bluuebunny/crossref_metadata_2025_split huggingface dataset:
MIND diet and risk of dementia in a population‐based cohort
Authors: de Crom Tosca , Ikram M Arfan , Voortman Trudy 
Published: December 2021

AbstractBackgroundNutritional approaches are considered a promising strategy for dementia prevention, but the composition of an optimal neuroprotective diet remains undetermined. The Mediterranean‐ DASH Intervention for Neurodegenerative Delay (MIND) diet has been developed which contains food components that are thought to be specifically neuroprotective. However, whether this translates into lower dementia risk in the population is uncertain. We examined the association between the MIND diet and the risk of dementia, and compared this to two general health promoting diets.MethodIn the population‐based Rotterdam Study, dietary intake was assessed with validated food‐frequency questionnaires at two time points: in 6,985 non‐demented participants (median age 65.4 years, 57.8% women) at baseline; and after 10‐20 years of follow‐up in 2,861 non‐demented surviving participants (median age 74.5 years, 57.4% women). We derived adherence scores for the MIND diet, and ‐for comparison‐ for the Dutch dietary guidelines and Mediterranean diet.ResultTotal follow‐up was 25 years from the first and 7 years from the second dietary assessment, during which 1,202 and 152 participants developed dementia, respectively. None of the three diets were associated with dementia over the 25 years since first dietary assessment (Figure 1). However, during the 7‐year follow‐up from the second dietary assessment, higher MIND diet scores were associated with a lower risk of dementia (hazard ratio (HR) [95% confidence interval] per standard deviation increase: 0.869 [0.760‐0.993]). Accordingly, when restricting follow‐up time to 7 years after the first assessment, higher MIND diet scores were also associated with a lower dementia risk (HR 0.714 [0.604‐0.846]). Associations with dementia were generally weaker or absent for the Dutch dietary guideline and Mediterranean diet score.ConclusionBetter adherence to the MIND diet is associated with a lower risk of dementia but these associations were limited to the first 7 years of follow‐up. Associations were stronger for the MIND diet compared to other healthy diets, suggesting that the MIND diet might be more specific for protecting brain health.
U.S. long‐term services and supports, Covid‐19, & dementia: Impacts and opportunities for policy change
Authors: Dawson Walter D , Stone Robyn I , Van Houtven Courtney H , Boucher Nathan A 
Published: December 2021

AbstractBackgroundThe COVID‐19 pandemic brings the many historical challenges of the long‐term services and supports (LTSS) system in the United States (U.S.) into clear focus. Inequalities across race, ethnicity, and socioeconomic status (SES) as well as an increased burden on family care partners have been amplified by the pandemic. In spite of multiple reform attempts and an increasing population of older adults living with multiple, chronic health conditions including Alzheimer’s disease and other forms of dementia (ADRD), who will need some form of long‐term care during their lifetime policy reform has remained elusive. Primary blame for the high rates of COVID‐19 infections and deaths have largely been assigned to formal LTSS care settings. Yet, more systemic problems have become clear during the pandemic: the failure of coordination of the U.S. public health system at the federal level and the effects of long‐term disinvestment and neglect of state and local level public health programs. Taken together, these failures contributed to an inability to coordinate with the LTSS system and act early to protect residents and staff in the LTSS care settings.MethodWe analyze several impacts of the COVID‐19 pandemic on the U.S. LTSS system and existing policy arrangements.ResultPolicies U.S. policymakers can implement include uniform public reporting of COVID‐19 cases in licensed LTSS settings, identifying and supporting unpaid care partners, increased support for the direct care workforce, increased coordination between public health departments and LTSS agencies and providers, enhancing collaboration and communication across health, LTSS, and public health systems, further reducing barriers to telehealth in LTSS, and providing incentives to care for our most vulnerable populations. The analysis also demonstrates that comprehensive reform is required in order to build the LTSS system that is needed through comprehensive workforce development, universal coverage through comprehensive financing reform, and the creation of an age‐friendly public health system.ConclusionThe COVID‐19 pandemic has exposed the deficits of the U.S. LTSS system and made clear the interdependence of LTSS with public health. Several policy responses to the pandemic would help provide the LTSS system that is needed to care for people living with dementia.
Association of physical strength and AD biomarkers in cognitively unimpaired patients
Authors: Kim Aelim , Kim Woo‐Ram , Noh Young 
Published: December 2021

AbstractBackgroundIn elderly, physical fitness is considered an important factor for well‐being and it has been reported that there is a correlation between brain health and physical fitness in people with neurodegenerative diseases. Physical fitness factors that are especially important for the elderly included muscle strength, aerobic endurance, flexibility, agility/dynamic balance. The purpose of this study was to investigate the relationship between physical fitness and imaging biomarker such as tau deposition and brain atrophy in elderly people.MethodWe recruited elderly participants (age≥65): cognitive impairment (CI, n=49) and cognitive normal(CN, n=45). CI included mild cognitive impairment (MCI) and dementia. All of subjects (Male:Female=33:61, mean age: 72.7 ± 4.97) performed senior fitness test (SFT), 3T magnetic resonance imaging(MRI), [18F] flutemetamol PET and [18F]MK‐6240 positron emission tomography(PET). Physical fitness was measured by muscle strength (upper and lower), aerobic endurance, flexibility (upper and lower), agility/dynamic balance according to the SFT protocol. Mean cortical thickness was calculated by T1‐weighted images. [18F]MK‐6240 Standardized Uptake Value Ratio (SUVR) used cerebellar gray matter as the reference region.ResultIn all, cortical thickness was associated with upper muscle strength, and agility/dynamic balance. The same result was shown in women. In male, only upper muscle strength was associated with cortical thickness. Tau was associated with all physical fitness factors. Physical fitness and tau were related each other in both males and females, except for upper flexibility. In CI, that was shown a significant correlation between tau and lower muscle strength, lower flexibility, and agility/dynamic balance.
ConclusionIn elderly, upper muscle strength and agility/dynamic balance were related to cortical thickness. In addition, the better physical strength was associated with the less tau deposition. This suggests that physical strength including muscle strength can affect to tau and brain atrophy in neurodegenerative diseases including Alzheimer's disease.
Balance and gait disorders in a memory clinic population: A prospective observational cross‐sectional study
Authors: Razay George 
Published: December 2021

AbstractBackgroundBalance and gait disorders (B&GDs) increase with ageing, but often they are not adequately evaluated and largely go underdiagnosed. We have therefore investigated the prevalence of B&GDs and the underlying diagnosis among patients with memory impairment.Method410 consecutive patients enrolled between 2010 and 2014 from the Memory Disorders Clinic, Launceston, Tasmania. All patients had a detailed history of memory, balance and gait symptoms including features suggesting dementia. A full examination included the Mini‐Mental State Examination (MMSE) and balance/gait functions by observing the patients standing with their eyes closed, on their toes, and doing the tandem test. All patients had a brain CT scan.Result218 women and 192 men participated in the study, the median age was 76.5 years (range 32.6‐94.8) and the mean MMSE score was 23.3 (SD 4.9). 214 (52%) had B&GDs of whom, 85 (40%) had mild cognitive impairment (MCI), 25 (12%) had Alzheimer’s disease (AD), 62(29%) had idiopathic normal pressure hydrocephalus (INPH), 11 (5%) had mixed dementia (MD), 10 (5%) had vascular dementia (VD), 9 (4%) had Parkinson’s disease dementia, 2(1%) had Lewy body disease (LBD). 196(48%) didn’t have B&GIs, of whom, 97 (50%) had MCI, 66 (34%) had AD, 13(7%) had MD, 6(3%) had Gertsmann’s syndrome, 4 (2%) had hypogonadism, and 4 (2%) had frontal lobe dementia (FLD). After excluding patients with MCI, patients with B&GDs (n=129); 60 (48%) had INPH, 25 (20%) had AD, 11 (9%) had MD, 10 (8%) had VD, 2 (2%) had LBD. Patients without B&GDs (n=100), 66% had AD, 13% had MD, 1% had VD and 4% had FLD.ConclusionThe study shows that B&GDs are common among patients with memory impairment, and highlights the high prevalence of INPH, a condition that could be treated with shunt surgery resulting in improvement of cognitive, balance and gait functioning.
The clinical use of Alzheimer’s biomarkers in patients with mild cognitive impairment
Authors: Caprioglio Camilla , Garibotto Valentina , Jessen Frank , Frölich Lutz , Frisoni Giovanni , Altomare Daniele 
Published: December 2021

AbstractBackgroundAlzheimer’s disease (AD) is defined as a clinic‐biological disease characterized by the abnormal deposition of amyloid and tau in the brain. AD biomarkers offer the perspective to confirm the presence of amyloid and tau pathology in vivo and supports their increasing use in clinical practice. The aim of this study is to investigate the clinical use of the main AD biomarkers, focusing on amyloid‐PET and tau‐PET, by examining the beliefs and preferences of clinicians (neurologists, geriatricians, psychiatrists) as well as biomarker experts (nuclear medicine, radiology, laboratory physicians) participating in the European Alzheimer’s Disease Consortium (EADC). In the present abstract, we focus on clinicians.MethodThe survey was made accessible from May to September 2020. The questionnaire assessed, among others: respondent’s profile (level of expertise, type of practice), frequency of use of biomarkers, beliefs about the pathogenic role of amyloid and tau in Alzheimer's disease, and perceived clinical utility of amyloid‐PET and tau‐PET.ResultIn total, 150 professionals filled in the survey, with an overall answer rate of 49% (150/306): among them, 100 were clinician experts in the field of neurodegenerative disorders. These clinicians reported a frequent‐to‐constant use of medial temporal atrophy (MTA) in 77% of cases, CSF in 45%, FDG‐PET in 32%, amyloid‐PET in 8%, and tau‐PET in 2%. Clinicians attributed a prevalent pathogenic role in AD pathology and symptoms to amyloid (42%) more frequently than tau (20%, p=0.001). The perceived clinical utility of amyloid‐PET and tau‐PET in supporting an etiological diagnosis in MCI and mild dementia patients was more balanced (35% vs 24%, p=0.121) then clinicians’ beliefs about the pathogenic role of amyloid and tau.ConclusionThese results highlight the frequent use of traditional AD biomarker (i.e. MTA, FDG‐PET, CSF) and a non‐negligible use of amyloid‐PET. Clinicians consistently attributed a greater pathogenic role in AD pathology and symptoms to amyloid rather than tau. However, when the focus switched from the belief about the pathogenic role of amyloid and tau to their diagnostic contribution, amyloid‐ PET and tau‐PET scans were considered equally useful.
Neuro‐COVID: Does severe COVID‐19 infection increase the risk for cognitive impairment?
Authors: Hagman Göran , Thunborg Charlotta , Andersen Pia , Levak Nicholas , Aspö Malin , Walles Håkan , Jokhader Elias , Kåhlin Jessica , Nelson David , Piehl Fredrik , Tzortzakakis Antonios , Zetterberg Henrik , Granberg Tobias , Eriksson Lars I , Kivipelto Miia 
Published: December 2021

AbstractBackgroundNeurocognitive manifestations of the coronavirus disease 2019 (COVID‐19) have been reported in the acute phase, especially in critically ill patients. The potential mechanisms underlying these symptoms are not fully understood but probably involves the inflammatory, vascular, and neurotropic effect of the coronavirus. While short‐, mid‐and long‐term consequences remain unclear, patients with neurocognitive sequelae reminiscent of other cognitive disorders, including AD have been reported. The aim of this study is to investigate if there is an increased risk for long‐term cognitive dysfunction/impairment, biochemical and structural brain changes after a severe COVID‐19.MethodThis is a prospective cohort study of 80 patients surviving intensive‐care for COVID‐19 at Karolinska University Hospital, Stockholm, Sweden. They will be examined at 3, 6 and 12 months after hospital discharge using neurological and neuropsychological (NP) tests combined with novel quantitative brain MRI and serial blood sampling to described relevant blood‐borne molecular patterns. This presentation focuses on NP testing, cognitive, mental, and neurological aspects at 3 months follow‐up. Cognitive testing and questionnaires (NP) include Rey Auditory Verbal Learning Test Rey Complex Figure test, Verbal Fluency Test, Category flow, Trail Making Test Symbol Digit Modalities Test, Mental Fatigue Scale, the Hospital Anxiety and Depression Scale, RAND‐36, AD8 Dementia Screening Interview and Subjective cognitive decline questions. A detailed neurological examination (neurologist), including Expanded Disability Status Scale, an adapted version of the Unified Parkinson's Disease Rating Scale for extrapyramidal dysfunction, and a brief smell test.ResultsAt present, 28 participants have completed the 3‐months follow‐up visit, including neuropsychological and neurological examinations. Mean age (SD) at baseline was 57.8 (11.1) years, and 68% were men. Several patients expressed cognitive and/or mental concerns and fatigue. The neuropsychological and neurological examinations have so far revealed varying and mixed patterns. Brain MRI revealed mainly microvascular pathology. Detailed analyses, including blood biomarkers for neuronal injury and astrocytic activation, based on the 3‐months examination will be presented.ConclusionsRepeated examinations will allow further analyses on longer term impact on cognition and underlying mechanisms. This may identify patients at risk and possible ways to mitigate cognitive complications, which is of great importance to reduce the pandemic's negative effects and socioeconomic burden.
Longitudinal plasma Alzheimer’s disease biomarkers in an Alzheimer’s disease research center cohort suggest pTau181 as the most reliable plasma biomarker for brain Alzheimer’s pathology
Authors: Sudduth Tiffany L. , Winder Zachary , Schmitt Frederick A. , Harp Jordan , Nelson Peter T. , Ali Doaa , Jicha Gregory A. , Wilcock Donna M. 
Published: December 2021

AbstractBackgroundBlood‐based biomarkers for the detection and longitudinal tracking of Alzheimer’s disease (AD) brain changes remains a goal for the field. In this study, we set out to evaluate Ab42/40, total tau, and pTau181 in our longitudinal clinical cohort. In most cases we have assessed five separate plasma samples spanning a seven‐year period. A subset of individuals had plasma samples aligning with an amyloid‐PET scan. A second subset of individuals cam to autopsy and had neuropathologic workup for correlation with the findings in the plasma biomarkers.MethodDuring their annual visits to the UK‐ADRC clinical core, participants had blood drawn and EDTA plasma was stored at ‐80oC in a standardized manner according to ADRC best practices. Quanterix Simoa assays were performed using Simoa Advantage assay kits and Quanterix Simoa HD‐1 and HD‐X instruments. Ab40, Ab42, total tau, and pTau181 analyses were performed. 96 participants had six annual plasma samples analyzed from an eight year period of collection. Of the samples assessed, 77 participants had plasma data aligning with an amyloid PET scan and 48 cases came to autopsy at the UK‐ADRC.ResultLooking at longitudinal plasma Total Tau, Ab40, and Ab42, Total Tau and the Ab42/40 ratio fluctuate significantly from year to year. In contrast, pTau181 does not show significant fluctuations year to year. Among those participants with an amyloid PET scan, pTau181 was significantly associated with amyloid SUVr in frontal, parietal, and anterior cingulate regions (R2 = 0.11 P<0.01; R2=0.12 P<0.01; R2=0.13 P<0.005 respectively). In contrast, we did not find statistically significant relationships between amyloid PET SUVr and plasma Ab42/40 ratio. Total tau showed modest associations with amyloid PET SUVr in the frontal, parietal, and anterior cingulate regions (R2=0.1 P<0.01; R2=0.05 P<0.05; R2=0.09 P<0.01 respectively). In our autopsy cases, we found a modest inverse relationship between brain amyloid load and plasma Ab42/40 ratio (P=0.05). Further analyses are required for the autopsy studies.ConclusionIn a community‐based cohort with longitudinal blood draws, pTau181 is a reliable, consistent plasma biomarker for AD pathology, showing more stability over time in participants than other candidate plasma biomarkers.
APOE Ɛ4 genotype is associated with thicker retinal layers in asymptomatic middle‐aged adults at high Alzheimer’s disease risk
Authors: Sharvit‐Ginon Inbal , Beeri Michal Schnaider , Weller Aron , Sher Ifat , Rotenstreich Ygal , Ravona‐Springer Ramit 
Published: December 2021

AbstractBackgroundRetinal abnormalities have been demonstrated in patients with mild cognitive impairment (MCI) and dementia due to Alzheimer's disease (AD), but findings in yet asymptomatic stages of the disease are scarce and inconsistent. This study examined the relationship of retinal thickness with APOE Ɛ4 genotype, the most important genetic risk factor for AD.MethodParticipants (n=245) were cognitively asymptomatic middle aged people taking part in the Israel Registry for Alzheimer's Prevention (IRAP) study, enriched for high AD‐risk due to parental history of the disease. Assessments included a complete ophthalmic examination, best‐corrected visual acuity (BCVA) evaluation and optic coherence tomography (SD‐OCT) imagingAPOE status was determined based on rs429358 and rs7412 SNPs' genotypes. MANCOVA was used to compare retinal thickness between APOE Ɛ4 carriers and non‐carriers adjusting for age, sex, education and BCVA in four retinal quadrants (nasal, inferior, temporal and superior).ResultParticipants' mean age was 59.60 (SD=6.42) years, 66.4% were women. Retinal thickness was significantly greater in APOE Ɛ4 carriers compared to non‐carriers (p=0.005), reaching statistical significance in the nasal (p=0.008) and inferior (p=0.022) regions. A secondary MANCOVA analysis examined differences between APOE4 carriers and non‐carriers in specific retinal layers‐ the neural and glial layers (Retinal Nerve Fiber Layer‐ RNFL, Ganglion Cell Layer– GCL, Inner Plexiform Layer‐IPL, Inner Nuclear Layer‐INL and the Outer Plexiform Layer‐OPL) and the non‐neural layers (Outer Nuclear Layer‐ONL and the Retinal Pigment Epithelium (RPE). In the nasal region, APOE4 carriers had thicker retinal nerve fiber layer (RNFL) (p=0.033), ganglion cell layer (GCL) (p=0.021) and inner plexiform layer (IPL) (p=0.010); in the inferior region, they had thicker GCL (p=0.035); and in the superior region, the APOE4 carriers had thicker IPL (p=0.019).ConclusionIn asymptomatic individuals enriched for AD risk, APOE4 carriers had thicker retinal nasal and inferior quadrants, which were driven primarily by the neural layers of the retina, but not by non‐neural layers. Our results suggest that retinal layers' thickness measurments may potentially be used as early biomarkers the disease.
COVID‐19 and vaccination programme in one residential home
Authors: Da Silva Miguel Vasconcelos , Velayudhan Latha , Khan Zunera , Manzar Beverley , Aarsland Dag , Ballard Clive 
Published: December 2021

AbstractBackgroundApproximately 410 000 people live in care homes (CH) or residential settings in the UK, with the majority of this population being above the age of 85, making this group fall in the category of higher risk of more severe COVID‐19 symptoms and death. CH have been disproportionately affected by COVID‐19, people living and working in these settings have a higher risk of exposure to infection and higher risk of severe disease and mortality. CH residents and staff were prioritised for the vaccination programme in the UK due to increased risk of outbreaks, morbidity and mortality.MethodOne Residential home reported a COVID‐19 outbreak following the vaccination programme. Most staff vaccinated between 16‐18 December 2020, and most residents vaccinated on 30/12/2020. Residents were on isolation from 22/12/2020 prior to vaccination. The first positive COVID‐19 case was on 27th December. Staff and residents were scored according to the World Health Organisation (WHO) Ordinal Scale for Clinical Improvement (OSCI), table 1.ResultOf staff vaccinated, 20,83% (n=5) tested positive for COVID‐19. Nine staff members (27.28%) didn't have the vaccine, with 7 of these (77.78%) developing more limiting symptoms (OSCI score 2), compared to 8.33% (n=2) of those who had the vaccine. With 100% of residents vaccinated, 21 residents (65,63%) developed COVID‐19 symptoms, and 31.25% (n=10) developing more limiting COVID‐19 symptoms or death. Nineteen residents have a diagnosis of dementia and 63.16% (n=12) developed COVID‐19 symptoms and 50% (n=6) of those with dementia died, whilst those without dementia did not have any deaths reported.ConclusionAlthough this reflects the experience of a single CH, it is of relevance in suggesting substantial protection for staff who have been vaccinated, even though there was only 11 days between vaccination and the start of the outbreak.The experience in this CH starkly emphasizes the poor outcomes of COVID‐19 for residents, especially those with dementia, and unfortunately suggests that there are no benefits from vaccination as a secondary prevention approach once an outbreak has started. Ongoing evaluation will be important to optimize the delivery of the vaccination programme in CH settings, and to optimize staff take up of the vaccine.