bluuebunny/crossref_metadata_2025_split huggingface dataset:
Main occupation complexity and later‐life cognitive function among older adults in Brazil and Mexico
Authors: Gonçalves Natalia G , de Medeiros Gabriela Mininel , Avila Jaqueline Contrera , Bertola Laiss , Ferri Cleusa P , Wong Rebeca , Suemoto Claudia Kimie 
Published: January 2025

AbstractBackgroundOccupation complexity during adulthood may contribute to cognitive reserve in later life. Research on occupational complexity and cognitive function has focused on high‐income countries, where there is a large proportion of individuals with complex occupations. Thus, it is important to investigate this association in the context of low‐ and middle‐income countries where there is greater variance in occupation complexity and where there is a higher proportion of lower‐complexity occupations due to educational and other socioeconomic limitations. We use nationally representative data from the two largest countries in Latin America, Mexico and Brazil, to assess the association between main occupation complexity and cognitive function.MethodThe sample included adults 50 years or older from the 2018 waves of the Brazilian Longitudinal Study of Aging (ELSI) (n = 9,916) and the Mexican Health and Aging Study (MHAS) (n = 16,171). Participants were classified as cognitively impaired or not impaired using cognitive performance scores and a regression‐based approach compared to a normative sample. Main occupation was categorized as unskilled (agricultural workers, cooks, artisans, and maintenance workers), semiskilled (clerks, customer service workers, and trades workers), and skilled (doctors, engineers, managers, and teachers). We used logistic regression models to estimate the association between occupational complexity and cognitive function adjusted for sociodemographic variables, chronic diseases, and health behaviors.ResultParticipants of the ELSI had a mean age of 64.0±9.6 years, median years of education of 4 years, 50% were women, 48% had unskilled occupations, and 6% were categorized as cognitively impaired (Table 1). Participants of the MHAS had a mean age of 62.8±10.3 years, median years of education of 6 years, 56% were women, 65% had unskilled occupations, and 7% were categorized as cognitively impaired (Table 1). Participants with semiskilled occupations had lower odds of cognitive impairment than those with unskilled occupations in both cohorts (Table 2). There was no association between main lifetime skilled occupations and cognitive impairment in either cohort (Table 2).ConclusionHigher occupational complexity may contribute to later‐life cognitive reserve. The results of this study suggest that increasing opportunities for higher‐complexity occupations in Latin America may benefit efforts to prevent cognitive impairment in this region.
Neural underpinnings of cognitive resilience in Brazilian SuperAgers
Authors: Borelli Wyllians Vendramini , Leal‐Conceicao Eduardo , Schilling Lucas Porcello , Portuguez Mirna Wetters , Zimmer Eduardo R. , da Costa Jaderson Costa 
Published: January 2025

AbstractBackgroundAlthough cognitive decline is a trait related to aging, some individuals are resilient to the aging process, defined as SuperAgers. Studying the neural underpinnings of SuperAgers may improve the understanding of AD pathology. In this study, our aim was to analyze amyloid and neurodegeneration imaging biomarkers in SuperAgers.MethodWe recruited 228 Brazilian adults and older adults to participate in this study. They underwent a neuropsychological battery, followed by PET [11C] PIB and [18F]FDG imaging. Individuals were classified as SuperAgers when at 80 years of age or above, episodic memory scores similar to 50‐65 normative data, and within 1 SD of normative values for age and education for executive functions, fluency and naming. Amyloid load and glucose metabolism standardized uptake value ratio (SUVR) was calculated using cerebellar crus and whole brain, respectively. SUVR values from predefined AD meta‐ROI for PIB (prefrontal, orbitofrontal, parietal, temporal, anterior and posterior cingulate and precuneus) and FDG (angular gyrus, posterior cingulate, and inferior temporal cortical) were extracted. No covariates were included in the models since sex and education were paired.ResultAfter initial screening, a total of 10 young controls (C50), 10 age‐matched controls (C80) and 10 SuperAgers (Table) SA, mean age 82.1±2.51 years) were included. Educational levels were similar between groups (p>0.05), while episodic memory scores were similar only between SA (10.7±3.4) and C50 (11.4±2) but higher than C80 (10.5±3.4, p<0.001). Amyloid SUVR was lower in C50 than older groups, but similar between SA and C80 (SA: 1.25±0.2, C80: 1.32±0.3, C50: 1.07±0.1, p = 0.03). FDG SUVR was increased in SA (Figure) when compared with C80 (1.06±0.1 vs. 1.01±0.1, p = 0.02), but similar to C50 (1.03±0.1, p = 0.21).ConclusionOur findings indicate that SuperAgers are more resilient to amyloid burden and seem to cope with AD pathology by increasing brain glucose metabolism. The higher FDG metabolism seen in SuperAgers compared with age‐matched controls may reflect a compensatory biological response, which ultimately leads to cognitive resilience.
Associations Between Deficit Accumulation Frailty and Baseline Markers of Lifestyle and Health in the U.S. POINTER Trial
Authors: Espeland Mark A. , Demesie Yitbarek N , Cleveland Maryjo , Farias Sarah Tomaszewski , Baker Laura D , Crivelli Lucia , Garcia Katelyn R , Lockhart Samuel N. , Olson KayLoni , Snyder Heather M , Tangney Christy C , Wing Rena R. , Whitmer Rachel A. , York Michelle , Callahan Kathryn E. ,   U.S. POINTER Study Group
Published: January 2025

AbstractBackgroundBehavioral interventions designed to promote healthy lifestyles have the potential to slow biological aging and increase health span. Multidomain interventions that simultaneously target multiple lifestyle behaviors may particularly be promising by increasing the number of interrelated processes that might be benefited. Deficit accumulation frailty indices (FIs) are increasingly used as measures of aging and health status in clinical trials and cohort studies.MethodA 49‐component FI was developed from baseline measures of age‐related 1) physical function and abilities, 2) cognitive function, 3) health related quality of life, 4) mood and affect, 5) clinical biomarkers, 6) physical measures, 5) sleep quality, 8) chronic diseases, 9) sensorineural abilities, 10) polypharmacy, and 11) behaviors. The FI was calculated for the 2,111 participants of the U.S. Study to Protect Brain Health through Lifestyle Intervention to Reduce Risk (U.S. POINTER), a two‐armed randomized controlled clinical trial comparing two multidomain lifestyle interventions on cognitive function. Associations between the FI and markers of intervention targets were assessed using correlation coefficients after covariate adjustment for age, gender, and clinical site.ResultThe 25%ile, 50%ile, and 75%ile of the FI distribution (Figure 1) were 0.112, 0.153, and 0.199 and are consistent with a cohort at risk for accelerated aging. Mean FI scores were greater by 13% among males compared with females and by 36% among those aged 75‐79 years compared with those aged 60‐64 years (Table 1; both p<0.001). Greater FI scores were associated with worse MIND diet scores, fewer minutes of moderate exercise per week, higher systolic blood pressures, higher fasting glucose concentrations, and worse domain‐specific and composite cognitive function (all p≤0.01) but were unrelated to the frequency of cognitive activities per week (Table 2).ConclusionThe U.S. POINTER FI has expected associations with targets of its multidomain lifestyle interventions. It is designed to serve as a basis for assessing whether these interventions differentially slow aging and, if so, how this may contribute to better cognitive functioning.
Poor Colonoscopy Bowel Prep in 69‐Year‐old with Mild Neurocognitive Disorder: A Case Example
Authors: Joffe Yonah , Eversole Kara , Burt Juliana S , Kimmet Faith , Estores David , Tanner Jared J. , Arias Franchesca , Price Catherine C. 
Published: January 2025

AbstractIntroductionColonoscopies are medical procedures used to identify colon abnormalities and remove polyps to decrease the incidence of colorectal cancer. Prior to this exam, patients must undergo bowel preparation to ensure proper cleansing of the colon and maximize outcomes (e.g., full identification of pre‐cancerous polyps). Many risk factors for poor bowel preparation have been identified (e.g., age, low health literacy). However, there has been minimal consideration of preoperative mild or major neurocognitive disorders as a risk factor. A 2019 study by Arias and colleagues found that 68% of older adults undergoing colonoscopies met criteria for neurocognitive disorders. For these patients, inadequate bowel preparation was identified in 100% of those with major neurocognitive disorder and 28% with mild neurocognitive disorder. The present case study provides another example regarding the importance of cognition when considering colonoscopy preparation.Case Presentation DemographicsCR is a 69‐year‐old non‐Hispanic White male with 13 years of education who worked in the oil field, then as an auto‐mechanic, and later owned an auto repair business. Neuropsychological Testing: Mild neurocognitive disorder, amnestic type, with rapid forgetting and impaired semantic fluency coupled with average attention, working memory, and processing speed. Lives with spouse and is largely independent in functional abilities. Medical records indicate history of postoperative delirium and cardiovascular history. Brain MRI shows white matter abnormalities. Problem: CR was scheduled to complete a routine colonoscopy screening. Review of medical records report colonoscopy was a failed procedure due to poor bowel preparation. Gastroenterology rating of preparation with the Boston Bowel Preparation Scale (BBPS) totaled to 4, indicating inadequate bowel preparation (0‐9, 0 = suboptimal; 9 = optimal). Outcome: CR was referred to undergo a second colonoscopy.DiscussionThis case highlights how preoperative cognitive impairment and the possibility of neurodegenerative disease (i.e., presence of white matter abnormalities) is an important consideration for individuals referred for routine colonoscopy procedures. The case is consistent with the work from Arias et al. (2019) and indicates the need for larger prospective examinations on cognitive risk for elective “routine” procedures involving preparation that involves patient planning. Supported by: K07AG066813.
Cardiometabolic health of persons at risk of APPV717I or PSEN1A431E autosomal dominant Alzheimer’s disease in Jalisco, México
Authors: Berumen‐Ocegueda Isaac Enrique , Zepeda‐Morales Adelaida Sara Minia , Figuera‐Villanueva Luis Eduardo , Ringman John M , Matute Esmeralda 
Published: January 2025

AbstractBackgroundIt is known that cardiometabolic diseases are related to Alzheimer´s Disease.MethodWe included 23 residents of Jalisco with at least one first‐degree relative with ADAD (ADADG). We rated the participants using the Clinical Dementia Rating (CDR) as CDR = 0 (n = 20, 87%), CDR = 0.5 (n = 2, 9%), and CDR = 2 (n = 1, 4%). Eleven participants were mutation carriers (APP
V717I = 9, PSEN1
A431E = 2). We compared the participant’s laboratory test results of the fasting plasma glucose (FPG), lipid profile, glycated hemoglobin (HbA1c), and thyroid function test (TFT) to those of 102 Jalisco residents within the same age range (CG).ResultThree (13%) carrier participants (APP
V717I = 3) reported being previously diagnosed with cardiometabolic disease (hypertension = 1, prediabetes = 1, dyslipidemia = 2). For the ADADG, the most common abnormality in the laboratory tests was dyslipidemia (n = 20, 87%; mixed dyslipidemia = 15, 66%). Other abnormalities found on laboratory tests were FPG≥126 mg/dL (n = 3, 13%), HbA1c≥6.5% (n = 7, 30%), and TFT findings compatible with hypothyroidism (n = 1, 4%). Similarly, in the CG, dyslipidemia was also the most prevalent abnormality (n = 15/22, 68%), followed by HbA1c≥6.5% (n = 6/12, 50%), and at last FPG≥126 mg/dL (n = 6/47, 13%). When comparing the ADADG to the CG, we found that the ADADG has a higher frequency of mixed dyslipidemia (χ2 = 5.02, p = .038), lower levels of free thyroxine (1.12±0.16 VS 1.28±0.19; t(37) = 2.8, p = .008), higher levels of triglycerides (187.1±75 VS 147.8±69.8; t(61) = 0.32, p = .04), and higher levels of very low‐density apolipoprotein (37.4±15 VS 28.2±11; t(43) = ‐2.3, p = .024). We did not find any difference in any measure or prevalence when comparing the mutation carrier group, the non‐carrier group, and CG.ConclusionDyslipidemia is the most common cardiometabolic abnormality in both ADADG and CG. The frequency of cardiometabolic abnormalities is not related to the presence of any of the two studied mutations. A follow‐up study could show if the cardiometabolic abnormalities are related to an earlier onset of ADAD.
Sleep and Physical Activity are Associated with Cognition and Resting‐State Functional Imaging Measures of Network Segregation in Non‐demented Older Adults
Authors: Callow Daniel 
Published: January 2025

AbstractBackgroundGreater physical activity and better sleep are associated with reduced risk of cognitive decline and dementia among older adults, but little is known about their associations with measures of brain function and neuropathology.MethodThis study investigated potential independent and interactive cross‐sectional relationships between actigraphy‐estimated total volume of physical activity (TVPA) and sleep patterns [i.e., total sleep time (TST), sleep efficiency (SE)] with cognitive performance (n = 157). In a subset of participants, the physical activity and sleep measures were also evaluated in relationship to resting‐state functional magnetic resonance imaging (rs‐fMRI) measures of large‐scale network connectivity, and positron emission tomography (PET) measures of amyloid‐β (n = 135). Participants were part of the BIOCARD study including 136 cognitively normal individuals and 21 participants with mild cognitive impairment (mean age = 71.7 years). Using linear regression analyses, we assessed the association between TVPA, TST, and SE with cognition, connectivity within the default‐mode, salience, and fronto‐parietal control networks, and with network modularity, a measure of network segregation.ResultGreater TVPA and SE each were positively associated with better global cognitive composite scores and executive function. Importantly, a TVPA by SE interaction suggested that adults with the poorest SE experienced the greatest benefit from physical activity in relation to cognition. In the imaging subsample, higher TVPA and SE were independently associated with greater network modularity, although the positive relationship of SE with modularity was only present in amyloid‐negative individuals. Additionally, higher TVPA was associated with greater connectivity within the default‐mode network, while greater SE was related to greater connectivity within the salience network. In contrast, longer TST was associated with lower network modularity, particularly among amyloid‐positive individuals, suggesting a relationship between longer sleep duration and greater network disorganization. Physical activity and sleep measures were not associated with amyloid positivity.ConclusionThese data suggest that greater physical activity levels and more efficient sleep may promote better cognition and more segregated and potentially resilient functional networks, as well as greater functional connectivity within specific large‐scale networks. Additionally, the relationship between sleep and functional networks connectivity may depend on amyloid status while associations with physical activity may be independent of amyloid status.
Innovating using mHealth for people with dementia and co‐morbidity and their carers: Screening and economic assessment at the population level
Authors: Anza‐Ramirez Cecilia , Cardenas Maria Kathia , Landeiro Filipa , Montesinos Rosa , Custodio Nilton , Da Re Marco , Calvo Rafael A , Belon‐Hercilla Veronica , Cuba María Sofía , Bernabe Antonio , Butler Christopher , Miranda Jaime ,   IMPACT Dementia Study Group
Published: January 2025

AbstractBackgroundDementia is a global health challenge, especially in low‐ and middle‐income countries like Peru, where diagnosis, access, and awareness are limited. Within the IMPACT Dementia project, a component focuses on developing, testing, and implementing an mHealth‐enabled system for dementia screening and diagnosis, and assessing its cost‐effectiveness.MethodsPhase I. To develop a dementia diagnostic screening mHealth system: The features of the screening tool will be locally adapted using a co‐design approach including community members and community health workers (CHW) in four regions in Peru (Lima, Tumbes, Iquitos, and Huancayo) to enhance adaptability and efficacy. The final tool will be applied to older adults (60+) in the community by CHW.Phase II. To assess the accuracy and acceptability, and characterization of older adults (60+) at the population level in Peru (n≈32,000): Using the mHealth system developed in Phase I, assessments including AD8, RUDAS‐PE, and PFAQ, will be conducted. Accuracy for dementia diagnosis will be determined through gold‐standard assessments involving interviews, neuropsychological testing, and the CDR in a subgroup of participants conducted by neurologists. The system will also collect data on socio‐demographic information, carers, co‐morbidities, quality of life, resource usage and costs.Phase III. To integrate the mHealth diagnostic system into Peru’s primary healthcare (PHC) level: After validation, a 3‐month quasi‐experimental study in 2 centres per region will assess system performance, using waiting room recruitment and provider‐conducted screenings for older adults. Indicators will evaluate integration success, sensitivity, and specificity of the tool, cost‐effectiveness, and stakeholder perspectives through a process evaluation, guiding future scalability.ResultEarly phases suggest that the IMPACT Dementia project will offer insights into dementia challenges in Peru. The co‐design phase prioritises cultural relevance. Phase II anticipates a comprehensive dataset characterising older adults, informing prevalence and risk factors, and validating the mHealth diagnostic system. Phase III aims to assess the integration feasibility of the diagnostic system into PHC.ConclusionThis component of IMPACT Dementia addresses the challenges of dementia in Peru, emphasizing diagnosis, comorbidity, and resource optimization through mHealth. The participation of CHW means a strategic change, which aims to alleviate the burden on health systems.
Interventions to Improve Mealtime Care Quality and Outcomes in Persons Living with Dementia and Their Caregivers: A Systematic Review and Meta‐Analysis
Authors: Liu Wen , Suh Heather , Lee Kyuri 
Published: January 2025

AbstractBackgroundMealtime is a fundamental daily activity to ensure nutrition, social interaction, and enjoyment of food for people with dementia (PWD). Interventions addressing multilevel barriers are critical to optimize mealtime care and outcomes. This review aimed to synthesize existing interventions on mealtime care and outcomes in PWD and their caregivers.MethodPubMed, CINAHL, AgeLine, PsycINFO, and Cochrane were searched from January 2012 to May 2023 using keywords including dementia, Alzheimer, food intake, and mealtime. Relevant bibliographies were manually searched. Eligibility criteria were developed by defining the population, intervention, comparator, outcome, timing, and setting of interest. Eligible studies were classified by intervention, accessed for quality using the Quality Assessment Tool for Quantitative Studies, and graded for evidence using the Grading of Recommendations, Assessment, Development and Evaluation Working Group criteria. Meta‐analyses were performed for studies within the same intervention type that tested the impact on same outcomes.ResultOf 1,137 records, 30 studies were identified and categorized into five intervention types: nutritional supplements (5), resident training/therapy (7), Dyadic training or mealtime interaction (7), environmental/food modification (7), and multiple‐component interventions (4). “Nutritional supplements” showed low evidence on cognition and nutritional status, and moderate evidence on ADL function and depression. “Resident training/therapy” showed moderate evidence on cognitive function. All intervention types showed very low to low evidence on food intake, weight, and BMI, eating difficulties, and hyperphagic behaviors. Meta‐analyses of limited number of heterogenous studies showed 1) “Environmental/food modification” increased food intake; 2) “Resident training/therapy” decreased eating difficulties, 3) “Resident training/therapy” did not increase food intake, 4) “Dyadic training or mealtime interaction” did not increase BMI, 5) “Nutritional supplements” did not improve cognition, and 6) “Multiple components” did not improve ADL function.ConclusionFindings support evidence of certain interventions on food intake and mealtime behaviors, and provide directions for clinical practice and research. Current evidence is based on a body of research with primarily moderate to weak quality. Future testing of interventions using high‐quality designs is needed.
A Study of Influence of Passengers on Driving Behavior of Drivers with Dementia or Mild Cognitive Impairment
Authors: Suzuki Mio 
Published: January 2025

AbstractBackgroundIn Japan, the increase in the number of accidents involving elderly drivers has become a very serious problem. The government has implemented a cognitive function test at the time of driver’s license renewal and has taken measures to disallow driving by elderly drivers with Alzheimer’s disease, but drivers with MCI and other types of dementia continue to drive. One of the measures recommended to contribute to the safe driving of elderly drivers is to encourage them to talk to their passengers. However, for drivers with MCI who are not good at multitasking, the presence and conversation with passengers may induce dangerous behavior. Therefore, the purpose of this study is to observe the differences in cognitive function and driving behavior of elderly drivers depending on whether they have a passenger or not, and to clarify the tendency of the passenger.MethodI recorded the driving behavior of healthy elderly drivers and elderly drivers with mild cognitive impairment who live in a city in the Tokyo metropolitan area and who drive on a daily basis using a drive recorder for a month. Then, I analyzed the differences in safety confirmation between drivers with and without a passenger.ResultThe results statistically showed that in Japan, where traffic is conducted on the left side of the road, the presence of a passenger increases head movement when turning left and increases eye movement alone when turning right. This means that the presence of a passenger increases safety checking behavior. In particular, the results indicate that the driver’s head moves more carefully to the left side of the road, which is difficult to look over, and that the driver’s head tends to move in the direction where the passenger is present.ConclusionSince a passenger increases the number of safety checks during driving, it is clear that the driver may consciously try to concentrate on driving so as not to be distracted by the passenger. While driving with a passenger is expected to provide training in selecting and choosing information, it is also necessary to consider that the passenger does not interfere with the driver’s driving.