bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying the optimal combinations of dementia risk factors to be targeted in multidomain lifestyle intervention in Canada
Authors: Son Surim , Speechley Mark R. , Zou Guangyong , Montero‐Odasso Manuel 
Published: January 2025

AbstractBackgroundThe optimal combinations of modifiable risk factors to be targeted in preventive dementia trials may vary across countries and settings. We aimed to identify the combinations of modifiable risk factors associated with cognitive change in Canadian adults.MethodPopulation Attributable Fraction analyses on 30,097 participants from the Canadian Longitudinal Study on Aging and prevalence of 2, 3 and 4 risk combinations of the 12 modifiable risk factors identified in the 2020 Dementia Lancet report were estimated to note the ten most prevalent combinations. Association between the identified combinations and 3‐year cognitive changes was examined with linear mixed models.ResultRisk factor combinations were associated with greater change in memory than executive function (Table 1). Among the ten most prevalent dyad combinations, hearing loss and physical inactivity showed the largest adjusted effect on global cognition (β = ‐0.08, 95% CI ‐0.09 to ‐0.06), memory (β = ‐0.1, ‐0.18 to ‐0.14), and executive function (β = ‐0.03, ‐0.04 to ‐0.02). The triad of hearing loss, physical inactivity, and sleep disturbance was associated with the largest adjusted effect across all domains (global: β = ‐0.06, ‐0.07 to ‐0.04; memory: β = ‐0.12, ‐0.15 to ‐0.09; Executive Function: β = ‐0.03, ‐0.04 to ‐0.01). The tetrad of hearing loss, depression, physical inactivity, and sleep disturbance was associated with the largest adjusted effect on memory (β = ‐0.11; ‐0.18 to ‐0.05). The dyad that was associated with greater memory change than their individual effect was hearing loss and physical inactivity, while it was depression, physical inactivity, and sleep disturbance for the triad combination (Figure 1). The tetrad combination included obesity, depression, physical inactivity, and sleep disturbance.ConclusionIdentifying risk factor clusters with the highest prevalence and potential effect size can optimize efficiency of trial design. Intervention programs should consider including hearing loss and physical inactivity or obesity, depression, physical inactivity, and sleep disturbance. These findings may help strategically tailor multidomain dementia intervention programs to have the greatest impact in the Canadian population.
RoboZen: Humanoid Robots Administer Mindfullness Based Stress Releif Therapy to people with dementia and help them relax and improve mood and cognition
Authors: Khan Arshia A 
Published: January 2025

AbstractBackgroundIn this study humanoid robots were programmed to deliver mindfulness‐based stress relief therapy to individuals with dementia. Precisely programmed, these robots aim to enhance well‐being, providing tailored interventions for relaxation, mood enhancement, and heightened cognition in dementia care, showcasing technology’s promise in improving overall quality of life [1, 2, 3, 4].MethodsIn this study, the humanoid robot was programmed with a carefully AI based design protocol incorporating calming activities, guided breathing exercises, and interactive engagement, tailored to the cognitive abilities and preferences of individuals with dementia, to effectively deliver mindfulness‐based stress relief therapy.This mixed‐methods study assessed the effectiveness of humanoid robots in delivering mindfulness‐based stress relief therapy to individuals with dementia. The sample included 9 participants diagnosed with dementia residing in nursing homes. Ethical approval was obtained from the Institutional Review Board.The intervention involved a humanoid robot delivering mindfulness‐based stress relief sessions. Quantitative data, obtained through pre‐ and post‐intervention assessments, included standardized scales measuring stress levels, mood, and cognitive function. Physiological indicators such as heart rate variability and electrodermal activity were recorded using wearable sensors during sessions.Qualitative data were gathered through participant observations and post‐session interviews to capture subjective experiences and perceptions of humanoid robot‐administered therapy. Thematic analysis identified recurring patterns and insights.The study aimed to offer insights into the feasibility, acceptability, and potential benefits of integrating humanoid robots into dementia care for stress relief, contributing to innovative approaches in dementia interventions.ResultsAnalysis of data from participants undergoing humanoid robot‐administered mindfulness‐based stress relief therapy showed significant improvements. The Brief Introspection Mood Scale (BMIS) indicated a highly significant enhancement in mood scores post‐intervention. Participants reported consistently positive shifts in emotional states, supported by electrodermal data showing reduced stress levels during and after sessions. Cognitive assessments, using the Montreal Cognitive Assessment (MoCA), consistently demonstrated improved cognitive function following the intervention.ConclusionIn conclusion, this study demonstrates the promising efficacy of humanoid robot‐administered mindfulness‐based stress relief therapy, revealing significant improvements in mood, physiological stress indicators, and cognitive function among individuals with dementia. This offers a valuable avenue for holistic care interventions.
Born during World War II: Associations with lower incident dementia
Authors: Moza Sotiria , Scarmeas Nikolaos , Yannakoulia Mary , Dardiotis Efthimios , Hadjigeorgiou Georgios M. , Sakka Paraskevi , Kosmidis Mary H. 
Published: January 2025

AbstractBackgroundPrior longitudinal studies have found that individuals born during World War II and the postwar period had lower incident dementia (Tom et al., 2020) than previous generations, a finding contradictory to research indicating early‐life stressors as adverse events for late‐life cognition. This study aimed to further explore this association and underlying factors.MethodsWe analysed data from 1063 older Greeks (Dardiotis et al., 2014). Of those, 614 were exposed to WWII during early childhood (≤6 years) (Mean
age = 70.61±2.13, Mean
education = 8.29 years±4.63, 37.50% men) while 349 were not directly exposed (born after 1944) (Mean
age = 66.89±1.37, Mean
education = 11.24 years±5.00, 28.70% men). Participants provided sociodemographic characteristics and medical history (number‐type of comorbidities), and were administered neuropsychological tests (standardised scores were grouped into visuospatial, memory, attention/speed, language, and executive function domains), the Mini Mental State Examination (MMSE) and the Clinical Dementia Rating Scale (CDR). Logistic regressions were performed with the two groups and cognitive variables, using sex, age, education, clinical depression and anxiety, and multimorbidity, as covariates. We also performed chi‐squared tests to compare the two groups’ parental occupations, as indices of prior socioeconomic status.ResultsIndividuals exposed to WWII in early childhood outperformed those not‐directly‐exposed, in visuospatial tasks and the MMSE, and exhibited lower scores on the CDR scale, even after adjusting for multimorbidity, and clinical depression and anxiety (Controlling for multimorbidity: Visuospatial perception: B = .538, p = .001, OR:1.713, 95%CI:1.236‐2.374, CDR score: B = ‐2.012, p<.001, OR:.134, 95%CI:.043‐.412, MMSE total score: B = .135, p = .021, OR:1.144, 95%CI:1.020‐1.283, Controlling for depression and anxiety: Visuospatial perception: B = .542, p = .001, OR:1.719, 95%CI:1.240‐2.383, CDR score: B = ‐2.119, p = .001, OR:.120, 95%CI:.035‐.409, MMSE total score: B = .135, p = .021, OR:1.145, 95%CI:1.021‐1.284). Parents in the non‐exposed group were more likely to hold white‐collar jobs than those in the early childhood‐exposed group (mother: χ2
(20) = 41.202, p = .004; father: χ2
(24) = 66.959, p<.001)ConclusionsOur results parallel the Tom and colleagues’ study (2020), indicating that individuals exposed to WWII‐related stressors demonstrate superior late‐life cognitive performance relative to non‐exposed individuals, even after accounting for covariates. This would suggest the development of cognitive resilience among those exposed to such traumatic events.
Measuring and reporting adherence in multimodal interventions to prevent cognitive decline
Authors: Soldevila‐Domenech Natalia , Ayala‐García Amaia , Forcano Laura , Barbera Mariagnese , Lehtisalo Jenni , Ngandu Tiia , Solomon Alina , de la Torre Rafael 
Published: January 2025

AbstractBackgroundAdhering to lifestyle‐based multimodal interventions to prevent cognitive decline is crucial for their success, but limited evidence exists on determinants of adherence. This gap may stem from inconsistent adherence measurement and reporting across studies. Additionally, uncertainties persist regarding the optimal intervention intensity needed for meaningful cognitive benefits. Addressing these gaps is vital for conducting comparative effectiveness research and for the successful implementation of precision prevention interventions. This study aims to present current evidence on determinants of adherence to multimodal interventions, and discuss how to harmonize the assessment of adherence and the reporting of multimodal interventions intensity in World‐Wide FINGER studies.MethodTo identify determinants of global adherence to multimodal interventions, we conducted a systematic search on PubMed and employed snowball methods, involving the pursuit of references within references and electronic citation tracking.ResultAs of January 2024, five studies quantitatively explored factors influencing global compliance or participation with multimodal interventions’ activity programs (Table 1), covering sociodemographic, lifestyle, psychological, cardiovascular, and cognitive factors. However, there was high heterogeneity in compliance reporting; some studies used a 66% completion criterion, while others employed different thresholds (e.g., 40‐50% participation in at least 50% of domains). We argue that using an arbitrary percentage as a compliance cut‐off might not be informative as it depends on the dose delivered and the length of follow‐up; i.e., the intensity of the intervention. We suggest reporting average participation in each intervention component to allow for better cross‐trial comparisons. Additionally, we suggest calculating expected intervention intensity as the ratio between the prescribed dose (number of pre‐specified sessions) and the length (months). Observed intensity could be estimated with the same formula, but correcting the prescribed dose by the average compliance to each intervention component. Lastly, we suggest rating group and individual sessions differently to estimate intervention compliance, and emphasize that global adherence should encompass both compliance and lifestyle change.ConclusionHarmonizing adherence reporting in World‐Wide FINGER studies will enhance comprehension of how intervention intensity impacts efficacy. It will also enable pooled analyses to explore adherence determinants, offering valuable insights for designing future precision studies for dementia prevention.
Midlife and old‐age cardiovascular risk factors, educational attainment, and cognition at 90‐years
Authors: Varjonen Anni , Aaltonen Sari , Urjansson Mia , Palviainen Teemu , Saari Toni T , Kaprio Jaakko , Vuoksimaa Eero 
Published: January 2025

AbstractBackgroundCardiovascular (CV) risk factors are associated with increased dementia risk, but their effects on cognition in the oldest‐old (90+) are not well studied. CV risk factors may appear to be protective against dementia due to reverse causation when they are measured during dementia process. To clarify this, we studied CV risk factors measured both at midlife and old age, with 48 years of follow‐up.MethodWe had 96, 90‐97‐year‐olds from the NONAGINTA study consisting of population based older Finnish Twin Cohort study participants born in 1922‐1933. CV risk factors included blood pressure (BP), body mass index (BMI), and physical activity (PA) assessed via questionnaires in 1975, 1981 and 2021‐2023, and cholesterol in 2021‐2023. Telephone‐administered cognitive measures included semantic fluency (1‐minute animal naming), and immediate and delayed recall of three trial 10‐word list learning. We used linear and negative binomial regression analyses (delayed recall) with CV risk factors as independent variables (age, sex, education, and Apolipoprotein E genotype as covariates and adjusted for family data) and 90‐year‐old cognition as a dependent variable.ResultThose with 7‐11 years and ≥12 years of education had better immediate recall than those with ≤6 years of education (p = 0.003 & p<0.001). Those with ≥12 years (n = 19) of education also scored higher than those with ≤6 years of education both in semantic fluency and delayed recall (p<0.001). Higher middle‐age BMI was associated with better animal fluency (p = 0.011), but not with immediate or delayed recall. Old‐age BMI or cholesterol, and middle‐age or old‐age PA were not related to cognition. Those with high middle‐age BP (n = 6) scored higher in animal fluency (p = 0.005), immediate recall (p = 0.023) and delayed recall (p = 0.003) than those with normal BP. In contrast, those with high old‐age BP (n = 63) scored lower in animal fluency (P = 0.010), but not in immediate or delayed recall.ConclusionThe most robust finding was that higher (secondary) education is associated with better cognition even in late old‐age. Middle‐age high BP was associated with better old‐age cognition, but this relationship was reversed for old‐age BP. Paradoxical positive effect of high midlife BP may reflect earlier start of BP medication.
Are there trends towards compression of morbidity for dementia? Evidences from four international population‐based cohorts
Authors: Grasset Leslie , Yaqub Amber , Joly Pierre , Ikram M. Arfan , Helmer Catherine , Seshadri Sudha , Beiser Alexa S , Wolters Frank J. , Dufouil Carole 
Published: January 2025

AbstractBackgroundDementia is a major contributor to loss of autonomy in the elderly. Every year spent with dementia results in significant medical and societal costs. Understanding secular trends of life expectancy with and without dementia would enable us to better anticipate future needs. To date, only a few studies have attempted to decipher the scenarios that occurred over the last few decades concerning the life expectancy (LE) with dementia, but heterogeneity in methods hampered comparison of results. A concerted effort for harmonized methods is essential to investigate whether a decline in dementia incidence is also associated with a compression of morbidity, i.e. a lower duration of LE with dementia.MethodsWe leveraged data from four population‐based studies: PAQUID, Three‐City (3C), the Rotterdam Study (RS), and the Framingham Heart Study (FHS). These studies have ascertained dementia cases and vital status over up to 30 years. Five birth cohorts of participants aged 55 years and older were included in the analysis: 1910‐1915, 1915‐1920, 1920‐1925, 1925‐1930, and 1930‐1935. Illness‐death models were used to compute risk of dementia, risk of death among participants with and without dementia, total LE, dementia‐free LE and LE with dementia. We used age as the time scale and models were adjusted for sex.ResultsResults displayed relate to French cohorts. We included 11450 participants, who were dementia‐free at baseline, from both PAQUID and 3C studies (mean age 75 years, 60% female). On average, the follow‐up duration was 11 years and 2003 incident dementia cases were identified. Overall risks of dementia and risk of death decreased by respectively 44% and 47% in participants from birth cohort 1930‐1935, compared to the 1910‐1915 one. From birth cohorts 1910‐1915 to 1930‐1935, total LE at age 70 rose from 16.3 to 20.3 years, and dementia‐free LE rose from 14.2 to 18.5 years. The risk of death among participants with dementia remained stable.ConclusionResults from French cohorts showed an increase in dementia‐free LE over 20 years, while LE with dementia remained stable, which indicates a compression of morbidity. We are replicating these analyses in RS and FHS, and will combine results.
Prevalence of modifiable risk factors in cognitive aging cohort participants in Bangkok, Thailand
Authors: Sengpanich Pannita , Thanapornsangsuth Poosanu , Hemachudha Thiravat 
Published: January 2025

AbstractBackgroundDementia poses an escalating socioeconomic challenge, yet evidence suggests potential prevention through proactive correction of risk factors and multidomain interventions. In cost‐conscious Thailand, targeting prevalent risk factors may offer the most feasible strategy for disease prevention, ultimately alleviating healthcare burdens.MethodNon‐demented participants were consecutively selected from the INDIE cohort, a longitudinal study on cognitive aging at Chulalongkorn University in Bangkok, Thailand. A 40‐minute interview encompassed symptoms, risk factors, social determinants of health, and quality of life. Modifiable risk factors for dementia were identified through an comprehensive literature review (Table 1) and categorized as modifiable at the individual level (e.g., still uncontrolled in the participant) or at the population level (indicating sufficient efforts by the participant). Beyond examining prevalence in the entire cohort, we explored the number of risk factors present in each participant and assessed the impact of correcting these factors on dementia prevention using figures from the Lancet Commission (Livingston, 2020).ResultNon‐demented participants were consecutively selected from the INDIE cohort, a longitudinal study on cognitive aging at Chulalongkorn University in Bangkok, Thailand. A 40‐minute interview encompassed symptoms, risk factors, social determinants of health, and quality of life. Modifiable risk factors for dementia were identified through an comprehensive literature review (Table 1) and categorized as modifiable at the individual level (e.g., still uncontrolled in the participant) or at the population level (indicating sufficient efforts by the participant). Beyond examining prevalence in the entire cohort, we explored the number of risk factors present in each participant and assessed the impact of correcting these factors on dementia prevention using figures from the Lancet Commission (Livingston, 2020).ConclusionThis underscores the necessity for healthcare policies targeting dementia prevention, emphasizing modifiable risk factors like low physical activity. While the impact of correcting these risk factors on an individual may seem modest, it can be substantial for those at high dementia risk, particularly when identified through biomarkers. Limitations include a small sample size and non‐generalizable participant selection; future research should extend to rural communities and impoverished urban areas with larger anddiverse samples.
Attitudes and Expectations regarding Dementia Risk Estimation among the General Population in Germany, Spain, and Switzerland
Authors: Baumeister Annika , Hübner Constanze , Gerards Michelle , Cantero‐Fortiz Yahveth , Ribaldi Federica , Sauer Jule , Braun Julia , Boada Mercè , Frisoni Giovanni B , Jessen Frank , Rostamzadeh Ayda , Schwegler Carolin , Schmitz‐Luhn Björn , Woopen Christiane 
Published: January 2025

AbstractBackgroundIn recent years, research on risk estimation and early detection of Alzheimer’s disease (AD) advanced swiftly. Studies are investigating the likelihood of developing Alzheimer’s dementia (ADD), even during asymptomatic, preclinical, and prodromal stages of AD. Particular hope is pinned on blood‐based biomarkers as these are less invasive than other methods such as lumbar puncture and Positron Emission Tomography (PET)‐scan. Due to the rapid progress of research in this area, it is anticipated that risk estimation measures will be made available to the general population in the future. As part of the PreTAD project (The Predictive Turn in Alzheimer’s Disease: Ethical, Clinical, Linguistic, and Legal Aspects), our objectives were to investigate attitudes and expectations regarding ADD risk estimation in the general population.MethodWe conducted online surveys within the general population (representative quota sample) in Germany (N = 1,000), Spain (N = 1,000), and Switzerland (N = 750). Among others, we assessed aspects influencing decision‐making regarding ADD risk estimation, accepted invasiveness of risk estimation measures, preferred information sources, and expected impact of a hypothetical high risk for ADD.ResultPreliminary analyses showed that 68% of the German population, 77% of the Spanish population, and 71% of the Swiss population would want to know their risk for developing ADD (rather yes/yes) with a preference for lower invasiveness in all countries (i.e. blood sampling). Physicians were stated as primary information sources regarding risk estimation. Most important aspects influencing decision‐making were existing possibilities to cure or prevent ADD (means > 3,7; 1 = no influence; 5 = strong influence). Individual risk knowledge was rather perceived as a chance to prepare for the future (means > 3.5, 1 = do not agree; 5 = agree) but was also expected to influence feelings of self (means > 3,2) or to cause psychological burden (means > 3,1).ConclusionAcceptance for ADD risk estimation, particularly with low invasive measures, seems rather high in Germany, Spain, and Switzerland indicating promising opportunities for the future integration of such strategies into public health initiatives. Physicians, as primary information sources, should carefully consider individual attitudes and expectations regarding ADD risk estimation as risk disclosure may have several psychological and long‐term implications.
Prevalence of Dementia among Malawian adults with HIV and without HIV: A Medical Record Review
Authors: Lee Haeok , Mlombe Yohannie , Song Yeunjoo E. , Choi Yun‐Beom , Yang Hyun‐Sik , Maseke Joseph , Jun Gyungah R , Ngoma Jonathan 
Published: January 2025

AbstractBackgroundMalawians, in Sub‐Saharan Africa (SSA), face the double burden of HIV and Alzheimer’s disease and related dementia (ADRD). The life expectancy among HIV‐positive people on antiretroviral therapy has increased consistently over the past 25 years. The purpose of the study was to determine the prevalence of dementia among people living with HIV (PLWHIV) and the general population without HIV as a comparison group in Malawi.MethodsWe conducted a retrospective medical records review of four hundred consecutive patients from a single tertiary health center (200 PLWHIV from the HIV clinic and 200 without HIV from an outpatient clinic) in Lilongwe, Malawi. Since there was no electronic medical records system in Malawi, trained data collectors manually reviewed the medical records based on the instrument devices and the definitions between August 2023 and October 2023. We examined dementia prevalence and clinical characteristics including age, gender, and other clinical history between PLWHIV and the comparison group.ResultsThe PLWHIV group was significantly younger than the comparison group (mean age = 44.23±8.07 vs. 57.67±16.28; p<2e‐16), while there was no significant difference in sex (male 55% vs. 50%; p = 0.37). The overall prevalence of dementia was higher in PLWHIV than that in the comparison group (22% vs. 10%; p = 1.4e‐03 before adjusting for age and p = 1.9e‐07 after adjusting for age). Prevalence difference was higher in the older individuals (age>50; 39% vs. 13%; p = 3.2e‐4 before adjusting for age and p = 4.9e‐07 after adjusting for age). Dementia increased with age in both groups: 13% (age<45), 17% (45‐64), and 22% (65 and over), but more rapidly in PLWHIV than in the comparison group (17%, 28% and 50% vs. 5%, 4% and 20% respectively).ConclusionThis is the first study to demonstrate prevalence of dementia in PLWHIV was significantly higher than that of the general population in Malawi. We confirmed the increased risk of dementia in PLWHIV and provided valuable groundwork for future ADRD research in SSA, specifically in Malawi.