6.3 years, 55.5% women), repeated scans were completed over a median follow‐up time of 5.6 years (range = 2.8‐8.1). Higher levels of NT‐proBNP were associated with a faster decline of scores in the global cognitive function, the Word‐Fluency test, and the Purdue Pegboard test, but were not related to a steeper deterioration in brain volumes, white matter microstructure, or focal brain lesions.ConclusionHigher baseline NT‐proBNP levels were associated with a faster decline in cognition, but not in structural brain changes. Further studies should focus on the causality of the association between NT‐proBNP and cognition.
Conversational AI for Monitoring Behaviour and Well‐being of People Living with Dementia
Authors: Lima Maria R. , Soreq Eyal , Daniels Sarah , Barnaghi Payam , Vaitheswaran Sridhar , Vaidyanathan Ravi 
Published: December 2023

AbstractBackgroundConversational AI offers an intuitive and natural user interface with significant potential to promote the independence, well‐being, and safety of people living with dementia (PLWD) at home. This technology, such as smart speakers and social robots, can be used to access information, set reminders, assist with activities of daily living (ADL), stimulate communication, encourage behaviour, or alert the caregiver. However, voice technology has yet to demonstrate a direct impact on supporting PLWD in daily living contexts, particularly with health and well‐being monitoring utility. Adaptation to individual changing needs and cognitive abilities for personalised support remains a major research challenge. Further studies are required to assess the impact of conversational technology in different cultural and economic contexts.MethodWe investigate conversational social robots that engage with PLWD to query health and well‐being, map household behavioural patterns, and assist with ADL. We analysed in‐home activity data, including regular interactions with Amazon Alexa, from 14 households with PLWD (75‐94 years, four females) over 388 days. We examined the overall usage of conversational technology over time. We further considered activity sequences preceding or following Alexa interactions to trace behavioural patterns.ResultA significant decrease in conversational technology usage was observed after the novelty phase (i.e., >3 months) across the cohort. We argue this overall decline in user engagement is due to the lack of perceived utility and adaptation of interactions over time. Initial findings from our data mining approach identified behavioural patterns in household activity before and after user‐initiated interactions with Alexa. Additionally, ongoing studies are exploring the feasibility of implementation in both the UK and India with a specific focus on the impact of conversational AI in dementia care and the challenges associated with different cultural settings.ConclusionIf well incorporated into the living environment, conversational technology can monitor behaviour and well‐being of PLWD. This may be accomplished by proactively verifying issues detected from other sensors in smart environments and alerting caregivers for appropriate intervention. An early focus must be placed on personalising interactions, ensuring accessibility and cultural feasibility.
Characterization of cognitive profile in young patients in Buenos Aires, Argentina: preliminary analysis of 5 years and comparing pre‐pandemic and in‐pandemic period
Authors: Fernandez Maria Cecilia , Berrios Waleska , Golimstok Angel , Segui Milagros , Deppleler Solange ,   Memory and Behavior Research Group of Hospital Italiano of Buenos Aires
Published: December 2023

AbstractBackgroundCognitive manifestations are an increasingly frequent reason for consultation among young adults ranging from a subjective cognitive complaint (CC), mood or behavioral disorders to attention disorders or other cognitive functions with an impact on their functionality. The objective of this work is to analyze the cognitive profile of patients evaluated during last 5 years, characterize them and compare the results before the COVID‐19 pandemic and after.Method742 cognitive evaluations were analyzed from a database of patients between 40 and 60 years old who consulted for CC and were evaluated with a standard neurocognitive battery (SNB) between July 2017 and July 2022. Demographic data, screening test (MMSE or MoCA), Beck Depression Inventory (BDI‐2) and/or Hospital Depression and Anxiety Scale (HAD), Wender Utah Rating Scale (WURS) and final assessment diagnosis including criteria for cognitive disorders and depression according to DSM V were performed. Period from 2017 to 2019 was considered pre‐pandemic COVID‐19 period and period from 2020 to 2022 as pandemic period.Result65.6% were female. Pre‐pandemic, 441 patients were evaluated and 296 during pandemic. The average MMSE/MOCA score was: MMSE (328 total): 26.8 and MOCA (402 total): 24.4. Percentage of normal SNB was 17%, of “cognitive deficit”, without conforming deterioration was 36.8%, mild cognitive disorder (mCD) was 43.4%, mayor cognitive disorder (MCD) greater than 2.6%. Of all the patients, depression diagnosis by Beck/ HAD or DSM V was 59.3%. In addition, 25% of the patients had history of TDAH (Attention deficit disorder and hyperactivity) according to WURS. Only 2 patients were evaluated for Intellectual Disability.ConclusionIn this preliminary work, we detected that a high percentage of young patients with CC present some alteration in their cognitive function and almost 60% meet criteria for depression that could impact in these functions. In addition, 25% of patients had a history of TDAH. No significant difference was found between pre and pandemic. We are expanding the sample to be able to characterize the alterations with more specificity.
Long‐term results of Alzheimers’ dementia treated with transcranial pulse stimulation
Authors: Lohse‐Busch Henning 
Published: December 2023

AbstractBackgroundThe treatment of the brain with focused extracorporal shock waves (ESW) in patients with unresponsive wakefulness syndrome dates back to 2006 (1). This was followed by preliminary investigations for the treatment of Alzheimer’s dementia and Parkinson’s disease in the years up to 2014.The introduction of a shock wave generator with a navigation system in 2016 (Neurolith, Storz Medical) was a breakthrough for the precise treatment of brain structures. This method of brain treatment was then called TPS. After a 3 month study with people living with Alzheimer’s dementia in 2019 (2), we now present patients with long‐term follow‐up over 3 years during continous monthly TPS treatment as a critical undertaking for future treatments.Method6 persons living with mild Alzheimer’s dementia (Mini Mental Status >18) were treated initially 6 times during 2 weeks with TPS. Subsequently, they received one TPS session monthly over 3 years. The results were assessed with the CERAD Plus score and compared with the data of the expected natural development with standard medication according to the ALSOVA study of Hallikainen.ResultWhile cognitive skills improved by 12% over 12 months, outcomes returned to the baseline in the second year. A two‐week booster of 6 sessions with TPS improved outcomes again by 4.5% compared to the baseline. After 3 years, the results were at the level of the expected natural development with standard medication.ConclusionA symptomatic improvement of Alzheimer’s symptoms with low‐energy TPS over several years seems to be possible. It was a methodological mistake not to examine the patients more frequently neuropsychologically. It is conceivable that this would achieve a better long‐term result.(1.) H. Lohse‐Busch, U. Reime and R. Falland, (2014) Symptomatic treatment of unresponsive wakefulness syndrome with transcranially focused extracorporeal shock waves. NeuroRehabilitation 35 (2014) 235‐244(2.) Beisteiner R, Matt E, …… Lohse‐Busch H (2019) Transcranial pulse stimulation with ultrasound in Alzheimer’s disease—A new navigated focal brain therapy. Adv Sci (Weinh) 23;7(3):1902583.
Cerebrovascular Changes in Dementia Patients with Alzheimer’s Disease and Vascular Parkinsonism
Authors: Maksimovich Ivan V 
Published: December 2023

AbstractBackgroundWhen examining patients with dementia, it is necessary to clearly differentiate the developed cerebrovascular and microcirculatory changes. We present the features of cerebral angioarchitectonics and microcirculation in Alzheimer’s disease (AD) and vascular parkinsonism (VP).MethodsThe research included 155 patients. The examination included assessment of CDR, TDR, MMSE, cerebral MRI, CT, scintigraphy (SG), rheoencephalography (REG), cerebral multi‐gated angiography (MUGA).Patients were divided into:• 93 people aged 34‐80 (mean age 67.5): men ‐ 32 (34.40%), women ‐ 61 (65.59%), suffering from AD. According to dementia severity, patients were subdivided: (TDR‐0) ‐ 10, (TDR‐1) ‐ 29, (TDR‐2) ‐ 36, (TDR‐3) ‐ 18 people;• 62 people aged 52‐80 (mean age 77): men ‐ 48 (77.42%), women ‐ 14 (22.58%), suffering from VP. According to dementia severity, patients were subdivided: no dementia ‐ 30 people, dementia at level (CDR‐1) ‐ 32 people.ResultsIn AD patients, changes in angioarchitectonics and microcirculation are manifested in:• Absence of calcium salts deposits and atherosclerotic changes in intracerebral vessels;• Increased tortuosity of distal intracranial arteries;• Reduction of the capillary bed in the temporal and frontoparietal regions;• Development of multiple, large arteriovenous shunts with early venous discharge of arterial blood in the same regions;• Development of abnormal, intracerebral venous trunks;• Development of intracerebral stagnation of venous blood.These changes are called “Discirculatory angiopathy of Alzheimer’s type” (DAAT).In patients with VP, changes in angioarchitectonics and microcirculation are manifested in:• Multiple calcium salts deposits with atherosclerotic changes in intracranial vessels, mainly in the thalamus, basal ganglia, and pons;• Local decrease in subcortical cerebral capillary blood flow in the same regions;• Development of local subcortical small intracerebral arteriovenous shunts;• Absence of expressed intracerebral venous blood stagnation.ConclusionsDiscirculatory angiopathy of Alzheimer’s type (DAAT), regardless of dementia severity, is an AD‐specific cerebrovascular and microcirculatory lesion of the brain, unconnected with atherosclerotic process.In patients with VP, regardless of dementia, vascular and microcirculatory changes are atherosclerotic in nature. Capillary bed lesions, presence of arteriovenous shunts are subcortical in nature, mainly in the region of the thalamus, basal ganglia, and bridge. Marked venous stasis does not occur in this case.
From plan to impact: does a national dementia plan make a difference? Comparing post diagnostic care in England and Malaysia.
Authors: Robinson Louise 
Published: December 2023

AbstractBackgroundIn 2009, England introduced a National Dementia Strategy, followed by a Prime Minister’s National Dementia Challenge. By 2020, England led a ‘European league table’ regarding dementia policy and research, but performed less well for access to care and support. Malaysia has co‐developed a National Dementia Plan but implementation has been delayed due to Covid. This talk will compare and contrast findings from two research projects which explored post diagnostic dementia care and support in a High Income Country (HIC), England (https://research.ncl.ac.uk/pridem) and a Lower Middle Income Country (LMIC), Malaysia (https://research.ncl.ac.uk/global_health_depec/).MethodThe PriDem programme in England initially mapped post diagnostic dementia services via an e‐survey to commissioners (n = 82) and then used qualitative approaches (1‐1 interviews, focus groups; in‐depth case studies) to explore services in depth (n = 61 commissioners/service managers; 68 health/social care providers and 48 service users (17 people with dementia, 31 carers). In Malaysia, DePEC interview sampling was restricted due to COVID (n = 20 professionals; 11 healthcare; 4 traditional medicine; 5 support services).ResultAnalysis revealed similar issues in both countries namely: i) considerable geographical inequalities in services, especially between rural and urban areas, with most support focused on the early period after diagnosis; ii) limited confidence and capacity of primary/community care services and iii) fragile, fragmented care due to funding limitations. In England, follow up interviews one year post Covid revealed further widening of these inequalities.ConclusionThis research has shown that the development of a national dementia plan is only the first step and that translation of rhetoric into reality, i.e. better quality care and improved patient experience, is a major challenge. In order to close the gap between policy and service provision, national dementia plans must incorporate formal implementation and evaluation programmes to successfully move from ‘plan to impact’.