bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing psychotropic medication use in patients with dementia: the impact of multimodal care‐communication skill training for medical staff in long term care hospital
Authors: Honda Miwako , Kobayashi Masaki 
Published: January 2025

AbstractBackgroundPsychotropic drug prescriptions are commonly used to manage behavioral and psychological symptoms of dementia in elderly patients in long‐term care facilities. The prevalence of psychotropic drug use in this population raises concerns due to potential side effects, polypharmacy and quality of life of the patients.AimTo assess the trends in psychotropic drug prescriptions for elderly patients with dementia following the continuous implementation of multimodal comprehensive care communication skills training for staff in a long‐term care hospital.MethodThis retrospective single‐centre cross‐sectional study utilized the database of an urban public long‐term care hospital, from 2016 to 2020. The study involved 130 hospital staff, comprising 52 nurses, 48 professional caregivers, 7 rehabilitation staff, 3 physicians, and 3 pharmacists. All staff members underwent a French origin multimodal comprehensive care communication skill training (Humanitude) from October 2014 to December 2015, followed by continuous monthly training sessions until the conclusion of the study in 2020. Antipsychotics prescription rates for patients aged over 65 years with dementia were measured throughout the study period. No significant changes in the proportion nor severity of patients' disease backgrounds were observed during the study period.ResultsA total of 506 eligible patients were identified, with a mean age of 86.0 years (IQR 81.0‐90.0), and 283 (55.9%) were women. The prescription rates for psychotropic drugs among residents with dementia showed a significant decrease (43.5% in 2016, 27.0% in 2020, p = 0.01). Notably, the prescription rates for anxiolytics demonstrated a significant reduction (from 4.7% to 0.0%), while rates for antipsychotic drugs, hypnotics, antidepressants, antiepileptic drugs, and lithium remained unchanged over time. The prescription rates for antidementia drugs significantly decreased from 15.3% to 4.0%.ConclusionThe study found a significant reduction in the prescription rates of psychotropic drugs after implementing multimodal comprehensive care communication skills training for staff at a long‐term care hospital. This outcome indicates that providing skill training to hospital staff is associated with a decrease in behavioral and psychological symptoms of dementia among patients, resulting in a reduced need for psychotropic drugs. The enhanced communication skills among long‐term care staff demonstrate a tangible impact on reducing drug use among patients with dementia.
Phospolipase D Insights: Elevated Levels in Mild Cognitive Impairment, Therapeutic Reduction in Alzheimer's Patients
Authors: Pereira Cícero Augusto Costa , Talib Leda Leme , Forlenza Orestes Vicente , Gattaz Wagner Farid 
Published: January 2025

AbstractBackgroundMembrane lipid compromise is also related to AD pathology, a large family of enzymes such as phospholipases that act on membrane integrity, cell signaling, and cellular processes is impaired during the disease phase. Membrane integrity is affected by the B amyloid by the pathological process of AD, moreover, releasing neurotoxic enzymes and vesicles consequently losing important neurotransmitters. Dysregulation of phospholipase D (PLD) can disrupt the plasma membrane and potentially contribute to worsening AD pathology.MethodThe study was conducted at the Institute of Psychiatry, University of Sao Paulo Medical School, Brazil. The plasma samples consisted of Mild Cognitive Impairment (MCI) (n = 20), AD patients (n = 18), and healthy controls (HC) (n = 19). Subjects with other psychiatric or neurological disorders were excluded. PLD activity was measured by a fluorescence method in duplicate by the Amplex® Red Phospholipase D Assay Kit (Thermo Fisher Scientific).ResultPLD activity showed an increase significantly in the MCL group compared to other groups (p=0.030).ConclusionThe early stages of dementia have high PLD activity. Our results suggest increased PLD activity significantly in MCL individuals compared to other groups. The highlight its AD with treatment has a decrease in PLD activity compared to other groups.
Utility of the PROMIS Physical Function measure using differential item functioning among individuals with cognitive impairment
Authors: Lovett Rebecca , Russell Andrea , Vogeley Abigail , Bonham Morgan , Graham Eileen , Mroczek Daniel , Yoshino‐Benavente Julia , O'Conor Rachel , Opsasnick Lauren , Batio Stephanie , Wolf Michael S 
Published: January 2025

AbstractBackgroundImpaired functional status is a central diagnostic feature of Alzheimer’s disease and related dementias (ADRD). Informant reporting is often relied upon, given concerns surrounding the ability of persons with ADRD to validly self‐report symptoms. We sought to investigate how cognitive impairment severity impacts psychometric properties of the Patient‐Reported Outcomes Measurement Information System Physical Function (PROMIS‐PF) scale.MethodsData from 396 older adults participating in a longitudinal cohort study on aging was used for this analysis. Cognitive function was assessed using an extensive neuropsychological battery consisting of 13 tests across 5 cognitive domains; z‐scores were calculated for each test and used to determine cognitive impairment severity. Physical function was measured using the PROMIS‐PF short‐form 10a. Differential item functioning (DIF) analyses were conducted using the lordif package in R with Monte Carlo simulations.ResultsParticipants were on average 71.2 years old (SD 5.3), primarily female (72.0%), white (54.3%), and well‐educated (60.0% at least some college). Nearly two‐thirds were cognitively normal (72.5%), while 14.4% and 13.4% had a mild and moderate/severe cognitive impairment, respectively. Seven out of 10 PROMIS‐SF items were flagged for DIF. Direction of DIF varied; participants with mild impairment exhibited a tendency to underestimate their physical function, while those with moderate/severe impairment were characterized by a tendency to overestimate. McFaddens pseudo R2 effect sizes were all below published thresholds of 0.13 (range: 0.01‐0.05). Test characteristic curves (TCC) were overlapping between the 3 groups.ConclusionsFindings indicate the presence of DIF by cognitive impairment severity on the PROMIS‐PF measure, although the magnitude of effect and overlapping TCC curves suggest the observed DIF was negligible. Nevertheless, researchers and clinicians should be aware that individuals with a cognitive impairment may respond differently to certain items on this measure and further study is needed to evaluate measurement bias among patients with cognitive impairment, including ADRD. However, overall, our evidence suggests patients with varying levels of cognitive impairment can provide reliable estimates of physical function using this measure. This has implications for researchers and clinicians seeking to assess functional status among older adults with ADRD, particularly if supplemental reports of functional status are not feasible or unavailable.
Immigration Status and Cognitive Function among Older Adults
Authors: Cheng Yan , Lakdawala Adnan , Ahmed Ali , Zamrini Edward , Zeng Qing 
Published: January 2025

AbstractBackgroundPrior research on immigration and cognitive functioning was limited with conflicting findings. This study seeks to understand the association between immigration status and cognitive function in a representative sample of the US population and examine physical activity and nutritional intake’s interaction with immigration status.MethodThe study cohort included 2,898 participants (673 immigrants and 2225 non‐immigrants) from US National Health and Nutrition Examination Survey (NHANES) 2011‐2014 who underwent at least one cognitive function test. Demographics, vital signs, cardiovascular diseases, physical activity, and nutrition were compared between immigrants and non‐immigrants by mean or proportion. Standardized z‐scores were calculated for each nutrient to ensure comparability. Cognitive function was assessed through four test scores (animal fluency, digit symbol, Consortium to Establish a Registry for Alzheimer’s Disease [CERAD], and global score). To account for potential cognitive disparities, standardized z‐scores were calculated for cognitive function scores within age, education, and language strata. Scores in the lowest quartile were classified as low. Multivariate logistic regressions were conducted to estimate the association between immigration status and risk of low standardized cognitive function scores, adjusting for all covariates. NHANES survey weights were applied to ensure the results are representative of US civilians.ResultCompared to the non‐immigrants, the immigrants in our sample were younger and less educated. (Table 1). Our analysis found that being an immigrant was significantly associated with a low global cognitive function score (OR = 2.13, 95% CI = (1.34, 3.40), p = 0.0024) (Table 2). Higher protein, folate and theobromine intakes were associated with a higher global cognitive function score, while higher carbohydrate and zinc intakes were associated with a lower score. No interaction was found between nutrient intakes and immigration status. Increased physical activity was associated with the reduced risk of low animal fluency score, especially beneficial in non‐immigrants (Figure 1).ConclusionBeing an immigrant was associated with low cognitive function after controlling age, education, language, and other covariates. A higher intake of protein, folate, and theobromine were found to be protective, though they did not have significant interactions with immigrant status.
Exploring digital cognitive measures as non‐invasive biomarkers: Association with AD plasma biomarkers
Authors: Ding Huitong , Karjadi Cody , Devine Sherral A. , Gurnani Ashita S. , Sunderaraman Preeti , Mez Jesse , Farrer Lindsay A. , Au Rhoda , Lin Honghuang 
Published: January 2025

AbstractBackgroundPlasma amyloid and tau levels are known to be associated with the risk of Alzheimer’s disease (AD). In recent years, digital cognitive assessment has been increasingly recognized as a potential tool for long‐term cognitive monitoring. This study aims to explore the potential of digital cognitive metrics as efficient and low‐cost alternatives to plasma biomarkers.MethodThis study included participants from the Framingham Heart Study who had either their spoken responses to neuropsychological examinations digitally recorded or had completed the digital Clock Test (dCDT), along with plasma biomarker measurements taken within five years. Simoa™ Tau 2.0 Kit and INNO‐BIA plasma Aβ were used for tau, and Aβ40 and Aβ42 measurement, respectively. The study analyzed digital cognitive metrics, comprising 65 acoustic features extracted via OpenSMILE software and 101 features derived from the dCDT. Linear regression models, adjusted for age and sex, were employed to examine the association between these digital cognitive metrics and plasma total tau, Aβ40, and Aβ42 levels.ResultThis study included 4274 participants (mean age 57±14 years old, 53.7% women). Table 1 shows the top digital cognitive metrics associated with plasma biomarkers. Notably, plasma total tau was associated with 38 acoustic features. The most significant association was observed between audspec_lengthL1norm (sum of the auditory spectrum) and plasma tau (beta=‐0.09, SE = 0.03, P<0.001). Among the dCDT features, COMTotInkLengthCC, which represents the total drawing length of pen strokes in the command clock drawing, showed the most significant association with the plasma total tau level (beta=‐0.13, SE = 0.06, P=0.023).ConclusionOur results demonstrate an association between acoustic and digital clock drawing with plasma total tau, which is consistent with previous research that finds that cognitive performance is linked to AD tau pathology. These results highlight the promise of these digital cognitive metrics as an easily scalable, low‐cost screening tool for those at high risk for AD. Future investigations to test the robustness of digital cognitive metrics as a surrogate screening measure will be critical in tackling AD pathology.
Deep‐learning‐based Polygenic Dementia Risk for Alzheimer’s Disease
Authors: Li Linke , Gurcan Metin Nafi , Luo Sheng , Ma Da 
Published: January 2025

AbstractBackgroundAlzheimer’s Disease (AD) is a common form of dementia among the elderly with a large percentage of estimated heritability. Conventional polygenic risk analysis only accounts for the linearly combined genomic effects of single nucleotide polymorphisms (SNPs). On the other hand, a deep‐learning‐based approach is able to uncover nonlinearly associated effects from data with high‐dimensional features such as genomics. This study aims to derive deep‐learning‐based polygenic risk analysis for AD through deep‐learning‐based classification analysis.Methods793 patients’ genetic data were extracted from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) GO/2 cohorts genetic database, with sex, age, and dementia diagnosis data extracted from ADNI clinical data. After quality control, 760 patients remained in the study and their SNP data was then imputed. Genome‐wide association study (GWAS) was conducted to determine the chromosome for study. One‐dimensional convolutional neural networks (1D‐CNN) were trained to discern phenotype‐associated SNPs for developing disease classification models. Subjects were classified into either cognitively normal & mild cognitive impaired (N = 542), or diagnosed with AD (N = 212) during the study period. The categorical information of SNPs (0, 1, or 2 alleles) on chromosome 19, containing APOE genes, was used as the input features for 1D‐CNN‐based disease case classifier model, with a 75/25 train/test split to evaluate. The weighted cross‐entropy function was used for the imbalanced AD and non‐AD cases in the samples.ResultsGWAS results showed strongest AD association for chromosome 19, which was selected for CNN dementia classification model training, while potential associated SNPs were also revealed on chromosome 1 (Figure 1). The model achieved area‐under‐the‐curve (AUC‐ROC) of 0.60. The sensitivity and specificity are 39.06% and 77.78%, respectively, and the balanced accuracy is 58.42%. Figure 2 shows the corresponding confusion matrix.ConclusionThe GWAS results reinforce the APOE region’s established association with AD. The 1D‐CNN’s model tended to misclassify diseased individuals, potentially due to the fact of including MCI patients with a potential risk of AD in the control group. Future work will include refining the model hyperparameter as well as collecting a more disease‐balanced dataset.
Subject‐level Detection of Focal Neurodegeneration Using Spatiotemporal Connectomics: Towards Atrophy Characterization in Preclinical Alzheimer’s Disease
Authors: Sánchez Cristina , Diez Ibai , Bueichekú Elisenda , Kim Chan‐Mi , Grothe Michel J. , Sanchez‐Juan Pascual , Sepulcre Jorge 
Published: January 2025

AbstractBackgroundBrain atrophy is a normal part of healthy aging, but it is aggravated by several neurodegenerative diseases. Previous studies have described a large heterogeneity in individual neurodegeneration patterns, but the underlying brain mechanisms are currently not fully understood. From a graph theory‐based framework, the estimation of subject‐specific focal or multifocal brain atrophy in healthy aging and in the preclinical stage of different neurodegenerative diseases, such as Alzheimer's disease (AD), will help to better understand individual atrophy networks and likely improve prediction of phenotypic heterogeneity in disease trajectories. This study aimed to develop a novel spatiotemporal connectomic method based on graph theory applied to serial MRI measurements to identify neurodegeneration focality (i.e., unifocal or multifocal atrophy patterns) in healthy aging at the single‐subject level.MethodThe study included a unique sample of 79 older cognitively normal participants from the the Vallecas project who underwent longitudinal T1 MRI scanning with 8 follow‐up timepoints over 9,46±1,97 years. Voxel‐based morphometry was used to define the brain atrophy topology of each subject, and uni‐ or multifocal atrophy patterns were identified using a graph theory approach based on structural similarity between each voxel and the rest of the brain across serial gray matter measurements (Figure 1).ResultWe identified individualized atrophy phenotypes characterized by different graph morphologies (Figure 2), which could be classified into three main groups based on their connectivity behavior. One group of subjects was characterized by atrophic voxels with a coordinated behavior, another with a predominance towards divergent or discoordinated behavior, and a third group that laid between these two extremes.ConclusionWe present a novel analytical tool for characterizing individualized atrophy phenotypes in healthy subjects based on graph theory and structural similarity analyses of longitudinal MRI data. This method may help to describe the first structural events in preclinical AD and other neurodegenerative diseases and, therefore, could be crucial for predicting differences in disease phenotype and progression in single subjects.
Caregiver Needs and Resources—2023 Summer Styles Survey, United States
Authors: Walker Jenny A , Kilmer Greta 
Published: January 2025

AbstractBackgroundThe United States population is aging, with more individuals requiring care—a shift that has made addressing the needs of the nation’s caregiver population a public health priority. Understanding the resources caregivers use and need can inform those public health efforts.MethodWe examined 2023 Summer Styles survey data addressing caregiver services and support among U.S. adult caregivers (n = 437). Participants responded to questions about their need for and utilization of seven resources: out‐of‐home services, in‐home services, support groups or classes, care recipient food and nutrition support services, care recipient transportation services, care recipient financial planning services, and caregiver training opportunities. We further analyzed results from caregivers reporting that it was somewhat or very difficult to afford household expenses (n = 90), and those who care for a person with dementia or another cognitive impairment (n = 96). All percentages were weighted to match the U.S. Current Population Survey proportions.ResultOverall, 45.5% of the surveyed caregivers indicated that they have utilized or would utilize one or more resource type. In‐home services were the most common (33.1%), followed by transportation services (26.6%) and care recipient food and nutrition services (25.2%). Care recipient financial planning resources were the least common (13.0%). About one third (34.2%) of caregivers indicated they would use at least one of the seven resources, but that it was unavailable or not known to be available to them. Among caregivers who struggle with household expenses, transportation services were the most frequently identified (29.3%) resource they would use if available. Among those who care for a person with dementia or another cognitive impairment, in‐home services was the most frequently identified (21.8%) resource they would use if available.ConclusionThese results suggest that caregiver resource use and need varies qualitatively based on financial limitations and the diagnosis of the care recipients. Additionally, over a third of caregiver respondents indicated that they would use a service or tool, but it is currently not available or known to be available to them. These results can help inform public health decision‐making in addressing the needs of the nation’s caregivers.
Does education years delay Alzheimer’s disease in cognitively normal oldest old?
Authors: Sohrabi Hamid R , Goozee Kathryn G , Weinborn Michael , Smith Stephanie Rainey , Taddei Kevin , Martins Ralph N 
Published: January 2025

AbstractBackgroundResearch on cognitive reserve (CR) in individuals aged 80 years old and above has resulted in inconsistent findings, mostly showing a relationship with baseline cognitive abilities but not follow up assessments. The effects of amyloid burden on the relationship between CR, cognitive decline and dementia in oldest old warrants further study in the presence of APOE e4. We hypothesised that CR in oldest old (≥80 yrs old) adults will result in different trajectories, depending on being amyloid PET positive or negative. Specifically, this study was to determine whether the relationship between CR and cognition is mediated by amyloid load in very old individuals.MethodData of 115 participants aged 80 years and above at baseline and one follow‐up was analysed for this study. Participants were recruited from the Western Australia Memory Study (WAMS, Perth) and the Kerr Anglican Retirement Village Initiative in Ageing Health (KARVIAH) Study (Sydney, Australia). In both sites participants have undergone amyloid imaging, as well as a comprehensive neuropsychological assessment, APOE genotyping and AD‐related blood‐based biomarkers analysis.ResultPreliminary results indicated a non‐significant relationship between education years, as the proxy for CR, and baseline cognition. Similar not‐significant findings was observed between CR and amyloid load. Individuals positive or negative for amyloid burden on the brain at baseline, as well as carriage of APOE e4 did not differ on years of education. Of interest, APOE e4 allele carriers were not different from not‐carriers on amyloid load in the brain. Due to nonsignificant relationships between the variables of interest, in both cross‐sectional as well as longitudinal data, further mediation analysis was not carried out.ConclusionOur nonsignificant results indicated that the commonly reported relationship between CR, cognitive function, amyloid load in older adults may not be present in individuals aged 80 years old and above. Although these findings are consistent with previous reports, other factors including longevity genetic factors that promote preserving cognition in oldest adults as well as lifestyle factors should be considered. Further analysis of such factors is currently ongoing and may result in interesting outcomes for this cohort.