bluuebunny/crossref_metadata_2025_split huggingface dataset:
“She’s my memory; and he’s my legs!” The experiences of couples living with dementia and multiple health conditions
Authors: Dunn Rosie J , Wolverson Emma , Hilton Andrea 
Published: January 2025

AbstractBackgroundDementia rarely travels alone. People with dementia (PwD) often have multiple other physical diagnoses (multimorbidity) and experience poor quality, fragmented care. Over two thirds of carers of PwD are spouses, over half of which are 85 years old or above. Age is strongly associated with increased multimorbidity; therefore, carers are also likely to experience multimorbidity. Consequently, married or cohabiting couples are likely to experience the dementia journey together as well as live with multimorbidity. However, research has neglected to explore couples’ experiences of living with both dementia and multimorbidity, and the potential challenges they may face. Understanding couples’ experiences collectively will inform the development of appropriate, psychosocial interventions.MethodMarried couples aged 65 or above were asked to keep a photo diary for one month, taking photographs of their experiences of living with dementia and multimorbidity. Couples were given a choice to use either disposable cameras or their own digital device. This was followed by an audio‐recorded interview, using their printed photographs as a photo‐elicitation technique to aid discussion. Interpretative Phenomenological Analysis (IPA) was used to analyse the data.ResultsSix couples participated. IPA revealed couples have to ‘fight for help’, particularly in relation to dementia and stroke care; living with uncertainty was a significant theme. Couples discussed changes in their relationship, and behavioural and practical adaptations they have made in order to support each other. Some couples do not identify as being ‘ill’ or ‘disabled’ despite the multimorbidity they experience. Maintaining hobbies and interests that are important to them both as a couple and individually was vital for them to continue living a good quality of life.ConclusionCouples living with dementia and multimorbidity face significant challenges that can pose a threat to their relationship and quality of life. Challenges include inadequate support and healthcare, changes in the relationship and couple identity. However, despite this, couples maintain a positive outlook and ‘work as a team’ in order to adapt to each other’s health conditions and to continue leading a fulfilling life. These findings can be used to develop relationship‐centred interventions to support couples in the community.
Improvements in Usability of MoCA XpressO, a Self‐administered Digital Cognitive Pre‐screening Tool
Authors: Gruber Johanna , Bodenstein Katie , Jansen Richard , Paquette‐Masson Marion , Krieger Joana , Gillies Murray , Nasreddine Ziad 
Published: January 2025

AbstractBackgroundXpressO from Montreal Cognitive Assessment (MoCA) is a self‐administered, digital cognitive screening test composed of memory and executive function tasks. Its purpose is to provide a brief pre‐screening of cognition in order to determine whether further cognitive testing is required. A previous validation study comparing the XpressO to the gold standard MoCA test revealed a strong predictive value. However, of the 118 participants recruited, 25% of the participants (n = 30) did not complete the XpressO test due to impaired comprehension (n = 10), requiring assistance (n = 4), skipped or uncompleted tasks (n = 11), and technology difficulties (n = 5). After a qualitative assessment of the users’ experience several improvements were envisioned and implemented in XpressO. This study aims to assess whether these improvements result in a higher completion rate in older adults.Method15 older adults that were referred to the MoCA Clinic were recruited to participate in this qualitative study. Each performed the XpressO test while being observed. The observers noted when people experienced difficulty and fed this back to the usability engineer for improvements. As a next step, 30 participants will be recruited from the MoCA Clinic in Greenfield Park, Quebec. Eligibility criteria will include: ability to speak English or French, adults aged 50 years or over, at least 6 years of formal education, and completion of a recent MoCA test within 3 months prior to the start of the study. Participants will complete the XpressO followed by the User Experience Questionnaire (UEQ). The completion rate of XpressO version 1 and version 2 will be compared using a chi‐squared test. To assess whether completion of the XpressO is dependent on MoCA score, an independent t‐test will be used.ResultResults from the 30 participants will be available by July 2024.ConclusionThe MoCA XpressO is emerging as an important tool in cognitive pre‐screening and facilitating early detection of cognitive impairment. However, barriers to accessibility need to be addressed in order to optimize the useability of the XpressO for the older population.
Longitudinal gene and protein expression changes associated with Mini‐Mental State Examination (MMSE) score in Hispanic/Latino population
Authors: Roshani Rashedeh , Zhu Wanying , Frankel Elizabeth , Chen Hung‐Hsin , Lee Miryoung , McCormick Joseph B , Fisher‐Hoch Susan P , Highland Heather M , North Kari E , Below Jennifer Elizabeth 
Published: January 2025

AbstractBackgroundStudies suggest that approximately 60 to 70 percent of the variability observed in cognitive abilities during aging can be attributed to genetic factors. Therefore, investigating the longitudinal multiomics changes associated with alterations in cognitive measures, such as the Mini‐Mental State Examination (MMSE) score, is of utmost importance.MethodLongitudinal changes in gene and protein expression related to MMSE scores were examined in the Cameron County Hispanic Cohort (CCHC), an extensively phenotyped, randomly‐recruited, cohort of Mexican Americans residing at the US‐Mexico border. This study focused on 763 CCHC participants with transcriptomics data and 240 participants with proteomics data. We utilized linear mixed‐effect regression models to estimate the effects of MMSE scores on gene and protein expression, incorporating up to 1044 and 415 measures, respectively. The models were adjusted for covariates such as age, sex, level of education, anxiety score, screening measure of depression (CESD) score, cell type proportions (for transcriptomics analysis only), 3 Principal Components (PC), and 10 Probabilistic Estimation of Expression Residuals (PEER) factors.ResultOur preliminary results identified 834 genes and 192 proteins that exhibited differential expression based on nominal significance. After mapping the significant proteins to gene IDs, one of the common genes found between the two studies is SCG3, which has previously been associated with cognitive performance and general cognitive ability in the GWAS catalog.ConclusionOur results provide evidence of the functional effect driving those GWAS signals, including mapping the effector gene.
Pretargeted Imaging for In Vivo Assessment of ASO Therapy Delivery in Alzheimer’s Disease
Authors: Cook Brendon E , Pickel Thomas C , Amatruda Mario , Zhang Qize , Nag Sangram , Bolduc Phillipe , Beshr Rouaa , Morén Anton Forsberg , Muste Cathy , Datta Prodip , Ochniewicz Piotr , Meynaq Yasir Khani , DuBois Jonathan M. , Klein Stephanie K , Halldin Christer , Passamonti Luca , Kaliszczak Maciej 
Published: January 2025

AbstractBackgroundIntrathecally (IT) delivered antisense oligonucleotides (ASOs) are promising therapies that can reduce tau pathology in Alzheimer’s Disease (AD). However, current plasma and CSF sampling methods to estimate brain tissue exposure of ASOs are inherently limited, hampering ASO clinical developmental plans. We developed the PET tracer [18F]BIO‐687, which binds ASO conjugates (ASO‐Tz) in vivo, allowing us to image ASO distribution in a living brain using “pretargeted” imaging. Pretargeted imaging proceeds by: 1) intrathecal ASO‐Tz dosing; 2) brain distribution of the ASO‐Tz; 3) intravenous (IV) [18F]BIO‐687 administration, where tracer binds to ASO‐Tz in the brain via ‘click‐chemistry’ reactions, followed by PET imaging. Pretargeting enables longer imaging timepoints while reducing radiation dose to patients. Using pre‐clinical experiments, we demonstrate the feasibility of pretargeted imaging to assess ASO distribution in AD.MethodA Malat1 ASO tool compound was developed and conjugated as a surrogate for therapeutic ASOs treating AD. ASO distribution was imaged in a non‐human primates (NHP) experiment. ASO‐Tz was IT dosed (20 mg), followed 24 hours later by IV [18F]BIO‐687 injection and PET imaging. Baseline scans of [18F]BIO‐687 with no ASO‐Tz were also performed. In a separate experiment, the Malat1 ASO‐Tz was dosed IT in an AD mouse model expressing hTau (P301S) and age‐matched controls. One week later, mouse brains were stained for hTau (AT8) and ASO distribution using immunofluorescence.ResultThe PET experiment in NHP showed high [18F]BIO‐687 binding in brain regions where ASO‐Tz distributed, indicating successful “pretargeted” imaging. As expected for any IT‐delivered ASO, uptake was higher in hindbrain and cortex. In mice, ASO signal (identified by immunofluorescence) was significantly higher in the hippocampus of P301S than control mice (p<0.05). Unexpectedly, higher ASO concentration was correlated with higher hTau concentration in regions such as the hippocampus and cortex (p<0.05).ConclusionThe NHP PET imaging data clearly demonstrated the feasibility and utility of pretargeted imaging for assessing Malat1 ASO (or potentially any ASO) distribution. Concurrently, our results from the P301S mice study intriguingly show that Malat1 ASO distributes more in brain regions showing higher tau pathology. Our findings support further pretargeted ASO imaging studies in healthy volunteers and AD patients.
Stakeholder Perspectives on Providing Person‐Centered Dementia Care in Low‐Resource Long‐Term Care Settings
Authors: Holmes Sarah D , Rataj Alison , Kusmaul Nancy , Wang Jing , Kim Yoon Chung , Murray Briana , Davie Laura , Lepore Michael , Corazzini Kirsten 
Published: January 2025

AbstractBackgroundThere is a growing number of residents living with dementia (RLWD) in long‐term care (LTC) settings, but dementia care access and quality are more limited in communities with fewer health resources and these limitations are exacerbated by current dementia care workforce shortages. Low‐resource LTC settings, including poorer urban and rural settings, serve older adults who are at high risk for health inequities in dementia care. These settings can experience barriers in providing quality dementia care due to their limited ability to capture pertinent information about residents’ needs and preferences and ensuring that information is known by dementia care staff. Although there is evidence about the consequences of care inequities for RLWD in low‐resource LTC settings, less is known about stakeholders’ perspectives about key issues and opportunities for improving dementia care. This study describes stakeholder perspectives regarding the collection and sharing of information about RLWD for supporting quality dementia care in low‐resource LTC settings.MethodThis was a community‐based, participatory research study in four low‐resource LTC settings (two rural, two urban) in the United States. All four settings were in medically underserved areas with two rural settings in New Hampshire and two urban settings in Maryland. In‐depth semi‐structured interviews were conducted with a purposive sample of participants (8 administrators/leaders, 20 care staff, 20 RLWD, and 20 care partners). Interviews were audio recorded, transcribed, and thematically analyzed in NVivo12.ResultThemes were identified in four core topic areas: 1) identifying information about RLWD to support quality care; 2) finding and accessing information by the care team; 3) sharing information with RLWD; and 4) describing quality measures most relevant for RLWD. Within each theme, subthemes were identified providing greater detail of the process for identifying, collection, and sharing information for supporting quality dementia care.ConclusionThis study revealed complexities in providing care for RLWD in diverse low‐resource communities and generates directions for addressing dementia care inequities. The findings shed light on practical strategies used by low‐resource LTC settings and motivate future research on measuring dementia care quality and advancing capacity among RLWD, their families, and care staff for inclusive, person‐centered dementia care.
Synergistic cognitive enhancement of repetitive transcranial magnetic stimulation with cognitive training in mild Alzheimer’s disease: preliminary results
Authors: Lee Juyoun , Park Kyung Won , Park Kun‐Woo , Lee Ae Young 
Published: January 2025

AbstractBackgroundRepetitive transcranial magnetic stimulation (rTMS) is a non‐invasive emerging tool to modulate brain activities and functional connectivity in various neuropsychiatric disorders. rTMS combined with cognitive training (rTMS‐COG) has been showing cognitive enhancing effects compared to those of placebo in mild Alzheimer’s disease (AD) in some previous studies. However, there is not much research to conclude how much each rTMS or COG contributes to therapeutic cognitive effects. This study aims to investigate the cognitive enhancing effect of rTMS‐COG in patients with mild AD.MethodThis study is a prospective, randomized, double‐blind, placebo‐controlled multicenter study. All recruited patients with the mild stage of AD had amyloid deposition in positron emission tomography. Participants fulfilled the inclusion criteria, including a 21∼26 score on the Mini‐Mental Status Examination (MMSE) and the Clinical Dementia Rating (CDR) scale 1, or the Global Deterioration Scale 3. The treatment group (T) had 30 sessions of rTMS‐COG for 6 weeks. The active control group (S) had digital cognitive training without rTMS for 6 weeks. High frequency (10Hz) rTMS was applied on six cortical areas (bilateral dorsolateral prefrontal cortex, bilateral posterior somatosensory cortex, Broca’s area, and Wernicke’s area). The primary outcome measure of this study was the differences in the ADAS‐cog score changes between groups, and its difference of 24 weeks of treatment from the baseline.ResultData from 20 patients (T:S 10:10) were used in the preliminary analysis. The mean values for the participants were 71.7 years of age, 10.5 years of education, and 20.2 ADAS‐cog score. There was no significant difference between the two groups' baseline epidemiological or cognitive characteristics. At 24 weeks, the ADAS‐cog score improved by 1.3 points from the baseline in T and worsened by 1.3 points in S, with a difference of 2.6 points between the two groups. The treatment group showed significantly better cognitive function compared to that of the active control group in the ADAS‐cog scores after 24 weeks from baseline.ConclusionThis preliminary outcome of the study suggests that rTMS‐COG treatment has significant positive cognitive therapeutic effects, and rTMS might take precedence over COG in terms of cognitive modulation in patients with mild AD.
24‐Hour Optimized Lighting for Persons with Dementia: Technology Development
Authors: White Jonathon David , Ansari MD. Azaharuddin , Al‐Mutawaly Nafia 
Published: January 2025

AbstractBackground65% of persons with dementia (PWD) suffer from disturbed sleeping patterns and 28% experience vision related falls. Improved lighting has been shown in numerous studies since the 1980s to mitigate these effects.MethodComputer code was written to optimize the spectra and intensity of light for vision and non‐vision purposes over a 24‐hour cycle based on off‐the‐shelf LEDs. Hardware was developed to implement the lighting scheme. Feedback was received from practitioners and interested parties.ResultThe 24‐hr dynamic white lighting exceeded the CIE specifications for vision for seniors with high CRI and low Duv at all times. The light’s correlated colour temperature (CCT) and intensity increased rapidly in the morning and dropped slowly into the afternoon and evening. The lighting schedule was implemented using a designated microcontroller that controlled the intensity of four 5‐m LED strips. Three strips were placed in an upper cove near the ceiling and 1 LED strip (nighttime) in woodwork a floor level. The resulting light was uniform throughout the room and shadow‐free. The ratio of horizontal to vertical illuminance was 20% higher than typical direct lighting systems. The final system was certified to Canadian standards and installed in 6 bedrooms at Ressam Gardens Memory Care Community, and at a few other facilities. The majority of feedback about the system was favorable.ConclusionA practical modular lighting system that delivers 24‐hr dynamic white lighting has been certified to Canadian standards and implemented in a number of locations in Hamilton, ON Canada serving persons with dementia. The majority of feedback has been positive.
Health communication, infodemics and disinformation about dementia related contents during COVID pandemic in Arabic countries: A bibliometric analysis
Authors: Taiebine Mohamed , Marfak Abdelghafour , Nejjari Chakib 
Published: January 2025

AbstractBackgroundThe spread of fake news may lead to a disparate wave of digital health‐seeking behavior, cyberchondria, anxiety, indecision, and other psychosocial dysfunctions, including collapse in social capital and stigmatization. In this study, we utilized a bibliometric analysis to discern the primary trends associated with health communication and health‐seeking behavior regarding dementia‐related contents in countries within the Middle East and North African (MENA) region.MethodA literature review was conducted in November 2023. We examined articles published in English from 2020 to 2023 in PubMed, Web of Science, and Scopus databases that addressed health communication, infodemics, and disinformation during the COVID pandemic in Arabic countries. In total, 38 articles were identified. Four studies were selected based on the inclusion criteria. Bibliometric and thematic analysis have been performed by word frequency, geographical position, target population and language (given the diglossic status of Arabic‐speaking countries). The factors that contributed to the successful implementation of the socio‐behavioral and health belief models were described.ResultThere is a dearth of research exploring content related to dementia or Alzheimer’s disease on social media in Arabic‐speaking countries. Several internal and external factors may influence health‐seeking behavior during the pandemic in Arabic‐speaking countries, including low levels of education and literacy, vulnerability to cognitive bias, lack of oversight from authorities, information overload, and an impulsive need to seek immediate responses without engaging in fact‐checking through social media.ConclusionIt is essential to implement a holistic framework to comprehend the behavior‐seeking attitudes of people with dementia based on socio‐cognitive and sociocultural beliefs during pandemics in order to protect vulnerable persons and provide the community with trustworthy and reliable information.
Protocol for an acceptability and feasibility study of sensor‐instrumented SmartSocks® for use by people with dementia
Authors: Creese Byron , Arnold Jacqui , McDermid Joanne , Medina‐Lara Antonieta , Ismail Zahinoor , Steer Zeke 
Published: January 2025

AbstractBackgroundCurrently ∼50% of people with dementia experience behavioural symptoms linked to unmanaged distress. Effective and safe management of these symptoms is critical to maintain the quality of life and overall care of people with dementia. Technological solutions have the potential to help with research into these symptoms. Milbotix are a health tech start‐up who are developing ‘SmartSocks®, a sock‐based wearable that provides wellbeing insights: notably by continually monitoring the physiological state of the wearer to recognise early signs of distress. In this study we will assess the acceptability and feasibility of SmartSocks® for clinical research in dementia in a care home environment.Method30 people with dementia living in care homes in the UK will be asked to wear the SmartSocks®. We will conduct a survey of care home staff to assess the acceptability of the SmartSocks® so that we can ensure the socks are suitable for the care home environment. We will then carry out a focus group with care home staff to evaluate the integration of the SmartSocks® into care planning so that we can determine how care homes use the socks alongside best practice in care. We will determine the concurrent validity of SmartSocks® data with established measures of agitation and pain so that we can evaluate the potential of the socks to be used to deliver better care and used as objective outcome measures in clinical trials. Finally, we will estimate the cost of providing the socks and will assess if there are differences between the groups in resource use utilization and health related quality of life data.ResultWe present a protocol for feasibility and acceptability study of a novel wearable technology.ConclusionThe study will start recruiting in July 2024 and finish in December 2024. Results will be used to inform the design of larger substantive studies that will test the efficacy of SmartSocks® in managing and measuring agitation and distress in care homes.
Validation of ICD‐10 diagnosis codes for identification of veterans with intracerebral hemorrhage and subarachnoid hemorrhage using clinical notes in the United States Veterans Affairs Healthcare System
Authors: Aguilar Byron J. , Arasa Vanesa Carlota Andreu , Morin Peter J , Wang Ying , Mittler Brant , Berlowitz Dan , Abdennadher Myriam , Reisman Joel , Querfurth Henry W , Zhang Raymond , Monfared Amir Abbas Tahami , Zhang Quanwu , Xia Weiming 
Published: January 2025

AbstractBackgroundCerebral amyloid angiopathy (CAA) is a significant contributor to hemorrhagic stroke, notably lobar intracerebral hemorrhage (ICH) and convexity subarachnoid hemorrhage (SAH). This study describes the natural occurrence of ICH and SAH events among veterans, including those with AD, within the United States Veterans Affairs Healthcare System (VAHS).MethodThe VAHS database was evaluated to identify ICD‐10 codes for ICH (I61.x) and SAH (I60.x) from 2015‐2023. A subsample of veterans with AD was identified based on 1 qualifier (AD diagnostic code or clinical note); a sensitivity analysis included veterans with ≥2 AD qualifiers, ≥30 days apart. Two‐thousand veterans were randomly selected from the ICH/SAH sample for validation of diagnostic coding using clinical notes. The positive predictive value (PPV) of ICH/SAH diagnostic codes was determined using notes from 100 randomly selected cases.ResultA total of 23,539 and 7,822 veterans were identified using ICD‐10 codes for ICH and SAH, respectively, out of 4‐5 million veterans receiving care annually. The ICH/SAH sample was 93/95% male, 65/69% white, with a mean age of 70 years. Approximately 14% and 4/5% of veterans with ICH/SAH had AD based on 1 and 2 AD qualifiers, respectively. From 2016‐2023, the yearly prevalence of ICH and SAH was approximately 8‐10 and 3/10,000 patients, respectively (Figure). Approximately 61/68% of veterans in the ICH/SAH sample were identified from outpatient visits only and 39/32% were identified from VAHS inpatient stays with or without outpatient medical records. Among 2,000 randomly selected cases for coding validation, 98% had notes available within ±14 days of the ICD coding; among these, 55/60% carried an ICH/SAH keyword. Brain MRI records were found in one‐third of ICH/SAH cases. Review of 2,000 clinical notes corresponding to 100 randomly selected cases found documentation of ICH in 80% (PPV) of veterans with an ICH diagnostic code and 100% with an SAH diagnostic code.ConclusionYearly prevalence of ICH/SAH (2016‐2023) was 0.08‐0.1%/0.03% in US veterans with 14% of the total cases carrying ≥1 AD identifier. Among cases with clinical notes for ICH and SAH, PPVs were 80% and 100%, respectively.