bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Alzheimer’s disease progression in healthy and MCI subjects using multi‐modal deep learning approach
Authors: Mirabnahrazam Ghazal , Ma Da , Beaulac Cédric , Lee Sieun , Popuri Karteek , Lee Hyunwoo , Cao Jiguo , Wang Lei , Galvin James E , Beg Mirza Faisal 
Published: December 2022

AbstractBackgroundAlzheimer's disease (AD) is a complex disorder influenced by many factors, but it is unclear how each factor contributes to disease progression. An in‐depth examination of these factors may yield an accurate estimate of time‐to‐conversion to AD for patients at various disease stages. Recent advances in deep learning have enabled researchers to predict patient’s disease onset time by exploring the influencing factors in AD progression.MethodWe used 543 subjects with 63 features from 3 data modalities from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. The following modalities were used: 1) MRI, 2) genetic and 3) DTC (Demographic, cognitive Tests and Cerebrospinal fluid). The 21 most important features were automatically selected for the three modalities.We used a Deep Learning‐based survival analysis model that extends the classic Cox regression model to predict the subjects' disease onset time. Here we re‐define the non‐AD‐progression as “survivor”, and AD‐progression as “non‐survivor”. The subjects were divided into two groups: progressive subjects (non‐survivor), who were either healthy or diagnosed with Mild Cognitive Impairment (MCI) at initial clinical visit and later developed AD, and non‐progressive subjects ("survivor”), who were either healthy or MCI at initial visit but did not develop AD later. We used 10 random sub‐samples, selecting 80% of the subjects for training and 20% for testing each time; 20% of training data was used for internal validation.ResultFigure 1 shows the estimated survival rates over 10 years. Both groups had a high survival chance at the start. The progressive group's survival chance dropped much faster and fell below 20% by the end of the period. The non‐progressive group's survival chance remained around 50%.Feature importance analysis is displayed in Figure 2. Eight of the top ten most important features are from the cognitive tests, demonstrating their importance in survival analysis. Amygdala and Hippocampus regions, as well as age, are also notable features.ConclusionOur study demonstrated that using powerful predictive models on multi‐modal data can improve prediction of time‐to‐conversion. This not only leads to a better understanding of AD, but also provides essential tools for practitioners who wish to follow their patients' disease progression.
Professor of computer science weighs in on robots in nursing homes
Authors: Khan Arshia A 
Published: December 2022

AbstractBackgroundStaff shortages are a major concern in nursing homes. The residents are experiencing reduced care. Care is suffering and actions are needed to address the shortage of staff.MethodHumanoid robots can be employed to address the shortages in staff. These robots can be performing tasks that are repetitive and can release the staff to perform other important tasksResultHumanoid robots can improve the care provision to the elderly and people affected with dementia.ConclusionConsider employing robots in nursing homes to improve quality of care in nursing homes.
Age Friendly Emergency Medicine Services: Integrating What Matters, Medications, Mobility, and Mentation into Emergency Response
Authors: Taylor Kate , Wagner Teresa 
Published: December 2022

AbstractBackgroundOur population is aging. The Age Friendly Health System (AFHS) initiative by the Institute of Healthcare Improvement (IHI) includes the 4 M’s of What Matters, Medications, Mobility, and Mentation, and is at the forefront of older adult health care. When applying the 4M’s to emergency medical services (EMS), the benefits include avoiding unnecessary transports and helping the patient stay healthy and safe in their home setting. The University of North Texas Health Science Center and other partnerships aspired to designate MedStar the first AFHS in the country within EMS practice.MethodThe Plan‐Do‐Study‐Act (PDSA) cycle aimed at various changes with the AFHS components of What Matters and Medications within an electronic medical record (EMR) algorithm for emergency medical paramedics. Additionally, previously piloted geriatric practice leadership institute projects embedded Mentation and Mobility by including specific screenings in the EMR.ResultThe preliminary result in the PDSA described showed 52% of older adults answered health when asked What Matters most to them today. However, updated data as of January 2022, showed an overwhelming 6732 (69%) patients out of 9685 patients, answered health when asked What Matters most to them today. Additionally, the EMR identifies high‐risk medications. Paramedics can now verify potential risks and develop a care plan based on the identified high‐risk medications.ConclusionImplementing AFHS components allows for better care delivery and outcomes as our older population is growing and embraces more complexities. The data is still novel but promising, requiring longitudinal information before conclusions can be considered.IHI is currently reviewing opportunities to expand its models of care into emergency medicine, behavioral health, and other settings. MedStar sets the example that EMS can practice the AHFS approach serving as a model for the EMS environment. We are currently awaiting feedback from IHI regarding our request to designate MedStar the first AFHS EMS practice in the country.
Physical Activity Trajectories, Autonomic Balance and Cognitive Function: the CARDIA Study
Authors: Gafni Tal , Gabriel Kelley Pettee , Shuval Kerem , Yaffe Kristine , Sidney Stephen , Weinstein Galit 
Published: December 2022

AbstractBackgroundPhysical activity (PA), and particularly moderate to vigorous intensity PA (MVPA), may protect against cognitive decline. However, the underlying mechanisms are not fully understood. Cardiac autonomic balance is influenced by PA and implicated in dementia pathogenesis. Therefore, the study aimed to examine whether autonomic balance mediates the association between PA and cognitive function.MethodThe sample included 1,939 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. MVPA was obtained in 7 consecutive examinations from baseline (1985‐86; 18‐30 years) to the Year 20 exam. Cardiac autonomic balance was assessed at Year 20 via resting heart rate, and via measures of heart rate variability: standard deviation normal to normal (SDNN) and root mean square of successive differences (RMSDD). A comprehensive cognitive assessment was performed at Year 30. Group‐based trajectory modeling was used to identify homogenous MVPA trajectory groups, and formal mediation analysis was used to test whether cardiac autonomic function indices lie on the causal pathway between MVPA trajectories and cognitive function.ResultThree distinct PA trajectory patterns were identified: (1) Below MVPA guidelines (n = 1,122; 57.9%); (2) Meeting MVPA guidelines (n = 652; 33.6%); and (3) Exceeding MVPA guidelines (n = 165; 8.5%) (Figure). Meeting and exceeding MVPA guidelines were related to lower resting heart rate and higher heart rate variability, which indicate improved autonomic balance. Meeting and exceeding MVPA guidelines were additionally associated with improved semantic fluency performance. The association between higher MVPA level and semantic fluency performance was fully mediated by RMSDD and partially mediated by SDNN. No additional associations were observed between MVPA trajectories and other cognitive outcomes, and no statistically significant mediation by autonomic balance indices was found for these associations (Table).ConclusionHigher MVPA levels across the young adult to midlife transition were associated with better cardiac autonomic function, which in turn explained some of the associations between PA trajectories and better semantic fluency performance. Future studies, particularly among older individuals are warranted to clarify the role of autonomic balance in the link between physical activity and brain health. These findings may lead to more targeted PA recommendations across the life‐course to slow cognitive decline and decrease dementia risk.
High Social Deprivation as a Risk Factor for Dementia: Findings from the longitudinal SHARE study of older Europeans
Authors: Hofbauer Lena M , Rodriguez Francisca S 
Published: December 2022

AbstractBackgroundIndividual‐level deprivation indices are only just emerging, but are better indicators than area‐level indices. The Social Deprivation Index (SoDep Index) was developed by our team last year as an indicator of the degree to which an individual experiences socioeconomic deprivation. It has shown a robust association with cognitive status and decline in adults over 50. However, its association with dementia diagnosis is unknown.MethodWe analysed data of > 11, 000 respondents in the Survey of Health, Ageing and Retirement in Europe (SHARE) over the age of 50 who were free of dementia at baseline. Social deprivation status (low, moderate, high) was classified on the basis of SoDep Index scores. The risk of dementia diagnosis was estimated using Cox proportional hazard and Fine and Gray models (correcting for mortality) including social deprivation status and relevant covariates. Further, we completed a sub‐group analysis of individuals with high social deprivation status and analysed the relevance of a history of depression in each deprivation group.ResultResults show that high, compared to low, social deprivation was associated with a significantly increased risk of being diagnosed with dementia. Both, depressive history and depressive symptoms were additionally associated with an increased risk. The associations between depression indicators and dementia risk were particularly pronounced in the high social deprivation sub‐group. Results were robust to correction for mortality.ConclusionSocial deprivation status is associated with an increased dementia risk. This adds to a growing body of evidence indicating that a public health approach to dementia prevention must address socioeconomic inequity. Increased risk in population groups with high social deprivation cannot be accounted for by higher rates of depression. Thus, our results lend additional weight to the argument that adults with depression from vulnerable groups need urgent intervention.
Moral emotions in neuropsychiatry : testing FTD and Schizophrenia patients with the MEA scale.
Authors: AUGER Raphaëlle LEROUX , Mouchabac Stephane , Daigmorte Chloé , GALLARDA Thierry , Hamisultane Jessica , Azuar Carole 
Published: December 2022

AbstractBackgroundMoral emotions have a key role in human prosocial behaviors. Impaired moral emotion processing can lead to disrupted decision‐making and behavioral adaptation.Better knowledge about moral emotion processing in neuropsychiatric diseases is necessary to facilitate diagnosis and patient care.The aim of this study was to investigate and to compare moral emotion processing in patients with neurodegenerative diseases ‐behavioral fronto temporal dementia (FTD) and Alzheimer’s disease (AD)‐ and patients with schizophrenia.MethodWe investigated 22 FTD, 15 AD, 30 schizophrenia patients and a control group with validated task, the Moral Emotions Assessment (MEA). This tool consisted in 42 scenarios exploring positive and negative moral emotions such as admiration, gratitude, shame or anger. Subjects had to choose between several emotions the most appropriate to the context of the scenario. To control for moral specificity, we contrasted the 42 moral scenarios with 18 extra‐moral scenarios eliciting the emotions without involving any inter‐human moral context.ResultFTD patients and Schizophrenia patients were significantly impaired in moral emotion processing, when compared to healthy controls, whereas AD patients were not impaired. There was a specific impairment of moral emotions in FTD, (73.1% of correct answers VS 95.1% in control group p<0,001) and the most impaired emotion was guilt. AD patients didn’t show impairment in moral emotion processing compared to healthy controls. In Schizophrenia patients, moral emotion processing was significantly impaired (85,8% of correct answers VS 95,9% in control group, p<0,001), and the most impaired emotions were anger and shame.ConclusionMoral emotions processing seemed significantly impaired in FTD patients and schizophrenia patients, with different patterns of deficits, whereas AD patients seemed to have preserved moral cognition. These results provide a better understanding of the behavioral changes observed in FTD and schizophrenia patients.
Bibliographic Analysis of Aging Anxiety and Lifestyle
Authors: Park Sun Ha , Lim Young Myoung , Kim Mi Kyeong , Lee Ha Min , Park Hae Yean 
Published: December 2022

AbstractBackgroundWith the recent increase in the older adults population, interest in successful aging is increasing. Aging anxiety, a psychological mechanism that affects successful aging, refers to the inability to feel stable due to worry or fear in old age, which negatively affects the older adult‘s feelings of depression and quality of life. According to a study on successful aging and aging anxiety, it was recently reported that aging anxiety can be prevented by realizing healthy aging through lifestyle intervention. To date, studies analyzing aging anxiety and lifestyle from a macro perspective are insufficient. To compensate for these limitations, bibliographic analysis methods that derive the characteristics of academic literature from bibliographic information are used. Since it is essential to understand research trends from a macroscopic point of view at a time when the need for research on aging anxiety and lifestyle is emphasized, in this study, the flow of research on aging anxiety and lifestyle is identified to prepare basic data for future research.MethodAmong the bibliographic analysis methods, first a citation analysis method that identifies the association based on the number of citations. Second a simultaneous appearance word analysis method that identifies the association based on the number of keywords appeared was used. VOSviewer was used to cluster and chart the analyzed information.ResultThe frequency of published papers by year showed a gradual increase until 2017 and a rapid increase from 2018. In the field of research paper study, research was most actively conducted in the field of psychiatry. In the citation analysis, the United States, Australia, and the United Kingdom showed high correlation with each other, and as a result of conducting simultaneous word analysis on major keywords, words with high association with ‘aging anxiety’ were found to be ‘depression’.ConclusionThis study is meaningful in that it grasped the flow of aging anxiety and lifestyle research from a macroscopic point of view using a bibliographic analysis method. Based on this, it is expected to understand the importance of lifestyle from the preventive point of view of aging and to be used as basic data for intervention and related education.
How well is Brazil prepared for a disease‐modifying Alzheimer’s treatment?
Authors: Mattke Soeren , Filho Otelo Corrêa dos Santos 
Published: December 2022

AbstractBackgroundWhile the majority of patients with Alzheimer’s disease resides in low and middle‐income countries, little is known of their preparedness for emerging disease‐modifying treatments. We analyze the preparedness of Brazil, one of the most populous middle‐income countries, from a capacity and institutional preparedness perspective.MethodDesk research and 12 interviews for background and capacity data. Markov model to estimate wait times for access to treatment.ResultBrazil has no national dementia strategy or established pathway for evaluation of cognitive concerns, and dementia is typically diagnosed late if at all. While members of private health plans have ready access to elective specialty care, wait times in the public sector are long. Assuming potentially treatment‐eligible patients are referred from primary to specialty care based on a brief cognitive exam and a blood test for the Alzheimer’s pathology, available capacity will not be sufficient to match the projected demand (Figure 1). The biggest obstacle is availability of dementia specialist visits, and the effect of population growth and ageing means that the wait list for specialist appointment will continue to grow from around 400,000 in 2022 to over 2.2 million in 2040. We do not project substantial wait times for confirmatory biomarker testing and treatment delivery but note that this is a consequence of patients waiting for their specialist appointments. These queues will result in estimated persistent wait times for treatment of around two years on average with substantial differences between the public and private sectors, as capacity growth is insufficient to keep up with increasing demand.ConclusionOur findings suggest that Brazil is ill‐prepared to provide timely access to an Alzheimer’s treatment with predicted wait times of about two years, largely because of a limited number of dementia specialists. Access is likely to be unequal based on socioeconomic status and geographic location. Closing this gap will be challenging because of high public debt and chronic underinvestment, leaving a focus on prevention and on use of scalable technologies, such as digital cognitive and blood tests for Alzheimer’s disease as viable option. A national dementia plan with an implementation strategy would be an important first step.
Family care partners experiences of delirium in caring for a person with dementia: Qualitative descriptive study
Authors: Shrestha Priyanka , Fick Donna Marie , Boltz Marie , Loeb Susan J , High Andrew C 
Published: December 2022

AbstractBackgroundDelirium in persons with dementia is common, distressing, and associated with poor outcomes not only for the older adults, but also for their family care partners. There is a practice and science gap in understanding the role care partners’ may play in the prevention, recognition, and management of delirium in persons with dementia, as well as care partners’ needs, necessary to inform co‐designed interventions to improve the lives of the dyad. This study explored family care partners’ understanding and experience related to delirium as well as their preferences in terms of need for education, support, and resources.MethodQualitative descriptive design was employed. Data were collected from 16 family care partners (age x̄ = 65, SD = 13.2) of persons with dementia using demographic questionnaires and semi‐structured in‐depth interviews [telephone (N = 7); Zoom video conference (N = 9)]. Demographic data of the sample were described. Qualitative thematic analysis revealed patterns and themes. The reporting of this study followed the criteria for reporting qualitative studies in the (COREQ) 32‐item checklist.ResultSix themes emerged: : (i) distressing sentiment; (ii) unexpected manifestation of delirium, (iii) unfamiliarity with delirium; (iv) changing roles; (v) complexities of delirium and dementia management; and (vi) longing for support.
ConclusionBalancing the care needs relating to pre‐existing dementia, while simultaneously identifying and managing delirium is difficult for family care partners. Challenges were related to communication, differentiating signs of delirium from dementia, lack of resources, and uncertainty and fear about the future. Providing education about delirium to family care partners through trained clinicians exhibits a promising approach, but utilization of existing community resources should also be encouraged. Care partner experiences should be valued and future research should involve family care partners in co‐designing therapeutic interventions to promote family care partners’ well‐being and to boost their confidence and efficiency in their caregiving role. Implications for practice, research, and policy will be discussed.
Post‐mortem assessment of retinal phosphorylated tau and amyloid beta in a cohort of neurodegenerative diseases.
Authors: de Ruyter Frederique J. Hart , Morrema Tjado , Gase Gina , den Haan Jurre , de Boer Johannes , Scheltens Philip , Rozemuller Annemieke J.M. , Verbraak Frank D. , Bouwman Femke H. , Hoozemans Jeroen J.M. 
Published: December 2022

AbstractBackgroundThe retina provides an opportunity for development of a screening tool to detect early stages of AD. Studies showing the presence of Aβ and p‐tau in AD retina are contradictory, and their characterization in a large, neuropathologically confirmed cohort with different neurodegenerative diseases is scarce. In this study we assessed the presence of different tau isoforms and Aβ (4G8) in the retinas of AD cases, control cases, as well as other neurodegenerative diseases, and correlated these directly to cortical cerebral tau and amyloid pathology loads.MethodPost mortem eyes (N = 62) with both clinical history and post‐mortem neuropathological reports available were collected through the Netherlands Brain Bank. Donors included AD, PSP, CBD, FTLD, PD(D), DLB, MSA, ALS, MS and controls, with and without cerebral cortical p‐tau. Superior‐temporal quadrants were cut in 10 µm sections. Sections were immunostained using antibodies directed against p‐tau (AT270, AT100, AT8, pS422) and Aβ (4G8). Linear mixed models were used to analyze between‐group differences and the relation between brain and retina.ResultTau appeared as a diffuse neuritic staining, and in some cases as somatodendritic‐like staining and was mainly present in the plexiform layers of the retina. AT8, AT100 and AT270 immunoreactivity showed a predilection in the far periphery. AT8 was generally found in tauopathy cases as opposed to non‐tauopathy cases. A strong correlation was found between retinal AT8 and brain cortical tau pathology. 4G8 appeared sporadically as extracellular structures, mainly present in the retinal nerve fiber layer, ganglion cell layer and near blood vessels. 4G8 did not differ between control and disease cases, and no group differences or relation with cortical amyloid load was found.ConclusionP‐tau measured with AT8 in the retina correlates with the presence of tau pathology in cortical brain areas. In contrast, Aβ (4G8) immunoreactivity is sporadically present in the retina, is not specific for AD and does not correlate with cortical amyloid load in a large cross‐disease cohort. Our study shows that p‐tau detected in the retina by AT8 is a potential biomarker candidate for tauopathies.