bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technology Assistance in Dementia (Tech‐AiD): Leveraging Everyday Technologies to Support Dementia Care
Authors: Kiselica Andrew M 
Published: January 2025

AbstractBackgroundCare partners to persons with dementia increasingly use everyday technologies, like smartphones, smart speakers, and wearable device, to improve care and minimize burden. However, there remains a significant gap in effective implementation of these devices in care routines. For example, while as many 90% of care partners own smartphones, less than 50% use these devices on a daily basis, and less than 30% take advantage of their assistive features. As a result, functions that may aid in caring, like GPS for navigation, notes for to‐do lists, and alarm reminders for appointments, are not routinely employed. Thus, there is a need for interventions to improve effective digital technology use among care partners to persons with dementia. This presentation will describe progress in developing a novel program to meet this need, called Technology Assistance in Dementia (Tech‐AiD).MethodsThe presenter will discuss results from four Stage I behavioral intervention development studies, including a qualitative interview study of 22 care partners to better understand technology use, a survey study of 100 care partners to develop improved measures of technology‐based strategies, development of an intervention framework, and a mixed methods study among 10 care partners and 10 healthcare professionals to gather feedback on the intervention.ResultsAn initial qualitative research study highlighted six domains of technology use in dementia care and also brought to light drawbacks of technology use, including cost, complexity, and privacy concerns. Next, the survey resulted in the development of the Technology in Caring Questionnaire (TCQ) to capture technology‐based strategy use. These studies informed the development of a treatment framework for Tech‐AiD, which was rated as appropriate, feasible, and acceptable by care partners and healthcare professionals.ConclusionsThe findings set the stage for a Stage IB pilot randomized control trial of Tech‐AiD to evaluate its feasibility, acceptability, and preliminary efficacy.
Communication Bridge 2: Primary and secondary outcomes from a global telehealth randomized controlled trial for persons with primary progressive aphasia and their communication partners
Authors: Rogalski Emily J , Rademaker Alfred , Mooney Aimee , Fried‐Oken Melanie , Bona Matthew , Roberts Angela C 
Published: January 2025

AbstractBackgroundPrimary progressive aphasia (PPA) is a currently incurable and relatively rare language‐based neurodegenerative dementia syndrome, which negatively impacts communication and quality of life. Non‐pharmacologic interventions show promise but have lacked randomized controlled trials (RCT). Here we report outcomes for Communication Bridge‐2 (CB2), the first global telemedicine speech‐language (RCT) for PPA.MethodCB2 is an international, single enrollment site, Phase 2, Stage 2, parallel‐group, active control, behavioral RCT delivered via video‐chat to individuals with PPA and their communication partners. CB2 is supported by a custom web application. Participants were randomized 3:2 into one of two arms: Communication Bridge™ a dyadic intervention based on communication participation models, or, the Control intervention, a non‐dyadic intervention based on impairment models. Participants completed two intervention blocks over ∼12 months. Primary outcomes included communication confidence and participation measures assessed at baseline, each intervention block, and ∼12 months post‐enrollment. Other outcomes included word and script performance. Post‐study interviews captured participant experiences and informed feasibility.ResultNinety‐five PPA participant dyads (mean enrollment age of PPA participants: 67.1 years, 49% female) were randomized (n = 4 countries). Dropout was <10%. Procedural and documentation fidelity were high (>90%, for both). Theoretical fidelity showed strong within‐arm alignment. Experimental arm superiority was demonstrated at Block 1 for the Goal Attainment Scale, measurement, a primary participation outcome evaluated by a blinded clinician. The Communicative Participation Item Bank showed positive within‐group responsiveness at Block 1 exclusively for the experimental arm. Communication confidence measurement was less responsive. Other outcomes including word and script training, showed significant gains at Block 1 for both groups. Post‐study interviews suggested high feasibility.ConclusionResults suggest feasibility and initial efficacy for a global telemedicine intervention, providing an exciting path for implementation and dissemination of clinically meaningful interventions for Alzheimer’s and related dementias using telehealth models that can improve care access.
Digital Assessment Approaches to Overcome Barriers to Cognitive Screening and Monitoring for Older Adults in Primary Care Settings
Authors: Thompson Louisa I. 
Published: January 2025

AbstractBackgroundRoutine cognitive screening for older adults in primary care could improve AD early detection and streamline referrals for treatment or clinical trials. Digital assessments, especially when self‐administered online, can overcome time barriers to cognitive screening in primary care settings and are conducive to repeat testing for disease monitoring and the evaluation of treatment outcomes. We report preliminary data on the feasibility and acceptability of three digital screening approaches for older adults completing annual follow‐up visits with a primary care provider (PCP)MethodsCognitive screening approaches included: 1) remote online screening with the Boston Online Cognitive Assessment (BOCA) 1‐4 weeks prior to the PCP appointment, 2) self‐administered BOCA in the waiting room before or after the appointment, and 3) provider‐administered screening during the appointment using the Digital Clock and Recall (Linus Health DCRTM). Participants also completed a brief in‐clinic cognitive health consultation that included the Montreal Cognitive Assessment (MoCA), test feedback, and recommendations. Five PCPs aided in protocol development and participated in data collection. Potential participants were identified using EMR. Exclusion criteria: dementia or other neurological disease, score of <13 on the t‐MoCA.Results48 older adults ages 55‐85 were screened, 34 enrolled, and 4 withdrew. The sample is 54% female, 84% White, education M = 14.8 years. Self‐administration of BOCA in waiting room was discontinued early due to space, time, and coordination challenges. Participants instead completed a second at‐home administration of the BOCA on the day of their appointment. Completion rates were 81% for advance BOCA, 62% for same‐day BOCA, and 86% for in‐clinic DCR. Higher priority health issues and not returning for the consultation visit were primary reasons for withdrawal. Most participants reported a preference for screening at home compared to in‐clinic.ConclusionsAt‐home, self‐administered assessment online and in‐clinic, provider‐administered assessment on a tablet both show preliminary evidence of feasibility and acceptability for cognitive screening and monitoring use in primary care.
Clonal hematopoiesis is associated with a seven‐year delay in the onset of Alzheimer’s disease in APOE ε4/ε4 cases
Authors: Guen Yann Le , Park Junyoung , Talozzi Lia , Belloy Michael E. , Greicius Michael D 
Published: January 2025

AbstractBackgroundRecently, clonal hematopoiesis of indeterminate potential (CHIP) was found to be associated with a reduced risk of Alzheimer’s disease (AD) and somatic mutations found in the blood of CHIP carriers were also in microglia‐enriched brain samples (Bouzid et al., 2023, Nature Medicine). We aimed to validate this finding in a larger dataset, explore the effect across APOE genotypes, and examine the association of CHIP with age‐at‐onset.MethodBouzid et al. (2023) analyzed the Alzheimer’s Disease Sequencing Project (ADSP) whole‐exome sequencing (WES) 10k subjects release and limited their analysis of this cohort to ε3/ε3 individuals, while we analyzed the new ADSP WES 20k subjects release and considered all APOE genotypes. We identified CHIP variants from joint‐called vcf files focusing on genes and variants provided in the previous study appendix. We further filtered variants requiring a median read depth above 30 among carriers and variant allele fraction below 40%. As in Bouzid et al., we restricted our analysis to European ancestry participants whose DNA was extracted from blood (Table 1). Using the generalized linear model implemented in the statsmodel Python package, we tested the association with diagnosis (Binomial family) and age‐at‐onset (Gaussian family) across and by APOE genotype. Analyses were adjusted for sex, and the first 3 principal components accounting for genetic ancestry. Additionally, the analyses considering all APOE genotypes were adjusted for ε2 and ε4 dosages.ResultWe confirmed CHIP association with reduced AD risk in ε3/ε3 individuals (OR = 0.68 [0.54; 0.86], p = 0.0016), and observed a similar direction of effect across APOE genotypes (OR = 0.77 [0.64; 0.93]; p = 0.0058), except in ε2/ε3 (Table 2). In addition, we found that CHIP was associated with 2.5 years delayed age‐at‐onset across APOE genotypes (b = 2.53 [1.27; 3.79]; p = 0.0001, Table 3), with a marked 7.7 years delayed onset in ε4/ε4 cases (b = 7.71 [2.66; 12.77]; p = 0.0028).ConclusionTaken together, these results provide stronger human genetic evidence that CHIP is associated with reduced AD risk and delayed age‐at‐onset, particularly in APOE‐ε4 carriers. These findings corroborate the notion that rescuing microglial phagocytic capacity during aging may be a therapeutic avenue for AD, most notably in APOE‐ε4 carriers.
The Relationship of Decision‐making capacity and the age of onset in Alzheimer´s Disease
Authors: Souza Natalie 
Published: January 2025

AbstractBackgroundWe investigated the relationship of decision‐making capacity in people with young‐onset Alzheimer´s Disease (YOAD) and late‐onset Alzheimer´s Disease (LOAD).MethodCross‐sectional study, with 169 (124 people with LOAD and 45 people with YOAD).ResultPeople with YOAD (young‐onset Alzheimer´s Disease) were more cognitively impaired when compared with LOAD (late‐onset Alzheimer´s Disease), but more aware of their cognitive deficits and health condition, with moderate effect sizes. All people with AD (Alzheimer´s Disease) presented deficits in the domains of decision‐making capacity, with more impairment in understanding. The majority of participants were in the mild stage of teh disease (CDR 1). The YOAD group had more years of education than the LOAD group.ConclusionA higher decision‐making capacity is involved in a better understanding in the YOAD (young‐onset Alzheimer´s Disease) group. Clinically, our findings shed light on the need to consider the differences according to age at onset of AD (Alzheimer´s Disease).
Diagnosis of Alzheimer’s disease‐ Analysis of cross‐species biomarkers
Authors: Bathla Shveta 
Published: January 2025

AbstractBackgroundAlzheimer disease (AD) is a heterogeneous multifactorial neurodegenerative disorder pathologically characterized by Aβ plaques, NFT, neuroinflammation, and synaptic and neuronal loss. The nature of most sAD cases strongly argues for an environmental link. The prominent pathological manifestations in AD patients are abnormal levels of Aβ 1‐42 (Aβ42), total tau (t‐tau) and p‐tau in brain and biofluids. Here, our goal is to find pathologically conserved phosphorylated tau signatures that are common to humans, non‐human primates and rodents, which may be utilized as biomarker candidates and/or therapy targets.MethodIn order to replicate the behaviors of AD in DKI mice (DKIhTau‐APPNL‐G‐F/NL‐G‐F), we employed a single‐step, antibody‐free method to extract tau from the prefrontal cortex, which was followed by quantitative phospho‐proteomics. We have further investigated p‐Tau changes in aged rhesus macaques which naturally develop amyloid and tau pathology at advanced ages. In the current study we have also tested whether chronic treatment with a GCPII inhibitor might also reduce tau hyperphosphorylation in aged rhesus monkeys with naturally‐occurring GCPII and tau pathology. Using an automated Lumipulse platform, we have further confirmed p‐tau (pT181 & pT217) changes in CSF (140) and plasma (∼200) in AD patients.ResultA total of 40 and 39 phosphorylation sites were measured in human and mouse tau respectively. In DKI mice, significant increase were seen in pT181, pS202, pS214, pT217, and pT396, among other markers. The western blot analysis of entorhinal cortex (ERC) of monkeys revealed higher expression level of pS214 (P = 0.0012), pT181 (P = 0.0004) and pT217 (P = 0.0235) in aged monkeys as compared to young ones which captured p‐tau signatures at very earlier stage of AD. Moreover, pT217Tau levels in dlPFC and ERC were considerably reduced in elderly macaques treated with the GCPII inhibitor, 2‐MPPA. In AD patients compared to cognitively normal, the CSF p‐tau181 concentration is considerably greater ROC‐0.9299). However, compared to plasms p‐tau181(ROC‐0.7556), plasma p‐tau217(ROC‐0.8997) demonstrated noticeably greater diagnostic accuracy.ConclusionWith the help of this study, which comprised two animal models as well as CSF and plasma from healthy and AD patients, we have developed a composite biomarker panel that shows great promise for early AD detection.
Bidirectional relation of depressive symptoms and cognitive function over 16 years follow‐up
Authors: Yin Jiamin , John Amber , Cadar Dorina 
Published: January 2025

AbstractBackgroundCognitive decline and depression often co‐occur among older adults, and they share several biological mechanisms. Despite that cognitive dysfunction has been linked to depression, the directionality of this association remains unclear. This study examined whether there is a bidirectional relationship between depressive symptoms and cognitive function in middle‐aged and older English adults over a 16‐year follow‐up period.MethodThe current analysis included 8,268 eligible participants from a nationally representative sample of community‐dwelling English older adults. These participants were examined longitudinally every other year from 2002 until 2018, resulting in a follow‐up period of up to 16 years. We used the bivariate dual change score models to estimate the multivariable associations between depressive symptoms and cognitive function, which are interchangeably used as exposures and outcomes. Cognitive measures include memory and verbal fluency tests, while the Center for Epidemiologic Studies Depression Scale evaluated depressive symptoms.ResultThe study population (n = 8,268) had an average age of 64 years at the study baseline, and 55% of the population was female. Higher depressive symptoms were cross‐sectionally correlated with poorer memory (β intercept = −0.018, standard error (SE) = 0.004, P < 0.001) and verbal fluency (β intercept = −0.009, SE = 0.004, P = 0.02) at study baseline. A steeper linear change in depressive symptoms was related to an accelerated memory change (β intercept = −0.253, SE = 0.079, P = 0.001), and a linear change in memory was associated with an acceleration in depressive symptoms over time (β intercept = 0.016, SE = 0.006, P = 0.005). This bidirectional change was not observed with verbal fluency.ConclusionGreater depressive symptoms were associated with poorer memory at baseline and steeper memory change over time. A gradual change in depressive symptoms contributed to accelerated memory loss and vice versa, suggesting that psychological mood and memory performance are intrinsically interrelated. In summary, these findings highlight the complex interplay between depressive symptoms and memory loss, underscoring the importance of integrated assessments and treatment approaches in clinical practice. Our work suggests that early intervention in depressive symptoms could provide a timely opportunity to slow down or delay memory decline in later life.
Examining Relationships Between Vitamin D Deficiency, Healthcare Access, Hispanic Ethnicity, and General Health Rating among Aging Rural West Texans: A Project FRONTIER Study
Authors: Morris Claudia , McCready Riley , McCrea Grace , Decourt Boris , Lawrence J. Josh 
Published: January 2025

AbstractBackgroundVitamin D (VD) deficiency is a risk factor for dementia and Alzheimer’s Disease (AD). Previously, we described health disparities in VD status, depression, and Hispanic ethnicity (HE) in an aging West Texas population from Project FRONTIER (Facing Rural Obstacles to Health Care Now Through Intervention, Education, and Research). Using the same sample, we examined relationships between VD status, health care access, and General Health Rating (GHR)MethodOf 299 participants in which serum 25‐hydroxyvitamin‐D levels were available, we examined relationships between access to care, VD, HE, and GHR. Logistic and linear regression analyses were performed on binary and categorical variables, respectively. We used Mann Whitney U tests for between group comparisons.ResultA significant negative association was found between the probability of health insurance and VD level (p = 0.0042). Lower VD levels were observed in uninsured (24.9 ± 1.4 ng/ml) compared to insured (29.4 ± 0.8 ng/ml) participants (p = 0.004). We found a significant negative association between VD levels and the probability of experiencing a time in the past 12 months when cost prevented seeing a doctor (n = 294, p<0.0001). We found a significant negative association between VD level and the length of time it had been since the participant had seen a doctor (p<0.0001). We found a significant negative correlation between VD level and GHR (p<0.0001). Lower VD levels were observed in HE (21.40 ng/ml) compared to non‐HE (34.00 ng/ml) participants (p<0.0001). Finally, we found a significant negative correlation between HE status and GHR (p<0.0001).ConclusionOur results reveal that insurance level, access to care, and length of time since seeing a physician likely impact VD status in this aging population. Additionally, our results reveal that VD status is negatively correlated with HE. Our results reveal that HE status and VD status likely impact GHR. Finally, the data highlights areas of healthcare in rural West Texas needing improvement, especially considering that studies show correlations between Vitamin D deficiency, dementia, and AD.
Systemic inflammation, lifestyle behaviours and dementia: A 10‐year follow‐up investigation
Authors: Hilary Leah , Frank Philipp , Cadar Dorina 
Published: January 2025

AbstractBackgroundLifestyle behaviours have been linked to dementia incidence, but their cumulative impact on dementia and the underlying mechanisms remain poorly understood. This study investigated the association of co‐occurring lifestyle behaviours with dementia incidence and the mediating role of systemic inflammation in this association.MethodThe sample comprised 3,131 participants (55.2% female) from the English Longitudinal Study of Ageing aged 52‐92 years at baseline (2008/09). Self‐reported baseline lifestyle behaviours (alcohol intake, fruit and vegetable consumption, smoking, physical activity, sleep duration, social engagement, and cognitive activity) were summed to derive an index of lifestyle behaviours, ranging from 0 to 7, with higher scores denoting a higher number of health‐risk behaviours. Incident dementia cases (n = 130, 4.2%) were identified through doctor‐diagnosed dementia, informant interviews, and health records between 2014/15 and 2018/19. Systemic inflammation was measured through fasting plasma concentrations of C‐reactive protein in 2012/13.ResultBinary logistic regression models indicated that the odds of subsequent dementia increased by 1.19 for each additional health‐risk behaviour (95% confidence intervals: 1.04, 1.37, p = .014) after adjusting for age, sex, ethnicity, wealth, education, marital status, body mass index, coronary heart disease, hypertension, stroke, and depression. However, this association was not mediated by C‐reactive protein.ConclusionCo‐occurring health‐risk behaviours were associated with higher dementia incidence up to 10 years later, underscoring the importance of modifying health‐risk behaviours for the prevention of dementia. Systemic inflammation did not explain the association between behaviours and dementia.
Retirement and Healthy Lifestyle: Mediating Effects on Life Satisfaction
Authors: Yun Sohyeon , Park Hae Yean , Kim Inhye , An Hyunseo , Shin Jiwon , Yang Hyun , Nam Sanghun 
Published: January 2025

AbstractBackgroundRetirement for elderly people marks a critical turning point in life, acting as a significant personal and social event associated with both positive and negative health impacts. Studies on elderly populations from the successful aging perspective suggest that individual efforts and external support are necessary for successful aging. The WHO emphasizes the importance of a healthy lifestyle in achieving health and well‐being in human life and indicates the need for professional programs.MethodData from 6,488 Korean adults, aged between 57 and 102 years, collected in the 2020 Korean data from the Korean Longitudinal Study on Aging (KLoSA), was used to analyze both direct and indirect effects of retirement status on life satisfaction. From the processed data, independent (retirement status), dependent (overall life satisfaction), mediating (lifestyle), and demographic characteristic variables were extracted for the mediation effect analysis. This process utilized the method of the mediating effect verification based on path analysis suggested by Baron and Kenny. To examine the statistical significance of the mediating role of lifestyle, a Sobel test was performed.ResultHealth behaviors accounted for a 14% partial mediation, while health status and social participation and activities demonstrated 70% and 96% full mediation effects, respectively. Additionally, the Sobel test results confirmed that the mediating effects of all subdimensions of lifestyle in the relationship between retirement status and overall life satisfaction were significant (p < .0001).ConclusionThese results indicate that factors determining life satisfaction and successful aging at an individual level are significantly influenced not only by physical and psychological health but also by social competence, forming social relationships, and pursuing collective values, aligning with that of previous studies. To maintain optimal health status and behaviors, efforts to maintain health are required, namely, practicing successful aging. These findings imply the need for social prescription lifestyle programs to prepare for successful aging before retirement. A healthy lifestyle can be formed through various behavioral patterns and is shaped over the long term based on individualized contexts rather than showing short‐term changes. Therefore, a strategic approach focusing on both long‐term habit formation and new habits is necessary.