bluuebunny/crossref_metadata_2025_split huggingface dataset:
Change in communication‐related participation in primary progressive apraxia of speech and aphasia
Authors: Utianski Rene L , Martin Peter R , Duffy Joseph R , Botha Hugo , Clark Heather M , Josephs Keith A 
Published: February 2022

AbstractBackgroundIndividuals with Primary Progressive Apraxia of Speech (PPAOS) have AOS as the initial and predominant symptom. Many develop aphasia and/or dysarthria later in the disease course. Past research has shown that patients with neurodegenerative AOS experience reduced participation in communication that is further exacerbated by co‐occurring language deficits. Previous studies suggest measures of disease severity do not necessarily correlate with measures of participation restrictions. The aim of this study was to describe changes in communication limitations in these patients over a one‐year interval, measured by 1) the patient via the Communicative Participation Item Bank (CPIB) and 2) the speech‐language pathologist via ASHA's Functional Communication Measures (FCMs) and an adapted Motor Speech Disorder (MSD) severity rating and determine if there are significant changes in these and other objective speech and language measures (e.g. Western Aphasia Battery‐Revised Aphasia Quotient, Apraxia of Speech Rating Scale‐3).MethodSeventeen patients (10 male) with progressive AOS were seen for a second visit approximately one year following the first visit. The measures collected at each visit were statistically compared. Correlations were calculated between the participation ratings and other clinical assessment measures at each visit and qualitatively compared.ResultThere were statistically significant differences in AOS and aphasia severity between visits. There were significant changes in clinical assessments, MSD severity rating, and all ASHA FCMs between visits, but not the CPIB. Comparison of correlations suggest the relationships among clinical and participation measures may change over time.ConclusionThe findings of this study support the use of patient reported outcome measures, like the CPIB, as they may better reflect the patient experience and associated changes in day‐to‐day functioning when other measures may simply index the progression of the disease.
Cognitive health risks posed by social isolation and loneliness in older Korean Americans
Authors: Jang Yuri , Park Nan Sook , Chiriboga David A 
Published: February 2022

AbstractBackgroundThis study examines associations among social isolation, loneliness, and cognitive health risks in older Korean Americans, focusing on the mediating role of loneliness in the relationship between social isolation and objective and subjective measures of cognitive impairment.MethodData are from 2,061 participants in the Study of Older Korean Americans, a multi‐state survey of Korean immigrants age 60 and older (M
age = 73.2, SD = 7.93). Social isolation was indexed with the Lubben Social Network Scale−6; loneliness, with the short‐form UCLA Loneliness Scale. Objective and subjective measures of cognitive impairment included the Mini‐Mental State Examination and a single‐item self‐rating of cognitive health.ResultIn the logistic regression model for objective cognitive impairment, social isolation was significantly associated, but loneliness was not. In the model for subjective cognitive impairment, both social isolation and loneliness were significant factors. However, the effect of social isolation became non‐significant when loneliness was considered, suggesting a potential mediating role of loneliness. The subsequent mediation analysis confirmed that the indirect effect of social isolation on subjective cognitive impairment through loneliness was significant (B = .33, SE = .04, 95% CI = .24, .42).ConclusionOur analyses provide evidence for the proposed mediating effect of loneliness in the relationship between social isolation and subjective cognitive impairment. Intervention efforts should focus on reducing feelings of loneliness experienced by older immigrants, possibly by engaging them in socially meaningful and cognitively stimulating activities.
Qualitative study of how care is planned and delivered to people living with dementia and a long‐term condition
Authors: Rees Jessica , Walters Kate , Burton Alexandra , Cooper Claudia 
Published: February 2022

AbstractBackgroundDementia rarely travels alone. In the UK, almost 8 in every 10 people with dementia have another chronic condition. Long‐term conditions require continuous management in primary care, including support for self‐management. Tailoring physical health care plans to account for dementia is vital and requires skill and confidence from health care professionals. The objective of this study was to understand how care is planned in primary care, and how professional advice is followed at home, when a person has dementia and a long‐term condition.MethodWe conducted a remote ethnographic study, beginning in September 2020, using qualitative interviews, participant observations supplemented by care plan document analysis and event‐based diaries. We invited people with dementia and their family carers, and relevant health and social care professionals and/or home care workers involved in care of long‐term conditions to participate. We used inductive thematic analysis to analyse observations and interviews and integrated the findings with document analysis to ensure data triangulation.ResultPreliminary findings indicate a degree of disconnect between participant account of health care and documented medical notes, specifically between the ‘goal setting’ and ‘action planning’ aspects of care planning. Participants discussed the impact of the pandemic and reduced physical contact with primary care; in addition to aspects of holistic health management such as the closure of swimming pools. We consider how relationships between participants and general practitioners, homecare workers, and pharmacists are constructed within the care networks of people living with dementia and how these have shifted during the pandemic. We will present our reflections on conducting remote observations with people with dementia, including challenges of developing trust over the phone and overcoming technology barriers.ConclusionContinued involvement of people with dementia in healthcare and in research is imperative despite the challenges of remote contact. Special consideration is required for people with dementia who lack capacity to ensure proxy management by family or home care workers does not become primary management.
A comparative study of 18F‐FDG PET brain metabolism and cognitive performance between normal controls and amnestic Alzheimer’s disease patients
Authors: Demey Ignacio , Falasco German , Mendez Patricio Alexis Chrem , Urrutia Leandro , Bérgamo Yanina , de Leon Magdalena Ponce , Sevlever Gustavo , Allegri Ricardo Francisco , Vazquez Silvia 
Published: February 2022

AbstractBackground18F‐fluorodeoxyglucose Positron Emission Tomography (18F‐FDG PET) allows the measurement of brain metabolism in vivo. In neurodegenerative diseases, hypometabolism´s topography patterns usually correlate with certain types of cognitive dysfunction. In the amnestic presentation of Alzheimer’s Disease (AD), the temporoparietal hypometabolism is the typical 18F‐FDG PET signature. However, much less is known about its spatial correlation with other cognitive manifestations typically seen in the clinical setting. Objectives: To compare the distribution of 18F‐FDG PET between Normal Controls (NC), patients with Mild Cognitive impairment due to AD (MCI‐AD), and patients with AD Dementia (ADD) and to analyze each cognitive test as a covariate.MethodCross‐sectional study, including 14 NC (13 PET‐PIB ‐, 1 PET‐PIB +), 25 MCI, and 28 ADD patients, (all PET‐PIB +) matched by age and education. Images were normalized to a template using non‐linear methods. The metabolic differences between the 3 groups were evaluated by a voxel‐wise analysis based on Statistical Parametric Mapping. Statistical models were applied using neuropsychological tests as covariates, and VOIS statistics were generated using the Boogle‐DKT atlas.ResultDifferences were observed between the groups analyzed in middle and inferior temporal, posterior parietal, posterior cingulate, and precuneus cortical regions, among other areas of interest (p <0.005). Some of these areas correlated with a worse performance in verbal episodic memory tests (left temporoparietal regions), visuospatial tests (right parietal regions) and phonological fluency tests (left frontal and temporoparietal regions), among other results (p<0.005).ConclusionIn this study, 18F‐FDG PET voxel‐wise analysis showed metabolic differences between the groups included, following the severity spectrum of each amnestic AD stage considered. Although these differences correlated with some cortical areas usually reported as the “AD metabolic signature”, some cortical regions were associated with cognitive functions that weren´t previously reported, allowing a better understanding of the cortical networks involved in the clinical manifestations of AD.
The connection between Down syndrome and Alzheimer disease
Authors: Battaglino Lisa B , Rodrigues Ashley B 
Published: February 2022

AbstractBackgroundIndividuals with Down syndrome (DS) face unique aging issues. Often the serious consequences of Alzheimer’s disease in individuals with DS are misunderstood and inadequately addressed due to a lack of understanding and sparse resources. This presentation explores research in medical advances, education, programming, housing, and transitioning.MethodThis presentation is a review of literature and research examining the relationship between Down syndrome (DS) and Alzheimer's disease.ResultOver the past 40 years the life expectancy of people with Down syndrome has more than doubled from 25 years in 1983 to 60 years in 2020 due to advances in cardiac surgery, medications, updated treatments, and the elimination of inhumane institutionalization. As a result, ever increasing numbers of people deal with the issues faced when people with DS experience premature age related changes. While memory loss is an early predictor of AD in the general population, according to the Alzheimer’s Association (2020) people with DS are more likely to experience other symptoms such as a reduction in being social, decreased enthusiasm for usual activities, a decline in focusing ability, sadness, fearfulness or anxiety, irritability, uncooperativeness or aggression, sleep disturbances, adult onset seizures, changes in coordination, and or increased excitability.ConclusionImplications for professionals include becoming knowledgeable of the signs of AD in clients with DS. Essential to the planning and implementation of effective medical interventions as well as programing is the development of medications, strategies and behavioral supports to ease transitions, the creation of resources for families and care givers, and the recognition of the growing demands of older adults with DS. Families are frequently ill prepared for the increased demands put upon them as a result of AD symptoms in their loved one with DS. Accessing state, federal, and privately funded services may be unknown, unavailable, and/or difficult. In addition, proper diagnosis and reliable information may not be readily available. These families are often in dire need of sound medical advice, financial, emotional, respite care, and physical assistance.
Comparison of Pittsburgh compound‐B and flutemetamol white matter binding
Authors: Zeydan Burcu , Schwarz Christopher G. , Przybelski Scott A. , Lesnick Timothy G. , Kremers Walter K. , Senjem Matthew L. , Kantarci Orhun H. , Min Paul H. , Kemp Bradley J. , Jack Clifford R. , Kantarci Kejal , Lowe Val J. 
Published: February 2022

AbstractBackgroundWhite matter (WM) 11C‐Pittsburgh compound‐B (PiB) and 18F‐Flutemetamol (FMT) uptake is increasingly being used as a reference region to calculate the standard uptake value ratios (SUVr) in longitudinal amyloid‐β PET studies. PiB uptake is lower in WM hyperintensities (WMH) in older adults. Furthermore, WM PiB uptake increases with aging. Our objective was to determine whether a similar variation in WM uptake exists with an 18F‐ligand FMT.MethodA cohort of cognitively unimpaired (CU) older adults with median (range) age of 67 (61, 83) years (N=31), and younger adults with median (range) age of 38 (30, 48) years (N=30) from the community responding to a study advertisement underwent MRI, PiB and FMT PET. MRI‐FLAIR images were segmented into WMH and normal appearing white matter (NAWM) and registered to the T1‐weighted image. PiB and FMT PET images were registered to the T1‐weighted image. PiB and FMT SUVrs from the WMH and NAWM compartments were calculated using cerebellar crus uptake as a reference.ResultWMH PiB SUVr and NAWM PiB SUVr were lower in the younger compared to the older adults (p<0.001). WMH FMT SUVr and NAWM FMT SUVr were lower in younger compared to older adults (p<0.001). PiB SUVr was lower than FMT SUVr both in younger and older adults in both WMH and NAWM compartments (p<0.001). In both age groups, PiB SUVr and FMT SUVr in WMH was lower than NAWM (p<0.001). AUROC analysis demonstrated no difference between PiB versus FMT SUVr in differentiating WMH from NAWM in younger and older adults.ConclusionWMH and NAWM SUVRs are higher with FMT than PiB, however both PiB and FMT show a similar topographic pattern of uptake in the WM with higher uptake in NAWM compared to WMH. Aging is associated with a decrease in myelin integrity and increase of WMH volume. Higher WMH and NAWM PiB and FMT uptake in the older compared to younger adults suggests that additional aging‐related mechanisms are influencing WM PET tracer uptake. Age and WMH volume should be considered when WM uptake is used as a reference region for the evaluation of cortical uptake of both PiB and FMT.
Caring for behavioral symptoms of dementia (CBD): A new investigation into cannabidiol for the treatment of anxiety and agitation in Alzheimer’s dementia
Authors: Ash Eleanor T , McManus Kaitlin R , Smith Rosemary , Harper David G , Gruber Staci , Forester Brent P 
Published: February 2022

AbstractBackgroundAnxiety and agitation symptoms affect 25‐70% of the dementia population, though there are no FDA‐approved medications that treat the behavioral symptoms of AD. Thus, the need for developing safe and efficacious treatments for anxiety and agitation in AD is dire. One potential treatment is cannabidiol (CBD), the major non‐intoxicating constituent of cannabis sativa, a variety of the cannabis plant that contains <0.3% delta9‐tetrahydrocannabinol (THC), the main intoxicating constituent in cannabis, by weight. The present open‐label clinical trial seeks to address this gap in knowledge by assessing the efficacy and tolerability of a high‐CBD/low‐THC sublingual solution as a treatment for anxiety and agitation in older adults with Alzheimer’s disease.MethodAn 8‐week open‐label clinical trial of an industrial hemp‐derived high‐CBD/low‐THC sublingual solution. This includes 12 research participants with AD and symptoms of anxiety with or without agitation. Our primary efficacy outcome measures include the anxiety domain of the Neuropsychiatric Inventory‐Clinician Version (NPI‐C) and the Generalized Anxiety Disorder‐7 Item Scale (GAD‐7). Our secondary safety outcome measures include monitoring for serious adverse events and medication side effects, cognitive decline estimates from the Mini Mental Status Exam (MMSE), and the emergence of possible delirium from the Confusion Assessment Method (CAM). Scores on the NPI‐C, the Cohen‐Mansfield Agitation Inventory (CMAI), and caregiver burden estimates from the Zarit Caregiver Burden Interview will be included as additional exploratory measures.ResultsWe hypothesize that twice daily treatment with a high‐CBD/low‐THC solution in older adults with AD for 8 weeks will be associated with a statistically significant reduction in anxiety and agitation symptoms compared to baseline, as measured by our efficacy outcome measurements. We predict that the solution will be well‐tolerated by the study population, as measured by our safety outcome measurements.ConclusionWith no current FDA‐approved treatments for these behavioral symptoms, patients with AD risk ineffective therapies or mortality‐associated antipsychotic treatments to address their NPS. Treating anxiety and agitation in these patients not only alleviates their symptoms but could also reduce caregiver burden and lengthen the time to institutionalization. CBD is a promising anxiolytic treatment that could advance our available treatment options for anxiety and agitation in AD.
Lesion‐network mapping of tau accumulation is predictive of domain‐specific cognitive deficits in Alzheimer’s disease
Authors: Luan Ying , Franzmeier Nicolai , Rubinski Anna , Ewers Michael 
Published: February 2022

AbstractBackgroundClinical heterogeneity is present in a substantial portion of patients with Alzheimer’s disease (AD). Understanding the underlying pathological differences is an unmet goal towards patient‐tailored medicine in AD. We hypothesized that the brain localization of tau deposition, a key driver of neurodegeneration, is predictive of which cognitive domain predominantly affected. We adopted a symptom‐network mapping approach applied to tau PET, reasoning that the functional connectivity of local tau PET to a cognitive‐domain specific network is predictive of which cognitive ability is impaired.MethodWe included 448 participants consisting of 234 amyloid‐PET‐negative cognitively normal subjects (CN‐Aβ‐), 95 amyloid‐PET‐positive mild cognitive impairment (MCI‐Aβ+) and 119 amyloid‐PET‐positive cognitively normal (CN‐Aβ+) patients. AV1451 tau‐PET was parcellated using the 400 ROI Schaefer atlas. Adopting a lesion‐network mapping approach (Darby et al. Brain 2018), we computed in the Aβ+ participants, subject‐level W‐scores, i.e. the standardized deviation of tau‐PET ROI values from those in CN‐Aβ‐. We computed for each subject and tau‐PET lesion (ROI W‐score > 2) the seed‐based connectivity based on resting‐state fMRI data from Human Connectome Project (n = 1000), rendering patient‐level lesion network maps. In order to identify symptom‐specific lesion‐networks, we regressed composite scores of episodic memory (ADNI‐MEM), executive function (ADNI‐EF), and language (ADNI‐LAN) onto the subject‐level lesion‐network maps, using partial least squares.ResultSubstantial variability in the tau‐PET lesions locations between subjects were observed (Figure 1A), with highest overlaps observed in the lateral and medial temporal cortex and posterior cingulate (Figure 1B). We found for each cognitive domain, a specific tau‐lesion network map: stronger connectivity of tau‐PET lesions to lateral temporal, posterior parietal and lateral prefrontal cortex were associated with lower episodic memory (ADNI‐MEM). In contrast, stronger connectivity to pre‐ and post‐central gyri and superior parietal cortex was associated with lower executive function (ADNI‐EF), and stronger connectivity to inferior frontal and auditory cortex was associated with language function, suggesting the presence of cognitive‐domain specific networks of tau lesions.ConclusionWe identified functional network patterns of local tau PET accumulation that map onto impairment in specific cognitive domains. This approach thus contributes to precision medicine guided prediction of specific cognitive impairments in AD.
Recommendations of nursing students to improve nursing curriculum in Germany: Current results of a study with mixed methods design
Authors: Panjaitan Hentry , Kowe Antonia , Vogel Jann Niklas , Wachholz Anne , Teipel Stefan J 
Published: February 2022

AbstractBackgroundDigitalization is key to face socio‐demographic change accompanied by an increasing care demand of people with dementia and a shortage of skilled healthcare workers. The project Digital Training of Nursing and Health Management (DigiCare) aims to involve people affected by dementia in the development of digital teaching formats that meet the needs of all stakeholders in dementia care. Here, we explored the needs of nursing students which already have practical experience in dementia care to identify gaps in the existing curricula and subjective improvement suggestions.MethodWe used a mixed methods design consisting of a quantitative survey with a questionnaire and semi‐structured qualitative interviews. We analysed the quantitative data descriptively and the qualitative data with qualitative content analysis approach according to Mayring.ResultSeventeen nursing students took part in the quantitative survey (agemean = 37.1 years; male: 29.4%) and five nursing students were interviewed qualitatively (agemean = 38.0 years; male: 40.0%). Participants named nursing care especially dealing with challenging behaviour in dementia and care management as gaps in the existing curricula in nursing courses. Participants wished for a practical orientation of the course or an internship during the training. In their daily working routines, smartphones and computer were the most frequently used technological devices. Barriers to use technological devices in care were additional effort for nurses, mistrust among patients and loss of a close relationship to patients. Although participants saw blended learning concepts as an opportunity to improve their training, they criticised the lack of a contact person for specific questions on the implementation of digital learning.ConclusionThe survey indicated that digital teaching methods in combination with a practical orientation of the curriculum could provide effective training in dementia care for nursing students. The existing doubts of nursing students about digital learning methods and the usage of technological devices must be taken into account when integrating new technologies into the curriculum and working routine.
Preliminary efficacy of an internet‐delivered behavioral intervention for insomnia in individuals with mild cognitive impairment
Authors: Mattos Meghan K , Manning Carol A , Quigg Mark S , Davis Eric M , Barnes Laura , Sollinger Ann , Ritterband Lee M 
Published: February 2022

AbstractBackgroundInsomnia is present in up to 50% of older adults with cognitive impairment. When insomnia is left untreated, pre‐existing cognitive problems may be exacerbated and potentially contribute to further cognitive decline. One promising approach to improve cognitive health in individuals with cognitive impairment is to improve quantity and quality of sleep. Our objective was to determine preliminary efficacy of an Internet‐delivered cognitive behavioral therapy for insomnia program in older adults with mild cognitive impairment (MCI).MethodOlder adults with MCI and insomnia were recruited from hospital‐based memory and sleep disorders clinics and enrolled in a single‐arm intervention pilot study. Participants completed the Internet‐delivered, six‐part CBT‐I intervention over nine weeks with two‐week pre‐ and post‐assessments using self‐reported sleep diaries. Preliminary efficacy was informed by patient‐generated data on sleep parameters.ResultTwelve participants enrolled and, on average, were 75.8 years of age with a 7.5‐year history of sleep difficulties. There were significant differences found on all pre‐ to post‐assessment sleep measures. Most notably, there were clinically meaningful changes in insomnia severity index (13.5 to 8.3, p<.01), sleep efficiency (77.3% to 86.5%, p<.001), wake after sleep onset (38.0 to 22.4, p=.02), and sleep onset latency (36.0 to 18.3, p<.001). There was no statistically significant change in cognitive measures over time (p>.05).ConclusionResults provide evidence that older adults with cognitive impairment can complete CBT‐I via the internet and achieve clinical improvements in their sleep.