bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Plasma P‐Tau‐217 And Amyloid PET In Racial And Ethnic Underrepresented Groups (RE‐URG) Compared With Non‐RE‐URG In LEARN And A4
Authors: Molina‐Henry Doris P. , Langford Oliver , Donohue Michael C. , Raman Rema , Yaari Roy , Sims John R. , Holdridge Karen Chilcott , Aisen Paul S. S. , Johnson Keith A , Rissman Robert A. , Sperling Reisa A ,   The A4 Study Team
Published: January 2025

AbstractBackgroundIndividuals from diverse racial and ethnic groups are severely underrepresented in AD trials in part due to disproportionate biomarker ineligibility. Evidence from recent studies support plasma phosphorylated tau (P‐tau217) as an early marker for brain Aβ pathology and a reliable marker in predicting elevated brain amyloid PET in cognitively unimpaired adults. We examined the relationship between P‐tau217 and florbetapir PET standard uptake value ratios (SUVR) by self‐reported racial and ethnic groups in preclinical AD studies.MethodsWe examined the relationship between baseline florbeptair PET SUVR and plasma P‐tau217 levels (as determined by the electrochemiluminescence immunoassay), in cognitively unimpaired adults ages 65‐85 with elevated amyloid PET (A4 Study, placebo arm, N=522) and participants who did not display elevated amyloid but were otherwise eligible for the A4 Study (LEARN, N=471). Given the small numbers across each subpopulation, participants were grouped into racial and ethnic underrepresented groups (RE‐URG; N=100) and non‐RE‐URG (N=893), based on their self‐identified race and ethnicity. A linear regression model was fit to determine differences in the relationship between plasma P‐tau217 and florbetapir PET SUVR by RE‐URG status, adjusting for age, and APOE ϵ4 carrier status.ResultsDemographic characteristics of RE‐URG (N=100) and non‐URG (N=893) are displayed in the Table. Groups were balanced across, age, sex, and education, with a higher proportion of APOE ℇ4 carriers among non‐RE‐URG (38.8%) vs RE‐URG (24.0%). Mean plasma P‐tau217 levels were the same across groups (Table). Results from the linear regression model suggest that the relationship between P‐tau217 and florbetapir PET SUVR was similar across groups (p=0.22). Furthermore, APOE ℇ4 carrier status did not influence the relationship in either group (RE‐URG p=0.61; non‐RE‐URG p=0.09).ConclusionThese findings suggest that there is no difference in the relationship between plasma P‐tau217 and elevated amyloid on florbetapir PET across racial and ethnic groups. Future analyses should corroborate these findings in a larger sample size, across different RE‐URG sub‐populations and examine whether plasma P‐tau217 reflects the differential amyloid prevalence previously reported for other biomarkers of amyloid.Acknowledgment: Lilly Clinical Diagnostics Laboratory for the performance of P‐tau217 testing.
Association Between Baseline Plasma p‐tau181 Levels and Cognitive Trajectory in Healthy Geriatric Populations
Authors: Samalapa Rapas , Thanapornsangsuth Poosanu , Hemachudha Pasin , Luechaipanit Watayuth , Haethaisong Thanaporn , Chongsuksantikul Adipa , Boonyaprapatsara Gann , Chunharas Chaipat , Hemachudha Thiravat , Praditpornsilpa Kearkiat 
Published: January 2025

AbstractBackgroundDementia is a critical concern in the aging population, and understanding biomarkers associated with cognitive trajectories can provide valuable insights to improve diagnosis and intervention strategies.MethodWe conducted our study at a geriatric check‐up clinic at King Chulalongkorn Memorial Hospital, focusing on a healthy cohort of older adults aged 60 or older without dementia. This study included patients with available plasma p‐tau181 levels (Quanterix, Simoa) concurrent with cognitive evaluations no more than one year before the blood test, as well as at least one cognitive test administered after the blood test. The data collection period extended from March 2022 to January 2024. Cognitive evaluation was conducted using the Montreal Cognitive Assessment (MoCA), with the total score and subsection MoCA scores serving as outcome measures. The data were analyzed using linear mixed‐effects models, incorporating time from the blood test and plasma p‐tau181 level as fixed effects, with individual subjects considered as random effects.ResultAmong 52 healthy participants, the median age was 66.5 years (IQR: 65‐73), the median education was 16 years, and 80.8% were female. Baseline assessments showed a median MoCA score of 26 (IQR: 23‐27) (Table 1). The fixed‐effects model revealed a negative association between plasma p‐tau181 levels and MoCA total score (coefficient = ‐0.104) as well as memory subsection scores (coefficient = ‐0.101), although the findings were not statistically significant. In contrast, a significant positive association was observed between time and MoCA total score (coefficient = 0.003, p = 0.001) and memory subsection (coefficient = 0.002, p = 0.004) (Table 2).ConclusionThe observed overall cognitive improvement over time in our study might imply a learning effect. Notably, among participants showing a positive correlation between time and cognitive performance, there is a trend towards lower cognitive function in those with elevated plasma p‐tau181. The lack of statistical significance in the association with plasma p‐tau181 may be attributed to small sample size and limited study duration. Our study suggests a potential association between plasma p‐tau181 and cognitive trajectories in a healthy geriatric population; however, future investigations with larger cohorts and extended follow‐up durations are necessary.
Exercise reduces white matter pathology in vascular cognitive impairment
Authors: Silva Narlon Cassio Boa Sorte , Dao Elizabeth , Falck Ryan S , Alkeridy Walid Ahmed , Tam Roger , Lam Kevin , Barha Cindy K , Crockett Rachel A , Brinke Lisanne F ten , Field Thalia S , Liu‐Ambrose Teresa 
Published: January 2025

AbstractBackgroundSubcortical ischemic vascular cognitive impairment (SIVCI) is highly prevalent in older individuals. White matter hyperintensities (WMH) are a defining feature of SIVCI. There are sex differences in SIVCI, with females having higher volume and faster WMH progression than males. Resistance exercise training (RT) can slow WMH progression in cognitively unimpaired individuals; however, evidence in SIVCI is scarce. It is also unknown if biological sex influences WMH response to exercise. We investigated whether RT mitigated WMH in older individuals living with SIVCI and assessed whether biological sex moderated intervention effects.MethodsThis was a 12‐month single‐blind, randomized controlled trial. Participants were randomized to RT (n = 45, females = 32) or a balance and tone (BAT) control group (n = 46, females = 29). Study eligibility included: 1) age 55 years and older; 2) magnetic resonance imaging (MRI) evidence of cerebral small vessel disease; 3) mild cognitive impairment; and 4) absence of dementia. We measured WMH using a seed‐based pipeline incorporating T2‐ and PD‐weighted MRI scans. We extracted volumes for whole‐brain and lobe‐specific regions‐of‐interest. Differences between groups from baseline to 12 months were assessed via analysis of covariance adjusting for baseline WMH volume, estimated intracranial volume, and sex. We assessed sex‐specific effects via group‐by‐sex interaction terms.ResultsSeventy‐four participants (aged 74.3 [SD = 5.6], 65% females) completed follow‐up assessment and were included in the analysis. At 12 months, no main effect of intervention was observed for whole‐brain WMH volume (estimated mean difference [asinh‐transformed cm3]: ‐0.045, 95% CI: ‐0.124 to 0.034, p = 0.264). Biological sex significantly moderated intervention effects on whole‐brain WMH volume (p = 0.019), whereby RT reduced WMH volume (vs BAT controls) in females (‐0.113, 95% CI: ‐0.208 to ‐0.018, p = 0.021) but not males (0.081, 95% CI: ‐0.048 to 0.211, p = 0.216). Lobe‐specific analysis revealed that RT reduced WMH volume (vs BAT controls) in the parietal (‐0.074, 95% CI: ‐0.148 to ‐0.0004, p = 0.049) and temporal (‐0.069, 95%CI: ‐0.138 to ‐0.00003, p = 0.049) lobes. Group‐by‐sex interaction effects approached significance for parietal WMH volume (p = 0.052), suggesting an overall sex‐dependent effect of training.ConclusionRT may be an effective strategy to mitigate WMH progression in older individuals with SIVCI and females likely reap greater benefits than males.
Modifiable dementia risk factors in a memory outpatient clinic in Brazil
Authors: Lazzaretti Fernando Jacob , Felício Andressa de Oliveira , Patatt Julia , Aguzzoli Cristiano Schaffer , Schilling Lucas Porcello 
Published: January 2025

AbstractBackgroundLow and middle income countries (LMIC) present a higher prevalence of dementia compared to high‐income countries due to health and social‐related modifiable risk factors inequities. Albeit the clear identification of these risk factors, the assessment and management of those situations before the development of dementia lacks attention in different health care levels. Thus, we aim to investigate the clinical impact and prevalence of health‐related risk factors among individuals referred to a specialized tertiary outpatient memory clinic from primary care facilities.MethodWe assessed 70 individuals (5 cognitively unimpaired (CU), 16 mild cognitive impairment (MCI), and 49 dementia) from an Brazilian Unified Public Health outpatient memory clinic from São Lucas Hospital located in the south of Brazil. The patients underwent clinical assessments comprising cognitive evaluation and a full neurologic examination. All participants underwent magnetic resonance imaging (MRI) and the clinical diagnosis was established by two experienced cognitive neurologists. We estimated the prevalence of risk factors for mild cognitive impairment (MCI) and dementia following those proposed by the Lancet Commission 2020. Tukey’s correction for multiple comparisons tested significant differences in risk factors among clinical groups.ResultMean age of the study population was 73 years (range, 31‐90 years); and 46% of whom were male. The most prevalent risk factors were depression (77.14%), hypertension (75.71%) and dyslipidemia (70%). Other notable factors included stroke (45.71%), diabetes (37.14%) and hearing loss (18.57%) (Figure 1). CU patients had significantly higher education attainment compared to MCI and dementia groups (Table 1). Stratifying the population according to appointment status revealed that patients who had their first appointment in 2023 exhibited a higher prevalence of depression (79%), hypertension (79%) and stroke (63%) (Table 2).ConclusionOur results highlight the high prevalence of dementia risk factors in patients referred by primary care units, but also in the outpatient memory clinic. Our findings provide a rationale for an urgent need of a better assessment and treatment of risk factors to reduce dementia incidence in LMIC.
Navigating Dementia Care in Northern Ontario: Exploring Health Professional Experience, Barriers and Facilitators
Authors: Shrestha Lucy , Shrestha Hom Lal 
Published: January 2025

AbstractBackgroundDementia is the seventh leading cause of death worldwide, impacting cognitive abilities and memory loss among aging populations. With the increasing prevalence of dementia, it is crucial to understand the distinct barriers and possibilities in providing care. Although there have been significant studies on dementia care, there is a lack of research that primarily focuses on the perspectives and worldviews of healthcare professionals, especially in the northern and rural regions of Ontario.ObjectivesThe objective of this study is to identify the essential components required to support healthcare professionals in caring for people living with dementia (PLWD) in Northern Ontario.MethodsThrough an appreciative inquiry framework, data collection includes semi‐structured interviews with healthcare professionals caring for PLWD. A literature review was conducted to understand what has been published on the perspectives of health professionals in dementia care. A comprehensive search in Google Scholar, PubMed, and the National Library of Medicine was conducted through peer‐reviewed research articles published between 2014 and 2023 that focused on quantitative, qualitative, and mixed methods.ResultThe peer‐reviewed articles serve as a basis for comprehending dementia care focusing on the experiences and perceptions of healthcare professionals on dementia care within a Canadian context. These articles address several aspects, such as the challenges, barriers, facilitators, and recommendations for enhancing the quality of care provided to PLWD. Furthermore, they discussed the possibility of enhancing the accessibility of healthcare facilities, researching to gain a deeper understanding of providing higher‐quality care and emphasizing the importance of ongoing support and training for healthcare workers specializing in dementia care.DiscussionThe worldview of health professionals in dementia care aims to reform and enhance health professionals for PLWD to improve care, support, and inform future practice in this area. The findings are broadly shared and contribute to informing future policymaking by including specialized educational materials, training programs designed to raise awareness and practice, encourage advocacy, improve comfort levels, and ultimately enhance patient care for those with dementia. Furthermore, it could explore the possibility of implementing community‐driven initiatives and assistance programs for PLWD and their families residing in rural regions.
Impact of Knowledge About Alzheimer’s Disease on Interest in Participation in Biomarker Research
Authors: Etchison Taylor , Eliacin Johanne , Polsinelli Angelina J , Richards Ralph , Richards Mollie , Campbell Christopher , Shaw Pamella , Gao Sujuan , Van Heiden Sarah , Risacher Shannon L. , Hendrie Hugh C , Saykin Andrew J. , Wang Sophia 
Published: January 2025

AbstractBackgroundPrevious studies suggest limited knowledge about Alzheimer’s Disease (AD) is a barrier to underrepresented group participation in AD research. Connections between knowledge of AD and factors like social determinants of health or confidence in biomarker research have not been carefully examined. We hypothesized perceived knowledge about AD would be associated with research hesitancy independent of sociodemographics and trust of researchers.MethodThe AD‐REACH study surveyed 399 research‐naïve non‐Hispanic Black and white adults 55 years and older living in Indianapolis, Indiana. Participants reported perceived knowledge of AD on a 5‐point scale (5 = “I know what [AD] is, what causes it, and how to manage and prevent it;” 1 = “I know nothing at all”). Knowledge was dichotomized into higher (≥ 3) and lower (< 3) levels. Demographics were compared using chi‐squared tests and t‐tests. Ordinal logistic regression models examined the association between perceived knowledge about AD and outcome variables (e.g., hesitancy towards research participation) and were adjusted for sociodemographics and very high trust of researchers.ResultThose who reported being Black, male, from a higher Area Deprivation Index, or having less than 16 years of education had lower perceived knowledge about AD (Table 1). Trust of researchers was not associated with perceived knowledge. Those reporting lower AD knowledge described more hesitancy to participate in biomarker research (53.0% vs 72.7%, OR 2.50, 95% CI 4.35‐1.39, p = 0.002) and blood draw (62.3% vs 80.9%, OR 2.17, 95% CI 4.00‐1.19, p = 0.012) but not neuroimaging procedures (Table 2). Those with lower perceived knowledge of AD were more likely to need additional information to make decision about whether to participate in research (58.1% vs 29.9%, OR 3.70, 95% CI 9.09‐1.49, p = 0.005) (Table 3).ConclusionPopulations with health disparities report lower knowledge of AD, and lower perceived knowledge is associated with research hesitancy, especially for biomarker procedures. Perceived AD knowledge is also independent from trust, suggesting the feasibility of a two‐pronged intervention to foster diverse participation in AD biomarker research. Future studies will need to confirm these findings in other cohorts and examine how culturally tailored strategies to increase AD knowledge may reduce research hesitancy among underrepresented groups.
Sex Specific Associations of BMI and Brain Regional Tau Deposition in a community‐dwelling cognitively normal older adult sample
Authors: Dominguez Joanna , Cesar Oliver , Gills Joshua L , Sogade Anamarie , Browne Laurel Y , Weisgerber Elizabeth , McBride Julian , Valkanova Elena , Mbah Alfred , Figueredo Luisa F , Jean‐Louis Girardin A , Masurkar Arjun V. , Osorio Ricardo S. , Bubu Omonigho Michael 
Published: January 2025

AbstractBackgroundIncreased body mass index (BMI) in mid‐life is associated with a higher risk of Alzheimer’s disease (AD). Neurofibrillary tangles (NFTs), comprised of hyperphosphorylated aggregated tau protein, are the pathological hallmark of neurodegenerative tauopathies including Alzheimer’s Disease (AD). The relationship between sex‐dependent adiposity in late adulthood and tau NFT pathology remain inconclusive. We examined sex differences between BMI and tau‐PET pathology among cognitively normal individuals.MethodThis cross‐sectional analysis consisted of 104 community‐dwelling cognitively normal older adults (mean±SD; males (n = 42): age = 72.8±6.5y; females (n = 62): age = 72.6±6.8y) from ongoing NYU longitudinal studies on memory and aging. Subjects completed clinical assessments and two PET scans (FBB and 18F‐ PI2620). Standard uptake value ratio (SUVR) values from images were computed using FreeSurfer, and normalizing to cerebellar grey matter. For tau, data were analyzed from composite regions corresponding to Braak pathological stages I–VI, (Braak I: entorhinal cortex; Braak II: hippocampus; Braak III: parahippocampal gyrus, amygdala, fusiform gyrus, lingual gyrus; Braak IV: neocortical regions including the insular cortex, medial temporal gyrus; Braak V: superior temporal gyrus; Braak VI: occipital neocortex), and control brain regions not expected to contain NFTs including the pericalcarine cortex, corpus callosum, and caudate nucleus. Linear mixed effects regression models examined association between BMI, sex, BMI*sex, PET SUVR amyloid & tau. Models were adjusted for age, race, amyloid and ApoE status.ResultRelative to females, males were on average slightly more educated (males, females; 17.0±2.4y, 16.6±2.1y), had similar BMI (29.6±10.3 kg/m2, 29.5±10.8 kg/m2), and had higher blood pressure (Systolic/diastolic; 168.4/116.3 mmHg, 156.9/100.7 mmHg). Sex and BMI were each associated with SUVR tau and the BMI*sex interaction was significant (p<0.05 for all). Males with higher BMI, showed increased SUVR tau burden (β[IV] = β[SE}; β[BMI*sex] = 0.0054[0.0025], p = 0.031), corresponding to Braak stage I (β[BMI*sex] = 0.0122[0.0055], p = 0.032), Braak stage III (β[BMI*sex] = 0.0054[0.0025], p = 0.034), Braak stage IV (β[BMI*sex] = 0.0058[0.0020], p = 0.006), Braak stage V (β[BMI*sex] = 0.0048[0.0019], p = 0.014), and Braak stage VI (β[BMI*sex] = 0.0039[0.0017], p = 0.026).ConclusionIn this sample of community‐dwelling cognitively normal older adults, higher BMI in males was associated with increased tau NFT burden. Thus, excessive adiposity in late‐life may contribute to Alzheimer’s disease pathology for males.
Dementia Risk Factors Are Undiagnosed and/or Uncontrolled in a Latino and Black Aging Cohort
Authors: Lachner Christian , Piura Yoav D , Aduen Paula , Carrasquillo Minerva M. , White Richard O , Graff‐Radford Neill R. , Day Gregory S 
Published: January 2025

AbstractBackgroundThe prevalence of dementia in populations that are underrepresented in research is projected to increase with population aging. Latino and Black individuals, the largest underrepresented populations in the US, experience a higher dementia burden than non‐Hispanic White individuals, which is not explained by ethnoracial biological factors. Disparities in structural and social determinants of health may contribute to the preponderance of medical conditions known to increase dementia risk, including potentially modifiable factors in Latino and Black communities. To assess the scope of this problem, we measured the frequency of common modifiable dementia risk factors in community‐dwelling, cognitively normal, Latino and Black adults.MethodCognitively normal community‐dwelling Latino and Black adults, ≥45‐years‐old, were enrolled within our longitudinal study of memory and aging at Mayo Clinic in Florida (Jacksonville, FL) and completed a baseline assessment between 3/2022 and 10/2023. Demographics, and self‐reported race/ethnicity and history of dementia risk factors were recorded. Dementia risk factors were objectively sampled through clinical interview (depression: Geriatric Depression Scale ≥5), examination (hypertension: BP >130/80 mmHg; obesity: BMI≥30), and serum analyses (hyperlipidemia: total cholesterol<200mg/dL, HDL>50mg/dL, LDL<100mg/dL, Triglycerides<150mg/dL; diabetes: HbA1C >5.6%, vitamin B12 deficiency: <350 ng/dL).Result86 participants (43 Latino, 43 Black), 65.8 (8.8) years‐old, female (62.8%), with 16 (2.4) years of education were assessed. Dementia risk factors were frequent in Latino and Black participants, including hypertension (63%, 90%; p = 0.005), hyperlipidemia (93%, 89%; p = 0.702), obesity (33%, 44%; p = 0.370), diabetes (60%, 47%; p = 0.370), vitamin B12 deficiency (21%, 21%; p = 0.989), and depression (5%, 24%; p = 0.781). These risk factors were unrecognized or suboptimally managed in a substantial proportion of Latino and Black participants: hypertension (56%, 73%; p = 0.170), hyperlipidemia (80%, 73%; p = 0.591), diabetes (57%, 47%; p = 0.502), vitamin B12 deficiency (21%, 21%; p = 0.789), and depression (5%, 3%; p>0.99).ConclusionPotentially modifiable dementia risk factors were detected in the majority of community‐dwelling Latino and Black cognitively normal older‐adults and were frequently unrecognized or suboptimally managed. Proactive screening for known dementia risk factors may provide opportunities for targeted interventions to improve brain health and decrease dementia disparities in underrepresented populations.