bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive Impairment in Firefighters and Emergency Medical Services Workers after Severe WTC Exposures
Authors: Mann Frank D 
Published: January 2025

AbstractBackgroundMembers of the Fire Department of New York (FDNY) who responded to the World Trade Center (WTC) attacks that occurred on 9/11/2001 were exposed to severe trauma. The present study screened for cognitive impairment in a prospective cohort study of FDNY fire fighters and emergency personnel who reside in the greater NYC metropolitan area.MethodA large sample (n = 338) of FDNY personnel who were exposed to the WTC attacks were recruited to complete a large battery of neuropsychiatric and psychological tests. The Montreal Cognitive Assessment (MoCA) was used to screen for mild cognitive impairment (MCI) and probable dementia. Neuropsychiatric, psychological, and physical deficits were further characterized by the Short Physical Performance Battery (SPPB), Hopkins Verbal Learning Task (HVLT‐R), Boston Naming Task (BNT), Wide Range Achievement Test (WRAT‐4), Trail‐Making Task (TMT), Symbol Digit Modalities Test (SDMT), Controlled Oral Word Association (COWA), Patient Health Questionnaire (PHQ‐9), and the Cognitive Function Instrument (CFI). Diagnoses of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) were made using the Structural Clinical Interview for DSM‐5.ResultCompared to the general population, prevalence of MCI (22.92%, CI.95 = [18.42%, 27.63%]) and probable dementia (4.14%, CI.95 = [2.28%, 6.85%]) were precipitously high. Compared to unimpaired firefighters, those with MCI and probable dementia exhibited statistically significant deficits (p‐values < .05) on the HVLT‐R, BNT, WRAT‐4, TMT, SDMT, and COWA, while differences on the SPPB, PHQ‐9, and CFI were not statistically significant (p‐values > .05). Prevalence of current PTSD (18.05%, CI.95 = [14.10, 22.57] and MDD (6.51%, CI.95 = [4.12%, 9.69%] were high and moderate, respectively, but not significantly associated with MCI or probable dementia (p‐values > .05).ConclusionThere is a high prevalence of MCI and probable dementia among member of the FDNY who responded to the WTC attacks. The present study further highlights the role of extreme physical exposes in the pathogenesis of cognitive impairment and dementia. This group is a high priority for public health efforts and clinicians need to anticipate MCI and dementia in treatment planning.
Incidence of dementia before age 65 years following World Trade Center exposure: A prospective study of cognition in general responders
Authors: Clouston Sean A.P. , Team World Trade Center Aging Research 
Published: January 2025

AbstractBackgroundThe goal of this study was to determine the incidence of dementia before age 65 years in a prospective study of WTC responders, and compare incidence among responders with severe exposures to debris versus responders not exposed to building debris or those who wore personalized protective equipment (PPE).MethodsData were collected in a congressionally mandated academic occupation‐based medical monitoring program available to all verified WTC‐exposed responders residing on Long Island, NY, most of whom are currently <65 years of age. WTC responders aged ≤60 years without dementia at the time of their first cognitive assessment were followed every 18 months on average, for up to five years. We determined exposure severity based on responses to a detailed questionnaire of WTC‐related exposures and exposure‐related work activities that proxied exposures to fine particulate dust and potentially neurotoxic chemicals/dust/debris, duration of work, and the use PPE. We categorized exposure levels using an ordinal variable with five categories ranging from low to severe exposure. The incidence of dementia before age 65 years was the outcome, and was diagnosed following standard guidelines.ResultsOf 9,891 responders in the cohort, 5,010 were eligible for inclusion in this study of cognitive function (median age 53; 437 (8.72%) female), and there were 228 cases of dementia identified during 15,913.1 person‐years of follow‐up. Increasing severity and duration of exposure reported at the WTC sites revealed incremental increases in the incidence of dementia (Figure 1). After adjusting for social, demographic, and relevant medical factors, each unit increase in exposure severity was associated with increased incidence of dementia (risk difference = 39.42 [11.12‐139.70] P<0.001; hazards ratio = 1.42 [1.18–1.71], P<0.001).ConclusionsAmong WTC responders who survived to participate in a longitudinal follow‐up study of cognition from 2014‐22, a higher level of reported exposure to dust/debris, when compared with the lowest reported exposure levels or use of PPE, was significantly associated with a higher risk of dementia before age 65 years.
Early Adversity and Its Impact on Cardiovascular Health: Laying the Groundwork for Dementia Research
Authors: Wang Liang , Bauermeister Sarah 
Published: January 2025

AbstractBackgroundCardiovascular disease (CVD) and dementia share common risk factors like hypertension, diabetes, obesity, smoking, alcohol consumption, physical inactivity, and depression, indicating a complex interplay in their etiologies. This systematic review investigates the connections between early adversity (EA), such as low socioeconomic status (SES) and emotional abuse, and the development of CVD, focusing on how early‐life experiences contribute to CVD comorbidity, a crucial factor in the development of dementia.MethodFollowing the PRISMA guidelines, we conducted a comprehensive literature search in databases including Medline, Embase, PsycINFO and Global Health, covering publications from 2000 to November 2023. The search focused on keywords relating to EA, CVD, and aging. Inclusion and exclusion criteria were applied, alongside the use of the QUIPS risk evaluation tool, to ensure rigorous analysis. The primary focus was on studies that explored long‐term cardiovascular outcomes in individuals exposed to EA.ResultFrom a comprehensive analysis of 22 articles, we revealed a significant association between EA and critical CVD risk factors like abdominal obesity, smoking, and late‐life hypertension, which are potential causes of dementia. Early life factors, such as lower education levels and socioeconomic status, were found to significantly influence the risk of CVD and associated factors. These early life challenges affect not only physical health, leading to conditions like hypertension and diabetes, but also lifestyle choices related to smoking and alcohol use. Moreover, factors like reduced physical activity, depressive symptoms, and environmental elements such as air pollution were identified as contributing to the development of CVD risks. Collectively, these factors form pathways through which EA increases the likelihood of CVD and subsequent dementia.ConclusionThis systematic review emphasizes the profound and enduring impact of early life adversities on key risk factors for cardiovascular disease. These insights highlight the need for early interventions and long‐term monitoring of individuals with adverse childhood experiences to reduce future CVD risk. Importantly, this research lays a pivotal foundation for future exploration into dementia risk factors, suggesting an important interrelationship between early adversity, cardiovascular disease and dementia.
MEG Biomarkers in relation to plasma neuropathology biomarkers of Alzheimer’s disease
Authors: García‐Colomo Alejandra 
Published: January 2025

AbstractBackgroundThe preclinical stage of Alzheimer’s disease (AD) has gained attention for the window of opportunity it opens for early detection and intervention. Given the high invasiveness of PET and CSF markers, electrophysiology and plasma biomarkers are being studied as alternate biomarkers for early detection and disease tracking. The aim of this study is twofold. First, to address the relationship between a compound centrality score (CS; i.e., a measure of the relevance of a region within the network) and plasma pathology markers of AD in unimpaired individuals with elevated neurofilament‐light chain (NfL) and phosphorylated tau 231 (p‐tau231). Lastly, to evaluate whether this association is greater in hubs.Method33 individuals with available MEG recordings and over‐the‐median plasma NfL and p‐tau231 levels were included. A compound CS for each 1210 brain sources of every subject was calculated combining classical centrality metrics. The association between each node’s CS and plasma biomarkers was studied using a correlation analysis. A subsequent correlation between the obtained rho and the grand‐average of the CS was performed to test whether greater associations were found in hubs.ResultIncreasing p‐tau231 concentrations were associated with greater relevance of posterior areas through their theta oscillations and lower relevance of left areas through their gamma oscillations. The most relevant areas are also the ones that present the greatest association between their CS and p‐tau231.ConclusionThe results of this pioneering study are consistent with previous literature and demonstrate early alterations in network communication associated with elevated plasma biomarkers in cognitively unimpaired individuals, particularly in vulnerable areas to AD pathology.
High‐frequency oscillations in animal models of Alzheimer’s Disease
Authors: Lisgaras Christos 
Published: January 2025

AbstractBackgroundClinical and preclinical evidence suggest that abnormal electrical activity strongly impacts outcomes in Alzheimer's disease (AD). Indeed, AD patients with interictal spikes (IIS) show faster cognitive decline than those without IIS. Furthermore, seizures in patients with AD have been suggested to accelerate disease progression. Here we asked whether high‐frequency oscillations (HFOs), which for the last 20 years have been considered a promising electrophysiological biomarker in epilepsy, also occur in preclinical AD models.MethodWe used three mouse lines with AD features: Tg2576 mice, presenilin 2 knock‐out (PS2KO) mice, and the Ts65Dn model of Down's syndrome. We recorded HFOs using wideband (0.1–500 Hz, 2 kHz) intra‐hippocampal and cortical surface EEG at 1 month until 24 months of age during wakefulness, slow wave sleep (SWS), and rapid eye movement (REM) sleep. In addition, we analysed IIS and compared their occurrence with HFOs.ResultHFOs occurred in all transgenic mice but no controls. They were also detectable as early as 1 month of age and prior to amyloid beta plaque neuropathology. HFOs were most frequent during SWS sleep (vs REM sleep or wakefulness) when patients with AD also show abnormal EEG. Notably, HFOs were more frequent than IIS and occurred during more behavioral states. Last, high numbers of HFOs correlated with fewer IIS, suggesting for the first time possible competing dynamics among them in AD.ConclusionOur data demonstrate that HFOs, an epilepsy biomarker with high translational value, occurs early during AD progression. Also, HFOs were the most abundant EEG abnormality when compared to IIS, and occurred in all behavioral states, suggesting they may become a promising surrogate marker of hyperexcitability in AD.
Using Podcasts as a Learning Tool to Decrease Stigma and Increase Awareness of the Experience of Dementia
Authors: Hickman Kathy 
Published: January 2025

AbstractDementia Dialogue is a podcast produced by the Alzheimer Society of Ontario that provides people with lived experience (people living with dementia and care partners) a way to share their stories with each other and the broader community. Listeners who have dementia and care partners gain insight and strengthen their adaptive skills. Listeners who work with people living with dementia and care partners as well as community members at large, develop an understanding of what it means to live with dementia and how these individuals can be supported, thereby increasing awareness about the experience of dementia and decreasing stigma.A series of Learning Guides utilizing these podcasts have been created to help people with lived experience of dementia as well as others within the community, specifically professionals and volunteers supporting those with dementia and their care partners, to explore the various themes of the Dementia Journey. The Learning Guides describe key points along the dementia journey and use embedded podcast excerpts that demonstrate these themes. Excerpts are followed by reflection/discussion questions targeted to specific learner groups to aid formulation of ideas about what can be learned and how it can be applied in practice to one’s own experience. Learners can engage with the guides through independent self‐study or in group settings with a facilitator. Focus groups and surveys were conducted with people with lived experience, professionals/volunteers and educators to assess utility of the learning guides and explore the potential for development of elearning versions of the learning guides.Delegates will learn about the podcast, learning guides and results from the testing of these.
Potential of targeting the alpha‐1 adrenergic receptor and phosphoglycerate kinase 1 with Terazosin to treat Alzheimer’s disease using a transgenic AD rat model
Authors: Pattanashetty Swastik G , Xie Lei , Serrano Peter , Rockwell Patricia , Figueiredo‐Pereira Maria 
Published: January 2025

AbstractBackgroundAlzheimer’s disease (AD) is a neurodegenerative disorder without a cure. Targeting this multifactorial disease by repurposing FDA approved drugs serves as a faster mode of treatment due to its pre‐established human safety. We tested terazosin (TZ), an a‐1 adrenergic receptor (AR) antagonist and phosphoglycerate kinase‐1 (PGK1) activator as having potential to treat AD. Early stage of AD is characterized with loss of noradrenergic neurons in the locus coeruleus (LC) that initiates an over compensatory mechanism leading to increased production of norepinephrine. This causes increased synaptic activity in LC thus increasing Ab deposition via endocytosis of APP. Furthermore, dysregulated glycolysis causing decreased ATP levels is shown to play a causal role in the progression of AD and PGK1 is the first ATP generating enzyme in glycolysis.HypothesisTZ via its dual mechanism of action by blocking a‐1 AR and activating PGK1, will exert neuroprotective effects and ameliorate AD pathology.MethodTo test this, we used the TgF‐344AD rat model that develops AD in an age dependent manner. TZ treatment starts at 5 months of age (pre pathology) until 11 months of age (moderate pathology). At 9 and 11 months of age, we used the active place avoidance test to compare the hippocampal‐dependent spatial and working memory of the transgenic not treated (TGNT) and transgenic treated (TGTR) rats with terazosin. Wild type rats were also tested as a control.ResultsOur data indicate that TZ significantly improves spatial and working memory of TGTR when compared to TGNT rats. Additionally, immunohistochemical (IHC) analysis show beneficial effects of TZ in decreasing Ab plaques in cornu ammonis 1 (CA1) and subiculum (SB) subregions of hippocampus in transgenic rats. Further, ongoing analysis will reveal the effects of TZ on neuroinflammation in TGTR rats. Future studies will perform IHC on pTau and NeuN, RNAseq, western blots, and luciferase assay on the treated and untreated Tg‐AD groups to test the effects of TZ on other AD pathologies.ConclusionOverall, this study will decipher the potential of TZ to treat AD and present new molecular candidates that can be targeted to cure or delay the progression of AD.
Population‐based age‐specific estimates of dementia in Canada
Authors: Collin Lindsay J , Lally Cathy , Flanders W Dana , Maserejian Nancy N , Gillis Cai 
Published: January 2025

AbstractBackgroundDementia is a heterogeneous syndrome caused by diseases that impact cerebral functioning leading to progressive cognitive decline and loss of functional independence. Approximately 55 million people worldwide are living with dementia; however, population‐based estimates of dementia are challenging due to non‐standardized surveillance in most countries. We estimated the number of dementia cases among Canadian residents in 2022.MethodTo create age‐specific estimates of dementia in Canada, we compiled data from Statistics Canada. These data included the 2021 Canadian Census (to estimate the total population and type of residence—institutionalized vs. non‐institutionalized), the 2019/2020 Canadian Community Health Survey (to estimate the number of non‐institutionalized persons with dementia), and the 2013 Survey of Neurological Conditions in Institutions in Canada (to estimate the number of institutionalized persons with dementia). These data were used to compute estimates of the number of persons with dementia by age group (65‐69, 70‐74, 75‐79, 80‐84, 85‐89, 90+) in Canada in 2022. Using the overall Canadian population estimates for these age groups, we then calculated age‐specific estimates of dementia per 100,000 persons.ResultIn 2022, approximately 364,280 individuals 65+ years in Canada were living with dementia and the prevalence increased by age. Among those 65‐69 years the estimated prevalence of dementia was 1,343 per 100,000 persons and increased to 25,350 per 100,000 persons among those 90+ years. The prevalence of dementia in non‐institutionalized Canadians 65+ years was approximately 2.1%, and the prevalence among institutionalized Canadians was 52.5%. Of those with dementia, 41% were non‐institutionalized and 59% institutionalized. The proportion of non‐institutionalized dementia cases exceeded the institutionalized cases among those younger than 80 years (65% vs. 35%); however, for those 80+ years, there was a higher proportion of institutionalized cases compared with non‐institutionalized cases (71% vs. 29%).ConclusionDementia is a substantial source of morbidity in Canada, with increasing prevalence in an aging population. Standardized surveillance is necessary to understand the needs of this growing patient population, which would lead to more reliable estimates and allow for proper allocation of resources to improve care.
Fast and insightful: triage‐level cognitive screening captures risks beyond delirium in emergency care for older adults
Authors: de Moraes Gabriel Stanziola , Curiati Pedro Kallas , Avelino‐Silva Thiago J , Morinaga Christian Valle , Suemoto Claudia Kimie , Aliberti Márlon Juliano Romero 
Published: January 2025

AbstractBackgroundAlthough delirium is a powerful tool for identifying high‐risk older patients at the emergency department (ED), the feasibility and importance of cognitive screening beyond delirium remain debated in fast‐paced healthcare settings. We estimated the effect of comprehensive but pragmatic cognitive screening, capturing delirium and preexisting cognitive impairment, on predicting adverse outcomes within 90 days of admission in older adults at the ED.MethodWe conducted a prospective cohort study comprising patients aged ≥65 years who were consecutively admitted to the ED of a large general hospital in Sao Paulo, Brazil. Trained healthcare professionals administered the brief Confusion Assessment Method (bCAM) and, for those without delirium, also the 10‐point Cognitive Screener (10‐CS), a practical 2‐minute tool validated for detecting preexisting cognitive impairment. Cognitive status was defined as normal (negative bCAM and 10‐CS>5), preexisting cognitive impairment (negative bCAM, but 10‐CS≤5), or delirium (positive bCAM). Investigators blinded to baseline data conducted telephone interviews to assess health outcomes, including functional decline in activities of daily living (ADL) and mortality over 90 days post‐admission. We used proportional hazards models to investigate associations between cognitive status and outcomes after adjusting for sociodemographic and clinical factors.ResultAmong 830 patients (mean age = 80±9 years; women = 47%), 434 (52%) were classified as normal cognition and 396 (48%) as cognitive impairment (165 [20%] had delirium and 231 [28%] had preexisting cognitive impairment without delirium) (Table 1). Interestingly, 52% of patients with preexisting cognitive impairment without delirium had neither been diagnosed with dementia nor reported memory complaints. Patients with preexisting cognitive impairment without delirium, similar to those with delirium, showed an increased risk of functional decline in ADL (sub‐HR = 1.59; 95% CI = 1.01‐2.49) and mortality (HR = 2.19; 95% CI = 1.18‐4.09) within 90 days of admission, compared to patients with normal cognition (Figures 1‐2).ConclusionIn older patients at the ED, preexisting cognitive impairment without delirium emerges as a crucial risk factor for adverse outcomes, underscoring the need for comprehensive yet expedient cognitive screening in fast‐paced healthcare settings. The 10‐CS battery, swift and practical, is ideal for detecting frequently overlooked preexisting cognitive impairments, enabling the quick identification of high‐risk acutely ill older patients.
Discontinuity of unmet social support among US adults with potential cognitive impairment before and after the confirmed diagnosis of dementia: an matched ambidirectional cohort study
Authors: Chen Shanquan , Zhang Huanyu , Underwood Benjamin R 
Published: January 2025

AbstractBackgroundIn the context of heightened attention to dementia, research gaps persist in the seamless integration of clinical and non‐clinical care, including long‐term support. This study aims to examine potential gaps in social support for US adults with cognitive impairment, focusing on the transition before and after a dementia diagnosis.MethodsIn this ambidirectional cohort study, we examined data from the Health and Retirement Survey(HRS) for US adults over 50, using data from 2000 to 2018. The index date was set as either the entry date into HRS or the start of the study, depending on which came later, and follow‐up lasted until death, withdrawal, or study end. Eligibility was limited to participants with potential cognitive impairment during follow‐up, identified through a validated HRS‐based dementia algorithm.The study divided participants into two groups: the exposure group with a confirmed dementia diagnosis during follow‐up, and the control group, matched by age, sex, race/ethnicity, and survey wave, but without a confirmed diagnosis.Our primary outcome was unmet social support, defined as reporting physical disability without receiving corresponding social support. We applied a controlled interrupted time series(CITS) model to assess the continuity of unmet social support pre and post‐diagnosis.ResultsFrom 2000 to 2018, our study involved 1,261 dementia patients in the exposure group and 12,604 in the control group. Following diagnosis, Hispanics showed a significant rise in unmet Basic Activities of Daily Living(BADL) support needs (coef = 0.74, 95%CI[0.03,1.46]), particularly for eating assistance (coef = 1.58, 95% CI[0.17,2.99]). Blacks experienced significant increased unmet BADL needs in toileting (coef = 1.52, 95%CI[0.57,2.47]) and Instrumental ADL (IADL) support (coef = 0.09, 95%CI[0.00,0.17]). Whites saw a significant rise in unmet IADL needs (coef = 0.11,95% CI[0.08,0.14]), especially for making phone calls (coef = 0.83, 95%CI[0.19,1.47]). Further analysis suggested these increases in unmet support were mainly due to a greater rise in disabilities compared to corresponding social support.ConclusionsOur study identifies a disconnect in the care provided to individuals with dementia before and after their diagnosis. Notably, post‐diagnosis, we observed substantial disparities in unmet social support needs across various racial groups. This highlights the need for more cohesive and equitable care strategies in the dementia care continuum.