bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating Predictors of Cognitive Impairment: Insights from a Cross‐Sectional Analysis in the Wayuu Indigenous Population
Authors: Preciado Jose Hernandez , Torres Wanda , Vargas Alex Dominguez , Pianneta Yesenia , Medina Mauricio , Sinisterra Marybel , Vargas José 
Published: January 2025

AbstractBackgroundCognitive impairment (CI) encompasses a wide range of symptoms and signs associated with a progressive decline in cognitive functions, which adversely affect the quality of life and autonomy of patients. Indigenous communities have been found to have a higher prevalence of CI and dementia. However, there is limited knowledge regarding the prevalence of CI in ethnically diverse populations, such as the Wayuu indigenous community. The aim of this study was to identify predictive factors of cognitive impairment in the Wayuu indigenous population.MethodsA cross‐sectional study. We included 100 Wayuu indigenous and 100 non‐indigenous individuals from the northern coast of the Colombian Caribbean. Cognitive function was assessed using the Prolonged Latency Test through electroencephalography, and it was categorized as follows: normal, low beta activity (mild CI), frontal slowing (moderate CI), and alterations in alpha activity (severe CI). Sociodemographic, clinical, cognitive, and functionality variables were evaluated. Multivariate logistic regression analysis was conducted to evaluate predictive factors associated with CI.ResultsA higher prevalence of moderate and severe CI was observed in the Wayuu indigenous population compared to non‐indigenous individuals (90% vs. 47% and 5% vs. 4%, p<0.05, respectively). Wayuu ethnicity (OR: 2.23, 95%CI: 1.95‐8.51, p = 0.02), epilepsy (OR: 5.5, 95%CI: 1.88–16.1, p = 0.006), and residing in the town of Uribia (OR: 30, 95%CI: 1.24‐767, p = 0.03) were identified as risk factors for CI. Normal levels of vitamin B12 (200‐900 pg/ml) (OR: 0.04, 95%CI: 0.02‐0.96, p = 0.04) and normal results in the Yesavage test (OR: 0.24, 95% CI: 0.09–0.65, p = 0.004) were found to be protective against CI.ConclusionsThis study highlights the need to address epilepsy, depression, and vitamin B12 deficiency in Wayuu indigenous communities to design cognitive health intervention strategies.
Music Attuned Technology: Care via eHealth (MATCH): A proof‐of‐concept study trialling a music therapy informed mobile application for caregivers of people living with dementia
Authors: Baker Felicity , Sousa Tanara , Tamplin Jeanette , Waycott Jenny , Thompson Zara , Vidas Dianna , Woodward‐Kron Robyn , Stretton‐Smith Phoebe , Lautenschlager Nicola T , Lampit Amit , Kulik Lars , Skafidas Stan 
Published: January 2025

AbstractBackgroundMATCH (Music Attuned Technology – Care via eHealth) is a music and health application that supports caregivers of people living with dementia to use music strategically to better manage care through virtual training and intuitive music technology. This study trialled a prototype version of the MATCH app with family caregivers and people with dementia residing in the community.Method16 Dyads trialled the prototype MATCH app. After completing the virtual training in the app, family caregivers created personalised playlists within the app and used strategies learnt during training with the person they care for at least twice per week over 8 weeks. Pre‐post measures on the Neuropsychiatric Inventory Questionnaire (NPI‐Q), Cohen‐Mansfield Agitation Inventory and Acceptability of the mobile app and training were captured to detect change in symptoms and feasibility of the application. Qualitative measures including a participation diary and qualitative interviews captured participant perspectives and usage of the app.ResultsSignificant pre‐post changes in symptom severity (‐4.23 [4.9], 95% CI ‐7.2 to ‐1.3, p = 0.009) and symptom distress (‐5.69 [5.8], 95% CI ‐9.2 to ‐2.2, p = 0.004) on the NPI‐Q were found, but not on the Cohen‐Mansfield Agitation Inventory (‐4.38 [11.6], 95% CI ‐9.9 to 1.34, p = 0.109). Subscales of the NPI‐Q found significant changes to mood symptoms (‐1.23 [1.9], 95% CI ‐2.36 to ‐0.01, p = 0.036) and frontal symptoms (‐1.45 [23], 95% CI ‐2.87 to ‐0.05, p = 0.043), but not agitation/aggression (‐1.1 (1.9], 95% CI ‐2.21 to 0.07, p = 0.062). 85% of carers were satisfied with the MATCH app features, and 92% were satisfied with the music training. Qualitative findings revealed that participants found the strategies to be effective, and that they were able to integrate music‐based strategies into their care routines.ConclusionThe MATCH app was found to be feasible and acceptable; family caregivers reported that MATCH training was understandable and useful. There is preliminary evidence that music interventions implemented by trained family caregivers are effective in reducing neuropsychiatric symptoms.
Improving mealtimes for people with dementia: Feasibility study
Authors: Faraday James , Hand Annette 
Published: January 2025

AbstractBackgroundMealtimes are a fundamental part of life; eating and drinking well is vital for health well‐being. People living with dementia are at increased risk of eating and drinking difficulties, and may experience difficulties at mealtimes due to the cognitive component of this condition. Such difficulties are prevalent in care homes, where people living with dementia are often dependent on carers at mealtimes. Mealtime care for this population can be variable, with an unhelpful focus on process and systems. This study will test the feasibility of an evidence‐based training intervention designed to improve mealtimes for people with dementia.MethodsThe study builds on previous work in which a care homes training intervention was co‐developed with experts by experience, informed by systematic review data and ethnographic fieldwork. Up to 30 staff are being recruited to participate in the study and receive the training intervention, across several care homes. Outcome measures are the Sense of Competence in Dementia Care Staff (SCIDS) scale, and Confidence in Mealtime Care questionnaire, which has been developed with experts by experience. Focus groups are also being used to gather participants’ views on the intervention. Data is being analysed using descriptive statistics and thematic analysis. A patient and public involvement (PPI) advisory group, comprising care home residents and staff, has shaped the research process throughout.ResultsThis feasibility study is essential to ensure the mealtime care training intervention is acceptable and practicable in care homes, and fit for purpose. The PPI advisory group have provided significant input into the design of the study, for example highlighting the importance of a skilled facilitator to deliver training, and advising on how best to measure staff confidence/knowledge. Results of the feasibility study are due later this year.ConclusionThis study is designed to address uncertainties about a future randomised control trial (RCT) of a mealtime care training intervention in the care homes, including recruitment, attendance rate, and compliance with training. The RCT will also consider resident outcomes such as incidence of aspiration pneumonia, nutritional outcomes, and quality of life outcomes, as well and other outcomes including staff wellbeing.
The relationship of sleep duration and quality to cognitive impairment in cART‐treated HIV positive adults aged 50 and older in Kilimanjaro, Tanzania
Authors: Sison Megan Patricia , Urasa Sarah , Dekker Marieke , Mosha Jane , Minde Zawadi , Davidson Sean , Fotheringham Lachlan , Kisoli Aloyce , Worth Miranda , Sharpe Molly , Burrus Bethany , Walker Richard , Paddick Stella‐Maria 
Published: January 2025

AbstractBackgroundHIV‐associated neurocognitive disorders (HAND) are prevalent complications of ageing with treated HIV, disproportionally affecting sub‐Saharan Africa. Causal HAND treatments are lacking worldwide; therefore, reversible factors are important to explore. Sleep duration and quality are frequently associated with risk of cognitive impairments. We explored the relationship between sleep duration and quality with cognitive impairments in older people living with HIV (PLWH) in Tanzania.MethodThis cross‐sectional observational study involved systematically sampled participants aged ≥50 undergoing longitudinal follow‐up for HAND in Kilimanjaro, Tanzania. Sleep duration and quality were measured subjectively using sleep diaries, the Chalder Fatigue Questionnaire and Epworth Sleepiness Scale, and objectively by wrist‐worn accelerometers. Contextual and subjective factors affecting sleep were evaluated using a locally‐developed questionnaire. HAND was diagnosed using 2007 ‘Frascati’ consensus criteria based on neuropsychological tests, clinical assessments, and informant histories. HIV disease severity was assessed using blood markers and case‐note review.ResultAmong 103 participants, 41 met criteria for HAND whilst 12 had non‐HAND cognitive impairments. Fragmented sleep (58.3%) and short nocturnal sleep durations (53.4%) were most prevalent. Average total sleep time (6.4 hours) was below the recommended seven hours. Every one‐point increase in Chalder Fatigue Questionnaire score increased the risk of HAND with functional impairment and non‐HAND cognitive impairments by 11.6% (Odds ratio = 1.116, CI(1.012,1.231)). Epworth Sleepiness Scale score and total sleep time were not associated with cognitive impairment.ConclusionThese pilot data suggest significant association between symptomatic HAND and non‐HAND cognitive impairments with fatigue in older PLWH. Future studies should examine longitudinal risk and relationship with clinically‐diagnosed sleep disorders.
Biomarkers and their place in dementia research and practice‐ the lancet commission recommendations
Authors: Schneider Lon S. S. 
Published: January 2025

AbstractBackgroundResearch on biomarkers for Alzheimer’s pathology has progressed rapidly. We summarize the evidence and make recommendations about biomarkers for future clinical use.MethodOur interdisciplinary, international, multicultural group of experts in the Lancet Commission on dementia adopted a triangulation framework, prioritizing systematic reviews and meta‐analyses and agreed on the best evidence for recommendations.ResultAmyloid prevalence increases with age (>20% age 70; >30% age 80). As amyloid accumulation occurs many years before neurodegeneration or symptoms a positive biomarker alone does not strongly predict future impairment. Most amyloid positive, cognitively normal people do not develop Alzheimer’s dementia (Lopez et al 2024).Neurodegeneration is more closely associated with cognitive decline than amyloid and tau fluid biomarkers. In a community‐based autopsy cohort, 8% of patients with plaques and tangles had incident dementia during their previous 5 years. But 68% of those with additional neurodegeneration had incident dementia. One population study of 2323 people found knowing blood‐based biomarkers status led to a tiny rise in concordance of prediction (0.88 to 0.9) in people with subjective cognitive impairment or MCI followed for 5 years. Biomarkers may not add value to prediction of Alzheimer’s dementia.Plasma p‐tau181, p‐tau217, and p‐tau231 have as good or better accuracy than plasma Aβ42/Aβ40 ratio in predicting positive amyloid‐PET and in identifying people with amyloid pathology. Blood‐based biomarkers may be especially useful in the future to identify people with dementia who have very low likelihood for AD pathology and need further investigation.Most research has been in samples of convenience and white populations with unclear generalisability. However, a recent community‐based sample of adults found no ethnic difference in plasma AD biomarkers when other risk factors were considered.ConclusionFor people with dementia, plasma biomarkers may overcome the challenges of PET even as their predictive accuracy needs improvement. Clinical use, however, is limited to assessing the cause in people with dementia. Amyloid plaque‐predictive biomarkers are at the point where they could be used clinically for people with dementia but minding the populations and regions where they have been validated.
Triangulation to make decisions about what are modifiable risk factors and the new risk factors
Authors: Mukadam Naaheed , Livingston Gill , Huntley Jonathan D , Liu Kathy Y , Gonzalez Sergi Costafreda , Selbaek Geir , Alladi Suvarna , Ames David , Banerjee Sube , Burns Alistair , Brayne Carol , Fox Nick C , Ferri Cleusa P , Gitlin Laura N. , Howard Robert J , Kales Helen C , Kivimaki Mika , Larson Eric B , Nakasujja Noeline , Rockwood Kenneth , Samus Quincy M , Shirai Kokoro , Singh‐Manoux Archana , Schneider Lon S. S. , Walsh Sebastian , Yao Yao , Sommerlad Andrew 
Published: January 2025

AbstractBackgroundThe 2020 Lancet Commission on dementia prevention, intervention and care estimated that up to 40% of dementia cases could be prevented by tackling 12 potentially modifiable risk factors, namely less education, hearing loss, hypertension, physical inactivity, diabetes, social isolation, excessive alcohol consumption, air pollution, smoking, obesity, traumatic brain injury, depression. As more evidence on risk factors emerges, the Lancet standing commission on dementia met to update evidence on established dementia risk factors and to consider the evidence for other risk factors.MethodWe used a lifecourse approach to understand how to reduce risk or prevent dementia, as many risks operate at different timepoints in the lifespan. We considered evidence for when in the lifecourse a risk factor was relevant to development of dementia as well as the size of the effect and strength of the evidence. Our interdisciplinary, international, multicultural group of experts adopted a triangulation framework, prioritising systematic reviews and meta‐analyses, performing new meta‐analyses where needed and debated and agreed on the best available evidence and its consistency. We considered whether there was evidence of disparities in impact of risk factors based on demographic characteristics, particularly ethnicity and socioeconomic status.ResultEvidence for two new risk factors was considered strong enough to include this in our lifecourse model. We will present evidence for incorporation of these risk factors, including strength of evidence and potential mechanisms. We will also discuss risk factors for which evidence was not strong enough.ConclusionAs more evidence about risk factors emerges we can increase our understanding of how dementia develops and how to potentially prevent it. Understanding the landscape of dementia prevention research is also helpful to appreciate where further evidence is needed and what form of evidence would be most helpful in advancing our understanding.
Interventions for people living with dementia: updates from 2024 Lancet Commission
Authors: Sommerlad Andrew , Huntley Jonathan D , Liu Kathy Y , Gonzalez Sergi Costafreda , Selbaek Geir , Alladi Suvarna , Ames David , Banerjee Sube , Burns Alistair , Brayne Carol , Fox Nick C , Ferri Cleusa P , Gitlin Laura N. , Howard Robert J , Kales Helen C , Kivimaki Mika , Larson Eric B , Nakasujja Noeline , Rockwood Kenneth , Samus Quincy M , Shirai Kokoro , Singh‐Manoux Archana , Schneider Lon S. S. , Walsh Sebastian , Yao Yao , Mukadam Naaheed , Livingston Gill 
Published: January 2025

AbstractBackgroundThe progressive nature of dementia and the complex needs means that people living with dementia require tailored approaches to address their changing care needs over time. These include physical multimorbidity, psychological, behavioural, and cognitive symptoms and possible risks arising from these and helping family caregivers. However, provision of these interventions is highly variable between and within countries, partly due to uncertainty about their efficacy and scarce resources. In the 2024 update of the Lancet Commission we aimed to summarise published evidence about the effect of non‐pharmacological interventions for people with dementia and their carers on cognition, neuropsychiatric symptoms and other person‐centred outcomes.MethodWe reviewed and summarised evidence according to expert consensus opinion.ResultThere is moderate‐quality evidence from a Cochrane review of 25 studies for effect of cognitive stimulation therapy on cognition; 1.99 (1.24‐2.74) Mini‐Mental State Examination points higher compared to control groups, and clinically relevant improvements in communication and social interaction. Multicomponent interventions for family carers reduce family carer depression, burden, or stress and are cost‐effective but remote delivery of these interventions was not better than care as usual. A meta‐analysis of 7 studies of tailored activity programmes for people with dementia found a moderate effect on improving quality of life (standardised ES Cohen’s d 0.79, 0.39–1.18; 7 studies, n = 160), decreasing neuropsychiatric symptoms (0.62; 0.40–0.83) and decreasing carer burden (0.68, 0.29–1.07) but there is little evidence on cost‐effectiveness. Exercise interventions were not effective in improving neuropsychiatric symptoms, cognition or functioning. We discuss evidence for other treatments for specific neuropsychiatric symptoms.ConclusionThere is developing evidence for benefit of psychological and social interventions on key outcomes including cognition, neuropsychiatric symptoms and quality of life, with sufficient strength of evidence and cost‐effectiveness to justify these being implemented and offered routinely to people with dementia. Interventions generally should be tailored to specific symptoms and individualised to patient preferences and goals. Most interventions have been tested in majority ethnic populations in high income countries: future interventions should be co‐designed with local communities to ensure that they are appropriate for the context, culture, beliefs and practices.
Measuring What Matters Most to People Living with Alzheimer’s Disease and Care Partners: What Matters Most Quantitative Research Development
Authors: Romano Carla (DeMuro) , Bratlee‐Whitaker Emily , Hartry Ann , Mearns Elizabeth S , Taylor Jim , Taylor Geri , Callahan Leigh F , Monks Doreen , Kremer Ian , Lappin Debra , Frangiosa Theresa , Sangodkar Sanjyot , Herring William L , Gnanasakthy Kajan , Goss Diana , McLeod Lori , Edwards Teresa , Poulos Christie , DiBenedetti Dana , Paulsen Russ 
Published: January 2025

AbstractBackgroundPrevious What Matters Most (WMM) research identified and verified patient‐important concepts among a diverse population of people living with Alzheimer’s disease (PLWAD) and their care partners across all stages of Alzheimer’s disease (AD). Additionally, a conceptual model of disease was developed using hypothesized domains and was further refined using qualitative data (Figure 1). This next phase of WMM research aims to quantify the importance of concepts, impacts, and outcomes and to determine priorities among PLWAD and care partners within a diverse sample including underrepresented ethnic and racial groups at each level of disease severity.MethodsA cross‐sectional, observational, web‐based survey will be administered to up to 600 adults ≥18 years living with or at risk for AD and care partners of individuals across the disease spectrum. We aim to sample an equal distribution of participants categorized in 1 of 5 AD groups (Table 1) maximizing representation of educational levels, socioeconomic status, and ages, and to include approximately 50% participants who self‐identify as Black, Asian, Hispanic, or a mixed ethnicity. The survey builds upon an initial rating study (Hauber et al., 2023. Neurol Ther;12:505‐527) to (1) determine ranked priorities among WMM concepts, (2) evaluate the impact of the lived experience of concepts, and (3) evaluate construct validity of specific hypothesized domains, alongside clinical outcome assessments to facilitate health economic assessment (Table 2). A draft survey will be refined following cognitive debriefing with small samples across groups 1‐5 before completion by our target sample. Data may be stratified by AD group or background factors (e.g., ethnicity, education) for subgroup analyses, sample sizes permitting.ResultsAnticipated survey and clinical outcome assessment findings will provide rankings of concepts, impacts, and outcomes among a diverse and inclusive population of PLWAD and care partners across the spectrum of disease.ConclusionsThis research expands upon prior identification and verification of WMM concepts to determine priorities and characterize the lived experience of PLWAD and care partners across diverse and inclusive populations. Data are intended to inform treatment‐related needs, selection of important patient‐centric outcome measures, and study endpoints to better guide the development of AD treatments and services.
How Illness Context Shapes Caregiving: Comparative Ethnography of Diverse Caregiving Experiences
Authors: De Jesus Alma V Hernandez , Ginn Brandi , Perez Ignacia Arteaga , Abramson Corey M , Dohan Daniel 
Published: January 2025

AbstractBackgroundPrior research shows that caregiving for people living with dementia (PLWD) varies with cultural, institutional, and social structural context, but less is known about the role of context in dementias of different etiologies. We compared experiences of caregiving in frontal‐temporal dementia (FTD) versus non‐FTD dementias using community‐based comparative ethnography. We expected to find differences in caring for people living with FTD (PLWFTD) versus people living with other dementias (PLWOD). Our analytical intent was to show how cultural, institutional, and structural context shaped these experiences and to identify opportunities for intervention.MethodData were obtained from three years of community‐based ethnography in diverse communities in five cities via participant‐observation (n = 282 daily fieldnotes) and in‐depth semi‐structured interviews (n = 80 PLWD and caregivers). For data collection, a diverse research team trained in observation and interview methods and met weekly to review field experiences. For analysis, we used a qualitative computational approach that included large language models to identify data about illness trajectory and caregiving experiences. We read through the resulting data deductively to examine our expected findings about PLWFTD versus PLWOD, and we used inductive analysis to make sense of unexpected and counterfactual findings. Our results highlight linkages among caregiving experiences, disease‐etiology, and social context.ResultAs expected, we found differences in caregiving experiences of PLWFTD and PLWOD, and we also found many similarities. Among PLWFTD, earlier onset and more difficulty obtaining diagnosis created difficulties and delays in assuming a caregiving role. Following diagnosis, caregivers could find it challenging to recognize and manage their own response to the behavioral and personality changes associated with FTD. These compounded challenges experienced by all caregivers such as feelings of guilt, frustration over behavioral changes, structural barriers to care, and institutional challenges showed much‐needed respite.ConclusionCaregiving for PLWD is taxing on multiple levels with some additional challenges related to dementia diagnosis. These findings contribute an in‐depth account of similarities and differences in caregiving experiences and can inform evidence‐based recommendations to support caregiving initiatives and PLWD. Among modifiable factors, our results suggest a need for mechanisms to support differential diagnosis and for provision of respite care.