bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Polysomnography‐Assessed Sleep Parameters with Alzheimer’s Disease Biomarkers in Older Adults
Authors: Chen Jiong , Cavaillès Clémence , Jin Jiangli , Stankeviciute Laura , Winer Joseph R. , Gao Song , Peng Dantao , Leng Yue , Milton Sasha 
Published: January 2025

AbstractBackgroundover the past decade, a bi‐directional relationship between sleep and Alzheimer’s disease (AD) has been increasingly recognized, with several studies suggesting a link between self‐reported sleep disturbances and AD biomarkers. However, the association between polysomnography (PSG)‐assessed sleep parameters and AD biomarkers remains unknown.MethodWe examined 128 participants [mean age 70.9 (±9.7) years, 43.8% of men; 23 healthy controls (HC), 41 with mild cognitive impairment (MCI), and 64 with AD] from an outpatient memory clinic. Sleep features were derived from overnight PSG and were categorized by tertiles. Four AD biomarkers were measured, including tau‐181, Brain‐Derived Neurotrophic Factor (BDNF), and neurofilament light (NFL) obtained from blood samples, and Aβ levels measured from amyloid positron emission tomography scans. We used multivariable linear regression models to examine the associations between sleep parameters and AD biomarkers.ResultAfter adjustment for age, sex, APOE4 status, diabetes, smoking habits, and body mass index, participants in the highest tertile of rapid eye movement (REM) latency (>192.7 minutes) had higher tau‐181 (β = 0.25, 95% confidence interval (CI) = 0.01;0.55) and Aβ (β = 0.15, 95% CI = 0.06;0.26) levels, and lower BDNF (β = ‐0.51, 95% CI = ‐0.70;‐0.20) compared to the lowest tertile (< 98.2 minutes). Moreover, participants in the middle slow wave sleep (SWS) percentage tertile (2.5‐10.2%) had lower tau‐181 levels (β = ‐0.18, 95% CI = ‐0.34;‐0.02) compared to those in the lowest tertile (< 2.5%). We did not find any association between AD biomarkers and sleep duration, efficiency, latency, or other sleep macro‐architecture features. The association between sleep and AD biomarkers did not differ by cognitive diagnoses (i.e., NC, MCI, or AD).ConclusionLonger REM latency was associated with higher levels of AD biomarkers in older adults with and without cognitive impairment. Future research is needed to examine the longitudinal association between sleep architecture and AD biomarkers and clarify underlying mechanisms.
The Associations of Self‐perception and Personality with Incident Dementia: The Health and Retirement Study, 2010‐2020
Authors: Wei Jingkai , Lohman Matthew , Zhang Yanan , Yang Chih‐Hsiang , Merchant Anwar T , Friedman Daniela B. 
Published: January 2025

AbstractBackgroundSelf‐perception and personality may play an important role in the development of dementia through lifestyle modification, social engagement, and mental well‐being. However, evidence regarding the associations of self‐perception and personality with incident dementia has not been well established.MethodA total of 14,099 participants aged 50 years and older in the Health and Retirement Study (7,335 in 2010 and 6,764 in 2012) were included. They were measured for characteristics of self‐perception and personality using a validated self‐administered questionnaire. This included assessments of anxiety, anger (including anger‐in and anger‐out), five personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), self‐perception of aging, positive and negative affect, sense of control (including perceived constraints and personal mastery), loneliness, hopelessness, optimism and pessimism, cynical hostility, and life satisfaction. Incident dementia through 2020 was self‐reported via questionnaire. Proportional hazards models were used to examine the associations of each component of self‐perception and personality with incident dementia, adjusted for age, sex, race, education, smoking status (current, former, never), physical activity (≥1 time of moderate and/or vigorous physical activity per week), body mass index, depressive symptoms, and prevalent diseases (hypertension, diabetes, heart disease, stroke). Death was considered a competing risk. Subgroup analyses were conducted by sex and race.ResultAfter an average follow‐up of 6.9±3.1 years, a total of 590 (4.5%) incident dementia cases occurred. Higher levels of anxiety, anger‐out, neuroticism, negative affect, sense of constraints, loneliness, hopelessness, pessimism, and hostility were associated with a higher risk of dementia. In contrast, higher levels of conscientiousness, openness, positive self‐perception of aging, positive affect, sense of mastery, optimism, and life satisfaction were associated with a lower risk of dementia. Modification of some factors was observed across different subgroups based on race and/or sex (Table 1).ConclusionSelf‐perception and personality are predictive of incident dementia. Individuals with unfavorable self‐perception and personality profile, indicating a higher risk of dementia, may be monitored for risk reduction.
AI‐based dementia risk prediction using voice digial biomarkers: A web‐based platform
Authors: Ko Hyunwoong , Park Nayoung , Kwon Sukbong 
Published: January 2025

AbstractBackgroundDementia is a major public health problem affecting millions of people worldwide. Early diagnosis and intervention are essential to improve quality of life and reduce the burden of dementia. Recently, voice digital biomarkers have emerged as a promising approach for the early detection of dementia owing to its clinical utility and accessibility.MethodIn this study, we present a voice biomarker‐based dementia prediction system using a Korean dataset from the AI hub entitled cognitive disorder diagnostic speech/dialogue. A total of 5,769 voice recordings were obtained, of which 2,424 were from CN, 1,611 from MCI, and 1,734 from AD, and were recorded during the administration of cognitive tests. We first extracted dementia‐related speech biomarkers using signal processing and speech activity detection. The extracted speech biomarkers were then used to predict the Clinical Dementia Rating (CDR) to discriminate the severity of dementia from the dataset using ML/DL framework. We also developed an automated engine to extract the voice biomarkers and predict the CDR. The engine was deployed using Docker containers and a web service was implemented using the Flutter framework.ResultThe results showed that the proposed system achieved a CDR prediction accuracy of 83.6% and precision of 0.872. This is comparable to the accuracy of other voice biomarker‐based dementia prediction systems developed using Western datasets. A Flutter‐based web service is shown in the attached figure.ConclusionThe proposed system is a promising new approach for early detection of dementia. It is easy to use, accessible and inexpensive, making it a potential tool for widespread use. The system could be used to screen large numbers of people for dementia, potentially leading to earlier diagnosis and intervention. In addition, the use of a low‐language digital voice biomarker makes the system more accessible to people from different linguistic backgrounds. This could help to reduce inequalities in dementia detection and care. In the future, we plan to add a variety of predictive models, including depression and Parkinson's disease. More detailed information, including a published web site, will be released through the AAIC 2024 poster session.
How well does the RAQ measure up? Assessing attitudes toward research in a diverse community sample
Authors: Gooding Diane Carol , Boykin C. Malik , Bouges Shenikqua , Van Hulle Carol A. , Lewis Jordan P. , Zuelsdorff Megan L. , Carter Fabu P. , Gleason Carey E. 
Published: January 2025

AbstractBackgroundIndividuals’ attitudes toward research predict recruitment, engagement, and retention. The Research Attitudes Questionnaire (RAQ), developed to predict individuals’ willingness to participate, is often used in AD research. It can be used to identify strategies to mitigate individuals’ reluctance to engage in research. To date, there are mixed findings regarding diverse groups’ willingness to engage in AD research. Between‐group comparisons are only meaningful and valid when the measures being used reflect true group differences in the construct i.e., measurement invariance (MI). One of the prerequisites for meaningful comparisons across diverse groups is to have measurement invariance. The study goal was to examine the suitability of the RAQ across age and ethno‐racialized identities.MethodsWe explored the MI of the 7‐item RAQ using Confirmatory Factor Analysis (CFA) via Mplus in a community‐derived sample of 457 younger and 594 older African American, 307 younger and 339 older American Indian/Alaska Native, and 173 younger and 679 older Non‐Hispanic White male and female individuals. CFA evaluated the one‐factor model across the groups. Subsequently, loadings, means, and residuals were consecutively constrained to equality. We examined whether the increased restrictions produced significant changes in the data‐model fit to determine whether conditions were met to demonstrate varying levels of measurement invariance.ResultsTable 1 summarizes sample demographics and provides mean total RAQ scores. The RAQ showed good internal consistency across age and ethno‐racialized groups (Cronbach’s a ranging from 0.78 to .85). A one‐factor model showed acceptable fit across the groups (Table 2). The results of the cross‐sample invariance tests are provided in Table 3. We found evidence of configural invariance; comparisons of successive models supported metric invariance, and scalar invariance. Strict invariance was not supported.ConclusionsThese data suggest that across the 6 groups, who differed in terms of age and ethno‐racial identity, the strengths of associations between the specific scale items and the latent construct being assessed by the RAQ are the same. However, the groups may differ in the extent to which they are characterized by the latent variable. This finding supports the suitability of the RAQ for cross‐cultural comparisons of willingness to engage in research.
Does six months of structured group exercise improve physical activity, sedentary behavior, and sleep in people living with dementia? A pilot randomized controlled trial
Authors: Oke Olabamibo , Dong Yanbin , Zhu Haidong , Soares Andre , Patel Charmi , Hergott Colleen , Waller Jennifer L , Young Lufei , Robinson‐Johnson Dawnchelle , Sams Richard , Hamrick Mark , Jehu Deborah A 
Published: January 2025

AbstractBackgroundPeople living with dementia (PWD) often have inactivity‐induced muscle atrophy, increased sedentary behavior, and circadian rhythm disorders. Exercise may improve physical activity, sedentary behavior, and sleep in PWD, but further research is needed. The purpose of this pilot randomized controlled trial (RCT) was to examine whether a structured exercise program improves physical activity, sedentary behavior, and sleep in PWD.MethodPWD were randomized (1:1) to exercise (n = 21) or usual care (n = 21) at two residential care facilities (NCT05488951; age = 82.1±8.05 years; Montreal Cognitive Assessment (MOCA) = 10.2 points; female = 35.7%; mobility device = 61.9%). Participants wore an actigraphy monitor on their non‐dominant wrist for 7 days (minimum of 4 days to be included in the analysis) at baseline and 6 months. The adapted Otago Exercise Program involved a physical therapist‐led strength, balance, and walking program for 1 hour, 3x/week for 6 months in groups of 5‐7. We controlled for age, race, sex, and the MOCA in the intent‐to‐treat (ITT; n = 42) and per protocol analyses (PPA; n = 21 usual care; n = 9 exercisers with 2/3 adherence).ResultThe ITT analysis revealed that the exercise group (pre = 78.8%, post = 83.7%) had a greater percentage of sedentary activity than the usual care group (pre = 68.2%, post = 67.7%) at 6 months (p = 0.01). The PPA disclosed that the average length of sedentary bouts decreased in the usual care group (pre = 22.2, post = 20.1 minutes) compared to exercise group (pre = 46.9, post = 54.1 minutes) from baseline to 6 months (p = 0.01). Adherence to wearing the actigraphy monitor for ≥4 days was poor (pre: n = 25/42 PWD, post: n = 13/42 PWD).ConclusionThis RCT provides insufficient evidence to suggest that exercise impacts physical activity, sedentary behavior, or sleep among PWD. The results suggesting that usual care improves sedentary behavior over exercise should be interpreted with caution because this is a pilot RCT and adherence to wearing the actigraphy monitor was poor in both groups due to cognitive impairment. Future work is still needed to determine the effects of exercise on physical activity, sedentary behavior, and sleep, and should consider alternative placements of the actigraphy monitors, such as the back or lower leg, to increase adherence.
Decision‐Making Competence in Health Behavior Among Rural Older Adults with Cognitive Decline
Authors: Park Myonghwa , Kim Heejung , Kim Jinju , Seo Eunkyung , An Wonmi 
Published: January 2025

AbstractBackgroundThe aging population in rural areas is a unique health challenge. Older adults with cognitive decline are particularly vulnerable due to limited access to medical resources and health‐related information, a disparity more pronounced in rural compared to urban settings. This study investigates key factors influencing perceived decision‐making competence for health behavior in this demographic.MethodThis study was conducted as a secondary analysis of data from a larger health promotion project in a rural area of South Korea. The data of 170 older adults, aged 60 and above was analyzed. These individuals were identified as having suspected cognitive impairments based on the 10‐item cognitive function screening test. The study focused on assessing various factors such as cognitive function, social support, quality of life, and perceived decision‐making competence for health behaviors.ResultThe assessment of decision‐making competence for health behavior was conducted using a scale ranging from 1 to 5, with the mean score being 3.03 ± 0.66. Detailed analysis showed varying levels of competence across different health behaviors: regular exercise (2.54±1.13), healthy diet (2.92±1.05), brushing teeth (2.87±1.19), regular health checkup (3.05±1.09), infection prevention (3.48±1.10), social activity (3.45±1.11), and health education participation (2.91±1.01). This revealed a pattern where participants showed lower competence in areas requiring more active engagement, like regular exercise, and higher competence in more passive or socially facilitated behaviors like infection prevention and social activity. Furthermore, a positive correlation was observed between the levels of social support, the quality of life (as measured by the EQ‐5D), and the decision‐making competence for health behaviors.ConclusionThe study’s findings highlight significant variations in decision‐making competence among rural older adults with cognitive decline, influenced by the type of health behavior and the level of social support and quality of life. These insights emphasize the need for tailored health promotion strategies that consider these variables. Future research should aim to deepen the understanding of these relationships, particularly by comparing this group with older adults without cognitive impairments or in urban area. and exploring the causal factors behind different levels of decision‐making competence.
Mortality associated with seizures in dementia
Authors: Zawar Ifrah 
Published: January 2025

AbstractBackgroundSeizures are a common co‐morbidity of dementia and are associated with accelerated cognitive decline. However, the impact of recurrent versus remote seizures on mortality outcomes in people with dementia (PWD) has not been studied. The purpose of our study is to fill this knowledge gap.MethodThis longitudinal, multicenter study is based on participants recruited from 39 Alzheimer’s disease Centers in the US from 9/2005 –12/2021. The effect of recurrent or active seizures (over the preceding 12 months and/or requiring active treatment), remote seizures (history of seizures but no seizures over the preceding 12 months) and no history of seizures (controls) were assessed on mortality outcomes in people with dementia.ResultAmong 26,598 cognitively impaired, 664 had recurrent seizures and 567 had remote seizures. Early onset of cognitive decline (p<0.001), dominant AD mutation (p = 0.002), Parkinson’s disease (PD, p = 0.055), traumatic brain injury (TBI, p<0.001), active depression (p<0.001) and stroke or TIA were associated with active or remote seizures. Patients with active seizures performed worse on Clinical dementia rating (P<0.001), and functional assessment scale (p<0.001) compared to those without seizures.Analysis of longitudinal mortality data showed that a higher proportion of active seizure patients had died compared to remote seizures and controls (35.86 vs 28.62 vs 19.11% respectively, p < 0.0001), and they were younger at death (74.88 vs 76.53 vs 79.81 years, p < 0.001). To examine mortality further, a Cox regression model was conducted to study age at death and seizure status. We adjusted the model for sex, race, ethnicity, age, severity of dementia, hypertension, diabetes, stroke, TIA, TBI, PD, depression, education, alcohol use and dominant AD mutation. Despite adjustment, patients with active seizures were at a higher risk of dying at a younger age (adjusted hazard ratio: aHR: 1.79, CI: 1.52‐2.10, p<0.001) but those with remote seizures were not (aHR: 1.05, CI:0.90‐1.24, p0.52).ConclusionOur research findings suggest that PWD with active or recurrent seizures have higher mortality rates at a younger age compared to PWD with remote or no seizures. Our findings highlight the need for more aggressive control of seizures in PWD.
Impact of multimodal intervention on cognitive function and nutritional status in older adults with oral frailty: Post‐hoc sub‐group analyses of the J‐MINT study
Authors: Nakamura Junya , Uchida Kazuaki , Sugimoto Taiki , Matsuo Koichiro , Sakurai Takashi , Arai Hidenori 
Published: January 2025

AbstractBackgroundIn Japan, effective interventions to prevent low nutrition in older people with oral frailty have not been well established. This post‐hoc sub‐group analysis of the Japan‐multimodal intervention trial for the prevention of dementia (J‐MINT) aimed to examine the efficacy of the multidomain intervention in older adults with and without oral frailty.MethodsJ‐MINT was an 18‐month randomized controlled trial in which participants aged 65‐85 years with mild cognitive impairment were randomized to a multimodal intervention group (physical exercise, nutrition counseling, cognitive training, and vascular risk factor management) and a control group. This study included the participants in J‐MINT who had undergone the intervention program and follow‐up evaluation at least once. Oral frailty was defined as oral frailty (Oral Frailty Index‐8 ≥ 4 points) at baseline assessment. Outcomes were the change from baseline to 18‐month assessment in cognitive function (the composite scores of eight neuropsychological tests), Body Mass Index (BMI), nutritional status (Mini Nutritional Assessment Short‐Form), fat‐free mass, fat mass, food diversity, and appetite (Council on Nutrition Appetite Questionnaire). A mixed model for the repeated measure was used to calculate the mean difference (MD) of outcome between the intervention and control groups.ResultsOf 531 participants enrolled in J‐MINT, 433 participants were included (mean age: 74.4±4.9; women, 226; intervention group: 215), and 152 participants had oral frailty at baseline assessment. In older adults with oral frailty, although no significant mean difference in cognitive function was observed (MD [95%CI] = 0.099 [‐0.019‐0.217]), significant intervention effect in nutritional status (0.548 [0.034‐1.062]), fat‐free mass (0.842 [0.216‐1.468]), fat mass (‐0.962 [‐1.890–0.038]), food diversity (1.263 [0.374‐2.150]), and appetite (1.315 [0.524‐2.110]) were observed. However, in older adults without oral frailty, there is a significant intervention effect in only food diversity (1.454 [0.808‐2.100]).ConclusionThe results of this study suggest the effectiveness of multimodal interventions on nutritional indicators for older adults with oral frailty. Oral frailty may be an effective target for multimodal intervention.
37‐year secular trends in prevalence, incidence, and survival rate of dementia in a Japanese community: the Hisayama Study
Authors: Ohara Tomoyuki , Minohara Toshifumi , Nakazawa Taro , Hata Jun , Shibata Mao , Ninomiya Toshiharu 
Published: January 2025

AbstractBackgroundFew population‐based prospective studies have investigated whether the prevalence, incidence, and survival rate of dementia in a community have changed since the 2010s.MethodSeven cross‐sectional surveys of dementia were conducted among residents of a Japanese community, aged ≥65 years, in 1985, 1992, 1998, 2005, 2012, 2017, and 2022. We also established three cohorts consisting of the residents of this age group without dementia in 1988 (n = 803), 2002 (n = 1,231), and 2012 (n = 1,521) and each was followed for 10 years. Trends in the prevalence of dementia were tested by using the logistic regression model. The age‐ and sex‐adjusted incidence and survival rate of dementia were compared between cohorts using the Cox proportional hazards model.ResultThe crude prevalence of dementia increased with time from 1985 to 2012 (6.7% in 1985, 5.7% in 1992, 7.1% in 1998, 12.5% in 2005, and 17.9% in 2012, p for trend <0.01), while the crude prevalence of dementia decreased with time from 2012 to 2022 (17.9% in 2012, 15.6% in 2017, and 11.9% in 2022, p for trend <0.01). These secular changes did not change even after standardizing by age. The age‐ and sex‐adjusted incidence of dementia significantly increased from the 1988 cohort to the 2002 cohort (adjusted hazard ratio [aHR] = 1.7, 95% confidence intervals [CI] = 1.4‐2.1). However, the age‐ and sex‐adjusted incidence of dementia significantly decreased from the 2002 cohort to 2012 cohort (aHR = 0.6, 95% CI = 0.5‐0.7). The age‐ and sex‐adjusted 5‐year survival rate of dementia significantly improved from the 1988 cohort to the 2002 cohort (47.3% to 65.2%, p<0.01), while no secular change was observed from the 2002 cohort to the 2012 cohort (65.2% to 58.3%, p = 0.39).ConclusionThe decreasing trends in the prevalence and incidence of dementia were observed since 2012 in the Japanese older population. The decline in the incidence of dementia may be due to prevention of lifestyle‐related diseases, such as hypertension and diabetes, and improvement of proper management of the disease, as well as awareness and promotion of healthy lifestyle behaviors.