bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using participatory approaches in the development of a digital care assessment for family caregivers of people with dementia
Authors: Klein Olga A. , Group DZNE GAIN Research 
Published: December 2022

AbstractBackgroundParticipatory approaches are increasingly used in technology development research to improve care and support for people with dementia and their caregivers. People with lived experience are able to provide valuable contributions and insights into their needs which can increase acceptance and use of interventions. Dementia family caregiving is associated with high burden. To increase time‐efficiency and to ensure prompt service provision, our aim was to develop a digitally supported unmet needs assessment to better identify and manage care and support needs of family dementia caregivers.MethodUsing a participatory approach with caregivers and clinicians, the assessment was piloted for its content and technical usability in a memory clinic with interviews, think‐aloud protocols and written feedback. Data were analysed thematically. The development of the assessment was embedded within a randomised controlled trial examining the effectiveness of a digitally supported care management intervention for family caregivers.ResultRegarding the assessment’s content, caregivers (n = 18) commented on the simplification of questions and answer options and suggested that they preferred direct questions whether care or support is needed in specific areas. Professional clinicians (n = 9) suggested that a focus on caregivers' care responsibilities was important. They commented on the order of instruments as well as the importance of avoiding duplicate questions. Reduction of completion time was named by both groups as important. Regarding the assessment’s tablet usability, caregivers provided information on the handling of the tablet, the ease of manual clicking and simple navigation. Professional clinicians commented primarily on the assessment’s layout and suggested one question at a time as well as adding an assessment progression bar. The final unmet needs assessment comprised several validated questionnaires with 57 questions examining a person’s self‐reported unmet needs, health‐related quality of life, caregiver burden, social support and the use of medical and non‐medical services and resource utilisation.ConclusionThe participatory approach allowed us to incorporate aspects into the development of the digital assessment that we would have missed otherwise. The input of people with lived experience has supported the development of the assessment ensuring a higher degree of acceptability. For future projects, a higher level of involvement is sought.
Skin advanced glycation end products and the risk of dementia
Authors: Mooldijk Sanne S. , Lu Tianqi , Waqas Komal , Chen Jinluan , Vernooij Meike W. , Ikram M. Kamran , Zillikens M. Carola , Ikram M. Arfan 
Published: December 2022

AbstractBackgroundConditions such as hyperglycemia and oxidative stress lead to the formation of advanced glycation end products (AGEs), which have also been implicated in neurodegeneration including dementia. Previous studies have shown a link between these AGEs and the occurrence of Alzheimer’s neuropathology and worse cognitive functioning. However, no study examined the association between AGE levels and the risk of dementia. Therefore, we used skin AGE levels, reflecting accumulation of AGEs in long‐lived tissues, to determine the association with the risk of dementia and brain MRI measures.MethodWithin the Rotterdam Study, we determined skin AGEs using skin autofluorescence (SAF [arbitrary units]) measured at the forearm, between 2013 and 2016 in 2938 participants without dementia. Of them, 1515 also underwent brain MRI. All participants were followed for the incidence of dementia until 2020. The associations of SAF with incident dementia and with brain MRI measures were assessed, adjusting for potential confounders, namely age, sex, education, APOE ε4 carriership, smoking, estimated glomerular filtration rate, fasting glucose level and use of antidiabetic medication.ResultOf 2938 participants (mean age 72.6 years, 57% women), 124 developed dementia during a median follow‐up of 4.3 years. Higher SAF was associated with an increased risk of dementia (hazard ratio (HR) 1.22 per standard deviation increase of SAF [95% confidence interval 1.03‐1.45]) and of Alzheimer’s disease (HR 1.21 [1.00‐1.48]). Stronger effects were seen in APOE ε4 carriers with HRs of 1.38 [1.03‐1.84] for all‐cause dementia and 1.51 [1.10‐2.09] for Alzheimer’s disease. Participants with higher SAF also had lower total brain volumes on MRI (difference per standard deviation increase: ‐2.71 mL [‐4.54; ‐0.89]), lower grey matter volumes (‐1.77 mL [‐3.45; ‐0.08]) and lower hippocampus volumes (‐0.04 [‐0.07; ‐0.01]). In addition, they tended to more often have lacunar infarcts and microbleeds (odds ratios: 1.22 [0.99‐1.50] and 1.09 [0.96‐1.25]).ConclusionHigher levels of AGEs in the skin are associated with an increased risk of dementia, especially in APOE ε4 carriers, and with lower brain volumes. These results suggest that AGEs are involved in dementia pathophysiology and may provide potential for prevention.
Needs Assessment Study in a Dementia Colombian Population
Authors: Romero‐Vanegas Sara Julieta , Vargas‐González Juan Camilo , Pardo Rodrigo , Moreno‐Angarita Marisol 
Published: December 2022

AbstractBackgroundDementia is a public health problem. In Colombia, there is no policy for dementia patients or their caregivers. Patients with dementia have unidentified needs and this lack of knowledge has contributed that a formal policy has not been raised. The recognition and identification of the needs facilitate the planning, provision, and evaluation of health services, and constitutes the first stage for the implementation of services or care plans. If the Colombian State wants to formulate policies that protect the population with dementia it should conduct studies that contemplate all dimensions and guarantee the social inclusion and equity of the affected population. A needs assessment study is required that includes the identification and analysis of physical, social, patrimonial, legal, access and psychological needs of patients with early stages of dementia and their caregivers.ObjectiveTo identify and analyze the needs of Colombian patients with mild dementia and their relatives with the purpose of contributing to the design of the health policy strategy for dementia, from a perspective of social justice and equity.MethodExploratory sequential mixed methods design. We will include Colombian adults with a mild dementia diagnosis, their caregivers and health professionals. We will employ a structured interview, an assessment of quality of life, psychiatric and medical comorbidities and we will employ case studies and focus groups to identify categories and interactions of the study problem. In the second stage, we propose to employ a needs assessment methodology and a mixed method using triangulation to evaluate the burden of known and unknown needs. Then, a theoretical analysis of inequities will be carried out stratifying by the insurance regime and city.ResultThe results will be analyzed in light of the theory of recognition as social justice.ConclusionWe will recommend a proposal for the design of the strategy in health for this population.
A genetically informed examination of posttraumatic stress disorder and traumatic brain injury’s impact on dementia risk in US Veterans
Authors: Logue Mark W. , Sherva Richard , Zhang Rui , Harrington Kelly , Fonda Jennifer , Merritt Victoria , Panizzon Matthew S. , Hauger Richard L. , Wolf Erika , Miller Mark 
Published: December 2022

AbstractBackgroundThe US Veteran population is aging, and Veterans have higher rates of dementia risk factors such posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). Moreover, some studies have indicated that APOE:ε4 (the largest Alzheimer’s disease genetic risk factor) x TBI interactions could further elevate dementia risk.MethodAlzheimer’s disease and related dementia (ADRD) risk was examined using the electronic medical record and survey‐based phenotypes in the VA Million Veteran Program (MVP) cohort. We examined the impact of TBI (survey‐based), PTSD (medical record and survey‐based), and APOE:ε4 on ADRD risk in a European‐descent cohort (EUR, n=11,112 ADRD cases; 170,361 controls) and an African American cohort (AA, n=1,443 ADRD cases; 16,191 controls).ResultPTSD, TBI, and ε4 were associated with ADRD in both cohorts (p<10‐9). In EUR, logistic models indicated dementia risk associated with TBI (OR=1.96) was approximately that of ε4 (OR=2.05), while the PTSD‐associated risk was slightly higher (OR=2.18). In AA, the effect of PTSD and ε4 were similar (OR=1.73 and 1.69 respectively), while the effect of TBI was higher (OR=2.69). GxE analyses yielded a modest but significant PTSD x ε4 interaction term in EUR (OR=0.84, p=0.0046). As multiplicative (logistic) interactions can be difficult to interpret, we calculated the risk curves predicted by the models (Figure 1) and relative excess risk due to interaction (RERI), which measures additive‐scale interactions. Modest but significant positive RERIs were observed for PTSD x APOE (EUR, RERI=1.28) and TBI x APOE (EUR and AA, RERI=0.86 and 1.45 respectively), indicating that risk of ADRD in terms of raw percentage associated with PTSD/TBI case status increases as ε4 dosage increases. For example, age 80 risk of ADRD associated with PTSD (PTSD case ADRD% – control ADRD%) in EUR is predicted to be 5.70% for those with one copy of ε4 and 11.19% for two copies of ε4.ConclusionAlthough the mechanisms have yet to be elucidated, PTSD, TBI, and genetic risk are strongly associated with dementia in Veterans. Veterans with PTSD and TBI have increased risk for ADRD and require monitoring for early detection of cognitive decline which can precede dementia onset.
Cognitive impairment is associated with cardiovascular remodeling in the mouse model of Alzheimer’s disease
Authors: Haghkar Mahdi , Grigorova Yulia N , Cezayirli Defne , Morrell Christopher H , Camandola Simonetta , Petrashevskaya Natalia , McDevitt Ross A , Zernetkina Valentina , Juhasz Ondrej , Wei Wen , Mattson Mark P , Lakatta Edward G , Fedorova Olga V 
Published: December 2022

AbstractBackgroundDouble‐mutant mice (APPswe/PS1dE9; 2xTg‐AD) represent a model of Alzheimer’s disease (AD). 2xTg‐AD mice develop progressive accumulation of amyloid plaques and cognitive impairment (CI) with age in >12 months old animals. The aim of the present study was to investigate the associations of CI and cardiovascular function in 2xTg‐AD mice.MethodsAortic pulse wave velocity (aPWV), an estimation of aortic stiffness, and cardiac parameters were measured by echocardiography in 16‐mo old male 2xTg‐AD (n=11) and wild type (WT; n=17) mice. Spatial memory (using Morris water maze; MWM) and the anxiety level (using open field test; OFT) were assessed. The relationship between cardiovascular and behavioral parameters were modeled using a linear regression analysis (LRA) with a backward elimination. P‐values <0.05 were considered significant, and 0.05≤P<0.1 were considered near significant and were included in the models.Results2xTg‐AD mice exhibited an increase in aPWV and had a thicker left ventricle (LV) posterior wall in diastole (LVPWd) and narrower LV internal diameter (LVIDd) vs. WT mice (Table 1). 2xTg‐AD mice spent less time in the center of OF vs. WT mice (Table 1). LRA revealed a negative association between time spent in the center of OF and LVPWd, and a positive association with LV volume in diastole (LVvold) in 2xTg‐AD mice (Table 2). In MWM, 2xTg‐AD mice exhibited impaired spatial memory estimated as prolonged average escape latency during their training vs. WT counterparts (Table 1). Although there was no difference between performance in the MWM probe trial, LRA showed a negative association between LVPWd and the mean distance from the platform in the probe trial in 2xTg‐AD mice, and a positive association of LVPWd with number of entries to the platform zone (Table 2). There was a positive association between aPWV and mean distance from the platform in the probe trial in both 2xTg‐AD and WT mice.ConclusionsLRA results indicate that LV remodeling is associated with anxiety‐like behavior in 2xTg‐AD mice, but not with spatial memory impairment. Positive association of aPWV with spatial memory impairment in both groups suggests that aortic stiffness contributes to the age‐associated CI.Supported by the NIH/NIA IRP.
Exploration of Multidimensional Needs in a Dementia Colombian Population: Preliminary Qualitative Results
Authors: Romero‐Vanegas Sara Julieta , Vargas‐González Juan Camilo , Pardo Rodrigo , Moreno‐Angarita Marisol 
Published: December 2022

AbstractBackgroundWorld population is ageing, and as a result, dementias are becoming one of the major challenges for societies. Dementia involves patients, caregivers, professionals and the health system; for this reason, in Colombia, we need inplemented a diffent health policy models with a social justice approach. To contribute as input to a national strategy on dementia, our first step is multidimensional needs information gathering. To evaluate the perceived needs of a group of Colombian patients with dementia and their caregivers under a Social Justice framework using the Needs Assessment Methodology.MethodWe designed an information‐gathering program consisting of the first phase of a semi‐structured interview and the second phase of focal groups. We will triangulate both results using mixed methods. Nevertheless, this abstract only addresses the first phase. Due to social distancing, we designed a computerized interview using google forms that could be self‐answered through the internet or assisted through telephone. We obtained a telephonic approved informed consent before we enrolled any participant. In this interview, we evaluated the seven aspects of the need assessment methodology regarding the caregiving of dementia or the experience of suffering dementia.ResultWe conducted the interviews between September 2021 to December 2021. We included a total of 68 caregivers and fifteen dementia patients. Most caregivers were women, with ages between 27 to 72 years. Two‐thirds were familiar unpaid caregivers. We found that caregivers identified a lack of adequate resources provided by the health system. However, the burden of caregiving appears to be low in our context, and the results suggest that informal agreements within the families allow to distribute of the responsibilities.Conclusioncaregivers in Colombia appear to present high resiliency and be assumed as an extended family responsibility even under the perception of neglected provision of resources by the health system.
The direct NLRP3 inhibitor and Phase 3 small molecule anticancer agent, RRx‐001, protects aged triple transgenic Alzheimer’s disease model mice from CNS degeneration and cognitive decline
Authors: Reid Tony , Oronsky Bryan , Caroen Scott , Cabrales Pedro 
Published: December 2022

AbstractBackgroundRRx‐001 is an aerospace‐derived, intravenously administered NLRP3‐specific inhibitor with confirmed CNS‐penetrant properties and a favorable safety profile in a Phase 3 clinical trial. It is under investigation as an anticancer agent, a chemoradioprotector for oral mucositis and a prophylactic for acute graft vs. host disease (aGVHD). RRx‐001 has been shown to reduce interleukin‐1β (IL‐1β) production in vivo and to attenuate the severity both of experimental autoimmune encephalomyelitis (EAE), a disease model of multiple sclerosis, and dextran sulfate sodium (DSS)‐induced colitis.MethodIn the present study, the neuroprotective effects of 2mg/kg RRx‐001 administration on Alzheimer’s Disease (AD), which has been linked to aberrant NLRP3 activation, were evaluated via i.p. injection once weekly for 3 months on aged (21‐24 months old) triple transgenic AD model (3xTg‐AD) mice and control non‐transgenic (NonTg) mice.ResultThis sub‐chronic administration of RRx‐001 improved performance on learning and spatial memory tasks and greater risk assessment behavior based on the elevated plus maze test. A significant increase in reduced glutathione and a decrease in lipid peroxidation and amyloid plaque density were also observed in the 3xTg‐AD mice.ConclusionTogether, these findings suggest that RRx‐001 reverses histological hallmarks of AD and protects cognitive and emotional function in aged 3xTg‐AD mice
Adherence to in‐person vs. virtual delivery of a multi‐domain behavioral intervention to prevent cognitive decline: The US POINTER Study
Authors: Katula Jeffrey A. , Ventrelle Jennifer , King Katelyn , Garcia Katelyn R , Graef Sarah , Lovato Laura , Wilmoth Sharon , Woolard Nancy , Espeland Mark A. , Snyder Heather M. , Kivipelto Miia , Carrillo Maria C. , Whitmer Rachel A. , Baker Laura D. ,   US POINTER
Published: December 2022

AbstractBackgroundIn response to the global pandemic, U.S. POINTER procedures were adapted to include virtual intervention delivery. Here we describe the impact of this adaptation on adherence in a large community‐based lifestyle intervention trial.MethodU.S. POINTER is conducted through a partnership between the Alzheimer’s Association (AA) and five clinical sites. A total of 2000 older adults at risk for cognitive decline are assigned to one of two 24‐month multi‐domain lifestyle interventions. The Self‐Guided (SG) group works toward lifestyle goals that best meet their individual needs and schedules. The Structured (STR) group follows a coordinated program with specific goals for physical activity, diet, cognitive/social challenge, and health monitoring. Both groups meet in teams of 12‐15 participants throughout the study for support and guidance, which are led by trained staff. SG teams meet six times over 24 months, and STR teams meet weekly for the first 4 months, then 2x/month for 2 months, and then monthly. Although Team Meetings for both intervention groups were planned as in‐person events, the global pandemic necessitated a pivot to virtual delivery.ResultFrom January through December 2021, N = 2103 Team Meetings were conducted in‐person and N = 4663 Team Meetings were conducted virtually for 824 participants. For both intervention groups, in‐person and virtual Team Meeting attendance was the same, at 90%. When Team Meetings were held in‐person, STR participants completed a median of 93 very active Fitbit minutes/week (IQR = 38,185) and reported a median MIND Diet score of 11.0 (IQR = 9.5,12.0). When Team Meetings were virtual, adherence metrics were comparable with median values of 101 very active Fitbit minutes/week (IQR = 43,192) and a MIND Diet score of 11.0 (IQR = 9.8,12.0). Blood pressure monitoring and cognitive training metrics were also comparable without regard to Team Meeting delivery format.ConclusionOur findings demonstrate that a shift to virtual participant contact during the pandemic did not compromise adherence to a complex multi‐domain lifestyle intervention in older adults. These findings have high relevance for other ongoing lifestyle intervention studies within and outside of WW‐FINGERS, and highlight the importance of adaptability in clinical trial design and implementation to foster sustainability under challenging life circumstances.
Identifying and Prioritizing Research to Improve Emergency Care of Persons Living With Dementia: A Geriatric Emergency care Applied Research 2.0 Network ‐ Advancing Dementia Care (GEAR 2.0‐ADC) Scoping Review
Authors: Gifford Angela , Shah Manish N , Carpenter Christopher R , Dresden Scott M , Dussetschleger Jeffrey , Leggett Jesseca , Taylor Zachary , Hwang Ula 
Published: December 2022

AbstractBackgroundPersons living with dementia (PLWD) frequently access emergency departments (EDs) for care, but current research surrounding their unique care needs is limited. The Geriatric Emergency care Applied Research 2.0 Network–Advancing Dementia Care (GEAR 2.0‐ADC) aims to identify and prioritize research gaps surrounding the most important needs for PLWD to advance their emergency care.MethodA Task Force of 61 stakeholders including ED‐ and non‐ED‐based clinicians, PLWD, care partners, and advocacy organizations was established. Task Force members voted to choose the top four topics for investigation. Two Patient‐Intervention‐Comparison‐Outcome (PICO) questions were developed per topic. Following the PRISMA‐ScR guidelines and working with medical librarians, systematic literature searches and scoping reviews were completed by Task Force members. Findings were presented at the GEAR 2.0‐ADC Consensus Conference to the full Task Force. After discussion, they developed research questions for each topic area and voted to prioritize the questions within each topic area for future investigations.ResultsTask Force voting identified four critical topics for investigation and two unique PICO questions for each topic. The literature search and abstraction process comprehensively summarized the research to date for dementia detection (3,651 identified, 132 abstracted), communication and decision‐making (8,138 identified, 24 abstracted), ED clinical practices (6,348 identified, 23 abstracted), and care transitions from the ED to the community (3,484 identified, 10 abstracted). General themes that emerged from the abstraction process included a need for effective patient‐centered care interventions in the ED and when transitioning back to the community following care, identification of communication barriers between care partners and medical staff, measurement of dementia in the ED setting that is both efficient and operational, a need to decrease stimulation, and for increased PLWD and care partner engagement. The stakeholders rank‐voted the research questions developed for each topic, resulting in a framework for GEAR 2.0‐ADC’s support for future research.ConclusionTransdisciplinary stakeholders, PLWD, and care partners identified critical research topics and performed four scoping reviews, leading to refinement of the research gaps and prioritization for future research. These gaps will be addressed in upcoming GEAR 2.0‐ADC funding opportunities.