bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning climate in long‐term care facilities for people with dementia
Authors: Hartstra Egbert , Prins Marleen , Overbeek Anouk , van der Roest Henriëtte G 
Published: February 2022

AbstractBackgroundTo allow learning processes within an organization, the presence of a facilitating and safe "learning climate" is of utmost importance. We studied which preconditions contribute to a facilitating and safe learning climate in long‐term care facilities for people with dementia. Furthermore, we studied the effect of a facilitating and safe learning climate on job satisfaction, person‐centred care and emotional exhaustion experienced by care staff.MethodData were collected among long‐term care facilities which participated in the fifth round of the Dutch Living Arrangements for people with Dementia (LAD)‐study. Care staff, supervisors and practitioners completed an online questionnaire which included two subscales of the Learning Climate Scale (facilitation and safety) and four subscales of the Learning Potential of the Workplace Scale (learning through reflection; through experimentation; from colleagues; from supervisor). We performed hierarchical linear modelling.ResultParticipants from 58 long‐term care facilities completed the questionnaire. Preconditions that significantly contribute to a facilitating learning climate include development opportunities, successful leadership characteristics, and small care teams. Preconditions that significantly contribute to a safe learning climate include social support from colleagues and supervisors, a high degree of emotional support, and being part of a self‐steering team. Both a more facilitating learning climate and a safer learning climate contribute to more job satisfaction, person‐centred care, and less emotional exhaustion experienced by care staff. Studying different ways of learning, we found that learning through reflection and learning from colleagues and supervisors contribute to more job satisfaction and person‐centred care, while learning through experimentation and learning from colleagues is associated with less emotional exhaustion.ConclusionA facilitating and safe learning climate has several positive effects on care staff and person‐centred care. Therefore, long‐term care organizations should offer sufficient development opportunities and training. Furthermore, this study provides insight in how organizations can learn. Care staff should be given the opportunity to discuss their mistakes without being ashamed, in order to allow further development.
Only within resting state network connectivity of the frontoparietal control and Cingulo Opercular networks predict useful field of view performance
Authors: Hardcastle Cheshire , Kraft Jessica N. , Hausman Hanna K. , O'Shea Andrew , Albizu Alejandro , Evangelista Nicole D. , Boutzoukas Emanuel , Nissim Nicole R. , Van Etten Emily J. , Bharadwaj Pradyumna K. , Song Hyun , Smith Samantha G. , Porges Eric , DeKosky Steven T. , Hishaw Georg A. , Wu Samuel S. , Marsiske Michael , Cohen Ronald , Alexander Gene , Woods Adam J. 
Published: February 2022

AbstractBackgroundThe Useful Field of View (UFOV) test assesses divided attention/speed of processing and relates to independent activities of daily living. Cognitive training utilizing UFOV improves speed‐of‐processing and reduces dementia risk by 29%. Neural correlates of UFOV include key regions of “higher‐order” resting state networks (RSNs) involved in attention processing and dementia risk: Frontoparietal control network (FPCN), Cingulo Opercular network (CON), Default Mode network (DMN), and Dorsal Attention network (DAN). Reduced anti‐correlation between the DMN and task positive RSNs (FPCN, CON, and DAN) is reported in dementia progression. Assessing the relationship of UFOV performance with within‐ and between‐ RSN connectivity may suggest neural mechanisms of cognitive training and potential pathways for reduced dementia risk. We hypothesize that FPCN, CON, and DAN within network connectivity will predict UFOV performance, as these networks are involved in attention processing. We also predict that DMN‐CON anti‐correlation will predict UFOV performance, as this anti‐correlation is related to dementia progression.Method279 healthy older adults (M = 71.6, SD = 5.1) from a larger multi‐site clinical trial were recruited. UFOV performance was measured via Double Decision (DD) task from Posit Science Brain HQ. Participants correctly identified a central target, while simultaneously specifying location of a peripheral target among distractors. Average within‐network connectivity of FPCN, CON, DAN, and DMN, and between‐network connectivity of DMN‐CON, DMN‐FPCN, and DMN‐DAN were extracted from resting‐state functional magnetic resonance imaging through the CONN Toolbox v18b via SPM 12. Multiple linear regressions predicted DD performance from within‐ and between‐network values, controlling for age, sex, education, and scanner. All between‐network values were included in the same regression model.ResultReduced CON (β=‐.134, p=.023) and FPCN (β=‐.126, p=.029) connectivity was associated with poorer DD performance. Less DMN‐CON anticorrelation demonstrated a trend for predicting better DD performance (β=‐.126, p=.060).ConclusionConsistent with previous research, faster DD performance is associated with RSNs involved in executive functioning, attention, and processing speed. Although only trending, reduced DMN‐CON anticorrelation may be related to DD performance. This suggests that within network connectivity may contribute more to DD performance than between‐network connectivity involved in dementia progression in healthy older adults.
Perfusion and free water show opposite trends across tissue layers surrounding white matter hyperintensities in participants with dementia and mild cognitive impairment
Authors: Donnay Corinne A. , Fan Audrey P. , DeCarli Charles S. , Maillard Pauline 
Published: February 2022

AbstractBackgroundWhite matter hyperintensities (WMH) are associated with an increased risk of cognitive impairment and AD. While WMHs are thought to reflect vascular disease, the physiological basis of WMHs remain unclear. New imaging biomarkers are needed to understand the cascade of events leading to the development of WMH. The present MRI study aims to investigate changes in both Free Water (FW) and Cerebral Blood Flow (CBF) in WMH and its penumbra elderly cohort with and without cognitive impairment.MethodFluid‐attenuated inversion recovery, diffusion tensor imaging, and pulsed arterial spin labeling (ASL) perfusion images were acquired in participants with dementia (n=17), MCI (n=41), and normal cognition (n=130) with an 8‐channel coil on a 3 Tesla MRI (Siemens Tim Trio). ASL scan parameters included TR/TE: 4000/13ms, inversion time=1800, voxel size: 4x4x10mm3. CBF maps, calculated using the FMRIB software library, and FW maps were co‐registered into structural space. WMHs were segmented from fluid‐attenuated inversion recovery and T1‐weighted images using an automated protocol. For each subject, individual WMH lesions were identified and successively dilated by 1mm to create 4 WM layers surrounding the lesion core (Figure 1). For each biomarker (CBF and FW), linear mixed‐effect models were used to compare (1) normal WM to WMHs and their surrounding layers; and (2) WMHs to their surrounding layers (lme4 in R software). All models specified individual lesions per participant as a nested random effect as random effects, and age and cognitive diagnosis as fixed effects.ResultCBF in WMHs and Layers 1‐4 were lower than the reference WM (p<0.001, Figure 2A). CBF reduced inlayer 1 (p=0.013) and increased toward normal values in layers 2‐4 (p<0.001) compared the WMH core (Figure 2B). In contrast, the mean FW content was higher in the WMHs and layers 1‐2 compared to the WM (p<0.001). The WMH core had higher FW content than the surrounding layers 1‐4 (p<0.001, Figure 3A, B).ConclusionDecreased CBF and increased FW was observed in tissue surrounding WMHs, suggestive of vascular and microstructural damage in a penumbra region beyond the WMH core. FW and CBF measures provide complementary information to understand the pathological mechanisms of WMH.
Developing a reminiscence therapy platform—LifeBio MemoryTM—with a novel machine‐learning‐based application that transfers speech to text and generates life stories for nursing home residents with dementia
Authors: Orsulic‐Jeras Silvia , Sanders Beth , Powers Sara , Ejaz Farida , Cordell Ashlee , Wilk Christa 
Published: February 2022

AbstractBackgroundNonpharmacologic interventions positively influence cognition, mood, and other behavioral and psychological symptoms of dementia. One such intervention, LifeBio, creates conversations through a series of questions to elicit memories in persons living with dementia. Gathering and processing life story data is often done manually, leading to challenges with feasibility. As a result, novel software, LifeBio MemoryTM, is being developed to streamline the process with the use of machine learning and artificial intelligence. LifeBio Memory will minimize the need to hand‐write or type individualized life story data with the use of speech‐to‐text technology and automatic processing.MethodSeven focus groups (n=35) were conducted with persons living with dementia, family care partners, and residential care staff. Feasibility of use and other general reactions to interacting with the new LifeBio Memory prototypes were examined. Each focus group was audiotaped and transcribed, followed by a thematic analysis of the data that resulted in a list of recommended changes that were first prioritized and then discussed by the research team.ResultResults from the work groups strongly suggest that the use of the LifeBio Memory application is the preferred method for obtaining life story information, showing less support for writing or typing responses as in previous versions of LifeBio. Staff participants report the app would create a more efficient workflow, allowing them to serve a larger number of residents. While a consensus was reached on the value of the concept of LifeBio as well as the LifeBio Memory prototypes, potential barriers to implementing the new platform in residential care settings with persons living with dementia were also identified.ConclusionThe existing LifeBio program faces challenges to scalability due to the time‐and labor‐intensive nature of processing life story information. Results suggest the feasibility of using machine‐learning as an effective, efficient, and preferred method for collecting life story data in place of manualized techniques of the past. Findings from this focus group study will be used to develop a list of specific changes to existing LifeBio processes and materials as well as a plan for developing a full‐scale system to automatically record and process individuals' life stories.
Hippocampal volumes across age at different stages of the AD continuum
Authors: Nebreda Alberto , de Frutos Jaisalmer , Cuesta Pablo , Del Cerro‐León Alberto , García‐Colomo Alejandra , Dolado Alberto Marcos , Fuertes Miguel Yus , Maestú Fernando 
Published: February 2022

AbstractBackgroundStructural imaging based on magnetic resonance, specifically the measurement of hippocampal volumes, has been found to serve as a useful biomarker to assess the severity and progression of Alzheimer’s disease (AD).Differences across stages, including the preclinical, where objective signs can not be clinically measured yet, have been reported in many studies. However, it would be useful for clinicians and researchers, not only to have the knowledge that these differences exist and could be used as a biomarker, but also to have access to an age‐related normative barometer for each stage of the disease.The purpose of this study is to provide a normative database of hippocampal volumes at the different stages of the AD continuum, to provide an easy, age‐adjusted determination of where an individual’s hippocampal volume lies within the distribution, as well as an accessible comparison standpoint for other studies assessing other disorders.MethodMagnetic resonance imaging scans were performed to 589 Spanish individuals (age 68.15 ± 8.74): 332 healthy controls (HC: age 64.12 ± 8.69), 98 who did not exhibit any objectively measurable neuropsychological impairment, but presented subjective cognitive complaints (SCD: age 72.57 ± 5.40), 143 with mild cognitive impairment (MCI: age 73.50 ± 5.28) and 16 participant with diagnosed AD (AD: age 76.75 ± 5.99).ResultPercentiles for average hippocampal volume were calculated across age, separately for each diagnostic subgroup. In addition, potential differences attributable to the method of choice were explored, as well as differences associated to sex or presence of different alleles of the gen APOE, related with AD.ConclusionThis study provides a normative database for hippocampal volume as a function of age, at different stages of the AD continuum, to be used as reference both in clinical and research settings.
Cognitive activity, cognitive function, and structural MRI findings
Authors: Krueger Kristin R. , Wilson Robert S. , Barnes Lisa L. , McAninch Elizabeth A. , Evans Denis A. , DeCarli Charles S. , Fletcher Evan M. , Rajan Kumar B. 
Published: February 2022

AbstractBackgroundMore frequent engagement in late‐life cognitive activities (e.g. reading, playing games) has been associated with slower cognitive decline in old age. Even after adjusting for neuropathological burden, cognitive activities were associated with less cognitive decline. However, it is not known whether people who engage more frequently in cognitive activities show differences in brain anatomy compared to those who participate less frequently. We tested the hypothesis that brain anatomy, as measured by structural MRI indices, mediates the association of cognitive activities and cognitive decline in old age.MethodIn a sample of 975 participants (60% African American and 60% female) from the Chicago Health and Aging Project, late‐life cognitive activities were collected at baseline; MRI was conducted an average of 7.9 years later. We identified several significant correlations of late‐life cognitive activity with MRI indices (brain regions and cortical thickness) and then used linear mixed‐effects regression models to examine those associations with global cognition. Global cognition was assessed using a standardized measure of episodic memory, perceptual speed, and the MMSE, before and after MRI scans.ResultHigher frequency of overall cognitive activity was associated with seven brain volumes and two cortical thicknesses, which were associated with global cognitive level. Of those associations, five were associated with cognitive decline and explained about 42% of the cognitive activity association with cognitive decline. Specifically, a higher reading frequency was associated with lower white matter hyperintensity volume (WMH) and third ventricular volume. Higher WMH and third ventricle volumes were also associated with lower global cognition and a faster rate of cognitive decline. We also found that a higher frequency of playing games was positively associated with greater hippocampal and parahippocampal volumes and caudal anterior cingulate thickness in the left hemisphere.ConclusionIndividuals who engage more frequently in cognitively stimulating activities show differences in brain anatomy compared to those who participate less frequently, as measured by structural MRI. These results suggest that cognitive activities are related to improved structure and function of the brain, thereby shedding light on the well‐established findings that cognitive activities are associated with cognitive decline independent of neuropathologic burden.
Stress biomarkers as outcomes for support groups for people with memory loss and their caregivers (SO CALM)
Authors: Yang Mia , Espeland Mark A , Berga Sarah , Clarke Philip , Ivers Nathaniel N , Shaw Edward G , Taylor Robert N , Hugenschmidt Christina E 
Published: February 2022

AbstractBackgroundDespite the significant burden neuropsychiatric symptoms impose, rigorous research on behavioral interventions to address anxiety, apathy, and depression in people with dementia is limited, especially in those with mid‐ to late‐stage dementia. The Memory Counseling Program (MCP) at Wake Forest School of Medicine offers multi‐tiered support groups that are unique because 1) they are 10‐week, structured groups rather than open, monthly support groups and 2) they include the person living with dementia (PLWD) rather than targeting the caregiver alone.MethodWe measured quantitative biomarkers of stress to complement self‐reports at baseline, prior to initiation of support groups, with follow‐up visit within 10 days of last support group. We used paired t‐tests to examine the differences between pre‐group and post‐group measures for caregivers (Perceived Stress Scale, urinary cortisol, and allostatic load) and for PLWD (Apathy Evaluation Scale, urinary cortisol, and allostatic load). Allostatic load is the burden of chronic and repeated exposure to stress and a marker of stress resilience derived from a combination of labs, blood pressure, waist‐to‐hip ratio, and body‐mass index.ResultAmong 20 participants (1:1 caregiver and PLWD), self‐reports of Perceived Stress Scale and Apathy Evaluation Scales did not change after support group participation, however biomarkers of urinary cortisol and allostatic load decreased significantly after group participation. Among 10 caregivers, urinary cortisol changed from baseline mean 15.6µg/L (SD 12.7) to follow‐up mean 10.3 µg/L (SD 11.4, p<0.05) and allostatic load from baseline mean 5.6 (SD 2.1) to follow‐up mean 4.4 (SD 1.4, p<0.06). Among 10 PLWD, their mean baseline urinary cortisol 22 µg/L (SD 18.3) decreased to 9.8 µg/L (SD 8.0) at follow up and their allostatic load decreased from 5.9 (SD 2.1) at baseline to 5.1 (SD 1.5, p<0.05) at follow up.ConclusionThe Wake Forest Memory Counseling program non‐pharmacologic 10‐week structured support groups may be able to reduce objective stress biomarkers for both caregivers and PLWD. Future studies should test structured support groups with an active attention control in a prospective manner.
Caregiving management styles and utilization of formal care services among dementia caregivers
Authors: Leggett Amanda N , Connell Cathleen M , Gitlin Laura N , Kales Helen C 
Published: February 2022

AbstractBackgroundWhile dementia caregivers report need for assistance, formal service utilization remains low (apprx. 25%). Research suggests demographic characteristics associated with service use, but caregivers’ cognitive and behavioral approach to care has not been considered. Prior work by this team has identified five distinct caregiving styles through qualitative analysis: “Externalizers” (superficial understanding, self‐focused, anger, frustration), “Individualists” (go it alone, emotionally removed), “Learners” (recognize need to change approach but stuck, emotionally turbulent), “Nurturers” (positive affect, empathy, natural mastery), and “Adapters” (arsenal of acquired management strategies, adaptable). We examine variation in formal care service utilization of the caregiving styles and hypothesize that styles showing greater adaptation to the care role (Adapters, Nurturers) will be more likely to utilize formal care services. We also explore reported barriers to use of formal services among those caregivers reporting non‐use.MethodParticipants included 100 primary caregivers for a person living with dementia (PLwD) who were 64 years old on average, 74% female, and 18% non‐White. Use (vs. non‐use) of formal services was a dichotomous outcome in a logistic regression with caregiving style classifications as the key predictors also adjusting for caregiver demographics, length of care, co‐residence, and dementia severity.ResultRates of service utilization varied by caregiving style (20%‐70%). Relative to nurturers (style least likely to use formal services), adapters had greater odds of utilizing formal services (OR=14.4, 95% CI= 1.8‐115.1). Additionally, caregivers who were older and providing care for a PLwD with greater dementia severity had greater odds of formal service use, while caregivers living with the PLwD reported lower odds of service use. Among those not using services, there were not significant differences in barriers to use (e.g. expense) across styles, however, over half cited not needing the assistance.ConclusionBeing an Adapter was significantly associated with service use suggesting that certain caregivers may have greater comfort in accessing such services. Styles showing less adaptability and more rigidity in care approach (e.g. Externalists, Individualists) may not recognize need for formal supports or benefit from support in selecting assistance that meets their needs. Future work may consider measuring for caregiving styles before making service recommendations.
Microstructural mapping of dentate gyrus pathology in Alzheimer’s disease: A 16.4 Tesla magnetic resonance imaging study
Authors: Shih Nien‐Chu , Jones Kymry T. , Kurniawan Nyoman D. , Wong Eellen , Miller Carol A. , Clark Kristi A. , Chui Helena C. , Sepehrband Farshid 
Published: February 2022

AbstractBackgroundThe dentate gyrus (DG) is an important part of the hippocampal structure and it comprises the molecular (ML), granular cell (GCL), and polymorphic layers (PL). Impaired DG is associated with Alzheimer’s disease (AD) pathology. MRI provides general structural information for the clinical diagnosis, but assessing subtle cellular pathological changes still requires histological observation. Here, we performed ultra‐high‐resolution MRI to investigate the correlation between MRI signals in DG and histological measurements of AD pathology.MethodPostmortem hippocampi tissues were used (5 cognitive normal, 5 AD; from USC ADRC). Approximately 2 cm3 of tissue dissected from the anterior hippocampus was scanned using 16.4T MRI, the adjacent tissue was processed for immunohistochemistry. Quantitative ex vivo MRI were acquired at 50 µm3 (T2, T2* and SWI). Multi‐shell diffusion MRI were acquired at 150 µm3 (scan time=72hrs). ITK‐SNAP was used to delineate ML, GCL, and PL regions of the DG; and Fiji software to divide histological images of ML, GCL, and PL into twenty equally sized regions of interest (Figure1A), guided by the Allen human brain atlas. Quantitative and morphometric features of DG subregions were calculated from MRI. Histological data was analyzed to measure cell count from H&E slides, neurofilament density and tau pathology from NF160 and AT8 stained slides, respectively (Figure1B).ResultT2‐map (Figure1C) was positively correlated with neurofilament density in ML (R=0.66, p=0.038), PL (R=0.75, p=0.033) and negatively correlated with p‐tau density (ML:R=−0.60, p=0.064; PL:R=−0.61, p=0.062). R2‐map (ML:R=−0.78, p=0.008; PL:R=−0.67, p=0.032 ) and SWI (ML:R=−0.79, p=0.006; PL:−0.80, p=0.005) was negatively correlated with neurofilament. R2 also had positive correlations with p‐tau density (ML:R=0.70, p=0.02; PL:R=0.6, p=0.068). Finally, diffusion decay rate was significantly correlated with neurofilament in PL (R=0.76; p=0.012).ConclusionResults suggest that quantitative MRI is sensitive to subtle neurite changes within the hippocampal formation, which could be used to assess the connectivity changes in the course of AD. This could also provide insight about the mechanism of AD progression if translated in vivo. The quantitative measurement of the connectivity alteration could also have early diagnosis value, given that recent studies have shown that connectivity changes precede cortical atrophy in AD.