bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cultural perceptions of medication management during hospital‐to‐home transitions of older Latino adults living with dementia
Authors: Arbaje Alicia I , Greyson Sylvan , Keita Maningbe , Sharma Rhea , Keller Sara , Gurses Ayse , Samus Quincy M 
Published: February 2022

AbstractBackgroundIn a country with a growing Latin American and Spanish‐speaking population, the health care system is tasked with providing care across changing landscapes of culture and language. Specifically, the hospital‐to‐home transition is a high‐risk period for medication errors and adverse events for older adults with Alzheimer’s Disease and Related Dementias (ADRD), and the older Latino population is widely understudied. Family caregiver perspectives are especially important in Latino populations. The field of human factors engineering, which studies the interactions among people and systems, can be useful to understand complex phenomena. Our objective was to elicit and categorize family caregivers’ cultural perceptions of ADRD and views on medication use during the hospital‐to‐home transition of Latino older adults with ADRD.MethodQualitative study using semi‐structured interviews and participant solicited diaries with family caregivers of older Latino adults with ADRD after hospital discharge. We used the human factors engineering‐informed Systems Ambiguity Framework to guide data analysis. At least two researchers independently coded each transcript using a content analysis approach. We identified recurring cultural perceptions of medication use and resource accessibility. We used Atlas.ti software to facilitate data analysis.ResultWe interviewed 11 caregivers of older Latino adults with moderate‐to‐severe ADRD. We elicited caregivers’ cultural perceptions of medication management, medication purpose, and available resources. Recurring themes expressed by caregivers indicate 1) Concern about over‐medication, 2) Resignation over limited medication effectiveness for treating ADRD, 3) Scarcity of culturally specific and appropriately translated resources, and 4) Wariness to trust providers and medical institutions based on negative experience. Multiple caregivers experienced initially incorrect diagnoses or contradictory information from multiple providers, contributing to a sense of resignation regarding treatment options and a lack of trust in providers and institutional resources.ConclusionWe identified four cultural perceptions of medication use and resource accessibility. The elicited themes point to a need for culturally tailored care instructions for family caregivers, appropriate language services across the care continuum, and a concerted outreach effort to form trusted relationships among Latino communities and health care providers.
Only baseline amyloid burdens and their incremental change could not predict AD progression in mild cognitive impairment
Authors: Choo Il Han , Chong Ari , Chung Ji Yeon , Ha Jung‐Min , Choi Yu Yong , Kim Hoowon 
Published: February 2022

AbstractBackgroundMild cognitive impairment (MCI) is the intermediate stage between cognitively normal and dementia. Cerebral amyloid burden by amyloid PET is the pathological biomarker of Alzheimer’s disease (AD). The goal of this study was to evaluate the prognostic ability of baseline amyloid burdens and their incremental change in the MCI participants.MethodSeventy‐two MCI participants were selected in this study by inclusion and exclusion criteria. They underwent baseline and annual follow‐up evaluation including comprehensive neuropsychological assessment, consensus clinical diagnosis for 2 years. The [18F]Florbetaben PET and MRI scans were also performed. T1‐weighted MR 3D volumes were acquired for co‐registration with PET. Dichotomous categorization was performed for baseline β‐amyloid (Aβ) positivity by mean cortical amyloid burden cut‐off score. And annual amyloid burden changes were also acquired.ResultBaseline Aβ positivity evaluation defined 36 Aβ positive (Aβ+ve) and 36 Aβ negative (Aβ‐ve) MCI individuals. Of 36 Aβ+ve MCI subjects, 9 MCI progressed to AD and of 36 Aβ‐ve MCI subjects, 7 MCI progressed to AD (p = 0.280). MCI subjects with amyloid burden increase were 4 of 16 AD converters and 22 of 56 non‐converters (stable MCI) (p = 0.294).ConclusionOur results suggest that only baseline MCI amyloid burdens and their incremental change could not predict AD progression.
Development and validation of cerebral white matter hyperintensity probability map of elderly Koreans
Authors: Kim Jun Sung , Lee Subin , Kim Grace Eun , Oh Dae Jong , Moon Woori , Bae Jong Bin , Han Ji Won , Byun Seonjeong , Suh Seung Wan , Choi Yu Yong , Choi Kyu Yeong , Lee Kun Ho , Kim Jae Hyoung , Kim Ki Woong 
Published: February 2022

AbstractBackgroundAlthough previously constructed white matter hyperintensity (WMH) probability maps of healthy older adults exist, they have several limitations in representing the distribution of WMH in healthy older adults, especially Asian older adults. We developed and validated a WMH probability map (WPM) of healthy older Koreans and examined the age‐associated differences of WMH.MethodWe constructed WPM using development dataset that consisted of high‐resolution 3D fluid‐attenuated inversion recovery images of 5 age groups (60–64 years, 65–69 years, 70–74 years, 75–79 years, and 80+ years). Each age group included 30 age‐matched men and women each. We tested the validity of the WPM by comparing WMH ages estimated by the WPM and the chronological ages of 30 healthy controls, 30 hypertension patients, and 30 stroke patients.ResultOlder age groups showed a higher volume of WMH in both hemispheres (p < 0.001). About 90% of the WMH were located in periventricular space in all age groups. With advancing age, the peak of the distance histogram from the ventricular wall of the periventricular WMH shifted away from the ventricular wall, while that of deep WMH shifted toward the ventricular wall. The estimated WMH ages were comparable to the chronological ages in the healthy controls, while being higher than the chronological ages in hypertension and stroke patients.ConclusionThe WPM may serve as a standard atlas in research on WMH of older adults, especially Asians.
Instituto Alzheimer Brasil: A Brazilian support group for Alzheimer's disease during the COVID‐19 pandemic
Authors: da Silva Novais Ticyana Moralez , de Santana Beatriz Raz Franco , Piovezan Mauro Roberto , Piovezan Elizabeth S , Silva e Moreira Raissa Carla Paulino , Reginatto Genita S , Stein Angelica Miki 
Published: February 2022

AbstractBackgroundThe Instituto Alzheimer Brasil (IAB) is a non‐governmental organization that promotes information about Alzheimer’s disease to community, offering support for people with dementia, caregivers and familiars. Before the pandemic period, two monthly presential meetings were organized by IAB, in two cities, São Paulo and Curitiba, with 80 participants estimated in each one. However, with social distancing regime, alternatives were required to maintain the activities. Thus, the present study aimed to describe the actions developed by IAB and the participants during the distancing regime of COVID‐19 in 2020.MethodThe mainly activities developed by IAB during the distancing regime included: 1) The virtual meetings by applicative; 2) Lives in the social media; 3) Message app group to support individualized cases. Parts of the meetings and the lives were recorded and posted after transmission. The number of participants was counted during the transmission and followed by the later access to the videos. The number of demands via message was counted, as well. As a part of apps, the geographic location of participants was showed and, in some cases, the location was asked directly to the caregiver via message.ResultNine virtual meetings and seven lives lectures had been broadcasted on social media open to the community, from March to November 2020. The total of 643 participants through the application meetings and 628 on live lectures. Being the most watched video with over 9000 views, and over 500 comments per video. The online actions reached more participants than São Paulo and Curitiba, in 14 Brazilian states and in other 6 countries: Portugal, Japan, Germany, Italy, Australia and the USA.ConclusionConsidering virtual activities, the main result had been an increase in the number of people assisted who need a huge dealing support for Alzheimer`s disease. With virtual actions, people from other countries and regions of Brazil were able to participate in the support group. The feedbacks of caregivers had been extremely positive, showing that online model should last along with the presential model, even with the end of the social distance regime.
The impact of COVID‐19 related isolation on the mental health of Alzheimer’s disease caregivers: Where does communication technology fit in?
Authors: Faieta Julie , Routier Francois , Faieta Lily , Best Krista 
Published: February 2022

AbstractBackgroundThe COVID‐19 lockdown and social isolation protocols implemented to slow the spread of the virus created a unique environment of separation between individuals with Alzheimer’s disease and related dementias (ADRD) and their informal caregivers. The health and wellness of dementia caregivers has been shown to be affected by the challenges of their caregiving role. Yet the inability to fulfill these roles may exude equally detrimental health outcomes. Furthermore, the impact of communication technologies such as smart phone and tablet apps, is not yet fully understood. This study investigated the mental health outcomes of ADRD caregivers in the wake of widespread COVID‐19 related social isolation, and the influence of app use on these outcomes.MethodCaregiver perceptions were gathered via a web‐based survey (available in both French and English). Inclusion criteria included: self‐reported status as a dementia caregiver, 18 years of age or older, and ability to read either English or French. Survey data was analyzed via descriptive statistics and specific variables of interested were investigated deeper via principal component analysis and ordinal regression model analysis.ResultA total of 84 complete surveys (67 English, 17 French) were collected. Of these, 80% reported that their loved one was isolated due to some form of institutionalization or hospitalization. Furthermore, 87% of respondents reported that they experienced negative mental health outcomes related to either experiencing, or worrying about isolation from their loved one. Using no or only 1 smart device application was significantly associated with increased likelihood of negative mental health outcomes for the caregiver.ConclusionThese findings highlight the need for methods of mitigating the negative effects of physical separation in periods of health and safety‐related lockdowns and isolation. Furthermore, the potential alleviating effect of increased technology use was indicated by the increased risk of health concerns with less app use as compared to more app use. Future studies should further investigate the extent to which various smart personal device applications can facilitate care provision at a distance.
“We’re Walking Around Blindfolded”: Diverse caregiver reflections on dementia diagnosis and care
Authors: Amjad Halima , Gundavarpu Sneha , Blinka Marcela D , Samus Quincy M 
Published: February 2022

AbstractBackgroundPrevalence of dementia is highest in African Americans and Hispanics. Yet, many minorities experience missed or delayed dementia diagnoses and disparities in quality of dementia care. The objective of this study was to understand racial and ethnic minority experiences of dementia diagnosis and develop recommendations for clinicians and health systems to improve diagnosis and early care for diverse populations from the caregiver perspective.MethodMinority dementia caregivers in the Baltimore, Maryland region were recruited from specialty clinics, prior studies, and the Alzheimer’s Association to participate in semi‐structured, in‐depth, qualitative interviews. Interviews topics included early dementia symptoms, diagnosis experiences, healthcare system interactions, and recommendations for clinicians. Interviews were coded and analyzed by three investigators using qualitative content analysis methods.ResultEighteen family caregivers (11 African American, 4 Asian and 3 Hispanic), mostly adult children (n=15) of the person with dementia, participated. Four themes emerged around recommendations for clinicians and health systems throughout the diagnosis process. 1) Involve family: Recommendations pertaining to family involvement included listening to family concerns, sharing patient information including diagnosis, recommending family counseling or meetings, and understanding family and culture specific care plans. 2) Knowledge is power: Information was felt to be essential. Caregivers desired clear or written diagnosis, guidance on what to expect (roadmap), and concrete resources. 3) Provide proactive care: Caregivers likened the need for cognitive screening to cancer screening. They felt clinicians should proactively detect early signs of dementia, educate caregivers on potential challenges (safety, finances), and offer support to both patient and caregivers. 4) Mind your (bedside) manners: Caregivers shared both positive and off‐putting interactions. They appreciated clinicians who were straightforward, demonstrated compassion rather than nihilism or negativity, and were readily available for questions.ConclusionMinority dementia caregivers shared recommendations for clinicians related to four themes, which included involving family, offering knowledge and information, providing proactive care, and being mindful of bedside manner and language in dementia detection, diagnosis, and early care processes. Caregiver perspectives and recommendations should be incorporated into clinical practice and dementia care interventions for diverse aging populations.
The impact of pandemic‐related measures on COVID‐negative dementia inpatients
Authors: Bukala Bernard R , Carpenter Kilda J , Fox Willow , Reyes Demi , Sanghvi Hazel , Vickers Philip 
Published: February 2022

AbstractBackgroundDuring the COVID‐19 pandemic, infection control measures and changes to patient flow have drastically altered the care provided to inpatients with dementia. Some of these emergency steps mainly affected COVID‐19 positive patients, whereas others had an impact on all. This project aimed to examine the pandemic’s impact on the demographics, care and outcomes of inpatients with dementia who did not test positive for the virus.MethodsThis analysis formed a part of an overarching initiative at Stoke Mandeville Hospital, which leveraged the National Audit of Dementia (NAD) framework to assess care during the pandemic. A tailor‐made questionnaire was composed of the relevant NAD elements and additional items, including questions on capacity assessment. The full sample included 100 patients with dementia admitted between April and July 2020. In this project, data from patients who tested negative for COVID‐19 (n=75) were compared to the local results of the last available NAD (2018; n=50). A combination of student’s t, binomial, and Chi‐squared statistical tests was applied to numerical, two‐answer categorical, and multiple‐answer categorical data respectively (with FDR correction where appropriate).ResultsDemographics of dementia patients admitted during the pandemic were different, with fewer males (27% vs. 40% in 2018), fewer ethnic minorities (13% vs. 36%) and fewer patients admitted from their own home (45% vs 63%). During admission, fewer functional assessments were carried out and less patient‐specific information made available. Inpatient falls were less frequent (19% vs. 64%), presumably due to decreased opportunities for mobility. Admissions were shorter overall, but discharges appeared less well planned and coordinated. Rates of delirium and mortality were unaffected.ConclusionsWhile major outcomes appear unchanged, the real impact may be masked by limited, selective admissions. The findings highlight the need to preserve assessment and discharge planning for COVID‐negative patients with dementia during future crisis response measures.
IDEAS and New IDEAS: Amyloid PET in diverse populations
Authors: Windon Charles , Dilworth‐Anderson Peggye , Carrillo Maria C. , Apgar Charles , Gatsonis Constantine , Gareen Ilana F. , Gutman Roee , Hanna Lucy , Hill Carl V. , Hillner Bruce E. , Hoover Stephanie , March Andrew , O'Bryant Sid , Rissman Robert A. , Rodriguez Mariela , Romanoff Justin , Siegel Barry A. , Smith Karen , Song Yunjie , Weber Christopher J. , Whitmer Rachel A. , Wilkins Consuelo H. , Rabinovici Gil D. 
Published: February 2022

AbstractBackgroundImaging biomarkers for neurodegenerative disease are understudied in diverse populations. The completed Imaging Dementia‐Evidence for Amyloid Scanning (IDEAS) and recently launched New IDEAS studies evaluate the clinical impact of amyloid PET in large samples of Medicare beneficiaries across the U.S. with MCI or dementia, enabling comparisons between patients from different racial and ethnic backgrounds.MethodAmyloid PET was performed in 18,295 IDEAS Study participants recruited from 590 clinical sites between 2016‐2018. Dementia specialists completed pre‐ and post‐PET case report forms. Medicare claims were followed for 12 months. New IDEAS will enroll 7000 Medicare beneficiaries (minimum 2000 African Americans and 2000 Latinos) with MCI or dementia at ∼350 memory clinics across the US between 2020‐2023, following analogous procedures. Quantified social determinants of health (quality of education, midlife/current income, marital status and living arrangement) will be measured. A team involving Vanderbilt University, University of North Carolina and the Alzheimer’s Association will use community engaged research principles (community stakeholders as study champions, tailored recruitment strategies) to ensure cohort diversity.ResultRecruitment in IDEAS included a low proportion of minority participants (83.9% White (N=15,568), 3.4% African American (N=639), 4.6% Hispanic (N=848), 1.8% Asian (N=328)). The proportion of positive amyloid scans was lower for African Americans (53.8%), Hispanics (54%) and Asians (45.1%) compared to Whites (62.7%). African Americans (52%), Hispanics (56%) and Asians (47%) presented more frequently with dementia (as opposed to MCI) than Whites (37%). There were disparities in vascular risk factors (hypertension/diabetes: 68%/28% African Americans, 55%/26% Hispanics, 48%/25% Asians, 50%/15% Whites) and lower educational attainment for African Americans and Hispanics. New IDEAS will examine the impact of amyloid PET on health outcomes and patient management in the total cohort and individual racial groups. A biorepository of banked plasma and DNA from 5000 participants will be established.ConclusionIDEAS demonstrated baseline differences in disease stage, risk factors and etiologies across racial and ethnic groups. New IDEAS will employ a multi‐pronged approach to improve participation of under‐represented populations and evaluate the clinical utility of amyloid PET and its relationship with social determinants of health in a diverse population of patients with cognitive impairment.
Differential atrophy along the longitudinal hippocampal axis in Alzheimer’s disease
Authors: Morais‐Ribeiro Rafaela , Coelho Ana , Oliveira Tiago Gil 
Published: February 2022

AbstractBackgroundAlzheimer’s disease (AD) is a progressive neurodegenerative disorder that primarily affects the hippocampus. Since hippocampal studies have highlighted a differential subregional regulation along its longitudinal axis, a more detailed analysis addressing subregional changes along the longitudinal hippocampal axis has the potential to provide new relevant biomarkers.MethodThis study analysed structural brain MRI data of 600 participants (aged 55‐92 years‐old) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Hippocampi of cognitively normal (CN) subjects (n=200), mild cognitively impaired (MCI) subjects (n=200) and AD patients (n=200) were segmented with Freesurfer v6.0 and sub‐segmented along its longitudinal axis in anterior, intermediate and posterior sub‐divisions using an in‐house algorithm.ResultTotal hippocampal volume normalized to intracranial volume (ICV) negatively correlated with age in all groups. Standardized residuals from the linear regression of normalized hippocampal volume by age were then calculated, showing that the mean relative atrophy corrected for the aging effect was higher in CN (µ = 0.54) than in MCI (µ = 0.13), and lower in AD (µ = ‐0.67), with significant differences between all groups (p < .001 in all comparisons). Both anterior, intermediate and posterior hippocampus negatively correlate with age in all groups, with no significant differences between them. However, when normalizing to total hippocampus, only CN subjects show a significant positive correlation (r = 0.15, p = .03) between anterior sub‐division and age, and only CN (r = ‐0.27, p < .001) and MCI (r = ‐0.18, p = .01) posterior hippocampus negatively correlate with age. The longitudinal ratio of hippocampal atrophy (anterior sub‐division divided by the posterior one) shows a significant increase with age in CN (r = 0.25, p < .001) and MCI (r = 0.15, p = .04) but not in AD (r = ‐0.07, p = .35).ConclusionNormal aging affects the hippocampus differently along its longitudinal axis: its posterior aspect shows more atrophy and the anterior one becomes relatively more prominent. In AD, this antero‐posterior gradient is disrupted early on, and hippocampal atrophy occurs in a similar manner along its longitudinal axis from late‐adulthood to older ages.