bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facilitating Conversations about Supportive Care Options in the Context of Cognitive Impairment using an Online Visual Elicitation Tool
Authors: Turner Anne M , Chen Annie T. , Child Claire E. , Miller Lyndsey M. 
Published: January 2025

AbstractBackgroundPersons with cognitive impairment may experience difficulties with language and cognition that interfere with their ability to make and communicate decisions. We developed an online visual tool to facilitate conversations about their preferences concerning supportive care.MethodsWe conducted Zoom interviews with persons with mild cognitive impairment (MCI) and mild to moderate dementia, using storytelling and a virtual tool designed to facilitate discussion. Each interview sought to discuss decision‐making in the context of three scenarios, one concerning a past decision about supportive care, and two hypothetical scenarios based on decreasing abilities and increasing care needs. Interviewers shared their screen with the visual tool, which used the visual diagramming platform draw.io (https://www.drawio.com/) to create an online “canvas.” Interviewers could drag icons (representing people, places, safety, emotions, activities, and issues) or type text onto the canvas to communicate concepts. We developed the tool with a multidisciplinary team of designers and researchers, and with input from people with cognitive impairment. Key user‐centered design goals for the tool included focusing on simplicity, minimizing cognitive load, and using concepts and images that resonated with participants. We also used pilot interviews to refine interviewers’ techniques for eliciting preferences with the tool. We examined the utility of the tool for engaging participants in dialogic interactions with the interviewer, and the cognitive and communicative processes exhibited by participants.ResultsWe conducted fifteen interviews with persons with MCI, and mild or moderate dementia [mean age 77.8 years ± 7.1 (SD), 9 male, 6 female]. With respect to dialogic interactions, interviewers actively used the visualization technique to facilitate the conversation; participants engaged with the interface to varying degrees. Common communicative issues included participants being unresponsive to the question or providing unclear responses. During the sessions participants also exhibited uncertainty, introspection, and self‐awareness.ConclusionWe present a visual technique to engage persons with cognitive impairment in dialogue about complex decisions. We hope to explore the potential use of this technique in research, clinical, and community settings.
The right to rehabilitation for people with dementia: A co‐design approach to barriers, solutions and strategies
Authors: Layton Natasha , Devanny Catherine , Hill Keith , Swaffer Kate , Russell Grant , Low Lee‐Fay , Lee Angel , Cations Monica , Skouteris Helen , O'Connor Claire , Collyer Taya , Neves Barbara Barbosa , Andrew Nadine , Haines Terry , Srikanth Velandai K , Petersen Alan , Callisaya Michele L 
Published: January 2025

AbstractBackgroundPeople with dementia of all ages have a human right to equal access to quality health care. Despite evidence regarding its effectiveness, many people living with dementia lack access to evidence‐based rehabilitation for promoting function and quality of life. The aims of this study were to 1) explore barriers to access to dementia rehabilitation; and 2) identify solutions which improve access to rehabilitation.MethodPeople living with dementia and care partners (n = 13) and health professionals (n = 13) were invited to participate. Experience based co‐design across three virtual workshops was used to understand barriers and solutions to improve access to rehabilitation treatments. Socio‐ecological analyses, using the Levesque Access to Health Care Framework, were applied to findings regarding barriers and to assist selection of solutions.ResultThere was high attendance (92.3%) across the three workshops. Barriers were identified at a person‐level (including lack of knowledge, difficulty navigating the health, aged‐care and disability system, transport, and cost) and health service‐level (including health professional low knowledge and negative attitudes, inequitable funding models and non‐existent or fragmented services). Solutions focused on widespread education and training in the area of dementia rehabilitation, including ensuring people with dementia and their care partners know about rehabilitation therapies and that health professionals, aged care and disability co‐ordinators know how to refer and deliver interventions. Dementia care navigators, changes to Commonwealth aged care and Medicare funding models, and specific dementia rehabilitation programs were also recommended.ConclusionBarriers to accessing rehabilitation for people with dementia exist at multiple levels and will require a whole community and systems approach to ensure change.
An RCT assessing the effects of varying exposure times of therapeutic communication robots on dementia in group homes in Japan
Authors: Inoue Kaoru , Kono Mitsunobu , Kobayashi Ryuji , Shibata Takanori , Yatsu Chiyomi , Yao Daryl Patrick Gamboa , Shigeta Masahiro 
Published: January 2025

AbstractBackgroundAs Japan experiences a super‐ageing society and caregiver manpower decreases, interest in the use of communication robots for active dementia care rises. In the U.S., the communication robot (PARO) has been used as a medical device for psychophysiological biofeedback therapy. We report the effects of varying the exposure time for (PARO) on BPSD severity in people with dementia and on the caregivers' burden of professional caregivers in group homes.MethodsCluster randomized controlled trial design. Group homes were randomly assigned to two groups, one using (PARO) once a week and the other thrice a week for one hour per session. For the intervention, (PARO) was placed on a table in a communal area, and participants interacted freely with (PARO). The caregivers provided no encouragement. Changes in BPSD severity and caregivers' burden before and after the intervention were compared using a linear mixed model. The primary outcomes were the severity score and caregivers' burden score of the Neuropsychiatric Inventory brief Questionnaire (NPI‐Q).ResultsNinety‐one participants were recruited, 85 were included in the analysis. The thrice‐weekly group showed improvement in severity scores before and after the intervention, but there was no statistically significant difference between the once‐weekly and thrice‐weekly groups. The caregivers' burden score was significantly improved in the thrice‐weekly group compared to the once‐weekly group.ConclusionsUsing (PARO) once a week for 1 month did not have a significant effect on either severity or caregivers' burden, whereas thrice a week contributed to reducing caregivers' burden. The effect was better scored on the severity in the thrice‐weekly group than that in the once‐a‐week group, but the difference was not statistically significant, suggesting the need to revisit this issue with a longer intervention period. The impact on caregivers may be evident after a relatively short period. The introduction of (PARO) potentially reduces caregivers’ burden and helps to improve the quality of care, hence providing operational support to group homes.
Icariin Mitigates Cognitive Impairments in Female Rats with Estrogen Deficiency
Authors: Goyal Ahsas , Varshney Vibhav , Aggarwal Kritika 
Published: January 2025

AbstractBackgroundCognitive dysfunction emerges as a manifestation of reduced estrogen levels following ovariectomy in an individual. However, the conventional use of estrogen replacement therapy could increase the risk of breast cancer and thromboembolism. Icariin is a natural compound that has been reported to be a neuroprotective agent against dementia. However, the therapeutic role of the icariin via Nrf‐2‐mediated neuroprotective effect to improve learning and memory is yet to be evaluated in ovariectomized challenged female rats.MethodExperimentally, dementia was induced by the bilateral ovariectomy of female Wistar rats on the first day (Day‐1) of the experimental protocol of 60 days. Biochemical estimation was done on last day of the protocol to evaluate the cholinergic function using commercially available kits.ResultIntraperitoneal administration of icariin (Day‐1 to Day‐60) significantly improved the learning and memory activity during the MWM schedule and increased the spontaneous alternation behavior during the performance of the Y maze. Further, icariin increased the activity of ChAT and the level of ACh respectively, and decreased the activity of AChE in HIP, PFC, and AMY. Additionally, the improved level of LPO, SOD and CAT activity have been observed in HIP, PFC and AMY brain regions after the administration of icariin. Moreover, Nrf‐2 antagonist significantly attenuated the therapeutic effect of icariin in ovariectomized‐induced altered behavioral and neurochemical observations in female rodents.ConclusionThus, these above facts suggested that icariin exerts the Nrf‐2‐mediated neuroprotection in ovariectomized rats indicating that icariin also should be taken into consideration as a therapeutic option in the management of estrogen deficit‐induced cognitive dysfunctions.
Distinct Association of Amyloid and Vascular Pathologies with Enhanced Perivascular Spaces
Authors: Kim Woo Sik , Yoo Roh‐Eul , Hwang Yejin , Yang Yelim , Seong Joon‐Kyung , Choi Seung Hong , Lee Wha Jin 
Published: January 2025

AbstractBackgroundGlymphatic system dysfunction as characterized by increased MRI‐visible Perivascular Spaces (PVS) is speculated to play a role in the acceleration of amyloid accumulation in Alzheimer’s Disease (AD). However, while PVS is also prevalent amongst Vascular Dementia (VD), the pathological distinctions between regional PVS in AD‐ and VD‐driven cohorts remain largely unknown. Through a mixed dementia cohort, we examined these pathology‐driven localization patterns via automated PVS segmentations from T2‐weighted MRI.Method99 cognitively unimpaired (CU) and 190 cognitively impaired (CI) patients’ data were collected from the Seoul National University Dementia cohort. Through visual assessments of individual’s 18F‐Florbetaben PET, FLAIR and SWI images, expert radiologists classified CI patients into 4 groups based on both amyloid and vascular‐damage burden (26 A‐VB‐, 63 A‐VB+, 26 A+VB‐, and 75 A+VB+). PVS segmentation involved masking and thresholding hyperintense vessel structures using slice‐wise Frangi filters applied to T2‐weighted MRIs at the basal ganglia (BG) and cerebral white matter (WM), segmented into 4 major lobes (frontal, parietal, temporal, and occipital). We calculated PVS volume fractions (PVS‐VF) as voxel counts normalized by intracranial volumes. Automated segmentations were validated against manually segmented PVS volumes at BG and whole WM (rank correlation coefficients: 0.634, 0.539). Groupwise differences were calculated through two‐sample t‐tests corrected for multiple comparisons.ResultFor A+ groups, significant increases in PVS‐VF were observed at the temporal and occipital lobes as compared to CU, a finding that agree well with prior visual rating studies. However, VB+ groups showed significant PVS‐VF increases across all lobes as compared to CU. Particularly, BG represented the most pronounced VD‐related PVS, with a significantly greater PVS‐VF in the VB+ groups compared to their VB‐ counterparts. Interestingly, PVS volume ratios of lobar regions and BG showed no significant increases for A‐VB+, while all A+ groups showed significant increases in temporal and occipital regions as compared to CU.ConclusionFull utilization of PVS as a core biomarker in discerning glymphatic dysfunctions of AD requires full understanding of their properties in those contexts. Cross‐sectional differentiation of regional PVS localization in AD can become a steppingstone into elucidating those associations within the AD continuum.
Associations of sleep efficiency and rapid eye movement sleep in early Alzheimer's disease (AD): Results of the RADAR‐AD study
Authors: Atreya Alankar , Conde Pauline , Doherty Aiden , Vairavan Srinivasan , Muurling Marijn , de Boer Casper , Curcic Jelena , Grammatikopoulou Margarita , Nikolopoulos Spiros , Brem Anna‐Katharine , Coello Neva , Fröhlich Holger , Narayan Vaibhav , Wittenberg Gayle , Aarsland Dag , Duijn Cornelia M Van , Hinds Chris ,   the RADAR‐AD Consortium
Published: January 2025

AbstractBackgroundThe relationship between sleep and AD is unclear: sleep problems may contribute to AD pathogenesis, but the spreading of AD pathology across the brain may also de‐regulate sleep. What aspect of sleep is relevant in which disease phase is also unclear, as many studies are based on questionnaires. We study sleep efficiency and rapid eye movement (REM) sleep, objectively measured using an activity tracker to shed light on sleep disturbances across the AD spectrum.MethodThe RADAR‐AD is a cross‐sectional study (N=204), including healthy controls (HC, n=67), preclinical AD (preAD, n=34), prodromal AD (proAD, n=56) and mild‐to‐moderate AD (MMAD, n=47) participants (Table 1). Participants wore a Fitbit Charge‐3 activity tracker on their non‐dominant wrists for eight weeks, measuring REM sleep (in hours) and sleep efficiency (sleep duration/total time in bed). CSF amyloid and phosphorylated Tau (pTau) levels were determined in the subset (N=117) and stratified into biomarker groups (A‐T‐, A+T‐, and A+T+). We evaluated the difference in these mean sleep features among AD stages and biomarker groups.ResultCompared to HC, we observed reductions in daily mean REM sleep for proAD (Estimate±SE=‐0.24±0.08, p=0.002) and MMAD (Estimate±SE=‐0.23±0.08, p=0.001) (Figure 1), and in sleep efficiency for preAD (Estimate±SE=‐0.012±0.005, p=0.016), proAD (Estimate±SE=‐0.011±0.004, p=0.015), and MMAD (Estimate±SE=‐0.009±0.004, p=0.046) participants. Compared to A‐T‐ participants, sleep efficiency was reduced for A+T‐ (Estimate±SE=‐0.016±0.006, p=0.022) and A+T+ (Estimate±SE=‐0.013±0.006, p=0.019) participants (Figure 2), while REM sleep was lower for A+T+ participants only (Estimate±SE=‐0.32±0.11, p=0.004).ConclusionSleep efficiency is altered across the AD spectrum, including the early pre‐clinical AD stage. There is a trend toward lower REM sleep among subjects at more advanced stages of AD and elevated amyloid and tau that may suggest an association between AD pathology and REM sleep.This work has received support from the EU/EFPIA Innovative Medicines Initiative Joint Undertaking (grant No 806999). 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.
New real‐time PCR test for APOE genotyping in patients with Alzheimer’s disease before anti‐amyloid therapy
Authors: Meißner Dirk , Denker Annika , Stallmann Sonja , Milbredt Sarah , Venkataraman Iswariya , Saschenbrecker Sandra , Steller Ulf 
Published: January 2025

AbstractBackgroundIn 2023, the FDA approved LEQEMBI, a monoclonal antibody therapy targeting beta‐amyloid plaques, for patients with early‐stage Alzheimer’s disease (AD). However, anti‐amyloid drug trials demonstrated an elevated risk for amyloid‐related imaging abnormalities with cerebral edema (ARIA‐E) in carriers of the AD risk allele apolipoprotein E epsilon 4 (APOE‐ɛ4), especially in ɛ4/ɛ4 homozygous individuals. Here, we report on the evaluation of a new real‐time polymerase chain reaction (PCR) test for APOE genotyping.MethodThe EURORealTime APOE (EUROIMMUN), which enables simultaneous testing for all six APOE genotypes (ɛ2/ɛ2, ɛ2/ɛ3, ɛ2/ɛ4, ɛ3/ɛ3, ɛ3/ɛ4, and ɛ4/ɛ4) by real‐time PCR, was performed using genomic DNA (gDNA) isolated from EDTA blood samples. The PCR amplification results were evaluated using the EURORealTime Analysis Software (EUROIMMUN). Samples from healthy blood donors (HBD) were used to assess intra‐assay, inter‐assay and between‐lot precision (n=6) as well as analytical sensitivity (n=21), with each APOE genotype represented by at least one sample. Assay accuracy was analyzed by comparing genotype assignments to the results of the CE‐IVD‐marked EUROArray APOE (EUROIMMUN) and bidirectional Sanger sequencing using 110 samples (100 AD, 10 HBD). APOE genotype frequencies were compared between patients (100 AD) and controls (250 HBD).ResultPrecision testing of the EURORealTime APOE resulted in 100% correct genotype calls. Assessment of the analytical sensitivity revealed valid and correct genotype assignment in all 21 samples, confirming 1 ng/µl as the recommended minimum gDNA concentration. The analytical accuracy amounted to 100% based on agreement with the two reference methods in 110/110 cases. Comparison of the APOE genotype distribution showed a higher proportion of ɛ4 allele carriers (i.e., ɛ2/ɛ4, ɛ3/ɛ4, and ɛ4/ɛ4) in AD patients than in HBD (50.0% vs. 25.2%). The prevalence of the ɛ4/ɛ4 genotype in these cohorts was 25.0% for AD patients compared with 2.8% for HBD.ConclusionThe well‐established high prevalence of the APOE‐ɛ4/ɛ4 genotype in AD patients, together with the increased risk of ARIA‐E in these homozygous carriers, substantiates the relevance of APOE genotyping prior to anti‐amyloid treatment. The EURORealTime APOE test provides sensitive and reliable determination of APOE alleles, thus presenting a suitable tool to improve risk stratification for potential LEQEMBI recipients.
The impact of the 6‐month adapted Otago Exercise Program on clinical measures of physical function relative to usual care alone in people living with dementia in residential care facilities: A pilot randomized controlled trial
Authors: Jones Melanie T , Dong Yanbin , Zhu Haidong , Soares Andre , Patel Charmi , Hergott Colleen , Waller Jennifer L , Young Lufei , Robinson‐Johnson Dawnchelle , Sams Richard , Hamrick Mark , Jehu Deborah A 
Published: January 2025

AbstractBackgroundDementia compromises physical function, posing risks for falls. People living with dementia (PWD) have been historically excluded from intervention trials due to researchers’ eligibility criteria. Exercise shows potential in enhancing physical function, but more evidence is needed. This pilot randomized controlled trial aimed to assess whether the adapted Otago Exercise Program improves physical function relative to usual care alone in PWD.Method42 PWD (Montreal Cognitive Assessment<19/30) were randomized (1:1) into the exercise (n = 21) or usual care (n = 21) group at two residential care facilities [NCT05488951]. The adapted Otago Exercise Program was a physical therapist‐led strength, balance, and walking program for 1 hour, 3x/week for 6 months in groups of 5‐7 participants. Physical function was evaluated by the short physical performance battery (balance, gait speed, and chair stands), timed‐up‐and‐go (TUG), and strength at baseline and 6 months. Gait speed (m/s) was measured over 4m. The single‐task TUG involved getting up, walking 3m, walking back, and sitting down (s); the dual‐task TUG involved simultaneously performing a category task. We used dynamometers to measure leg and grip strength (kg). We performed intent‐to‐treat (ITT; n = 42) and per protocol (n = 21 usual care and n = 9 exercisers with 2/3 adherence) generalized mixed models, controlling for age, race, sex, and the MoCA.ResultFor the ITT analysis, left leg strength increased in the exercise group (baseline = 13.4kg; follow‐up = 16.7kg) and decreased in the usual care group (baseline = 14.4kg; follow‐up = 13.7kg; p = 0.03). Exercise provoked faster dual‐task gait speed (baseline = 0.4m/s; follow‐up = 0.5m/s; p<0.01) and decreased TUG dual‐task duration (baseline = 37.3s; follow‐up = 27.6s; p = 0.01) with no change following usual care. The per protocol analysis showed no differences.ConclusionThe improvements in strength, gait speed, and functional mobility in the exercise group, plus the decline in strength in the usual care group suggest that exercise may prevent decline and improve physical function among PWD. There were no differences in the per protocol analysis, however, this could be due to our small sample of only n = 9 participants with ≥2/3 exercise adherence. Our results suggest that implementing any level of exercise into care plans may improve physical function in PWD, but further research should confirm these preliminary findings.
What Happens When the Honeymoon is Over? Sustaining Community Partner Relationships After Recruitment
Authors: Terry Melita H , Williams Lilcelia A. , Shaaban C. Elizabeth , Lingler Jennifer H 
Published: January 2025

AbstractBackgroundIncreasing calls for diversity in Alzheimer’s disease and related dementias (ADRDesearch have fueled significant investments in recruitment personnel and activities. However, the essential work of identifying and authentically engaging communities of color in relationship‐building begins well before, and continues long after, study recruitment activities take place. The purpose of this presentation is twofold: 1) to differentiate the work of trust‐building and relationship cultivation from that of research study recruitment, and 2) to describe the necessary steps to ensure that relationship cultivation is ongoing and supported beyond the timeline of a singular research study.MethodThis presentations draws on our team’s experience developing, implementing, and evaluating community engagement programming at a federally funded Alzheimer’s Disease Research Center (ADRC). We outline key features of relationship cultivation and contrast these efforts from the narrower, yet related, activity of study recruitment. We will offer real‐life exemplars to delineate the steps necessary for effective relationship cultivation, particularly in a post‐pandemic era. The importance of intentional actions to sustain partnerships, programming and participant relationships beyond the research recruitment phase will be demonstrated. The relevance of this work for individuals along the spectrum of participant readiness to enroll in ADRD research or consent to brain donation will be explained.ResultRelationship cultivation efforts at our Center have led to: a) sustained community partnerships, including a multi‐decade presence in a predominantly Black and African‐American neighborhood despite changes in local governance, businesses, and service organizations; b) sustained programming, including a lecture series honoring a prominent local historical figure; and c) sustained longitudinal research participation among individuals identifying as Black or African American, as exemplified by a case study of a participant who was active in our cohort for 28 years and ultimately provided brain donation.ConclusionThe value of relationship building as the primary step for powerful community engagement and participant partnership should not be underestimated by researchers. This work should be considered a critical aspect of research infrastructure. The foundation laid by building and sustaining the meaningful relationships is essential to bridging trust between community members and ADRD researchers and continues long beyond the recruitment honeymoon.