bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital nurses' knowledge and confidence in caring for persons living with Alzheimer’s disease and other dementias
Authors: Shaw Clarissa 
Published: February 2022

AbstractBackgroundPersons living with Alzheimer’s Disease and other dementias (PLWD) are twice as likely to be hospitalized compared to cognitively intact older adults and while hospitalized are significantly more likely to experience complications and increased length of stays. The purpose of this study is to determine if confidence in caring for PLWD is associated with knowledge of dementia in acute care nursing staff. We hypothesize that knowledge and confidence will be highly correlated. Additionally, we hypothesize that a higher knowledge of dementia will be associated with higher education and less elderspeak (i.e., infantilizing communication) use.MethodNursing staff (N=65) were recruited from one university hospital in the midwestern United States. A subset of nursing staff (n=32) were observed and audio‐recorded during care encounters with PLWD (n=16) and the nursing staff’s communication was coded for elderspeak using a reliable and evidence‐based coding scale. The nursing staff completed the 9‐item Confidence in Dementia (CODE) scale (9=not confident to 45=very confident) and 16‐item true or false Knowledge in Dementia (KIDE) scale (0=no items correct to 16=all items correct). The associations between nursing staff confidence, knowledge, and demographic characteristics were determined using Pearson’s correlation coefficient for continuous variables and ANOVA for categorical variables.ResultNursing staff were somewhat confident (mean=33.9, SD=4.9) in providing care to PLWD. More years working in healthcare was associated with higher confidence (r=.28, p=.03). Role, age, use of elderspeak, gender, education, and hospital unit were not associated with confidence. Nursing staff averaged 85% on the KIDE scale. More years working in healthcare was associated with lower knowledge (r=‐.26, p=.04) and staff nurses had higher knowledge compared to nursing assistants (p<.001). Age, use of elderspeak, gender, and hospital unit were not associated with knowledge. Confidence and knowledge were not associated (r=.02, p=.90).ConclusionConfidence in caring for a PLWD was not associated with knowledge of dementia itself. Acute care nursing staff—particularly experienced staff and nursing assistants—are in need of greater dementia education. Effective educational interventions for dementia care are warranted in order for education to enhance confidence in caring for PLWD.
The application of the Human Connectome Project in large scale brain network imaging: A potential biomarker for Alzheimer's disease and related dementias
Authors: Rosenbloom Michael H. , Hanson Leah R. , Kashyap Bhavani , Erickson Lauren O. , Sughrue Michael Edward 
Published: February 2022

AbstractBackgroundAlzheimer’s disease and related dementias (ADRD) result in progressive dysfunction of large scale brain networks (LSBNs) including the default mode network (DMN). Resting state functional MRI (rs‐fMRI) is an imaging tool offering the potential for tracking LSBN degeneration, but been underutilized as an imaging biomarker. Potential reasons include complexity of imaging protocols and analyzing imaging data. If these steps were simplified and operationalized, further integration of rs‐fMRI into clinical trials as a surrogate endpoint may be feasible. We describe an automated connectome mapping program (Infinitome) that leverages rs‐fMRI scans with standardized protocols, Human Connectome Project (HCP) data, and machine learning to understand longitudinal LSBN degeneration in dementia (figure 1).MethodThe Infinitome program creates a subject specific version of the Human Connectome Project Multimodal Parcellation (HCP‐MMP1) atlas using diffusion tractography (figure 2). Analytics are performed on both diffusion tensor imaging and rs‐fMRI. Outlier detection using a tangent space connectivity matrix is performed by comparing results with a subset of 300 normal HCP subject fMRI samples to determine the range of normal correlations for each regions of interest in a LSBN. Abnormal connectivity is determined as a 3‐sigma outlier for that correlation (figure 3). The imaging protocol for rs‐fMRI is limited to 8 minutes, enabling each study to be readily added on to structural MRI sequences. The program also provides automated image processing and analysis, thus simplifying the process of accessing imaging data and incorporating rs‐fMRI into routine practice.ResultPreliminary work has shown that connectomic analysis using this software in ADRD is feasible and can detect functional anomalies involving regions of interest described by the HCP.ConclusionBy providing support for fMRI processing through a cloud‐based server and incorporating normal control data from the HCP, the Infinitome program addresses the challenges associated with the analysis and interpretation of rs‐fMRI data. Thus, it has the potential to simplify the incorporation of rs‐fMRI into clinical trials as a biomarker for progressive neurodegeneration of vulnerable networks in ADRD. Further studies are planned evaluating LSBNs in AD and dementia with Lewy bodies.
The location of PSEN1 pathogenic variants in transmembrane vs. cytoplasmic domains may alter neurodegenerative and cognitive trajectories: Findings from the DIAN study
Authors: Schultz Stephanie A. , Schultz Aaron P. , Joseph‐Mathurin Nelly , McDade Eric , Klunk William E. , Fox Nick C. , Levin Johannes , Hassenstab Jason , Goate Alison M. , Hanseeuw Bernard J , Lee Jae‐Hong , Fitzpatrick Colleen D. , Jucker Mathias , Allegri Ricardo Francisco , Benzinger Tammie L.S. , Berman Sarah , Chui Helena C. , Cruchaga Carlos , Fagan Anne M. , Gordon Brian A. , Farlow Martin R. , Graff‐Radford Neill R. , Martins Ralph N. , Mori Hiroshi , Noble James , Perrin Richard J. , Salloway Stephen P. , Sanchez‐Valle Raquel , Schofield Peter R. , Levey Allan I. , Karch Celeste M. , Xiong Chengjie , Johnson Keith A. , Bateman Randall J. , Sperling Reisa A. , Chhatwal Jasmeer P. ,   DIAN
Published: February 2022

AbstractBackgroundThough pathogenic variations in PSEN1 leading to Autosomal Dominant Alzheimer's disease (ADAD) are all highly penetrant, there is substantial inter‐individual variability in the rates of cognitive decline and biomarker change observed in ADAD. We hypothesized that this inter‐individual variability may be associated with the location of the pathogenic variant within PSEN1. We tested this hypothesis using biomarker and cognitive data from the Dominantly Inherited Alzheimer Network (DIAN) observational study.MethodPSEN1 pathogenic variant carriers [grouped based on whether their ADAD genotype affected transmembrane (PSEN1 TM; N = 125) or cytoplasmic (PSEN1 CY; N = 62) domains] and non‐carriers [NC; N = 176] enrolled in DIAN underwent clinical evaluation, multimodal neuroimaging, and lumbar puncture for collection of cerebrospinal fluid (CSF). Linear mixed effects models with a restricted cubic spline were used to determine cross‐sectional differences in clinical and biomarker measures between NC, PSEN1 TM, and PSEN1 CY groups, across the disease course (estimated years to symptom onset; EYO).ResultBackground characteristics are reported in Table 1. PSEN1 CY and PSEN1 TM groups had elevated β‐amyloid (PiB‐PET) and phosphorylated‐tau levels (CSF pTauT181) compared to NC, but these biomarker measures were not different between PSEN1 TM and CY groups (Figure 1a‐b). Additionally, the PSEN1 TM group had decreased glucose metabolism compared to NC but was similar to the PSEN1 CY group (Figure 1c). However, we observed that PSEN1 TM carriers had significantly smaller hippocampal volume, greater lateral ventricle volume, and greater cognitive impairment (Figure 1d‐f) across EYO as compared to PSEN1 CY carriers.ConclusionDespite similar β‐amyloid PET and CSF pTauT181 levels across EYO, individuals with pathogenic variants affecting transmembrane domains in PSEN1 may have more rapid progression of disease as measured by cognitive function and neurodegeneration as compared to those with variants affecting cytoplasmic domains. These results have implications both for understanding the heterogeneity in ongoing ADAD clinical trials and for better understanding the pathobiology of ADAD.
Radial peripapillary capillary network microvascular changes in Alzheimer's disease, mild cognitive impairment, and cognitively healthy controls
Authors: Robbins Cason B. , Grewal Dilraj S. , Soundararajan Srinath , Stinnett Sandra , Liu Andy , Johnson Kim , Fekrat Sharon 
Published: February 2022

AbstractBackgroundThe retinal and optic nerve head microvasculature may represent a non‐invasive, inexpensive biomarker for Alzheimer’s disease (AD) and mild cognitive impairment (MCI). In this study, we characterize microvascular changes at the optic nerve head (radial peripapillary capillary network) using optical coherence tomography angiography (OCTA).MethodOptic nerve head‐centered OCTA images were obtained from 66 eyes of 36 patients with AD, 119 eyes of 63 patients with MCI, and 513 eyes of 265 cognitively healthy controls in a cross‐sectional study (NCT03233646) using Zeiss Cirrus HD‐5000 OCTA. Exclusion criteria included diabetes, uncontrolled hypertension, glaucoma, non‐AD dementia, and other optic nerve pathology. Two metrics of vessel perfusion were calculated in a 2.5mm‐wide annulus centered on the optic nerve head using Zeiss AngioPlex (Version 11.0.0.29946) – capillary perfusion density (CPD) and capillary flux index (CFI). CPD represents the percentage of perfused capillaries in a unit scan area; CFI is a unitless ratio of perfused capillaries in a unit scan area weighted by intensity of flow signal. Retinal nerve fiber layer (RNFL) thickness was measured using a peripapillary optic disc cube scan. Groups were compared using multivariable generalized estimating equations, controlling for age and sex as covariates.ResultAverage CPD was significantly greater in AD vs controls (0.446 ± 0.015 vs 0.439 ± 0.017, p = 0.001) and in MCI vs controls (0.443 ± 0.020 vs 0.439 ± 0.017, p = 0.007) but not AD vs MCI (p = 0.69). CFI and average RNFL thickness did not significantly differ among groups (all p > 0.05). Among all groups, average CPD differed significantly (p = 0.001), as did CPD in the nasal and inferior peripapillary quadrants (p < 0.001 and p = 0.001, respectively).ConclusionPeripapillary CPD is increased in eyes of patients with AD or MCI compared to cognitively healthy controls, despite similar RNFL thickness between these groups. This finding represents a novel biomarker and contrasts with macular microvascular changes, which show decreased vessel and perfusion density in AD and MCI compared to controls. Integration of optic nerve head OCTA in models using retinal imaging to diagnose AD and MCI may improve specificity; further investigation is necessary.
Attitudes towards screening for cognitive dysfunction: Interviews with Latinx adults with type 2 diabetes
Authors: Cuevas Heather E , Zuñiga Julie , Morgan Stephanie E , Ganucheau Grace E 
Published: February 2022

AbstractBackgroundOne in nine Latinx adults over 45 years old experience subjective cognitive decline (SCD). Yet less than half of people with SCD discuss symptoms with their provider (BRFSS, 2015‐2018). Because current diagnostic criteria focus on dementia, a later stage pathology, the window of opportunity for effective interventions may be missed. Cognitive screening can help identify pathology, and it can also assist in identifying those at risk for higher health care utilization. In qualitative interviews, Latinx adults with T2DM frequently avoided asking about cognitive problems or cognitive health due to stigma or discrimination (Cuevas & Zuñiga, 2020). The purpose of this project was to understand relevant factors affecting cognitive screening, which is critical for designing effective and timely interventions.MethodData was collected using semi‐structured interviews with Latinx adults with type 2 diabetes. General questions were asked regarding knowledge of cognitive screening, risks for cognitive dysfunction, and attitudes towards screening. Interviews were transcribed, entered into NVivo software, and analyzed using grounded theory techniques.ResultInterviews ranged from 30 minutes to 1 hour. Participants (n= 30) were 53% Female; mean age: 66.4 years; Mean A1C: 9.7%; and 57% Mexican American. Participants who were younger and had higher levels of education were more likely to report comfort with cognitive screening. Inability to work related to a possible diagnosis of dementia was a concern related to screening for most participants. However, that was not a reason to decline screening. Participants (88%) wanted more information on how the results of screening tests would be used as well as information on how to maintain or improve “brain health.” Although not part of the interview guide 45% said they would prefer to see healthcare providers with similar ethnic backgrounds.ConclusionOverall, screening for cognitive dysfunction was well received by participants. Themes included some hesitancy to be screened but also a desire to know more about risks for dementia and how to maintain health. Given the encouraging results, a larger study further exploring these themes with Latinx adults and comparing them with provider and clinic factors affecting screening is being conducted.
Perceptions and attitudes of brain donation for Alzheimer’s disease research among older Latinos
Authors: Morlett Alejandra , Guareña‐Espinosa Lesley A , Gonzalez Hector M 
Published: February 2022

AbstractBackgroundAlzheimer’s disease and related dementias (ADRD) continue to be highly debilitating, particularly among older Latinos. Latinos are 1.5x more likely to develop ADRD compared to Non‐Hispanic Whites. Even though Latinos comprise 18.5% of the US population, only 8% participate in ADRD research, which is a significant problem given the substantial public health burden of ADRD among this population. Specifically, there is a dearth of brain tissue currently available that is essential for confirming clinical ADRD diagnoses. The purpose of this abstract is to present preliminary findings on a study looking at the perceptions and attitudes related to brain donation (BD) among older Latinos.MethodSemi‐structured phone interviews were conducted over the phone in English or Spanish. Questionnaires were administered to assess demographic characteristics, psychological acculturation, fatalism, and knowledge of aging‐related research relevant to AD. The interview was used to guide participants in the topic of BD and their willingness to BD. All interviews were audio‐recorded and transcribed.ResultParticipants included 40 community‐dwelling Latinos living in the US (Mean age: 59.4, SD=7.35). The majority of participants were female (67.5%) and had an average of 12.55 (SD=3.21) years of education. Most participants were born in Mexico (85%), 10% in the US, and 5% in another Latin American country. Preliminary findings from a subsample of transcripts and the interviewer’s notes indicate some initial but salient themes, including but not limited to 1) lack of information and awareness about BD; 2) key social and cultural factors influencing willingness to donate; and (3) Interviewees’ recommendations for engaging and increasing Latinos BD knowledge and study participation.ConclusionBetter understanding attitudes and perceptions of BD for ADRD research can facilitate targeted culturally‐relevant approaches for increasing autopsy consent that will have a significant and enduring impact on eliminating critical barriers in ADRD for Latinos. Work generated from this study will be used to develop a survey instrument to assess dimensions of diverse Latino willingness to consent to BD research with the goal to increase Latino participation in BD studies that will help address the disparities that exist in this population.
Driving and dementia: An “emotionally‐charged” issue for people with dementia and their multidisciplinary healthcare providers
Authors: Naglie Gary , Stasiulis Elaine , Sandhu Harvir , Brookes Jahnel , Vrkljan Brenda , Mariano Claudia , Gelinas Isabelle , Byszewski Anna , Rapoport Mark ,   CCNA Driving Cessation Team Co‐Investigators and CCNA Study Group
Published: February 2022

AbstractBackgroundThe decision to stop driving and the transition to non‐driving is emotional and challenging not only for people with dementia (PWD) and their family members, but also for healthcare providers (HCPs) of multiple disciplines. With the growing number of older drivers, including drivers with dementia, HCPs are being increasingly tasked with addressing driving cessation issues. However, research indicates that most HCPs lack the knowledge, skills and resources to support PWD and their families in this context, often resulting in their avoidance of this issue. Our objective was to explore HCPs’ perspectives on the content they deemed important to include in an e‐learning program being developed to educate HCPs about dementia and driving.MethodIn‐depth semi‐structured interviews were conducted with 22 HCPs, including six primary care physicians, three geriatricians, three geriatric psychiatrists, six nurse practitioners and four occupational therapists practicing in six Canadian provinces. Participants were asked to provide feedback on the proposed content outline of an e‐learning program. Data were examined using a qualitative thematic analysis approach.ResultsParticipants emphasized the “emotionally‐charged” nature of driving cessation, which they identified as being extremely challenging for PWD, their families and for HCPs. The trauma and negative impact that driving cessation has on PWD also affects HCPs’ emotions and work stress, influencing how they navigate driving cessation with their patients/clients. Further contributing to some HCPs’ stress was a lack of knowledge and confidence about determining when drivers were unsafe to drive and how to support them through the transition to non‐driving. Protecting the therapeutic relationship was a primary concern for HCPs, which they managed by: 1) employing avoidance and referral practices; and 2) mitigating PWD’s and family members’ emotional responses via communication strategies (e.g. deep understanding, prepared scripts, early and on‐going discussions about driving).ConclusionStudy results highlight the importance of addressing the inter‐related emotional aspects of driving cessation for both PWD and HCPs in educational programs directed to HCPs.
Neuroimaging and neuropathological findings in older adults with COVID‐19: A cognitive‐neuroscience systematic review to inform the long‐term impact of the virus on neurocognitive trajectories
Authors: Manca Riccardo , De Marco Matteo , Ince Paul , Venneri Annalena 
Published: February 2022

AbstractBackgroundInfection due to Coronavirus Disease 2019 (COVID‐19) has been found to have detrimental effects on multiple body systems, especially in older adults. Acute neurological symptoms may be present and often associated with neural injuries. However, the long‐term consequences of COVID‐19 on neurocognitive functioning are still unknown. Therefore, this systematic review aims to summarise neuroimaging and neuropathological findings in patients with COVID‐19 aged ≥ 60 within a cognitive neuroscientific perspective, to clarify which brain areas may be more affected and the possible cognitive consequences.MethodTwo databases (PubMed and Web of Science) were searched to identify all relevant manuscripts published between 1st March 2020 and 14th September 2020. The papers were screened and selected for inclusion by two independent assessors. Additional relevant studies not detected by the literature search were added manually.ResultA total of 74 studies were included. A wide variety of neural findings in older patients with COVID‐19 emerged from most studies, with a prominent role played by cerebrovascular damage. Structural and functional abnormalities were reported in all brain areas. The most consistent findings were observed in white matter, brainstem and fronto‐temporal areas. Moreover, viral DNA was also detected mainly in olfactory, orbitofrontal and brainstem areas.ConclusionThe vast literature on the link between COVID‐19 and neural damage is currently limited to the description of hospitalised patients who either had a fatal outcome or severe symptoms. The damage observed in this population seems acute and largely irreversible, mainly in neural regions involved in major functional cognitive networks. It is currently unknown whether the long‐term impact of COVID‐19 will be limited to the chronic evolution of acute events or whether novel mechanisms will emerge. Future theoretical frameworks describing the long‐term impact of COVID‐19 infection on mental abilities will have to factor in major trends of aetiological and topographic heterogeneity.
Lessons learned on recruiting dyads for mild cognitive impairment clinical trials
Authors: Gibson Allison , Bardach Shoshana H , Pope Caitlin N , Rhodus Elizabeth K , Oaks Dawn C , Jicha Gregory A 
Published: February 2022

AbstractBackgroundPrevious research has shown that up to one‐third of patients diagnosed with mild cognitive impairment (MCI) demonstrate resistance to acceptance of the diagnosis, which may contribute to reduced engagement in clinical research activities including interventional trials.MethodThis study explored researchers’ experiences to recruit 18 dyads from a U.S. Alzheimer’s Research Center to participate in a nine‐month duration, pilot, platform trial of biopsychosocial interventions for persons with MCI and their study partner. Thirty‐nine individuals with MCI met the inclusion criteria for the study. The MCI‐study partner dyads were contacted by mail and phone solicitation for recruitment. Thematic analysis of recruitment case notes was used to track the number of telephone contacts, reasons for interest/disinterest in participation, and questions about the study.ResultWhereas many participants with MCI were interested and willing to enroll (92.3%), frequently study partners were not willing to enroll (53.8%). Study partners primarily consisted of male spouses with a mean age of 67. Study partners reported reasons for disinterest including being unavailable to participate in research sessions (due to availability or geographical distance) and lack of knowledge on MCI or the benefit of research involvement. Further data on the characteristics of study partners in regards to their willingness to engage in research will be presented.ConclusionRecruiting persons with MCI and their study partners for clinical trials research may require specialized communication messaging and strategies for dyad engagement. Strategies should target study partners by promoting the opportunities and potential benefits of MCI clinical trials while considering challenges to involvement due to availability (e.g., weekend meetings, remote offerings, and attempting to lessen the burden of research engagement), rather than focusing recruitment efforts solely on the participant. Further studies exploring strategies to educate and engage study partners to enhance recruitment into MCI research is warranted.