bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late‐life Blood Pressure and Cerebral Amyloid Angiopathy among Community‐based Older Adults: An Analysis using the U.S. National Alzheimer’s Coordinating Center Uniform Data Set
Authors: Sin Mo‐Kyung 
Published: January 2025

AbstractBackgroundCerebral amyloid angiopathy (CAA) and hypertension are the two most common risk factors of intracranial hemorrhage leading to cognitive impairment, but less is known about how the two relate. A better understanding of the association between these risk factors is a key step towards developing new strategies to manage hypertension and attenuate CAA progression.MethodThis study analyzed data from 2,510 participants in the National Alzheimer’s Coordinating Center (NACC) dataset who had CAA and longitudinal blood pressure (BP) measurements before death. The presence of CAA (autopsy‐based) was determined on immunohistochemistry and categorized as none, mild, moderate, or severe. Multivariable proportional odds logistic regression was used to examine the associations between CAA stages and BP. Systolic BP (SBP) and pulse pressure (PP) were modeled as primary predictors. Covariates also included age at death, sex, antihypertensives, microinfarcts, APOE e4, CERAD, and Braak stages.ResultCAA was present in 1,580 (62.9%) participants; 759 (30.2%) mild, 529 (21.1%) moderate, and 292 (11.6%) severe. Neither late‐life mean SBP ≥140mmHg nor (PP) ≥ 50mmHg were associated with CAA stages. Participants with APOE e4 allele (adjusted odds ratio (aOR) = 1.80, 95% CI: 1.53‐2.11) and males (aOR = 1.25, 95% CI: 1.08, 1.46) had significantly higher odds of having more advanced CAA stage than those who were APOE e4 noncarriers and females. The odds of more severe CAA increased with higher Braak and CERAD stages: Braak stage III‐IV (aOR = 1.51, 95% CI: 1.17‐1.95), Braak stage V‐VI (aOR = 2.43, 95% CI: 1.82, 3.23), CERAD mild (aOR = 2.73, 95% CI: 2.0, 3.60), CERAD moderate (aOR = 3.46, 95% CI: 2.61,4.60), and CERAD frequent (aOR = 5.25, 95% CI: 3.90, 7.09). Figure 1 shows the effect plots for all the variables included in the model.ConclusionHigh SBP (≥140 mmHg) and PP (≥50 mmHg) had no effect on CAA severity stage. Considering CAA and hypertension being major risk factors for intracranial hemorrhage, hypertension may have a synergistic effect on intracranial hemorrhage development in people with CAA positive. More empirical studies are needed to confirm the finding.
A Scoping Review of Non‐pharmacological Interventions for Adults with Cognitive Impairment and Diabetes
Authors: Zheng Yaguang , Rice Brynne Campbell , Wylie‐Rosett Judith , Wu Bei 
Published: January 2025

AbstractBackgroundAdults with comorbidity of cognitive impairment and diabetes is common (19.9%‐45.0%) and increasing; however, the evidence is lacking on non‐pharmacological behavioral interventions to support cognitive health and diabetes management for individuals with both conditions. The objective of this scoping review was to systematically map the research done in this area, characterize the interventions and outcomes that are under investigation, and identify any existing gaps in knowledge.MethodLiterature searches were conducted electronically using MEDLINE (Ovid), CINAHL (EBSCO), Web of Science Core Collection, PsycINFO (Ovid), EMBASE (Ovid), and AgeLine (EBSCO), limiting to articles published in English, but without any restrictions on publication date. The review protocol was registered prospectively with the Open Science Framework (https://osf.io/2w3sh). Two reviewers independently screened the title, abstracts, and full text articles, respectively.ResultsDatabase and citation searching yielded 26,532 records. Duplicates were removed, leaving 16740 unique titles and abstracts to be screened for eligibility. Following full text retrieval, 101 potentially relevant papers were screened against the inclusion criteria, leaving 14 articles that were eligible for inclusion in the review (Figure 1. PRISMA). Among the 14 included studies, the non‐pharmacological interventions included diabetes education, Tai Chi, diet and/or exercise, cognitive training, and technology. Three studies showed improved HbA1c, 4 of them showed improved cognitive function, 2 of them showed improved adherence to dietary intake, and 2 reported improved self‐efficacy scores.ConclusionsOur review indicated heterogeneous non‐pharmacological interventions for adults with comorbid cognitive impairment and diabetes, which demonstrated mixed effects on cognition and diabetes control. Limited interventions have involved family members and been tailored to the needs of both older adults with cognitive impairment and their care partners. The findings indicated the need for developing effective interventions to overcome dual care challenges for older adults with comorbid cognitive impairment and diabetes and their care partners.
The Associations of Sensory Impairment with 10‐Year Risk of Dementia and Alzheimer’s Disease: The Health and Retirement Study, 2010‐2020
Authors: Li Kun , Ghosal Rahul , Zhang Donglan , Li Yike , Lohman Matthew , Brown Monique J , Merchant Anwar T , Yang Chih‐Hsiang , Neils‐Strunjas Jean , Friedman Daniela B. , Wei Jingkai 
Published: January 2025

AbstractBackgroundAlthough visual and hearing impairment have been identified as established risk factors for dementia, evidence was limited on the association of the coexistence of these two sensory impairments with incident dementia, especially in the U.S. The study aimed to examine the associations between sensory impairment and 10‐year risk of dementia or Alzheimer’s disease.MethodA prospective cohort study was designed based on the Health and Retirement Study from 2010 to 2020. Individuals aged 50 years and older without self‐reported dementia and Alzheimer’s disease were included in the analysis. Information of self‐reported visual and hearing impairment was obtained at Wave 10 in 2010, and participants were categorized as normal, with visual impairment only, hearing impairment only, and dual sensory impairment. Main failure events included self‐reported incident dementia and Alzheimer’s disease over a 10‐year follow‐up period. Fine‐Gray competing risk regression models were applied for the associations of sensory impairment with incident dementia and Alzheimer’s disease, adjusted for demographic characteristics, health behaviors, and health conditions at baseline.ResultOf 20,248 identified individuals, 14.6% had visual impairment only, 11.2% had hearing impairment only, and 9.1% had dual impairment at baseline. After adjustment for all covariates, dual sensory impairment was associated with higher risk of dementia (hazards ratio (HR) = 1.46, 95% CI: 1.23‐1.73) and Alzheimer’s disease (HR = 1.35, 95% CI: 1.03‐1.76). Visual impairment only was associated with incident dementia (HR = 1.98, 95% CI: 1.38‐2.83) and Alzheimer’s disease (HR = 2.99, 95% CI: 1.60‐5.62) among individuals <65 years. No association was observed between hearing impairment only and incident dementia or Alzheimer’s disease.ConclusionOlder adults in the U.S. with visual and hearing impairments simultaneously had a particularly greater risk of dementia and Alzheimer’s disease, and having visual impairment alone was associated with an elevated risk of dementia; the associations were stronger among people <65 years.
Formal education, household size and cognitive outcomes among Latino individuals: Data from the Skills‐Based Educational strategies for Reduction of Vascular Events in Orange County, Ca (SERVE OC) Trial
Authors: Kurzman Alissa , Ding Xueting , Albala Bruce , Wing Jeffrey , Draughter Darnisha , Chavez Aryanna , Gutierrez Desiree , Boden‐Albala Bernadette 
Published: January 2025

AbstractBackgroundIn the United States, Latino communities are disproportionately impacted by Alzheimer’s disease and related dementias (ADRDs)1 with 11.1% and 5.3% living with mild cognitive impairment and mild dementia due to ADRDs, respectively.2 Education is known to be associated with adults’ cognitive function; greater amounts of formal education predict lower risk of dementia in late‐life.3 The Montreal Cognitive Assessment (MoCA) is dependent on the educational level of participants, recommending a 1‐point correction for ≤12 years of education when scoring the assessment. However, additional adjustments may be necessary for minority populations with average education levels ≤12 years. Less is known about household size, as a proxy of social support, and cognition. In this study we aim to evaluate education and household size with cognitive outcomes of Hispanic/Latino self‐identifying individuals residing in Southern California.MethodsBaseline data from the Skills‐Based Educational strategies for Reduction of Vascular Events in Orange County (SERVE OC) Trial were used (Grant Number P50MD017366). Study participants (n = 254) were restricted to individuals ≥18 years who self‐identified as Hispanic/Latino and completed the MoCA 8.3 in English or Spanish at baseline. MoCA scores were adjusted for education, per instrument protocol. Multivariable linear regressions estimated associations between number of household residents, education, and MoCA score, overall and by age (<50 and ≥50 years), controlling for gender and preferred language.ResultsParticipants were an average of 46.8 years (SD = 13.99) with 49.2%≥50 years; 67.2% of participants were female and 64.5% had ≤8 years of formal education. Average MoCA scores were 22.20 (SD = 3.71) and 20.67 (SD = 4.62) for individuals <50 and ≥50years respectively. For individuals ≥50 years, having ≤8 years of formal education was significantly associated with lower MoCA scores (B = ‐3.22; p<0.05) and with number of household residents trending towards intact cognition (B = 0.578, p = 0.063). For individuals <50 years, number of household residents is a significant predictor of MoCA score (B = ‐0.618, p<0.05).ConclusionUnderstanding the impact of education and household size is important when assessing memory/cognitive outcomes of Latino individuals. Research is needed to better understand if/how the MoCA should be further adjusted in underrepresented populations and the impact of household composition and dynamics on cognitive impairment.
Interrelationships among an Inflammatory Diet and Helicobacter pylori infection on Cognition in older adults
Authors: Chou Yi‐Chun , Han Ming‐Lun , Chiu Tina H.T. , Lee Meei‐Shyuan , Chiou Jeng‐Min , Chen Yen‐Ching , Chen Jen‐Hau 
Published: January 2025

AbstractBackgroundThe role of diet in modulating inflammation and its potential impact on cognition has raised attention. Additionally, recent research has addressed the disruption of the gut‐brain axis in dementia development. This study aims to explore how the interactions between inflammatory diets and Helicobacter pylori (Hp) infection affect cognitive domains in older adults.MethodThis eight‐year prospective cohort study recruited 511 non‐demented community‐dwelling older adults (age≥65 years) in the Taipei Metropolitan area from 2011 to 2019. At baseline, we assessed dietary inflammatory potential using the Empirical Dietary Inflammatory Index (EDII) through a 44‐item semi‐quantitative food frequency questionnaire. The level of Hp immunoglobulin G (IgG) was determined. Global and domain‐specific cognition were evaluated at baseline and biennial follow‐ups. A generalized linear mixed model was used to examine the association between EDII and cognition adjusting for important covariates. Stratified analyses by Hp seropositivity were conducted, and its interactions with EDII were tested.ResultThe average age of the study participants was 72.6 years with women accounting for 53%. Each additional increment in EDII (i.e., a more pro‐inflammatory diet) was associated with poor memory performance (logical memory‐immediate free recall: β = ‐0.69 and delayed free recall: β = ‐0.72). After stratification, one unit increment in EDII was associated with poor performance of global cognition (MoCA‐T: β = ‐1.68) and memory (logical memory‐immediate free recall: β = ‐1.07; delay free recall: β = ‐1.02) among participants with Hp seropositivity (Hp IgG ≥1.1 U/mL). Additionally, significant interactions were found between EDII and Hp seropositivity in the domains of executive function (pinteraction
= 0.08) and attention (pinteraction
= 0.02).ConclusionOur findings suggest that an inflammatory diet interacts synergistically with Hp infection, contributing to poor cognition. Preventing cognitive decline necessitates a holistic approach including healthy eating and Hp eradication.
Association between Self‐rated Health Status and Anxiety Symptoms in U.S. Adults with Dementia
Authors: Hong Ickpyo , LEE HOKYUNG 
Published: January 2025

AbstractBackgroundSelf‐rated health status goes beyond a mere indicator of one’s well‐being, encompassing biological, social, and functional aspects. It has emerged as a significant variable in predicting mortality. Against this backdrop, understanding the impact of subjective health status on anxiety symptoms is crucial for individuals with dementia. In patients with dementia, subjective health status reflects personal perception. Understanding how this relates to their anxiety symptoms can help develop effective health management and support strategies for them.MethodThis study utilizes the 2022 National Health and Aging Trends Study (NHATS). The relationship between subjective health status and anxiety symptoms among American adults diagnosed with dementia was examined using multivariate logistic regression analysis. The independent variable in this study was the self‐reported subjective health status, either positive or negative, among patients with dementia. The dependent variable was the level of anxiety symptoms, measured using the GAD‐2 questionnaire. Covariates include sex, age, race, and employment status.ResultIn this study of 1,176 subjects, a majority (90.65%) reported a positive perception of their health status. Demographically, women constituted a slightly larger proportion (58.35%), and the positive evaluation of subjective health status was predominantly observed in those aged over 80. The findings reveal a significant difference between dementia patients who perceived their health status positively and those who did not.. In particular, those with positive subjective health status experienced less anxiety, and women reported more anxiety symptoms than men (P = .0223, OR = 0.602; P < .05, OR = 1.653). Age and race differences in anxiety symptoms were generally not statistically significant, while black individuals tended to experience less anxiety than white individuals (P = .0269, OR = 0.709).ConclusionThis study indicated a significant association between subjective health status and anxiety symptoms among adult dementia patients in the United States. The majority of participants positively assessed their health, and this positive subjective health perception was associated with a reduction in anxiety symptoms. These findings underscore the importance of personalized approaches in mental health management for dementia patients, taking into account gender and racial factors.
Improvement of Knowledge and Research Attitudes on Preclinical Alzheimer’s Disease Trials through Community‐based Education Among Underrepresented Korean, Filipino, and Hispanic Americans
Authors: Shin Hye‐Won , Tallakson Melanie B , Duran Edwin , Russ Eunji , Hoang Dan , Romero Romina A , Sultzer David L , Grill Joshua D , Salazar Christian R 
Published: January 2025

AbstractBackgroundRacial and ethnic minorities, including Hispanic/Latino, Asian American and Pacific Islander individuals, lack adequate representation in preclinical Alzheimer’s disease (AD) trials. This study sought to examine the effectiveness of a culturally and linguistically appropriate community‐based educational intervention in enhancing knowledge and awareness of the AHEAD 3‐45 preclinical AD trial among underrepresented Filipino, Korean, and Hispanic/Latino Americans.MethodWith professional nursing and other partner organizations, we conducted 21 community‐based educational sessions for underrepresented older adults of Filipino, Korean, and Hispanic/Latino backgrounds. In addition to sociodemographic data, we collected the 7‐item Research Attitude Questionnaire (RAQ; Range 7‐35) and a 6‐item Knowledge Questionnaire about the AHEAD 3‐45 preclinical AD trial (Range 0‐6) before and after the educational intervention. Pre‐ and post‐summary scores were generated for both assessments. Paired t‐tests assessed changes in research attitudes and knowledge concerning the AHEAD 3‐45 trial.ResultAmong 654 attendees of the educational interventions, 472 (72%) completed surveys (Table 1). Most were women (77%), immigrants (83%), and had a primary language other than English (70%). The average age was 59 (16) years. Survey responses were obtained in English (41%), Spanish (29%), and Korean (30%). The primary motivations reported by attendees for attending the event were gaining information (48%) and concerns about memory loss for self and/or family members (41%).Knowledge of the AHEAD 3‐45 preclinical AD trial was significantly increased from a mean of 2.15 (SD 2.2) at baseline to 4.32 (SD 1.9) post‐educational intervention (p < 0.0001, Table 2). Overall RAQ scores remained unchanged for the sample and among Filipino, Korean, and Hispanic/Latino American subgroups (Table 3A), the educational intervention had a positive impact on the research attitudes of attendees under 55 years old (Table 3B)ConclusionOur findings indicate the potential effectiveness of culturally and linguistically tailored educational interventions in fostering increased awareness and knowledge of preclinical AD research among Filipino, Korean, and Hispanic/Latino Americans. However, this single intervention did not affect research attitudes overall or in different subgroups most relevant to the AHEAD 3‐45 trial (55 years and older), underscoring the need for additional tailored strategies to enhance representation in preclinical Alzheimer’s disease research.
Long‐term exposure to non‐steroidal anti‐inflammatory (NSAID) medication in relation to dementia risk: a population‐based cohort study
Authors: vom Hofe Ilse , Stricker Bruno H. , Ikram M. Kamran , Wolters Frank J. , Ikram M. Arfan 
Published: January 2025

AbstractBackgroundNon‐steroidal anti‐inflammatory (NSAID) medication are suggested to have beneficial effects in the prevention of Alzheimer’s disease, due to anti‐inflammatory and possibly amyloid‐lowering properties. However, the results of observational studies and randomized‐controlled trials have been inconsistent, and duration and dose‐response relationships are still unclear.MethodWe included 11,745 dementia‐free participants from the prospective population‐based Rotterdam Study (59.5% women, mean age 66.2 years). NSAID use from 1991 was derived from pharmacy dispensing records, from which we determined cumulative duration and dose. We defined four mutually exclusive categories of cumulative use: non‐use, short‐term use (<1 month), intermediate‐term use (between 1‐24 months), and long‐term use (>24 months). We determined the association with dementia risk until 2020 using Cox regression models, including NSAID use as time‐varying exposure. Models were adjusted for lifestyle factors, comorbidity and comedication use. We repeated the analyses stratified by previously established amyloid‐lowering properties of different NSAIDs.ResultDuring an average follow‐up period of 14.5 years, a total of 9,520 (81.1%) participants had used NSAIDs at any given time, and 2,091 participants developed dementia. Use of NSAIDs was associated with lower dementia risk for long‐term users (hazard ratio (HR) [95%CI]: 0.88[0.84;0.91]), but not with short‐term use (HR[95%CI]: 1.04[1.02;1.07]) or intermediate term use (HR[95%CI]: 1.04[1.02;1.06]). The cumulative dose of NSAIDs was not associated with decreased dementia risk (HR[95%CI] for <25th percentile: 1.06[1.03;1.09], 25‐50th percentile: 1.02[0.99;1.05], 51‐75th percentile: 1.03[0.99;1.06], >75th percentile: 0.99[0.96;1.02]). Associations were somewhat stronger for NSAIDs without known effects on amyloid than for amyloid‐lowering NSAIDs (HR[95%CI]: 0.79[0.74;0.85] versus 0.89[0.85;0.93]).ConclusionLong‐term NSAID use, but not cumulative dose, was associated with decreased dementia risk. This suggests that prolonged rather than intensive exposure to anti‐inflammatory medication may hold potential for dementia prevention.
Reasons for screening failure in the evoke and evoke+ trials of semaglutide for early AD
Authors: Sano Mary , Cummings Jeffrey L. , Feldman Howard H. , Hansson Oskar , van der Flier Wiesje M. , Bardtrum Lars , Jeppesen Rose , Johannsen Peter , Léon Teresa , Hansen Charlotte T. , Scheltens Philip 
Published: January 2025

AbstractBackgroundAlzheimer’s disease (AD) trials report a high screening failure rate (potentially eligible trial candidates who do not meet inclusion/exclusion criteria during screening) due to multiple factors including stringent eligibility criteria. Here, we report the main reasons for screening failure in the 12‐week screening phase of the ongoing evoke (NCT04777396) and evoke+ (NCT04777409) trials of semaglutide in early AD.MethodKey inclusion criteria were age 55‐85 years; mild cognitive impairment due to AD (Clinical Dementia Rating [CDR] global score of 0.5 plus CDR of ≥0.5 in ≥1 of three activities of daily living categories) or mild AD dementia (CDR global score of 1.0); Repeatable Battery for the Assessment of Neuropsychological Status delayed memory index (RBANS‐DMI) score ≤85; Mini‐Mental State Examination (MMSE) score ≥22; amyloid positivity (confirmed by positron emission tomography or cerebrospinal fluid). Additionally, evoke+ allowed the inclusion of participants with significant small vessel pathology (>1 lacunar infarct and/or age‐related white matter changes >2 [white matter >20 mm]). Among the exclusion criteria were evidence of neurological disorders other than AD; evidence of a clinically relevant or unstable psychiatric disorder; magnetic resonance imaging (MRI)/computerized tomography (CT) scan suggestive of clinically significant structural central nervous system (CNS) disease (other than the changes allowed for evoke+) nor suggestive of strategic infarcts. Screening failure rates were summarized descriptively. Data cleaning of the 3806 randomized individuals is ongoing in evoke/evoke+.ResultThe total number of screening failures was 2,836 (58.6%) in evoke and 3,087 (59.8%) in evoke+. The top five categories of screening failure in evoke and evoke+ were RBANS‐DMI score ≤85, MMSE score ≥22, amyloid positivity, CDR score, and MRI/CT scan suggestive of CNS disease (other than the changes allowed for evoke+) or strategic infarcts (Figure). This reflected the hierarchical procedure applied during screening, whereby individuals were firstly assessed on cognitive scores, followed by exclusion of other neurological disorders and, lastly, confirmation of amyloid positivity.ConclusionThe hierarchical screening procedure in evoke and evoke+ resulted in most ineligible patients being excluded early in the screening process. The main reasons for screen failure were cognitive assessment scores.