bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosocial factors associated with loneliness change during COVID‐19 pandemic in Italian older‐old individuals: Findings from the InveCe.Ab cohort
Authors: Rolandi Elena , Rossi Michele , Serini Miriam , Vaccaro Roberta , Colombo Mauro , Guaita Antonio 
Published: June 2023

AbstractBackgroundLoneliness is an issue for many older adults, significantly affecting physical, cognitive and mental health. The aim of the present study was to evaluate if loneliness worsened in older‐old individuals during the COVID‐19 nationwide lockdown in Italy, compared to their pre‐pandemic status. Moreover, we explored which pre‐pandemic psychosocial factors predict loneliness change.MethodThe present investigation was conducted on 409 older adults without dementia and aged between 79 and 84 years, participating in the fourth evaluation wave of the InveCe.Ab study in 2018 (NCT01345110) and then performing a telephone survey between March and May 2020, during the first Italian nationwide lockdown. Loneliness was evaluated with the UCLA 3‐item loneliness scale both in 2018 and 2020. The following pre‐pandemic measures, collected as part of the in‐person multidimensional assessment in 2018, were considered: age, sex, education, social contact, leisure and physical activity, digital technology usage (yes/no), perceived support from family network (yes/no), personality traits (psychoticism, extraversion, neuroticism), depressive symptoms (Geriatric Depression Scale, GDS), global cognition (Mini Mental State Examination, MMSE) and baseline loneliness. To compare pre‐post pandemic loneliness, we performed the Wilcoxson signed‐rank test. Kendal tau rank correlations were calculated to preliminarily explore the associations between each psychosocial factors and loneliness change (delta). Finally, stepwise multiple linear regression based on the p‐value criteria was used to test which variables independently predicted loneliness change.ResultLoneliness showed a significant increase during the lockdown (p<0.001). Loneliness change was associated with lower GDS (τ = ‐0.221, p<0.001), psychoticism (τ = ‐0.086, p = 0.024), neuroticism (τ = ‐0.116, p = 0.002) and higher extraversion (τ = 0.079, p = 0.035), MMSE (τ = 0.106, p = 0.006), social contacts (τ = 0.091, p = 0.015) leisure activities (τ = 0.103, p = 0.006). Multiple regression showed that only 2 psychosocial factors explained 27% of the variance (R2 = 0.27, F = 74,7, p<0.001). Specifically, baseline loneliness (β = ‐0.70, p<0.001) and perceived support from family network (β = ‐0.50, p = 0.007) predicted loneliness change.ConclusionLoneliness increased during the first nationwide lockdown among older‐old individuals in Italy, compared to their pre‐pandemic level. This change was most prominent among those with lower pre‐pandemic loneliness levels and it was mitigated by perceived support by family network.
Rate of cognitive decline before seizure diagnosis in individuals with dementia and seizures
Authors: keret Ophir , Beninger Felix , Allen Isabel Elaine , Goldberg Ilan , Glik Amir 
Published: June 2023

AbstractBackgroundSeizures and epilepsy occur frequently in individuals diagnosed with dementia. While previous studies report highest incidence in advanced disease stages, emerging studies suggest subclinical seizures noted only on Magnetoencephalography or electroencephalography(EEG) occur frequently in early stages. Such recorded subclinical seizure activity is associated with a more rapid course of cognitive decline on longitudinal assessment. We thus hypothesized individuals with dementia who are diagnosed with seizures in any stage experience a rapid cognitive decline before they are diagnosed with seizures.MethodStudy design is a retrospective case‐control study, assessing clinical data from 24142 research subjects evaluated longitudinally from the National institute of health Alzheimer Coordination Center, years 2006‐2019. Seizures diagnosed during follow up were used as a predicting variable. Individuals with seizures on their first visit as well as individuals with unknown seizure status were excluded. Individuals with unknown APOE genotype and those without longitudinal data were also excluded. We assessed cognitive decline as an outcome using annual Mini Mental State Exam (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR‐SB). We assessed the decline using a linear mixed effects models adjusting for other variables known to alter decline rate such as age at onset of symptoms, sex and ApoE4 genotype and included a random effect for time between visits within patients.ResultWe identified 205 and 4667 individuals with and without seizures respectively on follow up research visits. Patients with seizures had an younger mean age at symptom onset (65±11.3 vs 70±10.0), of similar sex (50.0% and 50.7% male) and remained longer on follow up (5±3 vs 3±2). Baseline MMSE and CDR‐SB was similar in both groups. Compared to subjects without seizures, those with seizures had a rapid annual decline in CDR‐SB (0.98, SE 0.24, 95% CI 0.51‐1.46, p<.0001) and MMSE (‐1.8, SE = .40, 95% CI ‐1.4 and ‐2.6, p<0.00001).ConclusionA rapid rate of decline can be observed in individuals with dementia prior to seizure diagnosis. Our study suggests undiagnosed seizures or seizures activity on EEG should be suspected in individuals who experience a rapid rate of cognitive decline.
Neuropathological features of antemortem atrophy‐based subtypes of Alzheimer’s disease
Authors: Mohanty Rosaleena , Ferreira Daniel , Frerich Simon , Muehlboeck J‐Sebastian , Grothe Michel J. , Westman Eric 
Published: June 2023

AbstractBackgroundPure Alzheimer’s disease (AD), characterized by combined amyloid and tau pathology, is not the most prevalent form of the disease as non‐AD pathologies (e.g., alpha‐synuclein and TDP‐43) are commonly observed postmortem. The role of AD and non‐AD pathologies is unclear in relation to disease heterogeneity. Therefore, we investigated whether antemortem MRI‐based atrophy subtypes of AD differ in postmortem neuropathological features and comorbid non‐AD pathologies.MethodsWe selected individuals from the ADNI with antemortem MRI evaluating brain atrophy within 2 years before death; antemortem diagnosis of AD dementia/mild cognitive impairment; and a postmortem‐confirmed AD neuropathologic change. Antemortem atrophy subtypes were modeled as continuous phenomena using a recent conceptual framework: typicality (spanning limbic predominant AD to hippocampal sparing AD) and severity (spanning typical AD to minimal atrophy AD). Postmortem neuropathological evaluation included AD hallmarks (amyloid‐beta, tau), non‐AD pathologies (alpha‐synuclein, TDP‐43) and concomitant pathological burden. Partial correlations assessed the associations between antemortem atrophy subtype dimensions and postmortem neuropathological outcomes.ResultsIn 31 individuals (mean age = 80y, 26% females), antemortem typicality was significantly associated with neuropathological features: amyloid‐beta (rho = ‐0.39 overall), tau (rho = ‐0.38 regionally), neuritic plaque density (rho = ‐0.4 overall), alpha‐synuclein (rho = ‐0.39 regionally), TDP‐43 (rho = ‐0.49 overall), and concomitance pathological burden (rho = ‐0.59 regionally). This suggests that limbic predominant AD was associated with higher burden of these pathologies compared to hippocampal sparing AD. Antemortem severity was significantly associated with concomitant pathological burden (rho = ‐0.43 regionally), such that typical AD showed higher burden than minimal atrophy AD.ConclusionsBased on our direct antemortem‐to‐postmortem validation, we hypothesize that: (a) typicality and severity in atrophy reflect differential aspects of susceptibility of the brain to AD and non‐AD pathologies; (b) limbic predominant AD and typical AD subtypes may share similar biological pathways, making them more vulnerable to the investigated AD and non‐AD pathologies compared to hippocampal sparing AD, which may follow a different biological pathway. Our findings provide a deeper understanding of associations of atrophy subtypes in AD with different pathologies, enhancing prevailing knowledge of biological heterogeneity in AD.
Development and evaluation of the Feasible and Sustainable Culture Change Model—an online training program designed to increase the provision of person‐centred care practice in residential care homes
Authors: Caspar Sienna 
Published: June 2023

AbstractBackground and ObjectivesInterventions aimed at increasing the provision of relational and person‐centred care in residential care homes (RCHs) that do not address contextual and system issues most often fail. Promoting positive change in RCHs requires a multilevel, systems approach. The objective of this study was to examine the effectiveness of the online Feasible and Sustainable Culture Change Model (FASCCI) model training program on influencing both the implementation and outcomes of culture change initiatives aimed at increasing the provision of person‐centred care practices during ‘move‐in day’ for newly admitted residents.MethodsUsing principles consistent with Cooperative Participatory Action Research (CPAR), we collected qualitative and quantitative data to examine the processes and outcomes associated with using the online FASCCI training program to implement changes in ‘move‐in day’ care practice in two RCHs. Surveys—including likert scales (1 = strongly disagree‐ 5 = strongly agree) and open‐ended questions, were used to evaluate the staffs’ (n = 24) perceptions of the online training modules. Interviews with the Process Improvement Team leaders (n = 2) were conducted to examine treatment fidelity and ascertain their perceptions regarding the intervention processes. Practice change outcomes were determined based on detailed descriptions and observations of the move‐in practices pre‐intervention and comparing these to the move‐in practices following the intervention.ResultsStaff members indicated they strongly agreed that the online training modules were “useful both personally and professionally” (M = 5.0) and that they “were able to use the skills they learned in their care practice” (M = 4.7). Analysis of data from qualitative interviews demonstrated that use of the online FASCCI model training program resulted in improved team building, communication, and collaborative decision‐making. Multiple changes to care practices occurred, including but not limited to, the creation and implementation of a “Move In Ambassador”, creating an effective process for ‘personal device labelling’ (i.e., walkers), and creating and distributing “Isolation Bags’—bags with personalized, creative activities for the residents to engage with during 2‐week isolation periods (due to the pandemic) at move‐in.ConclusionsThis study offers evidence that the online FASCCI model training program provides a promising approach for improving the provision of relationship‐centred move‐in practices in LTC homes.
Risk knowledge and risk perception of MCI patients and their caregivers in predictive diagnosis of AD: Findings from the PreDADQoL study
Authors: Rostamzadeh Ayda , Schwegler Carolin , Rosende‐Roca Maitee , Canabate Pilar , Moreno Mariola , Ortega Gemma , Schmitz‐Luhn Björn , Boada Mercè , Woopen Christiane , Jessen Frank 
Published: June 2023

AbstractBackgroundIndividuals with mild cognitive impairment (MCI) and their caregivers face complex probabilistic information when seeking diagnostic work‐up of early detection of Alzheimer’s disease (AD). When counseling about biomarker‐based AD detection and communicating dementia risk, clinicians need to consider the magnitude of cognitive impairment and the numeracy skills of their patients, in order to enable an informed decision‐making. The transnational PreDADQoL project used a mixed‐methods approach to provide data on this topic and was conducted in Germany and Spain.MethodA total of 76 MCI patients and caregivers were recruited and followed‐up over 3 months after a standardized counseling session about predictive AD diagnosis and cerebrospinal fluid (CSF)‐biomarker‐based dementia risk prediction. MCI patients consenting to biomarker testing were scheduled for a disclosure session together with their caregiver, where the individual biomarker profile together with the dementia risk was communicated. Risk communication was facilitated by graphical displays and take‐home material. Questionnaires on numeracy skills such expectations towards the predictive testing were applied. Moreover, a questionnaire and an open question on the risk perception regarding the MCI patient’s risk to develop Alzheimer’s dementia within 5 years were assessed.ResultOn average MCI patients answered 58% of items testing numeracy scale correctly, and caregivers 66%. After counseling on biomarker‐based AD detection and dementia risk prediction a substantial number of patients (25%) and caregivers (40%) expected a precise detection of a disease from the biomarker testing and not a risk prediction. MCI patients perceived their risk of developing Alzheimer’s dementia to be equal or lower as compared to a healthy person. The caregivers‘ risk perception correlated significantly with the communicated risk, however, in MCI patients no correlation between communicated risk and risk perception was detected.ConclusionThe disclosure of dementia risk did not have a major impact on the MCI patients‘ risk perception, whereas the caregivers‘ risk perception correlated significantly with the communicated risk. This study depicts that clinicians should be aware that not all the contents of the counseling and disclosure information may be understood by patients. Furthermore, competing preexisting attitudes, expectations and knowledge of the individuals need to be acknowledged by clinicians when communicating dementia risk.
Clinical profile of primary progressive Aphasia in Peru: Case series from a Neurological care center
Authors: Castro‐Suarez Sheila , Guevara‐Silva Erik Alberto , Caparo‐Zamalloa Cesar , Meza‐Vega Maria , Cornejo‐Olivas Mario 
Published: June 2023

AbstractBackgroundPrimary Progressive Aphasia (PPA) is one of the clinical syndromes of frontotemporal dementia (1). The frequency of PPA syndromes is low (16%) in this Latin America, with just one published report in Peruvian population (2). We aim to describe clinical features of PPA patients followed up at a Neurological healthcare center in Peru.MethodRetrospective review of clinical records of patients diagnosed with probable PPA (based on 2011 diagnostic criteria) during the 2010‐2020 period. Local IRB approval was obtained for this study.ResultWe included 11 cases that fulfilled the selection criteria. Nine cases (75%) were categorized as nfvPPA, and 3 (25%) svPPA. There was slightly female predominance (58%). The average of education was 10.8±4.8 years. Six cases (54.5%) declared place of birth from northern Peru. We found 4.2±1.8 years of diagnostic delay for PPA. The mean age at onset for nfvPPA and svPPA groups was 63 ±12.4, and 52(52‐64) respectively. The first symptom identified in the nfvPPA group was effortful, halting speech 7 (77.8%), while svPPA was impaired confrontation naming 3 (100%). nfvPPA group showed agrammatism in language production and effortful speech in 8 patients (88.9%) and impaired in comprehension of syntactically complex sentences and spared single ‐word comprehension 3(33.3%). Parkinsonism was present in 6 patients (66.7%) and only one patient reported coexistence of amyotrophic lateral sclerosis. Depression was present in most of the 50% of cases. svPPA group also presented impaired in single word‐ comprehension, in object knowledge, and spared repetition 3(100%), 3 (100%) and 2(66.8%) respectively. Less than 50% of PPA cases were in speech therapy.ConclusionThe main clinical features of the PPA reported are mostly consistent with previous reports. In our medical records review, no cases of apraxia of speech were found. There is a significant delay of PPA diagnosis. Further studies with prospective design are required to obtain a better description. Implementing training strategies for clinicians will allow to improve the timely and accurate diagnosis of PPA in Peru.
Underlying structure of the MBI‐C in pre‐symptomatic and prodromic states of dementia: A multidimensional scaling approach
Authors: Mallo Sabela C. , Real‐Deus Eulogio , Nieto‐Vieites Ana , Felpete Alba , Lojo‐Seoane Cristina , Pérez‐Blanco Lucía , Ismail Zahinoor , Pereiro Arturo X 
Published: June 2023

AbstractBackgroundThe Mild Behavioral Impairment Checklist (MBI‐C) (Ismail et al., 2017) is a 34‐item scale that evaluates Neuropsychiatric Symptoms (NPS) in pre‐dementia states. Its underlying structure has been little studied and remains largely unknown. Factor analysis‐based approaches may have difficulty finding stable relationships between NPS collected on a checklist to account for the large heterogeneity of manifestations. Thus, our objective was to analyze the underlying structure of the MBI‐C using an alternative approach.MethodEighty‐two MCI and 117 SCD older adults of the CompAS were recruited in primary care health centers. Asymptomatic participants were excluded from the analyses. A weighted model of multidimensional scaling (MDS) will be used. A two‐step bidimensional weighted dichotomous MDS was performed. All items were included in the first step. Items closely associated with each dimension (1 SD above or below the mean) were selected in a second step to obtain the final model solution.ResultsThe results obtained in the two analyzes were similar in terms of the good fit of the models, the type of two‐dimensional solution and the group weights. Model weights were also similar for the three diagnostic groups.The final model was built considering the 12 most relevant items selected in the first step analysis and showed optimal fit indices (stress‐II = .59; D.A.F. = .94).Figure 1 shows the coordinates for the 12 selected items in a bidimensional solution. Dimension I (right‐left) differentiate high and low emotional activation of NPS. Dimension II (top‐down) distinguishes between high and low behavioral activation. The combination of both generates four quadrants, indicating symptoms of resistance (Q‐I: low emotional and high behavioral activation), restlessness (Q‐II: high emotional and behavioral activation), flattening (Q‐III: low emotional and behavioral activation) and desolation (Q‐IV: high emotional and low behavioral activation) (see Figure 1).ConclusionsThe results suggest that two dimensions underlie the most discriminant NPS included in scale (i.e., emotional and behavioral activation). These two dimensions seem to differentiate between four NPS states (resistance, restlessness, flattening, and desolation), which could be the most useful NPS in the determination of risk factors for predementia patients.
Reduced beat‐to‐beat blood pressure variability is associated with cognitive decline over six years in the Malaysian Elders Longitudinal Research (MELoR) study
Authors: Asmuje Nur Fazidah , Mat Sumaiyah , Goh Choon Hian , Myint Phyo , Tan Maw Pin ,   Ageless Study
Published: June 2023

AbstractBackgroundBlood pressure variability (BPV) is defined as fluctuations in blood pressure (BP) from visit‐to‐visit, day‐to‐day, hour‐to‐hour and beat‐to‐beat. While published evidence on visit‐to‐visit BPV have suggested an association between BPV and cognitive decline, but published research on beat‐to‐beat BPV and cognitive decline remains limited. This prospective study, therefore, aimed to determine the relationship between beat‐to‐beat BPV and changes in cognitive performance over a six‐year period.MethodThe first and fourth wave data from Malaysian Elders Longitudinal Research (MELoR) study, which included community dwellers aged 55 years and over at recruitment, were utilized. Non‐invasive continuous beat‐to‐beat BP was recorded at baseline using the vascular unloading method (TaskforceTM,CNSystems). Systolic (SBPV) and diastolic (DBPV) BPV were calculated using standard deviation (SD), coefficient of variation (CV) and average real variability (ARV), which were then dichotomized using median cut‐offs. The Montreal Cognitive Assessment (MoCA) Blind instrument was utilized to allow for telephone‐based assessments at Wave 4 which occurred during the COVID‐19 pandemic. Cognitive decline was defined as 2 points reduction in MoCA.ResultData were available from492 participants, mean (SD) age = 67.8 (6.8) years. Mean MoCA‐blinds scores had increased from 17.1 (3.0) to 18.6 (2.7) from baseline to follow‐up. Cognitive decline was observed in 65 (13%). Individuals with cognitive decline had lower depression scores at baseline . Lower SD‐DBPV (mean difference, MD (95%CI) = 0.56 (0.31,0.98) and CV‐DBPV (MD (95%CI) = 0.51 (0.28,0.91) were significantly increased cognitive change after adjustment for potential co‐founders.ConclusionLower BPV was associated with increased risk of cognitive decline in our population‐based study, which conflicted with available studies using primarily visit‐to‐visit and ambulatory BP measurements and involving mainly hospital‐based populations. Beat‐to‐beat BPV may be a measure of arterial stiffness which may is associated with increased risk of vasculopathy and development cognitive impairment. Future studies should determine whether interventions which lead to increased beat‐to‐beat BPV could reduce cognitive decline.
Tau‐PET imaging with 18F‐PI‐2620 reveals lateralized distribution of tau pathology in critical language regions in patients with early onset of Alzheimer’s Disease and patients with primary progressive aphasia
Authors: Mendez‐Orellana Carolina , Kramer Vasko , Bustamante Gabriel , Escobar Sebastian , Juri Carlos , Haeger Arlette , Amaral Horacio , Santibanez Rodrigo A 
Published: June 2023

AbstractBackgroundLanguage disorders are frequent in patients in advanced and early stages of dementia (Goth & Strøm, 2018) together with the deterioration of other cognitive domains (e.g., memory) (Taler & Phillips, 2008). The first complaint in people with dementia often is language impairment, even preceding other cognitive declines (Ferris & Farlow, 2013). Logopenic variant primary progressive aphasia (lvPPA) and non‐fluent/agrammatic variant PPA (nf/avPPA) are rare neurodegenerative disorders being language impairment the main feature (Gono‐Tempini, 2011). Both β‐amyloid (Aβ) and tau appear to occur in Alzheimer disease (AD). Moreover, Aβ and tau aggregates also represent the underlying pathology in lvPPA (Montembeault et al. 2018) while nf/avPPA resembles a pure tau‐pathology. The purpose of this study is to explore the distribution of tau‐pathology in critical language regions in patients with early‐onset AD (EOAD) and patients diagnosed with primary progressive aphasia (PPA).MethodEight participants (55‐77y): 4 with EOAD, 3 with lvPPA (these first seven patients additionally had a positive 18F‐Florbetaben Amyloid PET), 1 with nf/avPPA, and 14 healthy controls (HC) (age range 54‐76y) underwent dynamic PET scans with 18F‐PI‐2620 to examine the distribution of tau‐pathology in the following cortical language regions: inferior frontal gyrus (IFG), superior temporal gyrus (STG), supramarginal and angular gyrus (PL). Group differences in language regions were examined using standardized uptake value ratios (SUVRs) normalized to the inferior gray matter of the cerebellum.ResultCompared to HC, 3/4 patients with EOAD showed elevated levels of 18F‐PI‐2620 binding, mainly in the right IFG and IPL and left STG, while 3/4 patients with PPA (2 lvPPA and 1 nf/avPPA) showed left lateralized elevated uptake of 18F‐PI‐2620 in all language regions. All PPA patients showed increased binding of 18F‐PI‐2620 predominantly in the left parietal regions.ConclusionOur preliminary results reveal a lateralized distribution pattern of 18F‐PI‐2620 in language regions in patients with EOAD and particularly in those with PPA. These findings suggest that 18F‐PI‐2620 PET imaging is a promising tool to visualize tau aggregations in patients with EOAD and PPA. However, further studies are needed to confirm these preliminary results.