bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing and disclosing test results for MCI: The perspective of UK old age psychiatrists
Authors: Saunders Stina , Ritchie Craig W. , Russ Tom C , Muñiz‐Terrera Graciela , Milne Richard 
Published: December 2021

AbstractBackgroundMild cognitive impairment (MCI) is a state between normal healthy ageing and dementia with an uncertain prognosis. This uncertainty creates a complex dynamic between the clinicians’ conception of MCI, what is communicated to the individual about their condition, and how the individual perceives the information conveyed to them. The aim of this study was to explore clinicians’ views around the assessment and communication of MCI in memory clinics.MethodAs part of a larger longitudinal study looking at patients’ adjustment to being told they have MCI, we interviewed Old Age Psychiatrists at the five participating sites across South‐East Scotland. The study obtained ethics approvals and the interviews (carried out between Nov 2020–Jan 2021) followed a semi‐structured schedule focusing on [1] how likely clinicians are to use the term MCI with patients; [2] what tests clinicians rely on and how much utility they see in them; and [3] how clinicians communicate risk of conversion to dementia. The interviews were voice recorded and will be analysed using reflective thematic analysis (Clarke and Braun, 2019).ResultInitial results show that most clinicians interviewed (Total N=19) felt MCI had significant limitations as a diagnostic label. Nevertheless, more clinicians reported using the term MCI (n=15) with patients than not (n=4). Clinical history was commonly described as the primary aid in the diagnostic process and also to rule out functional impairment (which was sometimes corroborated by Occupational Therapy assessment). All clinicians reported using the Addenbrooke's Cognitive Examination‐Revised as a primary assessment tool; neuroimaging (e.g., CT) was frequently found to have minimal usefulness due to the reports being non‐specific.ConclusionOur study revealed a mixture of approaches to assessing and disclosing test results for MCI. Some clinicians consider the condition as a separate entity among neurodegenerative disorders whereas others find the term unhelpful due to its poor prognosis. Clinicians report a lack of specific and sensitive assessment methods for identifying MCI in clinical practice. Our study demonstrates a broad range of views and therefore variability in MCI risk disclosure in memory assessment services which may impact on the management of individuals with MCI.
Patients with amnesic mild cognitive impairment due to Alzheimer's disease and with epileptiform‐like signatures showed abnormal cortical sources of resting state delta EEG rhythms: An EEG study
Authors: Tucci Federico , Babiloni Claudio , Noce Giuseppe , Di Bonaventura Carlo , Lizio Roberta , Lorenzo Ivan , Soricelli Andrea , Ferri Raffaele , Nobili Flavio , Famà Francesco , Arnaldi Dario , Palma Eleonora , Cifelli Pierangelo , Marizzoni Moira , Stocchi Fabrizio , Frisoni Giovanni , Percio Claudio Del 
Published: December 2021

AbstractBackgroundCortical sources of resting state eyes‐closed electroencephalographic (rsEEG) rhythms are abnormal in patients with amnesic mild cognitive impairment due to Alzheimer’s disease (ADMCI). In the present exploratory and retrospective study, we tested whether those abnormalities may be stronger in ADMCI with (ADMCI‐EEA) than without (ADMCI‐noEEA) epileptiform‐like EEG signatures.MethodClinical, neurophysiological, and rsEEG data in 56 ADMCI patients and 35 normal elderly (Nold) subjects were available in a national archive. The eLORETA freeware estimated rsEEG cortical sources. Area under receiver operating characteristic (AUROC) curves indexed the accuracy of eLORETA solutions in the classification between ADMCI‐EEA and ADMCI‐noEEA individuals.ResultAs compared to ADMCI‐noEEA patients, ADMCI‐EEA (N=25%) patients showed worse executive functions (Trail making Test B‐A) and more abnormalities in widespread delta (about 2‐4 Hz) and temporal theta (about 4‐6 Hz) source activities. Furthermore, those sources were able to classify with moderate/good accuracies (AUROC =0.75‐0.85) the ADMCI‐EEA vs. ADMCI‐noEEA individuals.ConclusionThese results suggest higher abnormalities in low‐frequency (i.e. delta and theta) rsEEG cortical activities in ADMCI‐EEA than ADMCI‐noEEA patients at both group and individual levels.
The association of the ANU‐ADRI Alzheimer risk index score with cognition in the FINGER study
Authors: Hall Anette , Barbera Mariagnese , Stephen Ruth , Lehtisalo Jenni , Ngandu Tiia , Anstey Kaarin J , Kivipelto Miia , Solomon Alina 
Published: December 2021

AbstractBackgroundThe ANU‐ADRI is a validated risk index for Alzheimer’s disease comprised of lifestyle, medical and demographic factors, with higher scores indicating more risk. We investigated the association of the ANU‐ADRI score with cognition over the 2‐year FINGER multidomain prevention trial.MethodThe ANU‐ADRI score was calculated for the participants in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), at baseline (N=1174) and 24‐months (N=1023). Cholesterol and BMI were excluded due to age and pesticide exposure was not available. Age and sex were excluded from changes in ANU‐ADRI score, to focus on change in modifiable factors only.ResultAt baseline, ANU‐ADRI score was strongly associated (p<0.001) with the total cognitive score as well as all the cognitive subdomains of memory, executive function and processing speed. Baseline ANU‐ADRI was also associated (p<0.001) with changes in all domains of cognition over the trial period, with lower ANU‐ADRI scores indicating better cognition. Additionally, the decline in the ANU‐ADRI score was associated with improvement in cognition (p<0.01) in all domains. Preliminary results indicated no significant modifying effect of the FINGER intervention on cognition by baseline ANU‐ADRI score. Overall, the ANU‐ADRI score was lowered 1.0 [0.8‐1.3] points during the 2‐year trial, but no significant difference was found between the intervention arms.ConclusionWithin the FINGER intervention, the ANU‐ADRI score and its change correlated negatively with cognition, with lower scores indicating better cognitive ability. However, the FINGER intervention, despite improving cognition, did not significantly modify the ANU‐ADRI score compared to the control group.
When verbal fluency inverts: Temporality of semantic impairment in preclinical Alzheimer’s disease
Authors: Vonk Jet MJ , Rentería Miguel Arce , Geerlings Mirjam I. , Avila Justina F , Mayeux Richard , Manly Jennifer J 
Published: December 2021

AbstractBackgroundWorse semantic than letter fluency performance is a clinical marker of Alzheimer’s disease (AD), but the longitudinal course of performance on these tasks in pre‐dementia stages remains undefined. This study investigated how many years before clinical AD the performance on the two verbal fluency tasks starts to diverge, and if this process develops similarly across race/ethnicity groups.MethodTo estimate the trajectories and inflection point of verbal fluency performance in years prior to AD diagnosis, we performed piece‐wise linear mixed effects models in a diverse sample of 569 individuals (mean age = 78.5) from a community‐based cohort who were cognitively normal at baseline but developed dementia across 10 years of follow‐up (up to 5 visits). Performance was standardized on 569 age, sex/gender, education, and race/ethnicity matched controls who remained cognitively healthy during follow‐up (i.e., robust norms approach). Models were adjusted for recruitment wave and demographic factors.ResultAIC model comparison of spline‐fit revealed that prior to AD diagnosis, performance on both fluency tasks started to decline more rapidly 3.6 years before diagnosis (slope within later timeframe: semantic: B=‐1.34 [‐1.52, ‐1.16], p<.001; letter: B=‐.56 [‐.70, ‐.42], p<.001). Point‐in‐time performance on semantic fluency became worse than letter fluency as of approximately 2.8 years before AD diagnosis due to the disproportionally fast decline of semantic fluency. Stratified models showed that the inflection point for Whites was earlier than for Blacks and Hispanics, but that the rate of decline and flip in performance between the two tasks was similar across race/ethnicity.ConclusionThese results show how the conventional clinical index of worse semantic than letter fluency develops over time in the years before AD diagnosis. This study highlights the importance of serial neuropsychological assessments in detecting high‐risk individuals by showing that the differential rate of decline in semantic versus letter fluency is a sensitive preclinical AD‐marker, equivalent across race/ethnicity.
Serum albumin and indoxyl sulfate were predictive of cognitive impairment via amyloid beta and tauopathy, respectively, in end‐stage renal disease patients
Authors: Hou Yi‐Chou , Lu Kuo‐Cheng , Huang Chuen‐Lin , Lin Yuh‐Feng , Chen Ruei‐Ming 
Published: December 2021

AbstractBackgroundPatients with ESRD tend to have more risk factors for cognitive impairment than members of the general population, including hypertension, malnutrition, and accumulation of uremic toxin. Blood‐based assays with immunomagentic reduction manner have the advantages of being less invasive and more cost‐effective for diagnosing patients with cognitive impairment. However, the clinical application for cognitive impairment in patients with ESRD is still lacking.MethodIn total, 76 participants aged >45 years were enrolled. The definition of ESRD was receiving maintenance hemodialysis for >3 months. Cognitive impairment was defined as a Mini‐Mental State Examination score of ≤24. The participants were divided into groups for health control (n=12), ESRD with (n=23)and without cognitive impairment (n=41). The blood‐based biomarkers (tau protein, Aβ1/40, Aβ1/42 ) were analyzed through immunomagnetic reduction assay. Other biochemical and hematologic data were obtained simultaneously.ResultThe study enrolled 76 patients with health control, ESRD who did not have cognitive impairment and ESRD who had cognitive impairment (Mini‐Mental State Examination [MMSE]: 30.00± 0.00, 27.60 ± 1.80 vs 18.00 ± 5.09, p < 0.05). The serum albumin was lower in the ESRD with cognitive impairment group (3.70 ± 0.24g/dL, vs 3.89±0.30 g/dL in ESRD without cognitive impairment and 4.40± 0.27g/dL in health control, p<0.05). The indoxyl sulfate concentration was lower in the health control rather than other group (5212 ±14621 ng/mL vs 44783 ±23799ng/mL in ESRD with cognitive impairment and 52148±23453 ng/mL in ESRD without cognitive impairment, p<0.05). Tau protein, and amyloid beta 1/42 and amyloid beta 1/40 were similar between groups. The area under the curve of albumin and indoxyl sulfate was 0.759 (95% confidence interval: 0.560–0.955, p = 0.037) and 0.748 (95% confidence interval: 0.542–0.954, p = 0.046) respectively for predicting cognitive impairment in the ESRD group. The concentration of albumin was negative correlated with tau (r=‐0.306, p=0.011). The indoxyl sulfate was positively correlated with amyloid beta 1/42 (r=0.283, p=0.013)ConclusionSerum albumin and indoxyl sulfate were predictive to the severity of cognitive impariment in patients with ESRD. The albumin was negatively associated with tau protein concentration. Indoxyl sulfate was positively correlated with amyloid beta 1/42.
Upper extremity dual‐task in autosomal dominant Alzheimer disease, PSEN1 E280A
Authors: Sarasti Luis , Alvarez Kevin Caicedo , Aguillon David , Garcia‐Cifuentes Elkin , Ochoa John F , Lopera Francisco 
Published: December 2021

AbstractBackgroundAlzheimer’s disease and identification of non‐cognitive preclinical biomarkers is one of the key aspects in research worldwide, in Latin‐American is even more important because the lack of biomarkers in clinical practice. Dual‐task cost have been proposed previously as biomarker in Alzheimer disease. This study aims to create a low‐cost technology using smart phones camera to identify dual‐task in with Early‐onset Autosomal Dominant Alzheimer’s‐Disease carrying PSEN1 – E280A.MethodPilot study creating a low‐cost technology. Procedure: The execution of the motor‐task is recorded with the integrated camera of a smart‐phone and the verbal fluency‐task with the microphone integrated in the headset or an external lavalier type microphone. To determine the angle of elbow‐flexion in the dominant arm, anatomical markers are placed in the acromion (shoulderjoint), lateral epicondyle(elbow) and the ulnar/radial styloid(wrist). After segmenting the markers in the video, the elbow flexion‐angle and the dynamics of the arm movement (angular velocity, range of motion, limb elevation time and number flexions); from the audio recording, the words and quantity named in the task execution and the changes of these with respect to the task execution during the dual task are extracted. The flexion angle was validated with commercial biomechanical‐analysis software and goniometer, also the arm movement dynamics curves were validated with OpenPose.Result21 controls. The value of the dual‐task cost in verbal fluency in animal category was ‐11.35 % and for arithmetic calculation tasks ‐1, ‐3 was ‐19.09 % and ‐3.13 % respectively. negative values indicating no impairment. 2 Cases with the disease were also evaluated, the results of the dual‐task cost were 28.77 % for the verbal fluency task in animal category and 14.44 % and 38.34 % for the arithmetic calculation (‐1 and ‐3) the latter being the one with the highest load.ConclusionThis evaluation method is widely applicable, low cost and time, does not require patient preparation and accessible, since it does not require large space availability or costly and complex instruments in comparison to its analogue, the dual‐task gait. It has great potential to be a non‐cognitive biomarker.
Construct validity of the Clinical Dementia Rating Scale to assess the level of cognitive decline by informants
Authors: Ferretti‐Rebustini Renata Eloah de Lucena , Rebustini Flávio , Suemoto Claudia K. , Grinberg Lea T. , Leite Renata Elaine P. , Rodriguez Roberta Diehl , Ferrioli Eduardo , Pasquallucci Carlos Augusto , Nitrini Ricardo , Jacob‐Filho Wilson 
Published: December 2021

AbstractBackgroundClinical Dementia Rating Scale (CDR) is one of the most used assessment scales in the care of dementia but it still lacks a detailed analysis of construct validity. We aimed to analyze evidences of construct validity of the CDR to assess the level of cognitive decline by informants.MethodWe analyzed 650 records of elderly subjects belonging to the Brazilian Biobank for Aging Studies. A trained nurse fulfilled the CDR during the clinical interview with a knowledgeable next‐of‐kin, after informed consent. We considered each domain of the CDR as one item. Exploratory (EFA) and Confirmatory factor analysis (CFA) were performed. We used Robust Unweighted Least Squares with promax rotation, with a bootstrapping of 1.000 cases, and Parallel Analysis. Sample adequacy was tested by the Kaiser‐Meyer‐Olkin and Bartlett sphericity tests. UniCo, ECV and Mireal tested the dimensionality. Factor loading ≥ 0.50 and communalities ≥ 0.40 were indicators of good factor solution. In CFA we tested: Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index (AGFI), Non‐Normed Fit Index (NNFI), Comparative Fit Index (CFI ), and Weighted Root Mean Square Residual (WRMR). Reliability was tested by standardized Chronbach’s Alpha, Ordinal McDonald’s Ômega and GLB. For the analysis, we used Factor 10.10.3.ResultSample was composed by 55.5% of females, the mean age of the sample was 68.7±11.3 years and 78.8% of the participants were cognitively normal (CDR = 0). KMO was 0.86 and Bartlett was <0.001. Total explained variance was 84.6%. Parallel analysis showed only one dimension and values of UniCo (0.994); ECV (0.919) and MIREAL (0.279) confirmed the unidimensionality of the structure. Factor loadings ranged from 0.846 to 0.945 and communalities from 0.716 to 0.894. Memory was the item with the higher factor loading and communality. All the goodness of fit indexes confirmed the structure of CDR. Indicators of reliability were also very good (Table 1).ConclusionCDR is a unidimensional instrument composed by six items that together explain 84.6% of the ‘level of cognitive decline’. Results indicated that the CDR has very good evidence of construct validity and reliability and can be used to assess the level of cognitive decline by informants.
Do polygenic scores of cerebral small vessel disease MRI markers predict white matter lesions?
Authors: de Silva Eric , Sudre Carole H , Barnes Jo , Scelsi Marzia Antonella , Altmann Andre 
Published: December 2021

AbstractBackgroundEvidence of cerebral small vessel disease (CSVD) is commonly found in those with a diagnosis of Alzheimer’s disease (AD) and is associated with T2‐weighted MRI‐visible white matter hyperintensities (WMHs). Here we investigate whether macrostructural and microstructural polygenic risk scores (PRS) predict WMH volumes.MethodWe used Genome Wide Association Studies (GWAS), based on UK Biobank (UKB) MRI markers of WMH, Fractional Anisotropy (FA) and Mean Diffusivity (MD) from (Persyn et al., 2020, https://doi.org/10.1038/s41467‐020‐15932‐3) to compute PRS for n=730 participants (following strict quality control) from the AD Neuroimaging Initiative (ADNI) using PRSice. We calculated WMH volumes for ADNI subjects using a Bayesian Model Selection method BaMoS (Sudre et al., https://doi.org/10.1109/TMI.2015.2419072). Linear regression models (with confounds for age, gender, education, APOE4 status, total intracranial volume and five principal components of population structure) were used to test for association (including multiple testing correction) between WMH, FA and MD PRS (based on p‐value thresholds at p=1.0e‐05 and p=0.5) and WMH volumes in each of three diagnostic groups: Healthy Controls (HC; n=218), Mild Cognitive Impairment (MCI; n=390) and AD (n=122).ResultWMH and FA PRS did not predict WMH volume in the ADNIGO and ADNI2 cohort (Table 1) despite high correlation between BaMoS‐derived and BIANCA‐derived WMH volumes (r=0.84 on 19,070 UKB subjects). However, MD PRS at the p=0.5 threshold in the MCI group was positively correlated with WMH volume (Table 1) with t=3.4 (FDR‐corrected P=0.0008; Figure 1).ConclusionDespite a high heritability of WMH (h2=0.76; Sachdev et al.. 2016, https://doi.org/10.1161/STROKEAHA.116.012532), unexpectedly, WMH PRS did not predict WMH volume in ADNI in any of the diagnostic groups. The correlation between total WMH estimated with both tools was very high and thus is unlikely the source of this lack of association,however, this may be due to different inclusion criteria for ADNI. The statistically significant relationship in the ADNI MCI group between MD PRS and WMH volume may reflect the early white matter tract damage that is visible before AD manifests and these structural insults become overwhelming. This is reflected in many of the other PRS‐WMH corelations in the MCI group which are borderline statistical significance.
Development and dissemination of an ethical guidance and person‐centred isolation care planning tool to support the care of people with dementia during the COVID‐19 pandemic
Authors: Iaboni Andrea , Grigorovich Alisa , Barned Claudia , Rodrigues Kevin , Pia Kontos , Chu Charlene H , Astell Arlene J. , Flint Alastair , Bingham Kathleen , Maxwell Colleen J , Kirkham Julia , McMurray Josephine , Quirt Hannah , Tsokas Mario 
Published: December 2021

AbstractBackgroundLong‐term care (LTC) residents have been disproportionately impacted by the COVID‐19 pandemic, both from the virus itself and the restrictions in effect for infection prevention and control. Many barriers exist in LTC to prevent the effective isolation of suspect or confirmed COVID‐19 cases. Furthermore, these measures have a severe impact on the well‐being of LTC residents. Our aim was to develop a guide for long‐term care to address the ethical challenges associated with isolating dementia patients during the pandemic. The Dementia Isolation Toolkit (DIT) was developed by members of the research team in partnership with LTC stakeholders to address: 1) the practical challenges of isolating or quarantining people with dementia in a compassionate, safe, and effective manner; and 2) the need for ethical guidance to support decision‐making regarding isolation and infection control in LTC, to prevent indecision and moral distress. To develop the DIT the team reviewed and synthesized the literature on pandemic ethics in a plain‐language document, which was then reviewed by our partners and stakeholders. The final ethical guidance tool includes a discussion of the ethics around infection control measures in a pandemic, an ethical decision‐making tool, and a person‐centred isolation care planning tool. The ethical guidance tool has been downloaded more than 6500 times since it was published (bit.ly/dementiatoolkit), and has been disseminated internationally. The worksheets are being used during outbreaks to support care and decision‐making, as well as proactively, to prepare for outbreaks by developing isolation care plans. There is a need for support for ethical decision‐making in the context of a pandemic, particularly in settings such as LTC. Future studies will evaluate the implementation of the tool and its impact in addressing moral distress in health care providers in long‐term care.