bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spirituality and Cognition in Black Older Adults: Examining Changes in Church Activity
Authors: Britt Katherine Carroll , Dong Fanghong , Massimo Lauren M , Hamilton Jill B , Hodgson Nancy A , Stites Shana D. , Mechanic‐Hamilton Dawn 
Published: January 2025

AbstractBackgroundHistorically underrepresented populations experience a disproportionate burden of Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD) compared to White populations. As a salient resource for coping in Black communities, spiritual and religious practice may support better cognitive health, but it is unknown if changes in these practices are related to cognitive decline.MethodsWe analyzed secondary data of cognitively normal (via Consensus Conference at enrollment) older adults in the U.S. (N = 158) from The University of Pennsylvania Alzheimer’s Disease Research Center (ADRC) Aging Brain Cohort (ABC) in 2021‐2022 to examine associations between change in spiritual and religious practice (i.e., major change in church activity) with cognition, separately between racial groups (Black (n = 44), White (n = 114)). Self‐reported age, sex, education, and number of friends interacted with monthly were entered as control variables in multivariable regression analysis.ResultsCognitively normal participants had a mean age of 74.4(6.54) years, were 64.6% female, and reported 16.7 (2.40) mean years of education. Significant associations were found for Black but not White older adults between major change in church activity (measured with one item: major change in church activity during the previous year (i.e. a lot more or less than usual)) with lower cognition (measured with Global Clinical Dementia Score) (β = 0.19, 95%CI [0.04, 0.34], p<0.05) controlling for age, social interaction, sex, and education.ConclusionA reported change in church activity over the last year was associated with a lower rating of cognitive and functional status among Black but not White older adults. As some individuals may progress, an early indicator of cognitive or functional change may be reported changes in church activity for older Black adults, for which spirituality is a cultural resource that may support cognitive health. Longitudinal studies are needed to further assess temporal associations between change in church activity and cognition in Black communities; maintaining church activity may be important in supporting cognitive and functional stability. The absence of significant findings in older White adults may be influenced by cultural differences that warrant further investigation and consideration in future research.
Frequency of modifiable risk factors in primary care compared with tertiary care in Brazil
Authors: de Freitas Núbia Alencar , Borelli Wyllians Vendramini , Rosa‐Neto Pedro , Castilhos Raphael Machado , Martins Sheila O , Vasques Vivian Silveira , Carello‐Collar Giovanna , Tello Brunna Jaeger , Zimmer Eduardo R. , Farina Jeanette Inglez‐de‐Souza , Araujo Mariana Dagnino , Maia Alberto Luiz Grigoli , Fuhr Anelise 
Published: January 2025

AbstractBackgroundThe Better at Home Program (BHP) is a Brazilian government initiative to provide dehospitalization through homecare health access in primary care. The profile of modifiable risk factors of dementia in this vulnerable population may provide targets for public health policies, as it represents the majority of the Brazilian population. In this study, we aimed at investigating the profile of modifiable risk factors in primary care compared with a tertiary care clinic in Brazil.MethodCommunity‐dwelling patients attending the BHP and from tertiary memory clinics were invited to participate. We collected demographic variables, the profile of modifiable risk factors of dementia, neuropsychological battery and blood sampling of both primary and tertiary care settings. Frequency of risk factors were compared with chi‐squared tests and quantitative demographic variables were compared with parametric tests.ResultsA total of 59 patients were included in primary care (mean 72.3±7.9 years of age, 62.7% females) and 63 in tertiary care setting (mean 70±11 years, 66.6% females). Primary care patients were significantly less educated compared with tertiary centers (7.44±3.9 vs. 16±5.34), and more racially diverse (Table), with similar MMSE scores (22.76±5.31 vs. 22±6.97). The profile of frequency of modifiable risk factors of dementia was distinct according to the level of care (Figure). Specifically, individuals from primary care presented increased frequency of low education (23 vs. 3, p = 0.03), social isolation (37 vs. 22, p = 0.007), physical inactivity (31 vs 10, p = 0.0001) and smoking. Furthermore, people in homebound situations were identified only in the primary care group (11 vs. 0, p<0.001).ConclusionPatients from primary care services present a distinct profile of modifiable risk factors of dementia when compared with tertiary care. They presented increased frequency of low education, social isolation, physical inactivity, and smoking. Public policies targeting primary care populations in LMIC may address risk factors differently.
A Prognostic Model to Predict Risk of Dementia or Death in Older Veterans with Traumatic Brain Injury (TBI)
Authors: Barnes Deborah E , Li Yixia , Boscardin W John , Bahorik Amber L , Peltz Carrie B. , Yaffe Kristine 
Published: January 2025

AbstractBackgroundPrior studies have found that traumatic brain injury (TBI) is associated with increased risk of both death and dementia in older adults including veterans. Clinically, it would be useful to be able to accurately predict the likelihood of these two outcomes for a given patient.MethodOur study population included all individuals aged 55 years or older who received care from the Veterans Health Administration between 2002 and 2019, had a TBI diagnosis, had at least one post‐TBI healthcare visit, and did not have a dementia diagnosis or medication before or up to 1 month after the TBI (n = 113,779). We used multinomial logistic regression with Lasso to develop a prognostic model that simultaneously predicts risk of dementia or death. Potential predictors included demographics, medical and psychiatric comorbidities, and healthcare utilization variables. Model accuracy was assessed based on c‐statistics. We also calculated observed outcome rates over decile of predicted risk and performed stratified analyses to assess for differences in accuracy based on TBI severity and combat veteran status.ResultCohort members had a mean ± SD age of 68 ± 10 years; 6% were female; and 20% were non‐White or Hispanic. The final model included 22 variables. Key predictors included older age, being male, number of inpatient visits, and comorbidities including Parkinson’s disease, diabetes, weight loss, epilepsy, substance use disorder, and psychosis. The c‐statistics were 0.756 (95% confidence interval: 0.751, 0.761) for dementia and 0.783 (0.779, 0.786) for death. Model accuracy was slightly better for mild vs moderate/severe TBI (0.777 vs. 0.743 for dementia, 0.805 vs. 0.755 for death) and for combat vs. non‐combat veterans (0.776 vs. 0.751 for dementia, 0.806 vs. 0.776 for death). The observed proportion who developed dementia ranged from 3% to 43% over decile of predicted risk, while the observed proportion of deaths ranged from 4% to 64%.ConclusionA single prognostic model that includes demographics, comorbidities, and utilization variables can predict risk of dementia or death in older veterans who have experienced TBI with good accuracy. Additional studies are needed to determine how this information might best be utilized to support better care.
The mediating effect of BMI on the association between gender and domain specific cognition in a diverse cohort of individuals 80+
Authors: Meunier Claire C. , Roscoe Joseph , Gilsanz Paola , Corrada María M. M. , George Kristen M. , Glymour M. Maria , Mayeda Elizabeth Rose , Gavett Brandon E , Posis Alexander Ivan B. , Whitmer Rachel A. 
Published: January 2025

AbstractBackgroundGender differences are often associated with specific cognitive domains. Additionally, gender may be associated with BMI through biological and social differences. We evaluated if mid‐life BMI mediated the effect of gender on domain specific cognition in an ethnoracially diverse population of individuals 80+.MethodData from three ongoing cohort studies, LifeAfter90, Kaiser Healthy Aging and Diverse Life Experiences, and Study of Healthy Aging in African Americans, was pooled to include participants aged 80+ (n = 671). Baseline verbal episodic memory (VEM), executive function (EF), and semantic memory (SM) were measured using the z‐standardized Spanish English Neuropsychological Assessment Scales. Mid‐life BMI was categorized as normal (18.5‐24.9 kg/m2), overweight (25‐29.9 kg/m2), and obese (30 kg/m2) using the first clinical measurement at ages 40‐60. Structural equation models were used to estimate the indirect effect (IDE) of mid‐life BMI category on the association between gender and cognition adjusting for age at baseline cognitive assessment, age at BMI measurement, racial/ethnic identity, and education.ResultParticipants were 37% male, 17% Asian, 35% Black, 12% Latino, 33% White, 3% other racial/ethnic group with a mean age of 88.5±5.3 at baseline cognitive assessment and a mean age at mid‐life BMI measure of 44.6±4.3 years (table 1). Midlife obesity (9%) and overweight (31%) were common. The total effect of gender (ref = women) on each cognitive domain was significant (VEM: ‐0.19, p < 0.001; EF: ‐0.12, p = 0.001; SM: 0.202, p < 0.001). Five percent (p‐value = 0.07) of the association between gender and VEM was explained by BMI category (IDE (β = ‐0.01; p‐value = 0.06) divided by total effect (β = ‐0.19; (p‐value<0.001); Figure 1). BMI did not mediate the association between gender and SM (β(IDE) = ‐0.003;p‐value = 0.29) or between gender and EF (β(IDE) = ‐0.005; p‐value = 0.19).ConclusionIn this ethnoracially diverse population of individuals aged 80+, mid‐life BMI marginally mediated the association between gender and baseline VEM, while it did not mediate the associations with EF and SM. Additionally, men had lower EF and VEM but higher SM compared to women. The effect of mid‐life BMI on the association between gender and cognition may vary by cognitive domain, suggesting that mid‐life BMI may impact specific late‐life cognitive functions that are associated with VEM.
CREATE: Enhancing Cognitive Reserve through Assistive Technology in Elderly Care – Introduction to a Primary Prevention Program
Authors: Taurisano Paolo , Abbatantuono Chiara , Gasparre Daphne , Biasi Madia Marika , Paparella Giulia , Dentamaro Vincenzo , Veneto Davide , Impedovo Donato , De Caro Maria Fara 
Published: January 2025

AbstractBackgroundIn the international landscape, assistive technologies are often integrated into programs to support elderly individuals with dementia and/or multiple disabilities (Lancioni et al., 2021). However, there is a need to extend these interventions to primary/secondary prevention of such conditions in the elderly population at higher risk. In response to this need, the collaboration between the U.O.S. of Psychology and Clinical Neuropsychology in Bari and the Welfare Association in Levante offers a novel program for active aging based on the use of health tracking smartwatches in the prevention of neurocognitive disordersMethodWe enrolled 10 MCI subjects who were over 65 years old and had them wear a smartwatch for a period of 6 months. The program requires participants to wear smartwatches that track their health using different sensors. These watches monitor various health parameters and provide personalized prompts. The goal of the program is to improve cognitive reserve, promote independence, and increase participants' awareness of their lifestyle. This is all done through a structured intervention and training sessions as part of the C.R.E.A.T.E. program.ResultThe use of affordable and easily accessible everyday technology, such as wristwatches connected to smartphones or PCs, has been proven to create a physical and psychological environment that participants perceive as “protected” and “safe.” This technology provides practical support for daily activities from the beginning of the intervention and helps maintain learned habits over time. Furthermore, the effectiveness of the technology is confirmed by the adoption of systematic indicators and criteria, which verify the observed behavioral changes in participants.ConclusionThe future integration of wearable technologies, such as smartwatches, with artificial intelligence is becoming increasingly important. This integration allows for interventions to be tailored specifically to each patient, which further enhances the effectiveness of preventive and supportive strategies in promoting active aging.
Neuroimaging Correlates of Alzheimer’s Disease biomarkers in a mid‐life, racially diverse high‐risk cohort
Authors: Misiura Maria , Munkombwe Chinkuli , Igwe Kay C. , Verble Danielle D , Likos Kelly D. S. , Zetterberg Henrik , Dotson Vonetta M , Brickman Adam M. , Wharton Whitney 
Published: January 2025

AbstractBackgroundClinicians and researchers utilize neuroimaging (NI) biomarkers of Alzheimer’s disease (AD) at an increasing rate. It is crucial that we determine whether these biomarkers generalize to underrepresented populations, particularly Black Americans (BAs), as they are 64% more likely as white individuals to develop AD. BAs may exhibit unique AD biomarker profiles across disease states, including NI biomarkers. Investigating biomarkers in at‐risk individuals may allow for early identification and intervention. Here we analyze comprehensive NI biomarkers including resting state fMRI, white matter lesions, and hippocampal volumes in conjunction with cerebrospinal fluid (CSF) markers in a midlife, racially diverse, cognitively normal cohort with a parental history of AD.MethodData included 57 cognitively normal, middle‐aged individuals, 14 BAs and 43 white. CSF was acquired via lumbar puncture to determine CSF t‐tau and Aβ1–42 concentrations. Using resting state fMRI data, we analyzed default mode network connectivity between the posterior cingulate & precuneus, parrahippocampal gyrus (PHG), temporal pole, hippocampus, and lateral temporal cortex. We obtained regional WMH data from FLAIR images using an in‐house algorithm, and hippocampal volumes from Freesurfer. In our multivariate model, outcome variables were connectivity values, regional WMH and hippocampal volumes, with race and CSF t‐tau and Aβ1–42 as our independent variables with a race X CSF interaction term.ResultWe identified a significant race X t‐tau and race X Aβ1–42 interaction term for temporal and parietal WMH volumes and connectivity between PHG and temporal pole. Higher AD CSF biomarkers negatively correlated with brain connectivity (p=0.01), and positively with WMH volume (p<0.001) in BAs.ConclusionWe extend our previous work to a middle‐aged cohort to show that DMN connectivity may be a predictor of AD risk in middle‐age, particularly for BAs, and that BAs may exhibit earlier vulnerability to vascular lesions. We support previous work that the temporal lobe is the first region to experience AD‐related connectivity changes, and that WMHs may predispose this region to AD vulnerability. This study emphasizes the need for recruitment of diverse cohorts in NI studies of AD.
Midlife hypertension status does not mediate associations between childhood community advantage and MRI‐derived markers of late‐life brain health
Authors: Peterson Rachel , Gilsanz Paola , George Kristen M. , Maillard Pauline , Jimenez Marcia Pescador , Barnes Lisa L. , Decarli Charles , Whitmer Rachel A. 
Published: January 2025

AbstractBackgroundPrior research suggests living in an advantaged community in childhood is protective for late‐life cognition and MRI‐derived markers of brain health, independent of individual socioeconomic status. We examined the extent to which this effect is mediated by midlife hypertension status.MethodKHANDLE and STAR are racially/ethnically diverse cohorts of older adults residing in northern California. A random subset of participants underwent 3T MRI; regional brain volumes and white matter integrity were derived. Participants’ self‐reported birth address was geocoded and linked to historical county‐level Area Deprivation Indices (ADI) for the Census decade of residence (1920‐1970). Childhood community advantage was defined as ADI<20, (i.e., most advantaged quintile nationally). Midlife hypertension was derived from prospectively collected blood pressure (bp) at ages 30‐45 and defined as systolic/diastolic bp ≥130/80 or prior hypertension diagnosis. Generalized linear models estimated the direct (c’) and total effects (ab+c’) of ADI on imaging measures among participants age 65+, adjusting for age, sex, race/ethnicity, and education. Indirect effects (ab) via midlife hypertension were calculated by subtracting direct from total effects. Standard errors were bootstrapped with 500 replications.ResultImaging participants (n = 392) from advantaged childhood communities were younger (mean age = 72.6 vs. 76.4), had more education (15.3 vs. 14.3 years) and were less likely to have midlife hypertension (49% vs. 58%; Table 1). The total effect of childhood community advantage was associated with better MRI‐derived measures of brain health (e.g., total gray β = 0.26, 95%CI = 0.04, 0.48; lateral ventricle β = ‐0.22, 95%CI = ‐0.44, ‐0.003; log white matter hyperintensity volumeβ = ‐0.35, 95%CI = ‐0.56, ‐0.13; Table 2, column A). The direct effect of not having midlife hypertension was associated with better MRI‐derived measures of late‐life brain health (e.g., total gray β = 0.31; 95%CI = ‐0.10, 0.53); Table 2, column D). Null indirect effects (Table 2, column C) indicate the effects of childhood community advantage on MRI‐derived measures are not mediated by midlife hypertension status.ConclusionLate‐life brain health benefits among participants from an advantaged childhood community were not explained by the absence of midlife hypertension. Future work will investigate additional modifiable risk/protective factors as alternative mechanistic pathways by which community advantage may affect late‐life brain health.
The process of creating culturally and linguistically appropriate materials on dementia for Hmong and Cambodian elders
Authors: Yang Kao Lee , Thor Yer , Bendlin Barbara B. , Chin Nathaniel A. 
Published: January 2025

AbstractHmong and Cambodian Americans, minoritized Asian American subgroups, are underrepresented in research, and prevalence of Alzheimer’s disease (AD) in these communities is unknown. However, our community partners in the Madison, Wisconsin area, who have served Hmong and Cambodian elders in the community for over 20 years, informed us in the fall of 2021 that they have encountered cases of dementia among elders they serve. They expressed a need for educational materials on dementia that could aid their community work. Following this meeting, we spent the year 2022‐2023 developing culturally and linguistically appropriate informational brochures on dementia.Brochures were developed with funding from the UW‐Madison Morgridge Center for Public Service. The project involved a diverse team of dementia researchers, community partners with expertise in providing wraparound services to the Hmong and Cambodian communities, a geriatrician, professional Hmong and Cambodian translators, and a professional graphic designer. The brochure development process was iterative. We started by researching existing educational materials on dementia for individuals with various health literacies. A draft of a 3‐panel brochure was drawn up by the first author in English and discussed with the team. Verbiage for each panel was carefully chosen based on feedback from our community partners. Specifically, the brochure would minimize verbosity and technical terms so elders could more easily grasp concepts. The graphic designer skillfully enhanced our preliminary brochure design. The translators worked in consultation with the first author to ensure the brochure’s overall concepts were accurately translated. The final product was a single brochure on dementia available in Hmong, Khmer (the Cambodian language), or English (Figure). Brochures were then disseminated to our community partners and during community events in the spring and fall of 2023.Our project demonstrates the feasibility of creating brochures that are culturally and linguistically tailored for the Hmong and Cambodian communities. We found the collaborative efforts of experts across various fields and vital insights from community partners familiar with target audiences to be imperative in our success. Similar initiatives should prioritize assembling diverse teams and engaging with community specialists at the beginning of the project to best reach underrepresented groups.
Obstructive Sleep Apnea and Alzheimer’s Disease in Down Syndrome
Authors: Yoon Dasoo Milton , Schworer Emily K , Fleming Victoria L , Handen Benjamin L , Peven Jamie C , Plante David T , Hartley Sigan L 
Published: January 2025

AbstractBackgroundThe present study examined OSA using an objective home sleep test in 81 adults with DS (aged 25 ∼ 61 years) and evaluated associations between sleep‐disordered breathing problems and biomarkers of AD pathology (PET Aβ and tau) and symptomology (cognitive performance and depressed mood).MethodAs part of the ABC‐DS study, participants completed a 2.5‐hour battery of cognitive measures and underwent MRI and PET imaging scans and a blood draw. Study partners completed informant measures to report on the participant’s sociodemographics, dementia symptoms, and mood. As part of the lifestyle auxiliary study, the adult with DS wore the WatchPAT 300 device for one night to assess sleep‐disordered breathing and caregivers reported on sleep habits and any sleep‐related conditions or treatments. The adults with DS and study partners earned up to $200 for completion of ABC‐DS study activities and $50 for completion of WatchPAT study activities.ResultOf the 81 participants with valid sleep data, 67 (83%) screened positive for OSA based on the WatchPAT data. When considering pAHI, 25 (31%) had mild OSA, 19 (24%) had moderate OSA, and 22 (27%) had severe OSA. In total, 25 of the 39 (64%) participants without a medical diagnosis of OSA screened positive for OSA based on the WatchPAT. A chi‐square test indicated no significant difference in OSA severity level (none, mild, moderate, severe) between participants who did versus did not have a medical diagnosis of OSA (𝝌2 = 1.648, p = .648). Main findings between sleep and biomarker variables included PET Aβ being significantly associated with mean of desaturations, wake state, and total sleep time, while tau being significantly associated with % of REM Sleep, minimum oxygen level, wake state, and number of wakes.ConclusionFindings indicate there is a high prevalence of sleep problems and OSA in adults with DS. There were also significant correlations between the presence and severity of OSA‐related sleep problems with higher PET Aβ and tau levels, as well as more AD‐related cognitive impairments and worse mood.