bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of people with Alzheimer’s disease, relatives, and dementia trainers on the usability of a tablet‐based dementia training
Authors: Schüssler Sandra , Zuschnegg Julia , Paletta Lucas , Russegger Silvia , Fellner Maria , Ploder Karin , Strobl Bernhard , Sekulic Maja , Koini Marisa , Hofmarcher‐Holzhacker Maria , Roller‐Wirnsberger Regina 
Published: December 2022

AbstractBackgroundNon‐pharmacological interventions for people with dementia, like tablet‐based cognitive trainings, are increasingly popular to counteract the disease progression. Usability research on such trainings in the field of dementia is essential to raise acceptance and increase training intensity, as regular practice may contribute to their effectiveness. The aim was to explore the experiences of people with Alzheimer’s disease (PwAD), relatives, and dementia trainers regarding the usability of a tablet‐based dementia training.MethodThis qualitative study is part of an ongoing randomized controlled trial (project multimodAAL) which investigates the effects of an individually performed tablet‐based dementia training program (i.e., physical and cognitive exercises) in PwAD living at home. Individual interviews were conducted with people with mild AD (n=5), relatives (n=5) and dementia trainers (n=5) who had been performing the training for at least 6 months. A qualitative content analysis was conducted.ResultParticipants were predominantly women (73.3 %), with an average age of 73.4±11.4 years for PwAD, 66.2±10.7 years for relatives, and 43.1±10.4 years for trainers. Participants confirmed a good feasibility of the video‐provided physical exercises (e.g., coordination, strength), but some PwAD reported feeling unchallenged. Relatives and trainers wished for exercises to be more motivating (e.g., direct motivational address by the gymnast in the video, colorful sportswear). Regarding cognitive exercises, participants appreciated the varied and alternating types of exercises (e.g., puzzle, quiz) within the training sessions. Trainers and relatives recognized that PwAD particularly enjoyed exercises related to topics of their past/biography (e.g., hobbies, previous occupation) and to religious/seasonal traditions (e.g., Easter). Relatives and trainers highlighted that most PwAD needed support during the physical and cognitive exercises in terms of (technical) guidance, motivation/feedback/praise, as well as hints/tips/thought‐provoking impulses to perform their training successfully and to avoid frustration and cancellation of the training. Some suggested to extend the program regarding written and verbal support (e.g., hint button, voice assistant). Furthermore, participants emphasized a good sensitivity of the tablet‐PCs’ touch screen.ConclusionResults show that the presented tablet‐based dementia training is received well by participants, but there is still potential for (technical) enhancements regarding support through the exercises and motivational strategies.
DEMENTIA CAREGIVER SUPPORT PROGRAM IN VIETNAM: DEVELOPMENT, IMPLEMENTATION AND FIRST RESULTS
Authors: Huong Tran Thi Thu , Tam Pham Thi Thanh , Luu Phan Thi , An Nguyen Thi Thai , Liem Do Thanh , Truc Nguyen Tran Thanh , Thang Tran Cong , Weschke Sarah , Klein Olga A. , Kilimann Ingo 
Published: December 2022

AbstractBackgroundPrevious studies on support programs including psychoeducation, care training, and counselling have shown to be beneficial for family dementia caregivers with the potential to reduce care giver burden. In this pre‐post study, we aimed to assess the effects of a new support program to reduce caregivers’ burden.MethodsWe developed and conducted a 4‐week support program (4 sessions, 1.5 hours each). An 8‐module course developed by the German Center for Neurodegenerative Diseases (DZNE) and the German Alzheimer’s Society was culturally adapted to fit into the Vietnamese context. Caregivers of people with dementia were invited to participate in the program at Hospital 30‐4 in Ho Chi Minh City, Vietnam.Caregiver burden was assessed with the 22‐item Zarit Burden Interview (ZBI) at baseline and after the intervention using the Wilcoxon signed‐rank test.ResultsA total of 15 caregivers underwent the study. The mean age was 52.7 years, 67% of patients were women, the mean time duration of care was 16 (±9.5, max 30) months. Wilcoxon signed‐rank test indicated that median ZBI scores post‐intervention (median = 40) were not statistically significant difference to the median pre‐intervention (median = 44, Z = 34.5, p = 0.26).ConclusionOur study showed no statistically significant change of burden, however, a tendency towards a reduction of the ZBI score after the intervention. The reasons for not reaching significance might be the small sample size of the intervention. Furthermore, the ZBI assessment directly after the end of the program might miss the effect of the intervention as participants will need time for the implementation of new coping strategies.
Experiences of people with Alzheimer’s disease, relatives, and dementia trainers on the usability of a tablet‐based dementia training
Authors: Schüssler Sandra , Zuschnegg Julia , Paletta Lucas , Russegger Silvia , Fellner Maria , Ploder Karin , Strobl Bernhard , Sekulic Maja , Koini Marisa , Hofmarcher‐Holzhacker Maria , Roller‐Wirnsberger Regina 
Published: December 2022

AbstractBackgroundNon‐pharmacological interventions for people with dementia, like tablet‐based cognitive trainings, are increasingly popular to counteract the disease progression. Usability research on such trainings in the field of dementia is essential to raise acceptance and increase training intensity, as regular practice may contribute to their effectiveness. The aim was to explore the experiences of people with Alzheimer’s disease (PwAD), relatives, and dementia trainers regarding the usability of a tablet‐based dementia training.MethodThis qualitative study is part of an ongoing randomized controlled trial (project multimodAAL) which investigates the effects of an individually performed tablet‐based dementia training program (i.e., physical and cognitive exercises) in PwAD living at home. Individual interviews were conducted with people with mild AD (n = 5), relatives (n = 5) and dementia trainers (n = 5) who had been performing the training for at least 6 months. A qualitative content analysis was conducted.ResultParticipants were predominantly women (73.3%), with an average age of 73.4±11.4 years for PwAD, 66.2±10.7 years for relatives, and 43.1±10.4 years for trainers. Participants confirmed a good feasibility of the video‐provided physical exercises (e.g., coordination, strength), but some PwAD reported feeling unchallenged. Relatives and trainers wished for exercises to be more motivating (e.g., direct motivational address by the gymnast in the video, colorful sportswear). Regarding cognitive exercises, participants appreciated the varied and alternating types of exercises (e.g., puzzle, quiz) within the training sessions. Trainers and relatives recognized that PwAD particularly enjoyed exercises related to topics of their past/biography (e.g., hobbies, previous occupation) and to religious/seasonal traditions (e.g., Easter). Relatives and trainers highlighted that most PwAD needed support during the physical and cognitive exercises in terms of (technical) guidance, motivation/feedback/praise, as well as hints/tips/thought‐provoking impulses to perform their training successfully and to avoid frustration and cancellation of the training. Some suggested to extend the program regarding written and verbal support (e.g., hint button, voice assistant). Furthermore, participants emphasized a good sensitivity of the tablet‐PCs’ touch screen.ConclusionResults show that the presented tablet‐based dementia training is received well by participants, but there is still potential for (technical) enhancements regarding support through the exercises and motivational strategies
The Effects of Stressful Life Events on Alzheimer’s Disease Biomarkers, Neuroinflammation and Brain Integrity in Later Life: A Life Course Perspective
Authors: Palpatzis Eleni , Akinci Muge , Operto Grégory , Garcia Marina , Blennow Kaj , Zetterberg Henrik , Suridjan Ivonne , Kollmorgen Gwendlyn , Wild Norbert , Gispert Juan Domingo , Suárez‐Calvet Marc , Sánchez‐Benavides Gonzalo , Grau‐Rivera Oriol , Peña‐Gomez Cleofé , Arenaza‐Urquijo Eider M 
Published: December 2022

AbstractBackgroundStress is associated with adverse health outcomes, but the pathways through which stressful life events affect brain health, and the age periods most vulnerable to these effects, are unknown. We investigated these questions in relation to Alzheimer’s disease (AD) pathophysiology and brain integrity in cognitively unimpaired participants at risk for AD.MethodIn this cross‐sectional cohort study, 1168 participants completed the 18‐item Elder’s Life Stress Inventory measuring the occurrence (and age at occurrence) of stressful life events. Of these, 393 participants had data available on AD biomarkers (cerebrospinal fluid [CSF] phosphorylated‐tau and amyloid‐beta1−42/amyloid‐beta1−40 ratio measured with Elecsys® assays and NeuroToolKit panel of robust prototype assays [Roche Diagnostics International Ltd, Rotkreuz, Switzerland], respectively) and neuroinflammation markers (CSF interleukin 6 [IL‐6], soluble TREM‐2 and glial fibrillary acidic protein measured with NeuroToolKit). In total, 830 had structural magnetic resonance imaging data available for amygdala and hippocampal volume, and grey matter volume/thickness for areas of the prefrontal cortex. The association of stressful events with AD biomarkers, neuroinflammation and brain integrity (adjusting for total intracranial volume) was examined using multiple regression analyses adjusting for sex, age and education. Associations of stressful events during early life (ages 0−25), early adulthood (26−40), middle adulthood (41−55) and late adulthood (≥56) were also examined. Analyses were stratified by sex and Apolipoprotein ε4 (APOE ε4)‐status.ResultParticipants’ age ranged between 47−76 and 62.5% were women. A higher number of stressful events during life‐course was associated with an increase in IL‐6 levels among APOE ε4‐carriers; with a decreased amyloid‐beta ratio among APOE ε4‐noncarriers; and with a reduction in caudal anterior cingulate cortex volume among women. A higher number of events during early adulthood was associated with higher phosphorylated‐tau levels and prefrontal brain integrity, and during middle adulthood was associated with decreased prefrontal brain integrity (Table 1. & 2.).ConclusionStress may affect later‐life brain health through multiple pathways, including neuroinflammation, amyloid‐beta and brain integrity, depending on APOE ε4‐carrier status and sex. Stressful events during early adulthood may promote phosphorylated‐tau in later‐life, while events during early/middle adulthood may have differential effects on brain integrity, suggesting potential windows for stress‐prevention strategies.
Usmarapride Oxalate (SUVN‐D4010): A Serotonin‐4 Receptor Partial Agonist for the Treatment of Cognitive Disorders
Authors: Abraham Renny , Subramanian Ramkumar , Rasheed Mohammed Abdul , Ravella Srinivasa Rao , Malleshwari Durga , Thentu Jagadeesh Babu , Nirogi Ramakrishna 
Published: December 2022

AbstractBackgroundAlzheimer’s disease is a growing unmet medical need which involves a gradual decline in cognitive function. The therapeutic options for the treatment of cognitive disorders of this type are few with limited efficacy.MethodUsmarapride was characterized for its in‐vitro properties using binding and functional assays. Its pharmacokinetic properties were evaluated both in rats and dogs. The procognitive efficacy of usmarapride was evaluated in combination with the current standard of care used for AD type dementia. As AD is associated with comorbid depression, usmarapride was evaluated for its antidepressant like activity as well.ResultFrom in‐vitro functional studies, usmarapride was characterized as a partial agonist at 5‐hydroxytryptamine 4 (5‐HT4) receptors. It has excellent oral bio‐availability in rats and dogs. Usmarapride potentiated the procognitive effects of donepezil in behavioral animal models. Usmarapride also enhanced donepezil evoked acetylcholine levels in electroencephalogram (EEG) assay. Usmarapride was also found to have antidepressant like activity in an animal model of depression.ConclusionUsmarapride showed excellent oral efficacy in combination with donepezil in tested animal models of cognition. Additionally, usmarapride distinguish itself from currently used standard of care for the treatment of AD as it exhibits potent antidepressant like properties as well.
Heart rate variability: a novel biomarker for agitation propensity in Alzheimer’s disease?
Authors: Liu Kathy Y , Whitsel Eric A , Heiss Gerardo , Palta Priya , Reeves Suzanne J , Lin Feng Vankee , Roiser Jonathan P , Howard Robert J 
Published: December 2022

AbstractBackgroundAgitation, a common symptom in Alzheimer’s disease (AD), may be related to impaired emotion regulation capacity with involvement of autonomic networks. Heart rate variability (HRV), an index of integrity of neural networks involved in autonomic function and emotion regulation, could be a potential marker of agitation propensity. We investigated the cross‐sectional and longitudinal association between HRV and agitation prevalence in AD using the Atherosclerosis Risk in Communities (ARIC) Study cohort that followed up participants from 1987–2013.MethodParticipants at ARIC visit 5 who were clinically diagnosed with dementia (or MCI that subsequently progressed to dementia) primarily or wholly attributed to AD were included. Agitation at visit 5 was defined based on the Neuropsychiatric Inventory agitation/aggression subscale alone, or a composite score comprising agitation/aggression, irritability, disinhibition, and aberrant motor behavior subscales. HRV measures at visits 1–5 were the root mean square of successive differences in R‐R intervals (RMSSD) and standard deviation of normal‐to‐normal R‐R intervals (SDNN) obtained from resting, supine, standard twelve‐lead electrocardiograms. The associations between agitation and visit 5 HRV or visit 1–5 change in HRV (defined as individual slope coefficients from mixed effects models) were assessed using simple regression models.ResultsAmong 456 participants who had dementia during the study, N = 302 received a primary diagnosis of AD, of whom N = 120 were classified with pure AD (see Flowchart). In the pure AD subgroup, a 0.1 log‐unit higher RMSSD (odds ratio = 1.14 [1.03‐1.29]) and positive RMSSD change over the preceding two decades (odds ratio = 2.23 [1.24‐4.38]) were associated with agitation point prevalence after accounting for heart rate (change), age, sex, cognitive status, study site and race. A 0.1 log‐unit change in HRV approximated the observed difference in HRV with each decade of age. The associations persisted after accounting for use of medications with autonomic effects.ConclusionThe finding that higher HRV was associated with agitation point prevalence in N = 120 participants clinically diagnosed with dementia solely due to AD supports the potential use of HRV as a biomarker of agitation propensity, and autonomic dysfunction as a target of treatment. Future studies are needed to explore this relationship alongside measures of emotion regulation and locus coeruleus‐noradrenergic system integrity.
Cortisol, cognition, and Alzheimer’s disease biomarkers among memory clinic patients
Authors: Holleman Jasper , Adagunodo Sofia , Kåreholt Ingemar , Hagman Göran , Aspö Malin , Udeh‐Momoh Chinedu T. , Solomon Alina , Kivipelto Miia , Sindi Shireen 
Published: December 2022

AbstractBackgroundChronic stress has been studied as a potential lifestyle risk factor for Alzheimer's disease (AD). Prolonged stress can lead to alterations in diurnal patterns of cortisol. This study aims to investigate the relationship between diurnal cortisol patterns, cognition, and AD biomarkers in memory clinic patients.MethodParticipants diagnosed with subjective cognitive impairment (SCI), mild cognitive impairment (MCI), or AD dementia were recruited from Karolinska University Hospital memory clinic in Sweden (n=155). Baseline cognition was measured using five cognitive domains (memory, working memory, processing speed, perceptual reasoning, overall cognition), operationalized as average z‐scores. Diurnal cortisol patterns were assessed using five salivary cortisol measures: awakening levels, cortisol awakening response, bedtime levels, the ratio of awakening to bedtime cortisol levels (AM/PM ratio), and total daily output. AD biomarkers Aβ42, total tau (T‐Tau), and phosphorylated tau (P‐Tau) were measured from cerebrospinal fluid. Cognition was measured at follow‐up (average 32 months) in a subsample of participants (n=57).ResultAwakening cortisol levels were significantly higher in AD dementia compared with SCI. Greater cortisol awakening response was associated with better memory performance (OR= 1.57, 95% CI: [1.10 – 2.23]), while a greater AM/PM ratio (OR= 2.21, 95% CI: [1.15 – 4.25]) and lower bedtime cortisol levels (OR= .64, 95% CI: [.40 – 1.01]) were associated with better overall cognition. Cortisol measures were not associated with cognitive decline during follow‐up or with AD biomarkers in the full sample. However, in stratified analyses, higher awakening cortisol levels were associated with lower CSF Aβ42 in amyloid‐positive participants (b= ‐60.13; 95% CI [‐102.73 ‐ ‐17.52]), while higher bedtime cortisol levels (b= .09; 95% CI [.02 ‐ .17]) and a lower AM/PM ratio (b= ‐.12; 95% CI [‐.23 ‐ ‐.02]) were associated with higher CSF T‐Tau in amyloid‐negative participants.ConclusionThis study shows that diurnal cortisol patterns are associated with cognitive performance in memory clinic patients. In people without amyloid pathology, cortisol may affect cognition through neurodegeneration‐related mechanisms, leading to the observed correlation with T‐Tau. Meanwhile, in amyloid‐positive participants, the greater pathology level may affect cortisol patterns. Further research should investigate the complex relationship between cortisol, cognition, and brain pathology.
The impact of Alzheimer’s Disease on care partners
Authors: Hahn‐Pedersen Julie Hviid , Larsen Tove Holm 
Published: December 2022

AbstractBackgroundThe burden of informal caregiving of people with Alzheimer’s Disease (AD) is often overlooked. We wanted to provide an overview of the burden of AD for care partners and to explore how the burden increases with disease progression through a systematic literature review.MethodA protocol was developed before searches in PubMed, Embase, PsycINFO, and Cochrane Library were run October 2021 via the Silvi.ai‐platform. Eligible studies were published in English and provided data from 2010 or later. Two reviewers screened titles and abstracts independently. A single reviewer conducted full‐text analysis and data extraction, and a PRISMA overview was generated. Studies were quality ranked in accordance with Oxford quality grading scale.Result911 hits were identified of which 61 studies were relevant for data extraction. Most care partners were women. The majority of studies reported moderate‐to‐severe levels of impact on care partners life (using the Zarit Burden Interview (ZBI) and the Maslach burnout inventory) and on care partners’ overall quality of life (using the WHO Quality of Life questionnaire);1,2 care partners exhibited higher levels of stress, depression, and anxiety compared to control groups.3,4,5,6 Females had significantly higher score on care partner burden than males (measured by the Caregiver Burden Inventory (CBI)).7 The higher the number, frequency and severity of symptoms affecting patients, the more intense care partner distress as measured by the Neuropsychiatric Inventory Distress Scale.8 The care partners of people with severe dementia due to AD reported the greatest care partner burden measured by the short version of the ZBI and the CBI.9,10 There was a clear correlation between hours of care giving and score of the ‘Activities of Daily Living’ questionnaire. The higher the score, the more hours of care giving.11,12,13,14
ConclusionBeing a care partner to a person with AD is often associated with emotional stress, depression, anxiety, low overall QoL as well as impact on physical health. Female care partners are disproportionally affected compared to males. The more severe the AD, the larger the burden. More research within the field is required to illuminate the true health consequences for care partners of people with AD.
VRCT: Randomized Controlled Trial Evaluating the Impact of Virtual Reality Therapy on BPSD and QoL of Acute Care In‐Patients With Dementia
Authors: Appel Lora , Appel Eva , Kisonas Erika , Lewis Samantha , Rosenberg Jarred , Appel Julian , Smith Christopher 
Published: December 2022

AbstractBackgroundVirtual Reality (VR) is increasingly considered a valuable therapy tool for managing behavioural and psychological symptoms (BPSDs) and quality of life (QoL) in dementia (Parsons, 2013). However, rigorous studies are still needed to evaluate its impact in acute care settings (Appel, 2021). This study evaluated the impact of VR‐therapy on managing BPSDs, falls, and length of stay (LoS) and QoL for inpatients with dementia admitted to an acute care hospital.MethodAn open longitudinal interventional randomized controlled trial was conducted between April 2019 and March 2020 (ClinicalTrials.gov, ID:NCT03941119). A total of 69 participants (age ≥65, diagnosis of dementia, did not meet exclusion criteria) (Figure 1) who were randomly assigned either followed standard of care (Control Arm, n = 35 or received VR‐therapy every 1‐3 days (Intervention Arm, n = 34) (Figure 2). VR‐therapy entailed watching 360‐degree‐VR‐films on a HMD for up to 20 minutes (Figures 3 and 4). Instances of daily BPSDs documented in EMR nursing notes were categorized based on the Neuropsychiatric Inventory (NPI). QoL measures included the Quality of Life in Late‐Stage Dementia scale (QUALID) and semi‐structured interviews conducted at scheduled visits. Structured observations (including the standardized “ObsRVR” tool) and interviews were used to measure treatment feasibility (Figure 5).ResultVR‐therapy had a statistically significant effect (p = .014) in reducing aggressivity (i.e., physical aggression and loud vociferation). A sentiment analysis of patient responses to the semi‐structured interviews on QoL revealed a statistically significant impact of VR therapy (p = .013). No statistically significant impact of VR therapy was found for other BPSDs (e.g., apathy), falls, or LoS or QoL as measured by the QUALID. VR‐therapy was overall an acceptable and enjoyable experience for participants and no adverse events occurred as a result of VR‐therapy.ConclusionImmersive VR‐therapy appears to have an effect on aggressive behaviours and QoL in acute care patients with dementia. Although the RCT was stopped before reaching the intended sample size due to COVID‐19 restrictions, trends in the results are promising. We suggest conducting future trials with larger samples and, in some cases, more sensitive data collection instruments.