bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of built and social environmental characteristics on incidence and estimated risk of dementia
Authors: Bagheri Nasser , Mavoa Suzanne , Tabatabaei‐Jafari Hossein , Knibbs Luke D , Coffee Neil T , Salvador‐Carulla Luis , Anstey Kaarin J 
Published: December 2021

AbstractBackgroundDementia is a public health priority1 and the current study designed to investigate associations between built and social environmental characteristics and dementia incidence, and the estimated future risk of dementia. Further we investigated spatial variations in dementia risk and dementia incidence to identify unmet areas for policy intervention.MethodWe used 25,511 patients (aged 65 years and older) records in Adelaide between 2011‐2015. In addition to dementia incidence, we calculated a dementia risk score based on risk and protective factors for patients not diagnosed with dementia. The following built and social environment exposures were estimated for each statistical area level 1 (SA1)2: social fragmentation, nitrogen dioxide (NO2), public open spaces, walkability, socio‐economic status and the length of main roads. We performed multilevel regression analyses to allow for the hierarchical nature of the data and applied spatial cluster analysis to identify areas with high and low risk of dementia.ResultWe found that a one standard deviation (SD) increase in NO2 and walkability score was associated with 10% higher odds of any versus no dementia (95% confidence interval (CI): 1%, 21% for NO2 and 0%, 22% for walkability score). For estimated future risk of dementia, a 1‐SD increase in social fragmentation (mobility component) and NO2 was associated with a 1% increase in dementia risk (95% CI: 0, 1%). 1‐SD increases in public open space and socioeconomic status were associated with 3% (95% CI: 0.95, 0.98) and 1% decreases (95% CI: 0.98, 0.99) in dementia risk, respectively. There was spatial heterogeneity in the pattern of dementia incidence and dementia risk.ConclusionAssociations of neighbourhood NO2 level, walkability, public open space and social fragmentation with dementia incidence and estimated future risk of dementia were statistically significant, indicating the potential to reduce the risk through changes in built and social environments. Mapping the estimated future risk of dementia and diagnosed cases of dementia offers a novel approach to identifying areas of unmet need. 1. Towards a dementia plan: a WHO guide. Geneva: WHO; 2018. 2. Australian Statistical Geography Standard (ASGS): Volume 1 ‐ Main Structure and Greater Capital City Statistical Areas, 2016.
The improvement effects of Orengedokuto for aggression and violence to caregiver’s care from patients with dementia
Authors: Urabe Shinji , Tsuchida Hideto , Tamura Junichi , Nabika Toumei , Shirakikawa Shinsuke , Yoshikawa Yoshimi , Moritoki Yukihiro , Matsuo Koji , Tsunemi Teppei , Wada Takatosi , Shiomoto Takayuki , Urabe Mie 
Published: December 2021

AbstractBackgroundBehavioral and psychological symptoms of dementia (BPSD) increase the distress of patients with dementia and the burden for care givers and they are the symptoms that need to be solved immediately. Antipsychotics are not recommended for the treatment of aggression and violence in BPSD, because they make the risk of death of the elderly according to Food and Drug Administration (FDA, 2005). So, as a medicine with less side effects which give the expected effect, herbal medicine is used often for BPSD in Japan. We have focused on Orengedokuto within Japanese herbal medicine, and reported that it improve the aggression (Urabe et al., AAIC2019) and behavioral deviation and the rejection of care by patients with dementia ((Urabe et al., AAIC2020) in AD. The purpose of this research is to clarify the effect of Orengedokuto to aggression and violence of patients with dementia.MethodThe subjects were 11 patients with dementia admitted to a psychiatric hospital in Japan. The group of the patients with dementia who were administered with Orengedokuto (ODG;8 patients, average age ; 83 years old) and a control group of the patients with dementia who did not take Orengedokuto (NODG; 3 patients, average age; 80.3 years old). We evaluated the patients with Behavioral Pathology in Alzheimer’s disease (Behave‐AD), Mini Mental State Examination, the improvement effects of aggression and violence were compared the changes before and after administration between ODG and NODG. There is no conflict of interest in this study.ResultThe average score of aggression and violence, was 7.25 point (before administration: before) to 1.5 point (at the time of leave from hospital: after) in ODG (p<0.05), and 7.6 point (before) to 4.6 point (after) in NODG.ConclusionIn ODG, aggression and violence behavior was improved. It was clarify that Orengedokuto has the improve effect of aggression. And it was suggested that Orengedokuto has the improve effect of violence behavior related aggression, too.
Subjective cognitive decline and self‐reported sleep at a memory clinic: The SCIENCe project
Authors: Exalto Lieza G , Hendriksen Heleen MA , Barkhof Frederik , van den Bosch Karlijn A , Ebenau Jarith L , van Leeuwenstijn Mardou , Prins Niels D , Teunissen Charlotte E , Visser Leonie NC , van der Werf Ysbrand D , Scheltens Philip , van der Flier Wiesje M 
Published: December 2021

AbstractBackgroundsleep problems have been associated with Alzheimer’s disease (AD) pathology and they have been suggested to occur early in the disease process. Sleep problems have also been associated with subjective cognitive decline (SCD), although in many subjects with SCD, no AD biomarker evidence is found for the experienced cognitive decline. Our aim was to investigate whether frequency and type of sleep problems in memory clinic patients with SCD are associated with cognition, mental health, MRI measures, and AD CSF biomarkers.Method308 subjects (65±8yrs, 44% female, MMSE 29±1) from the Subjective Cognitive Impairment Cohort (SCIENCe) project with available information on sleep were included. Sleep was evaluated by the Berlin Questionnaire (3 categories; ≥2 high risk sleep apnea) and Pittsburgh Sleep Quality Index (range 0‐21; ≥5 poor sleep quality). All underwent a standardized memory clinic work‐up. Subjects were classified as having sleep problems when ≥1 sleep questionnaire was above the cut‐off. Sociodemographics, cognitive performance (attention, memory, language, and executive functioning), depressive symptoms, anxiety, self‐reported cognitive decline (Cognitive Change Index; CCI), medial temporal lobe atrophy, global cortical atrophy, white matter hyperintensities, and CSF levels of Aβ42, t‐tau, p‐tau were compared between subjects with and without sleep problems.Result198/308 (64%) subjects reported sleep problems, based on 107 (35%) sleep apnea and 162 (53%) poor sleep quality. Subjects with sleep problems tended to be younger (63.8±8.1 vs 65.7±8.5), more often female (47% vs 39%) and more often APOE ε4 carrier (40% vs 28%), but these differences did not reach statistical significance (all p>.05, Table 1). They reported more depressive symptoms (CES‐D median(IQR): 10(5‐16) vs 4(2‐7)), anxiety (HADS‐A: 5(2‐10) vs 2(0.25‐4)) and cognitive decline (CCI: 43(31‐56) vs 35(25‐47)), all p≤.001. Sociodemographics, cognitive performance, MRI measures and AD CSF biomarker levels did not differ between groups.Conclusionsleep problems are common in subjects with SCD and are associated with higher levels of anxiety, depressive symptoms and self‐reported cognitive decline, but not AD biomarkers. Our results suggest that poor sleep quality and hygiene are a potentially reversible cause of the subjective experience of cognitive decline and potential leads for treatment in many subjects with SCD.
Characterization of the NIA‐AA Research Framework stage 2 in the longitudinal multicenter DELCODE study
Authors: Sannemann Lena , Meiberth Dix U. , Schild Ann‐Katrin , Bürger Katharina , Heneka Michael T. , Laske Christoph , Perneczky Robert , Peters Oliver , Priller Josef , Schneider Anja , Spottke Annika , Teipel Stefan J. , Wagner Michael , Wiltfang Jens , Wolfsgruber Steffen , Düzel Emrah , Jessen Frank ,   the DELCODE study group
Published: December 2021

AbstractBackgroundThe latest NIA‐AA Research Framework for Alzheimer’s disease (AD) includes a numerical staging system for individuals in the Alzheimer’s continuum. The authors introduce “stage 2” as a transitional stage, characterized by the earliest detectable cognitive or neurobehavioral changes. We aimed to characterize stage 2 in a large German multicentre cohort study.MethodOur analysis included baseline data of N = 349 cognitively healthy participants with available CSF biomarker information from the DZNE Longitudinal Cognitive Impairment and Dementia (DELCODE) study. A subsample of n = 110 participants presented with abnormal Aß42/40 biomarkers and was therefore classified as part of the Alzheimer’s continuum. Stage 2 characteristics at baseline were defined by subjective decline with concern in any domain on the SCD interview that persisted for at least 6 months. In addition, subtle impairment of objective cognitive performance (<0,5SD) was derived from factor scores of the DELCODE neuropsychological test battery. Subtle neurobehavioral changes were defined by the presence of at least one neuropsychiatric symptom (NPS) on the Neuropsychiatric Inventory Questionnaire (NPI‐Q).ResultThe majority of participants in the Alzheimer’s continuum presented with only SCD (22.7%) or both SCD and NPS (20.9%), whereas 12.7% presented with only NPS and 5.5% with only subtle objective cognitive decline. While 10.9% showed all three stage 2 characteristics, 14.5% showed none. The distribution of stage 2 characteristics differed between participants in the Alzheimer’s continuum and those with normal Aß42/40 (X2
(7)=21.21, p<.01). In addition, the number of fulfilled stage 2 criteria was higher in participants with abnormal Aß42/40 (M=1.41, SD=0.87) compared to those with normal amyloid biomarkers (M=1.10, SD=0.84, t(347)=1.45, p=.001).ConclusionOur findings provide a systematic overview on stage 2 characteristics in a large cohort of cognitively healthy participants with abnormal AD biomarkers and indicate that both the number of fulfilled stage 2 criteria and their distribution differs from participants outside the Alzheimer’s continuum.
Impairment of recognition of facial expressions in different types of dementia
Authors: Güntekin Bahar , Yıldırım Ebru , Kıyı İlayda , Akturk Tuba , Calısoglu Pervin , Uzunlar Hakan , Yirikogullari Harun , Helvacı‐Yılmaz Nesrin , Bayraktaroglu Zubeyir , Hanoğlu Lutfu , Sequeira Henrique , Yener Gorsev 
Published: December 2021

AbstractBackgroundImpairment of facial expression recognition in dementia is one of the cognitive deficits that could affect the social life of dementia patients. The severity of the facial expression recognition in different types of dementia has not been fully addressed. Previous studies showed that EEG event‐related oscillation (ERO) studies could reveal the brain dynamics during successful facial expression recognition. Furthermore, the impairment of facial recognition in Alzheimer's disease patients were represented with abnormal EROs (Güntekin et al., 2019). The present study aims to compare the impaired facial expression recognition between different types of dementia by analysis of event‐related delta responses. The role of delta responses in facial expression and emotional paradigms was reported previously by several researchers (Güntekin and Başar, 2014).Method25 Healthy elderly controls (HC), 25 Mild Cognitive Impairment patients (MCI), 25 patients with Alzheimer's disease (AD), 15 patients with Parkinson's disease with Mild Cognitive Impairment (PDMCI) and 16 patients with Parkinson's disease Dementia (PDD) were included in the study. The electroencephalographic activity was recorded during the perception of the facial expression recognition task (Angry, Happy, Neutral). Delta power and phase‐locking were computed for each facial recognition stimuli and compared among the groups (ANOVA, p<0.05).ResultBoth delta power and delta phase locking were lower in dementia groups than healthy controls being worst in PDD. Figure 1 shows the grand average of delta power in all groups for the right occipital location. PDD (p<0.0001) and AD (p<0.05) had lower delta power than the healthy controls, the reduction of delta responses in PDD and AD were especially found over occipital locations. MCI and PDMCI subjects were found less impaired facial expression recognition compared to AD and PDMCI.ConclusionThe present study showed that dementia patients had severe facial recognition deficits that increased cognitive impairment. Event‐related delta responses successfully showed the impaired recognition of facial expression in different types of dementia groups. Among all dementia subjects, PDD patients had the most reduced delta responses that could be an electrophysiological biomarker of impaired facial expression recognition. Acknowledgments: This work (grant number 218S314) was supported by TUBITAK. References: 1) https://doi.org/10.1111/psyp.13434.2) https://doi.org/10.1016/j.neuropsychologia.2014.03.014
A stepwise approach towards diagnostic workup in dementia using online cognitive tools
Authors: Meester Hanneke FM Rhodius‐ , Tolonen Antti , Van Gils Aniek M , Koikkalainen Juha , Barkhof Frederik , Herukka Sanna‐Kaisa , Hänninen Tuomo , Ngandu Tiia , Kivipelto Miia , Hasselbalch Steen Gregers , Mecocci Patrizia , Remes Anne , Soininen Hilkka , Scheltens Philip , van der Flier Wiesje M , Lötjönen Jyrki 
Published: December 2021

AbstractBackgroundDementia affects more and more people worldwide. Unfortunately, only half of dementia cases are well recognized. This indicates a need for both efficient and tailored tools for diagnosis. To improve the number of correctly diagnosed patients while retaining cost‐effectiveness, we study a stepwise data‐driven approach for the diagnostic workup. By using the online cognitive test tool cCOG [1] as prescreener, we aim to select the right diagnostic workup for each patient.MethodsWe included 710 subjects from three memory clinic cohorts (PredictND, VPH‐DARE and Amsterdam dementia cohort) with different types of dementia and subjective cognitive decline (SCD). All patients performed a neuropsychological (NP) test battery (consisting of MMSE, RAVLT, TMT‐A and B and Animal Fluency) and had MRI of the brain. A subset of 214 subjects additionally performed cCOG. To verify results we imputed missing cCOG based on corresponding NP tests [1]. From MRI, multiple imaging biomarkers were defined [2]. We tested a stepwise diagnostic approach, starting with screening using cCOG, then if needed testing with NP test battery and MRI, using the Disease State Index (DSI) classifier [2]. At each step patients were selected for the next step based on DSI model’s confidence (Figure 1).ResultsThe stepwise approach was as accurate as performing all tests in every patient (Table 1), but it reduced the number of tests done especially in SCD patients considerably, with NP in only 57% and MRI in 38% (Table 2). This was also reflected in reduced cost per patient in typical memory clinic population (from estimated 510 € to 238‐243 €). For dementia patients the reduction in number of tests and costs was smaller.ConclusionThis study suggest that using a stepwise approach, applying online cognitive tests as prescreening at home, can reduce the number of patient visits to clinic and costs. The results were as accurate as with the standard traditional work‐up. Online cognitive testing is therefore a promising tool to funnel the patient flow to memory clinics, also in times of social distancing. References: [1] Rhodius‐Meester, H.F.M. et al. Alzheimers Dement 2020 Aug25;12(1) [2] Bruun, M. et al. Alzheimers Dement 2018 Aug17;10.
Tau368 in cerebrospinal fluid is associated with severity of tau pathology load in the Alzheimer’s continuum
Authors: Simrén Joel , Benedet Andréa Lessa , Ashton Nicholas J. , Pascoal Tharick A. , Zetterberg Henrik , Rosa‐Neto Pedro , Blennow Kaj 
Published: December 2021

AbstractBackgroundRecent developments in the biomarker field allow Alzheimer’s disease (AD) pathophysiology to be reflected at the preclinical stage. We recently presented an assay targeting tau fragments ending at residue 368, which exhibited a stage‐wise decrease in a ratio with total‐tau. The tau368/T‐tau ratio also correlated with tau positron emission tomography (PET) uptake, and was present in tau tangles. In this study, we aimed to validate these findings in a larger cohort including a larger subset spanning the AD continuum.MethodWe investigated 129 participants cross‐sectionally from the Translational Biomarkers of Aging and Dementia (TRIAD) cohort (22 young, 60 cognitively unimpaired (CU) elderly (14 Aβ+), 26 mild cognitive impairment (MCI; 10 Aβ+), 14 AD dementia and 7 frontotemporal dementia (FTD)). For all individuals, [18F]AZD4694 and [18F]MK‐6240 PET were used to index Aβ and tau load (Braak stages) respectively. T‐tau was quantified using ELISA (INNOTEST®) and Tau368 was quantified by an in house Single molecule array (Simoa) assay (Quanterix, Billerica, MA). Spearman rank tests assessed correlation between continuous variables. Linear models tested the effect of tau368/t‐tau ratio on PET summary measures and at the voxel level, always adjusting for age and sex.ResultCompared to young controls, we observed a stage‐wise decrease of tau368/t‐tau, with the lowest ratio found in AD dementia (P<0.01), followed by CU‐ (P<0.001), CU+ (P<0.01) and MCI‐ (P<0.001). MCI+ had a lower ratio than CU‐ (P<0.01). Furthermore, there was a strong negative correlation between tau368/t‐tau ratio and PET Braak stages in the whole population (I‐II; ρ=‐0.46, P<0.001, III‐IV; ρ=‐0.44, P<0.001, V‐VI; ρ=‐0.37, P<0.001), in MCI+ (I‐II; ρ=‐0.79, P<0.01, III‐IV; ρ=‐0.84, P<0.01, V‐VI; ρ=‐0.83, P<0.01) and in AD dementia (V‐VI; ρ=‐0.57, P<0.05). Voxel‐wise analysis demonstrated strong correlation between tau368/t‐tau and tau PET ligand uptake in the medial and lateral temporal lobes in cognitively impaired individuals, while no significant association was found in CU.ConclusionWe provide further evidence of a stage‐wise decrease in CSF tau368/t‐tau, which tracks cortical tau accumulation only in clinically manifest AD dementia and amyloid positive MCI. These results further support that CSF tau368/t‐tau captures severity of tau pathology within the AD continuum.
Can community‐based cognitive screening identify individuals with MCI associated changes in complex instrumental activities of daily living?
Authors: Marks Timothy S , Giles Gordon Muir , Edwards Dorothy Farrar 
Published: December 2021

AbstractBackgroundUnrecognized deficits in complex instrumental activities of daily living, termed “preclinical disability”, have been identified in individuals experiencing mild cognitive impairment (MCI: Fieo & Stern, 2018; Peterson et al., 2017). Screening for difficulties in the performance of cognitively demanding complex IADLs may facilitate earlier identification of people on the threshold of MCI and can facilitate earlier intervention (Rodakowski et al., 2014). We examined the ability of three cognitive screening tests to identify individuals reporting IADL problems on the ADCS‐ADL‐MCI scale.MethodsA sample of 87 adults living independently in the community were assessed with the Menu Task, Mini‐Cog, Montreal Cognitive Assessment (MoCA), the ADCS‐ADL, and the 18 and 24 item versions of the ADCS‐MCI‐ADL scale. Established cut‐off scores for each cognitive screen identified impaired and unimpaired groups. Mann‐Whitney U tests compared differences between unimpaired and impaired groups for each cognitive screen on the 18 and 24 item ADCS‐MCI‐ADL composite scores. Between group differences were also examined for each of the ADCS‐MCI‐ADL‐24 individual items.ResultsSample demographics are presented in Table 1. Individuals impaired on the Menu Task had significantly lower composite scores on both the ADCS‐MCI‐ADL‐18 and the ADCS‐MCI‐ADL‐24 (p < .01), although no significant composite score differences were found for the Mini‐Cog (p = .061, p = .155) or the MoCA (p = .053, p = .099). Individual ADCS MCI items were also analyzed to explore the types of IADL impairments identified by each of the three cognitive screens scales. Different patterns of IADL impairment emerged for each of the cognitive screening measures. Individuals impaired on the Mini‐Cog had significantly lower ADCS‐ADL composite scores (p < .05).ConclusionIndividuals living in the community who score as impaired on the Menu Task demonstrated significantly lower ADCS‐MCI‐ADL‐18 and ADCS‐MCI‐ADL‐24 composite scores, but no significant difference on ADCS‐ADL. Impairment on each of the cognitive screening measures was associated with lower scores on individual ADCS‐ADL‐MCI complex IADL items. Cognitive screening measures that detect early and subtle changes in function may lead to earlier diagnosis and interventions for cognitively complex IADL deficits.
Overlooked threats to person‐centered dementia care: An imperative to explore the family terrain
Authors: Podgorski Carol Ann 
Published: December 2021

AbstractBackgroundAdoption of person‐centered care practices for older adults has increased considerably across the United States in recent years. This momentum is due largely to the dissemination of evidence‐based models including those delineated in both the Alzheimer’s Association® Dementia Care Practice Recommendations (2018) and the Age‐Friendly Health System initiative (2018). Both frameworks call for health care providers to work collaboratively with patients and their families to deliver care in accordance with what matters most to the patient. The role of family, particularly in person‐centered dementia care, generally involves informing, interpreting, and advocating for the patient. In healthy, well‐functioning families with strong attachment bonds and clear, open communication, the family is likely to know the patient’s wishes and to act in their best interest. In fractured, wounded families, however, this is less often true. Limited knowledge and understanding of the patient’s family dynamics preclude consideration of the complex, interdependent nature of family relationships and how those relationships influence not only the patient information that family members share, but also how they interpret information that gets exchanged with health care providers, and how the dynamics shape the goals of care for which families advocate. Family dynamics also influence whether and how care plans are implemented, which inevitably affects patient quality of life along with health care outcomes and costs. Evidence suggests that patients with dysfunctional families often require more careful monitoring regarding care compliance. Family history and relational dynamics pose threats to effective delivery of person‐centered care in a number of important ways including, for example: whether a family member will commit to step into the caregiver role and to what extent; whether, how, and when advance care planning takes place; and whether interdependent family relationships create power dynamics that lead to misrepresentation of the patient’s wishes, elder mistreatment, or family violence. This presentation will provide evidence to support a call for person‐centered care approaches to incorporate screening and assessment of patient and family relationship history as a means to better ensure the delivery of person‐centered dementia care that promotes safety as well as compliance with legal and ethical standards.