bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between dementia and functional activities of daily living: Mediating effect of visual functions
Authors: Jin Yeonju , Hong Ickpyo 
Published: January 2025

AbstractBackgroundDementia and visual impairment are both associated with reduced mobility and impaired functioning in activities of daily living (ADL) and instrumental activities of daily living (IADL). Cognitive deficits in older adults have more difficulties in performing daily tasks, increase the risk of fear of participation and may lead to injury (e.g. falls, fractures). However, it is not clear whether visual function mediates the association between dementia and functional activities of daily living.MethodsA retrospective, cross‐sectional design that analyzed the mediating effects of visual functions on the association between dementia and functional activity of daily living. We retrieved 2,523 adults from the 3,817 survey participants in the 2022 National Health and Aging Trends Study. We utilized a series of path analysis models and estimated the mediating effects of visual functions between dementia and functional daily activities. We used the older adults with and without dementia as the independent variables. The mediators were total scores of three visual function variables (distance acuity, near acuity, contrast sensitivity). The dependent variables were the total scores of ADLs (e.g., dressing, toileting) and IADLs (e.g., laundry, shopping).ResultsAmong the 2,523 older adults, 201 (8.0%) older adults with dementia, and 1,446 (57.3%) females. In the association between dementia and ADLs, the distance acuity revealed a significant mediation effect of 9.9% (direct effect β = 0.1875, p <0.0001, indirect effect β = 0.0205, p <0.0001), and IADLs showed a significant mediating effect of 8.8% (direct effect β = 0.2095, p <0.0001, indirect effect β = 0.0.0201, p <0.0001). In the association between dementia and ADLs, the contrast sensitivity revealed a significant mediation effect of 11.2% (direct effect β = 0.1847, p <0.0001, indirect effect β = 0.0233, p <0.0001), and IADLs showed a significant mediating effect of 11.6% (direct effect β = 0.2030, p <0.0001, indirect effect β = 0.0266, p <0.0001).ConclusionsThe study findings revealed the importance of visual function between dementia, ADL, and IADLs. Our findings indicated that healthcare professionals would need to provide interventions that consider visual functions to maintain functional activities of daily living in older adults with dementia.
Feasibility and effects of using location‐tracking devices to individuals living with dementia: An integrative review
Authors: Kim Jayeong , Hwang Mina , Hwang Yeji 
Published: January 2025

AbstractBackgroundWandering is a common issue among individuals living with dementia. This behavior often leads to increased worry for family caregivers, as those with dementia are at a heightened risk of becoming lost. Location‐tracking devices have potential as effective tools for providing independence to individuals living with dementia while reducing the risk of them getting lost. However, there is limited knowledge regarding the effectiveness of these devices specifically for people living with dementia. This study aims to examine the feasibility and effects of using location‐tracking devices in individuals living with dementia.MethodsAn integrative review was conducted using five databases: PubMed, Embase, Web of Science, CINAHL, and Scopus. Literature published up to August 2023 was screened for review. The inclusion criteria for a full‐text review were as follows: Empirical studies which (1) applied location‐tracking devices, (2) explored the effects of applying these devices, (3) involved a population of individuals living with dementia or their caregivers, and (4) were published in peer‐reviewed journals. Among the 1,429 studies initially identified, 10 studies were ultimately included in the review.ResultsThe severity of cognitive impairment in the study participants varied across the studies. The duration of using the location‐tracking devices also varied from 1 day to 3 years. The location‐tracking devices were either worn on a belt, on the wrist as a watch, carried in a pocket, or embedded in mobile phones. Overall, these devices proved beneficial for both individuals living with dementia and their family caregivers. For individuals living with dementia, the devices provided greater independence when going outside and enhanced their sense of safety. For caregivers of individuals living with dementia, the devices alleviated concerns about their loved ones getting lost.ConclusionsLocation‐tracking devices have the potential to increase independence in individuals living with dementia and to lessen psychological stress among family caregivers. Researchers and stakeholders need to put more effort into encouraging the use of location‐tracking devices and minimizing the barriers.
A Machine Learning Approach Utilizing Normal‐appearing white matter Amyloid uptake for Amyloid Positivity Classification and Clinical progression prediction
Authors: Jo Sungman , Han Ji Won , Kim Ki Woong 
Published: January 2025

AbstractBackgroundAmyloid positron emission tomography (PET) positivity is usually determined using visual assessment or a cutoff for standardized uptake value ratio (SUVR) based on cortical amyloid uptake. Our study aimed to develop and validate a machine‐learning based method for classifying amyloid PET positivity utilizing amyloid uptake in cerebral normal‐appearing white matter (NAWM).MethodWe analyzed Florbetaben (FBB) PET and MRI data from 813 participants aged 50 and over, recruited from dementia clinics of Seoul National University Bundang Hospital and the Korean Longitudinal Study on Cognitive Aging and Dementia cohort. Using global cortical composite SUVR and the NAWM Dominance Ratio (NDR; ratio of global SUVR to NAWM SUVR), we developed a machine‐learning algorithm called Gaussian Mixture Model NDR (GMM NDR). This algorithm iterates through two mixture components to categorize individuals as amyloid‐positive (A+) or negative (A‐). We compared the classification performance of GMM NDR to a conventional SUVR cutoff (0.96) using confusion matrices, receiver operating characteristic (ROC) analysis, and visual assessment as the gold standard. Additionally, we explored which classification method, among the three, best predicted clinical progression in individuals with discordant amyloid positivity across methods.ResultsThe GMM NDR method demonstrated accuracy, sensitivity, specificity, and Youden’s index of 0.936, 0.988, 0.897, and 0.885, respectively, while the global SUVR method reported similar values of 0.941, 0.974, 0.916, and 0.890 for these metrics. The area under the curve (AUC) for each method were found to be comparable (0.943 for GMM NDR, 0.945 for global SUVR, p = 0.818). Among 59 participants with discrepancies in amyloid positivity across three methods, only the GMM NDR‐identified A+ group showed more clinical progression than the A‐ group (71.7% vs. 33.3%, p = 0.02). Logistic regression revealed a significant association between GMM NDR positivity and clinical progression (OR = 11.42, 95% CI = 1.105 – 117.92, p = 0.041), not observed in other methods.ConclusionThe GMM NDR method demonstrates both robust classification accuracy for amyloid positivity and superior ability to predict clinical progression compared to traditional methods. This suggests its potential as a sensitive marker for monitoring disease progression and informing treatment decisions in neurodegenerative diseases.
Noun‐Classifier as a Semantic Cue for Lexical Retrieval Therapy for svPPA patients: Treatment Evidence Supported by a Single‐case, Multiple Baseline Analysis
Authors: Chen Lorinda Li‐Ying Kwan 
Published: January 2025

AbstractBackgroundLexical retrieval therapy (LRT) has been proven to be an effective speech therapy for individuals with semantic variant primary progressive aphasia (svPPA) and semantic cue plays an important ingredient in LRT. In recent findings, differential performance in using and choosing noun‐classifiers amongst Chinese individuals with the three subtypes of PPA were observed. The current study aims to explore the treatment effect of employing noun‐classifier as a semantic cue of LRT for Cantonese‐speaking svPPA.MethodA single‐case, multiple‐baseline intervention study, modified lexical retrieval therapy using noun classifiers was conducted on two native Cantonese speakers (one male aged 74 and one female aged 76) diagnosed with svPPA. Eighteen sessions with daily home practice were conducted. Treatment outcomes were measured by naming accuracy and were measured at timepoints of pre‐treatment, immediate post‐treatment, and an additional 4 to 6 weeks post‐treatment (follow‐up stage). Primary and secondary outcome measures were the gain in accuracy of the naming of trained and untrained stimuli after therapy and at the follow‐up stage. One‐way ANOVA repeated measure was performed to demonstrate changes in treatment outcomes across time.ResultBoth participants showed significant improvement (F(2, 142) = 11.48, p = .000 and F(1.60, 113.39) = 25.07, p = .000 for the two participants respectively) in naming trained stimuli in immediate post‐treatment with a large effect size (η2 = .14 and .26 for male and female participant respectively). Generalization to untrained stimuli was shown in immediate post‐treatment measurement (F(1.47, 104.28) = 12.91, p = .000 and F(1.51, 107.38) = 35.18, p = .000 for the two participants respectively) also with a large effect size (η2 = .15 and .33 for the two participants respectively). Maintenance over six weeks after treatment was recorded for both trained and untrained stimuli for both participants. There was statistically significant improvement in naming accuracy for trained stimuli (F(1.27, 90.31) = 15.58, p = .000 for male participant and F(1.23, 87.04) = 37.95, p = .000 for female participant) in 4‐week and 6‐week follow‐up as compared to pre‐treatment with large effect size (η2 = .18 and .35 for the two participants respectively).ConclusionThis study provides evidence for using noun‐classifiers as semantic cues in LRT for Chinese svPPA.
Prevalence of Unmet Care Needs of community based People with Dementia and their caregivers in Lusaka
Authors: Simushi Faith , Tanner Jeremy A. , Zimba Stanley , Saylor Deanna 
Published: January 2025

AbstractBackgroundGlobally, 47.5 million people were living with dementia in 2015. This figure is expected to reach 75.6 million in 2030, and over 135 million by 2050, with Sub‐Saharan Africa being among the regions expected to have the greatest future increase in dementia incidence and prevalence due to the aging population. With this growing number across the world, identifying a source of regular caregiving for people with dementia (PWD) has become a routine practice. While high income countries have formal support systems for people living with dementia and their caregivers, including adult day care and residential programs, in lower‐income countries such as Zambia, informal caregivers (often family members) assume this responsibility and serve as an interface between PWD and health services. The challenges and needs of community‐based PWD and their caregivers in Zambia have not previously been identified and understood; hence limiting the medical team’s ability to address those needs and increases the risk of negative outcomes for PWD.MethodThis was a cross sectional study (n = 33) community based people living with dementia each with a caregiver. The participants underwent a one‐time in‐depth in‐home assessment enabling collection of socio‐demographic characteristics, clinical characteristics, measurement of performance in activities of daily living and impact of supporting someone with dementia. Assessment of care needs was a based on the John Hopkins Dementia Care Needs Assessment tool. Regression analyses were conducted to identify demographic, clinical, functional and quality of life correlates of unmet needs as well as identify the independent predictors of unmet needs among PWD and their informal caregiversResultThe mean proportion of unmet needs for patients with dementia was 57% while that of caregivers was 62%. Significantly higher unmet needs were associated with having attained a tertiary education and having an unknown type of dementia.ConclusionThe study identified that patients with dementia and their informal caregivers had a high prevalence of unmet care needs in multiple domains. It also demonstrated that in this particular cohort, having a tertiary education and an unknown type of dementia was significantly associated with a higher proportion of unmet needs.
Long‐term effectiveness and cost‐effectiveness of collaborative dementia care: A general practitioner based randomized controlled trial
Authors: Michalowsky Bernhard , Blotenberg Iris , Platen Moritz , Kilimann Ingo , Teipel Stefan , Thyrian Jochen René , Hoffmann Wolfgang 
Published: January 2025

AbstractBackgroundPrevious trials reported that collaborative Dementia Care Management (cDCM) could be effective for patients and caregivers and cost‐effective for healthcare systems in the short term. However, long‐term evidence is lacking. Therefore, the study’s objective was to determine the long‐term efficacy and cost‐effectiveness of cDCM compared with usual care.MethodA General Practitioner (GP)‐based, cluster‐randomized‐controlled intervention trial (DelpHi‐MV) was conducted. Participating GP practices were randomly allocated to one of two arms (care as usual or cDCM). Participants of the intervention group received a comprehensive needs assessment and individualized interventions by nurses specifically qualified for dementia collaborating with GPs and healthcare stakeholders over six months. Controls received usual care. Primary endpoints were behavioral and psychological symptoms (NPI), caregiver burden (Berlin Inventory of Caregivers' Burden), Health‐Related Quality of Life (HRQoL, QoL‐AD, SF‐12), anti‐dementia drug treatment, potentially inappropriate medication, and cost‐effectiveness (incremental cost and Quality‐adjusted Life Years, QALYs) after 36 months.Result308 participants (n = 221 cDCM, n = 87 usual care) were included for the efficacy analyses, and 428 (n = 303 cDCM, n = 125 usual care) for the cost‐effectiveness analysis that included deceased patients. Based on multivariate regression models adjusted for baseline scores, participants receiving cDCM showed significantly less behavioural and psychological symptoms (adjusted mean difference ‐10.3 [95% CI ‐16.9 to ‐3.6], p = 0.003, Cohens‐d = ‐0.78), better mental health (+2.26 [0.3 to 4.2], p = 0.023, d = 0.26) and lower caregiver burden (‐0.59 [‐0.8 to ‐0.4], p<0.001, d = 0.71), and more likely received anti‐dementia drugs (adjusted odds ratio 1.91 [1.0 to 3.8], p = 0.065, Cramérs‐V = 0.12) compared to usual care participants. There was no effect on overall HRQoL, physical health, or potentially inappropriate medication after 36 months. cDCM gained QALYs (+0.14 [0.01 to 0.27], p = 0.050, d = 0.20) and increased costs (+437€ [‐5,438 to 6,313], p = 0.868, d = 0.02), resulting in a cost‐effectiveness‐ratio of 3,186€/QALY. Cost‐effectiveness was significantly better in PlwD living alone (‐3,815€, +0.224 QALYs, cDCM dominates) compared to those living with a caregiver (+3.283€, +0.079 QALYs, 47,538€/QALY).ConclusioncDCM is effective and cost‐effective in the long term, improving patients, caregivers, and health system‐relevant outcomes beyond the intervention or short‐term periods, and, therefore, should become a health policy priority and translated into routine care practice.
Longitudinal evolution of brain hypometabolism patterns in autopsy‐confirmed AD and LATE
Authors: Labrador‐Espinosa Miguel , Silva‐Rodríguez Jesús , Moscoso Alexis , Sanchez‐Juan Pascual , Schöll Michael , Grothe Michel J. 
Published: January 2025

AbstractBackgroundLimbic‐predominant age‐related TDP‐43 encephalopathy (LATE) can underlie clinical presentations mimicking Alzheimer's disease (AD). Recent imaging‐pathological studies have shown that LATE associates with a specific temporo‐limbic FDG‐PET signature that differs from the typical temporo‐parietal pattern of hypometabolism in AD and may be of clinical utility for differential dementia diagnosis. Little is known about the temporal evolution of the respective hypometabolic patterns from early disease stages. We investigated the temporal evolution of LATE‐ and AD‐specific hypometabolism patterns using longitudinal ante‐mortem FDG‐PET data from autopsy‐confirmed cases.MethodSerial ante‐mortem FDG‐PET scans acquired in an interval of ‐11 to 0 years before death (mean: ‐4.8±2.9 years; median of 3 scans/subject) were analysed from 30 autopsy‐confirmed AD patients and 10 LATE patients enrolled in ADNI. FDG‐PET images were spatially normalized to MNI space and standard uptake value ratios (pons reference) were calculated across 52 brain regions defined in the Harvard‐Oxford atlas. Region‐wise z‐scores were calculated to quantify hypometabolism relative to a healthy elderly control group (N=179). Group‐wise longitudinal metabolic decline of brain regions was calculated using linear mixed‐effects models. Predicted z‐scores were estimated in 2‐year steps over a 10‐year interval from the time of death and referenced to approximate onset of first memory problems. In addition, we evaluated the longitudinal evolution of the inferior‐to‐medial temporal ratio (IMTr) as a previously proposed differential diagnostic imaging marker.ResultIn AD, first pronounced hypometabolism (z>1) was observed in the posterior cingulate cortex and precuneus, approximately 6 years before death (5.5±4.5 years after estimated symptom onset) and progressively affecting additional temporal and lateral parietal brain regions (Fig‐1a). By contrast, first hypometabolism in LATE was observed in the hippocampus/parahippocampal cortex as early as 10 years before death, coinciding with the estimated onset of cognitive symptoms (0.1±3.3 years) and progressively including anterior temporal, subcallosal, and frontal brain regions (Fig‐1b). Interestingly, the IMT ratio showed a constant difference between AD and LATE patients across the entire observation period, including earliest disease stages (t=3.04, p=0.005)(Figure 2).ConclusionLATE and AD show markedly different origins and temporal trajectories of regional brain hypometabolism, indicating that FDG‐PET may differentiate between these pathologies even at early disease stages.
Efficacy and safety of DL‐3‐n‐butylphthalide in patients with mild cognitive impairment: a multicentre, randomized, double‐blind, placebo‐controlled trial
Authors: Wang Pin , Sun Wenxian , Gong Jin , Han Xiaodong , Xu Chang , Chen Yufei , Yang Yuting , Luan Heya , Li Shaoqi , Li Ruina , Wen Boye , Lv Sirong , Wei Cuibai 
Published: January 2025

AbstractBackgroundThe DL‐3‐n‐butylphthalide (NBP), a multi‐target neuroprotective drug, improving cognitive impairment in patient with vascular cognitive impairment has been confirmed. The efficacy of NBP in patients with cognitive impairment due to Alzheimer’s disease (AD) remains unknown. This study aimed to evaluate the efficacy and safety of NBP in patients with mild cognitive impairment (MCI) due to AD though a clinical randomized controlled trail.MethodThis is a 12‐month, randomized, double‐blind, placebo‐controlled, multicentric trial. The trial included patients 50 to 85 years of age who had MCI due to AD, with a clinical dementia rating (CDR) score 0.5 and a mini‐mental state examination (MMSE) score 20‐26. Subjects were randomly assigned to receive either NBP soft capsule (200mg, three times a day), or equivalent dose of placebo for up to 12 months with an allocation ratio of 1:1. The primary endpoint is the change in 12‐item Alzheimer’s disease assessment scale‐cognitive subscale (ADAS‐cog12; range, from 0 to 75, with lower scores indicating lesser severity) after 12 months. Secondary outcomes included the change in scores on the MMSE, the Sum of Boxes of CDR (CDR‐SB), Activities of Daily Living (ADL), Neuropsychiatric inventory (NPI), Auditory Verbal Learning Test (AVLT), Trail Making Test (TMT), Digit Span, as well as the standardized uptake ratio (SUVR) on FDG‐PET. All patients were monitored for adverse events (AEs).ResultA total of 270 patients were enrolled, with 135 assigned to receive NBP soft capsule and 135 to receive placebo. The mean ADAS‐cog score at baseline was approximately 12 in both groups. The change from baseline in the ADAS‐cog score at 12 months was ‐1.30 with NBP and 0.73 with placebo (difference, ‐2.04 95% confidence interval [CI], ‐2.92 to ‐1.16; P = 0.0001). Other mean differences between the two groups in the change from baseline favoring BNP were Immediate Recall score, 1.53, (95% CI, 0.47 to 2.59; P = 0.0111). NBP‐related AE were uncommon and primarily consisted of liver dysfunction and nausea symptoms.ConclusionThe results of the 12‐month treatment period showed that NBP was effective in improving cognitive function in patients with MCI due to AD and exhibited good safety.
Protocol for Integrating Memory Workshops into the timely detection of Alzheimer’s Disease associated with prevention, awareness and action on risk factors
Authors: Filho Otelo Corrêa dos Santos , Dunley Glaucia , França Lucia 
Published: January 2025

AbstractBackgroundThe use of blood biomarkers predictive of the presence of amyloid Aβ and ApoE4 is an effective tool to facilitate a timely AD diagnosis. About a third of dementia cases can be attributed to potentially modifiable risk factors, and the incidence of the disease can be reduced by addressing these factors. Memory Workshops integrated with early detection and actions on risk factors is an operational strategy that is both therapeutic and preventive.MethodMemory Workshops and Timely Detection of Alzheimer’s Disease and Control of Risk Factors ‐ Memory Workshops will be held for elderly, with two components: Guided Autobiography (GAB), a life review technique, which provides the rescue, search and reinforcement of individual purposes, in a historical and sociocultural scenario common to the group, reviving and valuing the main aspects of the history of life aiming to develop new projects and the Popular Memory Collective based on psychoanalysis, which should address central themes such as significant losses, sexuality, melancholy, differentiating physiological needs, deficiencies, fears of death and illness. Elderly with cognitive complaints will be invited to undergo: 1 ‐ Collection of biomarkers for AD, with defined exclusion criteria. 2 – Recording and monitoring the evolution of risk factors for AD. Elderly people will also receive informative material about AD.ResultIt is a protocol to be implemented from February 2024 in a partnership between the Human Aging Center of the State University of Rio de Janeiro and the Intergenerational State Secretariat for Youth and Human Aging of the State of Rio de Janeiro – Brazil – Memory workshops, timely detection strategies and management of risk factors will be carried out through appropriate training by health professionals from the Project 60+ Centers of the Secretariat of State in agreement with the State University of Rio de Janeiro. 100 Centers will be created in the State of Rio de Janeiro with an estimated care of 100 elderly people per Center. Training and coordination of the work will be carried out by the authors of this abstractConclusionIt is a protocol to be implemented.