bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity, cognitive decline and biomarkers of Alzheimer’s disease in adults with Down syndrome
Authors: Fleming Victoria , Piro‐Gambetti Brianna , Patrick Austin M , Zammit Matthew D , Alexander Andrew L , Christian Bradley T , Handen Benjamin L , Cohen Ann D , Klunk William E , Laymon Charles M , Okonkwo Ozioma C. , Ances Beau M. , Plante David T , Hartley Sigan L 
Published: December 2021

AbstractBackgroundAdults with Down Syndrome (DS) are at high risk for Alzheimer's disease (AD), which is characterized by the early accumulation of amyloid‐beta (Aβ), followed by neurofibrillary tangles of tau, and subsequent pathology. There is variability in the age of AD onset in DS, which may mean that non‐genetic factors impact AD timing. Physical activity is associated with less age‐related cognitive declines and lower risk of AD in non‐DS populations. The goal of this study was to examine the association between physical activity and cognitive performance and AD biomarkers (Aβ PET, tau PET, and white matter (WM)) in non‐demented adults with DS.Methods66 adults with DS from the Alzheimer Biomarker Consortium Down Syndrome participated. Participants wore an actigraph accelerometer on their non‐dominant wrist for 7‐days. Cognitive performance was assessed via measures of memory, executive functioning, visuospatial ability, and dementia symptoms. Participants underwent MRI and PET scans to assess the standard uptake value ratio of [11C]PiB (15 mCi) in the neocortex and striatum and [18F]AV‐145 across braak regions I‐VI. WM integrity was assessed using DTI mean diffusivity and fractional anisotrophy in major association tracts.ResultsGreater sedentary activity was associated with more dementia symptoms (r = ‐0.298, p<.05). Higher moderate‐to‐vigorous activity was associated with better memory (r = 0.309, p<.01), executive functioning (r = 0.270, p<.05), visuospatial ability (r = 0.311, p<.05), and fewer dementia symptoms (r = 0.356, p<.01). Models controlled for age and level of intellectual disability. Neither sedentary nor moderate‐to‐vigorous activity were significantly related to PET Aβ or tau PET. However, both were associated with WM integrity in the superior longitudinal fasciculus (r = ‐0.445, p<.05; r = 0.393, p<.05) and sedentary was associated with inferior longitudinal fasciculus tracts (r = ‐0.362, p<.05), after controlling for age and intellectual disability.ConclusionPhysical activity might have a protective effect against age‐related cognitive declines in in DS. However, the reverse time‐order could also be true. Physical activity was not associated with PET Aβ or tau PET cross‐sectionally. In contrast, physical activity was associated with WM integrity, Longitudinal studies are needed to understand mechanisms driving associations, including the cardiovascular impairment
Policy recommendations from the perspective of health professionals who work with people with dementia in public tertiary hospitals in China
Authors: Zhao Wenhong , Moyle Wendy , Wu Min‐Lin (Winnie) , Petsky Helen 
Published: December 2021

AbstractBackgroundChina has the largest number of people with dementia in the world. However, there is currently no specific national policy or plan related to dementia care in China. Health professionals working in public tertiary hospitals are the primary sources of diagnosis and treatment of people with dementia. They are very familiar with this population and are in the best position to provide information to inform policymakers. The purpose of this study was to explore health professionals’ policy recommendations on dementia care in China.MethodA qualitative study using thematic analysis with ATLAS.ti software was used. Semi‐structured in‐depth interviews using an interview guide were employed. Purposive maximum variation sampling was used to recruit health professionals working in settings where people with dementia are cared for in public tertiary hospitals (i.e., neurology, psychiatric, and geriatric departments) and who have more than six months’ experience of caring for people with dementia. Data was collected between July and December 2019 in Shijiazhuang, Hebei Province, China. Interviews were recorded and transcribed, and translated form Mandarin into English, and then analyzed into categories and themes. Ethical approval was obtained from the University Human Research Ethics Committee (2019/269) and hospitals as required.ResultTwenty‐four participants were recruited from three public tertiary hospitals. Four themes emerged. Participants described that the medical treatment and care provided in China was not meeting the needs of people with dementia. Daycare centers and specialized nursing homes for people with dementia were recommended as a means to support family caregivers. Participants also identified low public awareness of dementia. To improve this, participants suggested that training in dementia care should be provided to family caregivers and health professionals. Setting up dementia curricula in universities was also recommended by participants.ConclusionChina is not adequately equipped to deal with the challenges of dementia care. An integrated health system is urgently needed in China, where policymakers and stakeholders work collaboratively for the formulation of effective treatment and care strategies for people with dementia.
Change in care location of older adults who resided in group homes in Japan: An observational study using long‐term care insurance comprehensive database
Authors: Nakanishi Miharu 
Published: December 2021

AbstractBackgroundGroup homes have been introduced into Japanese public long‐term care insurance program to accommodate people with dementia in a homelike, small‐scale environments. The national dementia plan was launched in 2013 to promote provision of end‐of‐life care to people with dementia at group homes. However, discharge destinations from group homes have rarely been investigated. The present study examined the discharge destination of older adults between group homes and other types of homelike, small‐scale environments under the public long‐term care services.MethodWe used monthly data of January and July during 2013‐2016 from the long‐term care insurance comprehensive database. The 3,468 discharges from group home (n = 500), housing with care (n = 571), nursing home (n = 2097), or in‐home multiple service (n = 300) during 2013‐2016 were included in analysis.ResultOf the 500 discharges from group homes, 173 (34.6%) were admitted to hospitals, 110 (22.0%) were admissions to facilities, and 178 (35.6%) were deceased. Controlling for individual characteristics and the use of specialized care, residents of group homes were more likely to be admitted to hospital rather than discharged by death, in comparison to those of housings with care (adjusted odds ratio [OR] = 0.35, 95% confidence interval [CI] = 0.25‐0.48) or nursing homes (adjusted OR = 0.25, 95%CI = 0.19‐0.32).ConclusionGroup home residents were more likely to be hospitalised compared to residents of housings with care or nursing homes. Further dementia care strategies should be explored to reduce changes in location of care among people with dementia.
Gaps and novel approaches in nutrition epidemiology for dementia prevention
Authors: Grodstein Fran 
Published: December 2021

AbstractBackgroundThere is general appreciation that diet is important in the maintenance of health and prevention of chronic diseases. However, traditional epidemiologic and statistical approaches to understand specific dietary habits in the etiology and prevention of dementia may benefit from further consideration in the context of modern methods of mining data. Additionally, better investigation of culturally‐specific approaches to understand diet patterns and apply dietary research is critical.MethodWe will review several novel methods for population research in diet, including how to better incorporate under‐represented minorities in nutritional epidemiology.ResultNetwork science methods of understanding biologic patterns which may underlie health have become increasingly common in basic and population research. These methods can also provide novel means of identifying diet patterns that may play key roles in dementia. In addition, especially since dementia develops over decades, better investigating the relation of diet to dementia risk through the adult lifecourse may offer new information on timepoints during life which may be especially important for halting or delaying disease processes. New statistical methods can estimate lifestyle trajectories over many repeated measures of diet in population cohorts. Finally, successful identification of diet patterns depends on broader research in more diverse populations, and new ways to conduct research and apply findings in underrepresented minorities are critical.ConclusionNew methods to fully understand diet patterns across populations, and over time, may offer novel insights for effective interventions to test in randomized trials.
Precision medicine and biomarkers in nutrition science for dementia prevention
Authors: Samieri Cécilia 
Published: December 2021

AbstractBackgroundThere is substantial inter‐individual variability in the metabolic and neurobiological responses to diet. Deciphering such heterogeneity ‐ the foundation of precision medicine ‐ may help refine nutritional interventions for the prevention of dementia. The development of high‐throughput technologies applied to biological matrices has fostered characterization of the molecular architecture underpinning such heterogeneity across individuals, allowing to refine knowledge on how specific elements of the food matrix may impact pathways leading to dementia. Moreover, a critical step in precision medicine is to interrogate effect modification by some biological modulators that may define individualized vulnerability profiles.MethodWe will review recent epidemiological and clinical studies leveraging biomarkers, genomics and microbiomics for the identification of molecular pathways underlying the effect of nutrition on brain health and of factors of heterogeneity in metabolism and efficacy (eg, baseline nutritional status, host genome and the microbiome).ResultRecent advances in omics (proteomics, metabolomics, nutrigenomics, epigenetics and transcriptomics) have started reveal both neurobiological pathways that may be corrected by appropriate diet as well as potential novel diet‐related targets for preventive interventions. Moreover, observational studies and randomized controlled trials have suggested that nutrient supplementation may specifically benefit individuals with baseline nutrient deficiencies. Emerging studies also suggest gene‐by‐environment interactions in dementia, as well as a strong influence of the microbiota as a key mediator and/or modulator on the way nutrients are absorbed and metabolized and how they exert biological effects on the brain along the so‐called gut brain axis.ConclusionA precision medicine approach of nutrition and brain health needs to be expanded, from observational epidemiology to clinical research through basic science. Given the heterogeneity of nutritional behaviors across cultures, this will necessitate cross‐cohort collaborative projects to identify robust nutritional exposures that determine neurobiological changes leading to dementia. The multiple dimensions of nutrition will have to be captured through repeated behavioral, environmental and biological measures, both reliable and valid in cross‐cultural populations. Measurement of genomic variation and of the individual microbiome have started to develop in epidemiological studies and should be expanded. Most promising strategies will be validated in preclinical models and in appropriately powered clinical trials.
Rhizolutin directly dissociates Aβ and tau aggregates and reduces apoptosis/inflammation related to Alzheimer’s disease
Authors: Shin Jisu , Kwon Yun , Nam Kwangho , An Joon Soo , Yang Seung‐Hoon , Hong Seong‐Heon , Bae Munhyung , Moon Kyuho , Cho Yakdol , Woo Jiwan , Park Keunwan , Kim Kyeonghwan , Shin Jongheon , Kim Byung‐Yong , Kim YoungSoo , Oh Dong‐Chan 
Published: December 2021

AbstractBackgroundAlzheimer’s disease (AD) is characterized by the aggregation of amyloid‐β (Aβ) and tau, leading to neuronal cell death, neuroinflammation, and brain atrophy. As Aβ and tau aggregates are observed in the brain decades before the onset of cognitive symptoms, clearance of these aggregates has been widely accepted for AD treatments.MethodThrough the unbiased screening against the natural product libraries, rhizolutin was selected and its regulatory effects on Aβ and tau aggregation were validated by thioflavin T assays. Clearance of Aβ plaques was observed in APP/PS1 double transgenic AD model mice and subsequent analyses regarding apoptosis and inflammation were conducted using neuronal and glial cell lines.ResultRhizolutin‐treated AD model mice significantly decreased hippocampal Aβ plaques. Additionally, rhizolutin effectively inhibited the aggregation of Aβ and tau in vitro, more importantly, dissociated both aggregates, thereby reducing Aβ‐induced apoptosis and inflammation in neuronal and glial cells.ConclusionOur findings reveal that a unique chemical rhizolutin regulates both Aβ and tau at the same time by therapeutic and preventive approaches, representing its novel structure is attractive for AD drug discovery.
Motoric cognitive risk syndrome: Prevalence and cognitive performance
Authors: Márquez Isabel C , Garcia‐Cifuentes Elkin , Velandia Felipe Ramirez , Saavedra Ana María , Borda Miguel German , Chavarro‐Carvajal Diego Andrés , Osuna Margarita , Ailshire Jennifer , Cano‐Gutierrez Carlos Alberto 
Published: December 2021

AbstractIntroduction: Cognitive decline and dementia have a significant impact on the quality of life of older adults and their caregivers. Increasing and optimizing accessibility of clinical dementia risk assessment is important to set up preventive measures and reduce health care costs. Motoric Cognitive Risk Syndrome (MCRS) is a pre‐dementia stage where slow gait speed and subjective memory complaints are present, but where cognitive performance is adequate and without functional impairment. In addition to dementia, MCRS seems to increase the risk of having other geriatric outcomes including frailty, disability, falls and overall mortality.MethodsData from the SABE Colombia study (Health, Well‐Being, and Aging) conducted in 2015 in community‐dwelling adults aged 60 years and older. Using the 4 aspects considered within the MCRS definition, we evaluated the presence of this syndrome and factors associated in this population with regression models. A sub‐sample of 19,004 participants was obtained.ResultsThe multivariate analysis showed a prevalence of 5,45% of MCRS. After adjusting for cofounding variables MCRS was associated with MMSE (OR 0.90, CI 0.82‐0.99; p 0.028) and frailty (OR 9.1, CI 3.26‐25.47, p 0.000; OR 21.38, CI 6.30‐72.57, p 0.000).ConclusionThis study found a prevalence of 5.45% of MCRS in Colombian older adults. We found an association between cognitive performance (MMSE), frailty and MCRS. Our results increase the awareness of a pre‐dementia stages different to Mild Cognitive Impairment (MCI), as these individuals are at greater risk than those with MCI to develop dementia.
Future use and implementation of AD blood biomarkers from a clinical and epidemiological perspective
Authors: Mielke Michelle M. 
Published: December 2021

AbstractBackgroundBlood‐based biomarkers for the diagnosis and prognosis of Alzheimer’s disease are now becoming a reality. Indeed, the first plasma amyloid‐beta blood test and algorithm is available for clinical use in some locations. With the very promising plasma phosphorylated tau 181 and 217 results in the past two years, it is likely additional tests will be approved in the near future. However, many questions remain as to how blood‐based biomarkers should best be used in the clinic, including how they should be utilized in the general population and among primary care physicians.MethodWe will discuss some of the key considerations and steps that must be taken before implementation in the clinic, especially in primary practice. Examples will be incorporated from the existing literature and data collected in the Mayo Clinic Study of Aging.ResultOne consideration includes the peripheral factors that might affect the levels of the biomarkers in blood including demographics (age and sex), and comorbidities. For example, a high body mass index is associated with a larger blood volume and renal disease can affect the clearance rate of the biomarker. Another consideration is the utility of a blood‐based biomarker among those with subjective memory complaints and the corresponding ethical implications and guidance for use that is needed. A third consideration is the context of use of blood‐based biomarkers in healthcare settings would could include general screening purposes, targeted screening in people at high risk and actively seeking counseling in primary care, and/or diagnosis in specialized/tertiary care.ConclusionBlood‐based biomarkers for the diagnosis and/or prognosis of Alzheimer’s disease and related disorders are much more feasible and less costly and invasive than a lumbar puncture for the collection of cerebrospinal fluid or amyloid and tau PET imaging. However, it is critical to address several concerns prior to implementing blood‐based biomarkers into the clinic, both in specialty and primary care settings, for the interpretation of the results and upmost consideration of the patient. Specific research actions will be needed to better understand the role of peripheral factors and the use of blood biomarkers in clinical care.
Effectively training dementia care specialists and other dementia professionals on using the DICE ApproachTM with caregivers to improve the management of behavioral and psychological symptoms of dementia
Authors: Walaszek Art , Schroeder Molly , Albrecht Tammi , Endicott Sarah , Marschall Katelyn , Felten Kristen , Sayavedra Noelia , LeCaire Tamara , Russmann Sydney , Kern Vincent Joseph , Blazek Mary C , Kales Helen C , Carlsson Cynthia M , Mahoney Jane 
Published: December 2021

AbstractIntroduction: Most persons living with dementia will exhibit at least one behavioral or psychological symptom of dementia (BPSD) (Kales, et al., 2015). As brain pathology progresses, challenging behaviors can increase in frequency and severity, causing an increase in caregiver stress and burden. Furthermore, BPSD can result in unplanned hospitalizations and unnecessary use of psychotropic medications. Non‐pharmacological management of BPSD should be the first line of treatment. The DICE (Describe, Investigate, Create, Evaluate) ApproachTM was developed by experts from the University of Michigan and John Hopkins University, to help caregivers learn how to identify and manage BPSD. This project describes a statewide implementation of the DICE approach with community‐based dementia care providers.MethodsFrom September 2017 to April 2020, we held four DICE trainings (three in‐person trainings, one web‐based training) for Dementia Care Specialists (DCSs) and other dementia care professionals who work directly with family caregivers of people with dementia in Wisconsin. We assessed trainees’ knowledge and attitudes from the Dementia Attitudes Scale (DAS) and the Knowledge about Memory Loss and Care test (KAML‐C) at baseline of training, immediately after training, and six months after training. Consultations were provided to address challenging cases.ResultsParticipants (N=136) in both in‐person and online DICE trainings experienced significant changes in knowledge, self‐efficacy and attitudes from baseline to post‐training (immediately after training) assessments (p<.01) (see Table 2 for details). Narrative feedback from trainees was generally very positive. Trainees used DICE with 165 caregivers who were primarily non‐Hispanic white (92%) females (74.4%) from an urban location (68.1%), caring for their spouse (52.7%) (Table 1).Discussion: By using the DICE approach with caregivers of persons with dementia, Wisconsin’s DCSs and other dementia professionals are uniquely positioned to help reduce risks associated with BPSD, including the use of psychotropic medications. Training satisfaction was high, knowledge about BPSD increased, and attitudes improved. The DICE trainings prepared trainees to implement this intervention with 165 family caregivers. A follow‐up survey will explore the real‐world application of DICE, including barriers to its use and modifications made in communities across the state.
Motoric cognitive risk syndrome: Its prognostic value for dementia and other adverse age‐related health outcomes—A systematic review
Authors: Mullin Donncha S. , Cockburn Alastair , Welstead Miles , Luciano Michelle , Russ Tom C. , Muñiz‐Terrera Graciela 
Published: December 2021

AbstractBackgroundMotoric Cognitive Risk (MCR), a syndrome combining objective slow gait speed and subjective cognitive complaints, is being used to identify older adults at high risk of developing dementia. Yet, uncertainty exists regarding the prognostic value of MCR for this and other major causes of morbidity in ageing, such as cognitive impairment and falls.This review is the first to synthesise all mental and physical health outcomes associated with MCR since the term was coined in 2013, and with its component parts of objective slow gait and subjective cognitive complaint prior to 2013. The aim of the review is to evaluate the prognostic value of MCR for adverse age‐related health outcomes.MethodResults from multiple databases (MEDLINE, AMED, EMBASE, CINAHL, PsycINFO, and the Cochrane library; inception to May 2021) for original longitudinal cohort studies of adults aged ≥60 years that compared an MCR group to a non‐MCR group, for any health outcome were screened independently and risk of bias was assessed. We meta‐analysed incident health outcome results where appropriate using a restricted maximum‐likelihood estimator.ResultOf 1057 records identified, 15 studies were eligible. Of these, 11 studies that examined 15 cohorts were combined by meta‐analysis reporting on four health outcomes: cognitive impairment (n=6,458), dementia (n=9,955), falls (n=12,640), and mortality (n=19,818). Risk of bias was deemed low‐to‐moderate in all studies except one, where falls was the outcome. Our meta‐analysis found that participants with MCR were at an increased risk of cognitive impairment (adjusted hazard ratio (aHR) 1.76, 95%CI 1.49–2.08; I2=24.9%), dementia (aHR 2.12, 1.85–2.42; 33.1%), falls (adjusted Relative Risk 1.38, 1.15–1.66; 62.1%), and mortality (aHR 1.49, 1.16–1.91; 79.2%), see figure 1.ConclusionEvidence suggests that participants with MCR at baseline are at an increased risk of cognitive impairment, dementia, falls, and mortality on follow‐up.