Pub Date : 2023-01-01Epub Date: 2023-02-20DOI: 10.1159/000528117
Thomas V Fungwe, Julius S Ngwa, Steven P Johnson, Jilian V Turner, Mara I Ramirez Ruiz, Oludolapo O Ogunlana, Fikru B Bedada, Sheeba Nadarajah, Oyonumo E Ntekim, Thomas O Obisesan
Background: Cardiovascular disease (CVD), including elevated blood pressure (BP), is known to promote Alzheimer's disease (AD) risk. Although brain amyloid load is a recognized hallmark of pre-symptomatic AD, its relationship to increased BP is less known. The objective of this study was to examine the relationship of BP to brain estimates of amyloid-β (Aβ) and standard uptake ratio (SUVr). We hypothesized that increased BP is associated with increased SUVr.
Methods: Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we stratified BP according to the Seventh Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Classification (JNC VII). Florbetapir (AV-45) SUVr was derived from the averaged frontal, anterior cingulate, precuneus, and parietal cortex relative to the cerebellum. A linear mixed-effects model enabled the elucidation of amyloid SUVr relationships to BP. The model discounted the effects of demographics, biologics, and diagnosis at baseline within APOE genotype groups. The least squares means procedure was used to estimate the fixed-effect means. All analyses were performed using the Statistical Analysis System (SAS).
Results: In non-ɛ4 carrier MCI subjects, escalating JNC categories of BP was associated with increasing mean SUVr using JNC-4 as a reference point (low-normal (JNC1) p = 0.018; normal (JNC-1) p = 0.039; JNC-2 p = 0.018 and JNC-3 p = 0.04). A significantly higher brain SUVr was associated with increasing BP despite adjustment for demographics and biological variables in non-ɛ4 carriers but not in ɛ4-carriers. This observation supports the view that CVD risk may promote increased brain amyloid load, and potentially, amyloid-mediated cognitive decline.
Conclusion: Increasing levels of JNC classification of BP is dynamically associated with significant changes in brain amyloid burden in non-ɛ4 carriers but not in ɛ4-carrier MCI subjects. Though not statistically significant, amyloid burden tended to decrease with increasing BP in ɛ4 homozygote, perhaps motivated by increased vascular resistance and the need for higher brain perfusion pressure.
背景:众所周知,心血管疾病(CVD),包括血压(BP)升高,会增加阿尔茨海默病(AD)的风险。虽然大脑淀粉样蛋白负荷是公认的症状前阿尔茨海默病的标志,但其与血压升高的关系却鲜为人知。本研究旨在探讨血压与大脑淀粉样蛋白-β(Aβ)估计值和标准摄取比(SUVr)之间的关系。我们假设血压升高与 SUVr 升高有关:利用阿尔茨海默病神经影像学倡议(Alzheimer's Disease Neuroimaging Initiative,ADNI)的数据,我们根据第七届国家预防、检测、评估和治疗高血压联合委员会(JNC)的分类(JNC VII)对血压进行了分层。氟贝他匹(AV-45)的SUVr来自额叶、前扣带回、楔前区和顶叶皮层相对于小脑的平均值。采用线性混合效应模型阐明了淀粉样蛋白 SUVr 与血压的关系。该模型排除了APOE基因型组中人口统计学、生物制剂和基线诊断的影响。采用最小二乘法估计固定效应均值。所有分析均使用统计分析系统(SAS)进行:结果:在非ɛ4携带者的MCI受试者中,以JNC-4为参考点,JNC血压类别的升级与平均SUVr的增加有关(低正常(JNC1)p = 0.018;正常(JNC-1)p = 0.039;JNC-2 p = 0.018和JNC-3 p = 0.04)。尽管对非ɛ4携带者的人口统计学和生物变量进行了调整,但脑SUVr的明显升高与血压升高有关,而在ɛ4携带者中则没有这种关系。这一观察结果支持以下观点,即心血管疾病风险可能会促进大脑淀粉样蛋白负荷的增加,并有可能导致淀粉样蛋白介导的认知能力下降:结论:在非ɛ4携带者中,JNC血压分类水平的升高与脑淀粉样蛋白负荷的显著变化动态相关,但在ɛ4携带者MCI受试者中并非如此。虽然没有统计学意义,但ɛ4 基因同源者的淀粉样蛋白负荷往往随着血压的升高而减少,这可能是由于血管阻力增加以及需要更高的脑灌注压所致。
{"title":"Systolic Blood Pressure Is Associated with Increased Brain Amyloid Load in Mild Cognitively Impaired Participants: Alzheimer's Disease Neuroimaging Initiatives Study.","authors":"Thomas V Fungwe, Julius S Ngwa, Steven P Johnson, Jilian V Turner, Mara I Ramirez Ruiz, Oludolapo O Ogunlana, Fikru B Bedada, Sheeba Nadarajah, Oyonumo E Ntekim, Thomas O Obisesan","doi":"10.1159/000528117","DOIUrl":"10.1159/000528117","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD), including elevated blood pressure (BP), is known to promote Alzheimer's disease (AD) risk. Although brain amyloid load is a recognized hallmark of pre-symptomatic AD, its relationship to increased BP is less known. The objective of this study was to examine the relationship of BP to brain estimates of amyloid-β (Aβ) and standard uptake ratio (SUVr). We hypothesized that increased BP is associated with increased SUVr.</p><p><strong>Methods: </strong>Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we stratified BP according to the Seventh Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Classification (JNC VII). Florbetapir (AV-45) SUVr was derived from the averaged frontal, anterior cingulate, precuneus, and parietal cortex relative to the cerebellum. A linear mixed-effects model enabled the elucidation of amyloid SUVr relationships to BP. The model discounted the effects of demographics, biologics, and diagnosis at baseline within APOE genotype groups. The least squares means procedure was used to estimate the fixed-effect means. All analyses were performed using the Statistical Analysis System (SAS).</p><p><strong>Results: </strong>In non-ɛ4 carrier MCI subjects, escalating JNC categories of BP was associated with increasing mean SUVr using JNC-4 as a reference point (low-normal (JNC1) p = 0.018; normal (JNC-1) p = 0.039; JNC-2 p = 0.018 and JNC-3 p = 0.04). A significantly higher brain SUVr was associated with increasing BP despite adjustment for demographics and biological variables in non-ɛ4 carriers but not in ɛ4-carriers. This observation supports the view that CVD risk may promote increased brain amyloid load, and potentially, amyloid-mediated cognitive decline.</p><p><strong>Conclusion: </strong>Increasing levels of JNC classification of BP is dynamically associated with significant changes in brain amyloid burden in non-ɛ4 carriers but not in ɛ4-carrier MCI subjects. Though not statistically significant, amyloid burden tended to decrease with increasing BP in ɛ4 homozygote, perhaps motivated by increased vascular resistance and the need for higher brain perfusion pressure.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-08-14DOI: 10.1159/000533357
Élodie Toulouse, Daphnée Carrier, Maire-Pier Villemure, Jessika Roy Desruisseaux, Christian M Rochefort
Introduction: Depression is often difficult to detect in long-term care (LTC) patients with major neurocognitive disorders (MNCD), and an observer-rated screening scale could facilitate assessments. This study aimed to establish the external validity and reliability of the Nursing Homes Short Depression Inventory (NH-SDI) in LTC patients with MNCD and to compare its estimates to the Cornell Scale for Depression in Dementia (CSDD), the most used scale for depression in MNCD.
Methods: A focus discussion group of experts assessed the content validity of the NH-SDI. Then, a convenience sample of 93 LTC patients with MNCD was observer-rated by trained nurses with the NH-SDI and CSDD. For 57 patients, a medical assessment of depression was obtained, and screening accuracy estimates were generated.
Results: The prevalence of depression was 8.8% as per reference standard. NH-SDI's content validity was judged acceptable with minor item wording modifications and specifications. The NH-SDI (cut-off ≥3) achieved 100% (95% confidence interval [CI]: 46-100%) sensitivity, 83% (95% CI: 69-91%) specificity, and 36% (95% CI: 14-64%) positive predictive value (PPV). The CSDD (cut-off ≥3) achieved 100% (95% CI: 46-100%) sensitivity, 75% (95% CI: 61-86%) specificity, and 28% (95% CI: 11-54%) PPV. No significant differences in areas under the receiver operating characteristic curve were found between scales. The NH-SDI and CSDD were highly correlated (rs = 0.913; p < 0.001) and reliable (ICC = 0.77; p < 0.001).
Conclusion: The NH-SDI appears valid and reliable in LTC patients with MNCD and quicker than the CSDD to rule out depression in a busy or short-staffed setting.
{"title":"The External Validation of the Nursing Homes Short Depression Inventory in Older Adults with Major Neurocognitive Disorders in Long-Term Care Centers.","authors":"Élodie Toulouse, Daphnée Carrier, Maire-Pier Villemure, Jessika Roy Desruisseaux, Christian M Rochefort","doi":"10.1159/000533357","DOIUrl":"10.1159/000533357","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is often difficult to detect in long-term care (LTC) patients with major neurocognitive disorders (MNCD), and an observer-rated screening scale could facilitate assessments. This study aimed to establish the external validity and reliability of the Nursing Homes Short Depression Inventory (NH-SDI) in LTC patients with MNCD and to compare its estimates to the Cornell Scale for Depression in Dementia (CSDD), the most used scale for depression in MNCD.</p><p><strong>Methods: </strong>A focus discussion group of experts assessed the content validity of the NH-SDI. Then, a convenience sample of 93 LTC patients with MNCD was observer-rated by trained nurses with the NH-SDI and CSDD. For 57 patients, a medical assessment of depression was obtained, and screening accuracy estimates were generated.</p><p><strong>Results: </strong>The prevalence of depression was 8.8% as per reference standard. NH-SDI's content validity was judged acceptable with minor item wording modifications and specifications. The NH-SDI (cut-off ≥3) achieved 100% (95% confidence interval [CI]: 46-100%) sensitivity, 83% (95% CI: 69-91%) specificity, and 36% (95% CI: 14-64%) positive predictive value (PPV). The CSDD (cut-off ≥3) achieved 100% (95% CI: 46-100%) sensitivity, 75% (95% CI: 61-86%) specificity, and 28% (95% CI: 11-54%) PPV. No significant differences in areas under the receiver operating characteristic curve were found between scales. The NH-SDI and CSDD were highly correlated (rs = 0.913; p < 0.001) and reliable (ICC = 0.77; p < 0.001).</p><p><strong>Conclusion: </strong>The NH-SDI appears valid and reliable in LTC patients with MNCD and quicker than the CSDD to rule out depression in a busy or short-staffed setting.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9944845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Stem cell-based regenerative medicine has provided an excellent opportunity to investigate therapeutic strategies and innovative treatments for Alzheimer's disease (AD). However, there is an absence of visual overviews to assess the published literature systematically.
Methods: In this review, the bibliometric approach was used to estimate the searched data on stem cell research in AD from 2004 to 2022, and we also utilized CiteSpace and VOSviewer software to evaluate the contributions and co-occurrence relationships of different countries/regions, institutes, journals, and authors as well as to discover research hot spots and encouraging future trends in this field.
Results: From 2004 to 2022, a total of 3,428 publications were retrieved. The number of publications and citations on stem cell research in AD has increased dramatically in the last nearly 20 years, especially since 2016. North America and Asia were the top 2 highest output regions. The leading country in terms of publications and access to collaborative networks was the USA. Centrality analysis revealed that the UCL (0.05) was at the core of the network. The Journal of Alzheimer's Disease (n = 102, 2.98%) was the most productive academic journal. The analyses of keyword burst detection indicated that exosomes, risk factors, and drug delivery only had burst recently. Citations and co-citation achievements clarified that cluster #0 induced pluripotent stem cells, #2 mesenchymal stem cells, #3 microglia, and #6 adult hippocampal neurogenesis persisted to recent time.
Conclusion: This bibliometric analysis provides a comprehensive guide for clinicians and scholars working in this field. These analysis and results hope to provide useful information and references for future understanding of the challenges behind translating underlying stem cell biology into novel clinical therapeutic potential in AD.
{"title":"Comprehensive Bibliometric Analysis of Stem Cell Research in Alzheimer's Disease from 2004 to 2022.","authors":"Rui Wang, Yi Zhu, Lan-Fang Qin, Zhi-Guo Xu, Xi-Ren Gao, Chong-Bin Liu, Guo-Tong Xu, Yi-Zhu Chen","doi":"10.1159/000528886","DOIUrl":"https://doi.org/10.1159/000528886","url":null,"abstract":"<p><strong>Introduction: </strong>Stem cell-based regenerative medicine has provided an excellent opportunity to investigate therapeutic strategies and innovative treatments for Alzheimer's disease (AD). However, there is an absence of visual overviews to assess the published literature systematically.</p><p><strong>Methods: </strong>In this review, the bibliometric approach was used to estimate the searched data on stem cell research in AD from 2004 to 2022, and we also utilized CiteSpace and VOSviewer software to evaluate the contributions and co-occurrence relationships of different countries/regions, institutes, journals, and authors as well as to discover research hot spots and encouraging future trends in this field.</p><p><strong>Results: </strong>From 2004 to 2022, a total of 3,428 publications were retrieved. The number of publications and citations on stem cell research in AD has increased dramatically in the last nearly 20 years, especially since 2016. North America and Asia were the top 2 highest output regions. The leading country in terms of publications and access to collaborative networks was the USA. Centrality analysis revealed that the UCL (0.05) was at the core of the network. The Journal of Alzheimer's Disease (n = 102, 2.98%) was the most productive academic journal. The analyses of keyword burst detection indicated that exosomes, risk factors, and drug delivery only had burst recently. Citations and co-citation achievements clarified that cluster #0 induced pluripotent stem cells, #2 mesenchymal stem cells, #3 microglia, and #6 adult hippocampal neurogenesis persisted to recent time.</p><p><strong>Conclusion: </strong>This bibliometric analysis provides a comprehensive guide for clinicians and scholars working in this field. These analysis and results hope to provide useful information and references for future understanding of the challenges behind translating underlying stem cell biology into novel clinical therapeutic potential in AD.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9680435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Note of Thanks: Victoria Chan-Palay.","authors":"Victoria Chan-Palay","doi":"10.1159/000529442","DOIUrl":"https://doi.org/10.1159/000529442","url":null,"abstract":"","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9581312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prashanth Poulose, Ravi Prasad Varma, Meenu Surendran, Sushama S Ramachandran, P G Rajesh, Bejoy Thomas, Chandrasekaran Kesavadas, Ramshekhar N Menon
Introduction: The study aimed to explore longitudinal cognitive outcomes and to ascertain predictors of conversion to dementia in a hospital-based mild cognitive impairment (MCI) cohort classified according to the neuropsychological phenotype at baseline.
Materials and methods: Subjects aged >55 years who had a clinical diagnosis of MCI at initial visit between 2010 and 2018, with at least one formal neuropsychological assessment at baseline and follow-up of a minimum of 2 years were included. The prospective study was completed based on evaluation at last follow-up to gauge conversion to dementia, quantification of performance on activities of daily living and when available, longitudinal neuropsychological test scores.
Results: Ninety-five patients with MCI met the inclusion criteria with a mean age of 68.4 ± 6.4 years at baseline and a mean duration of follow-up for 6.4 ± 3.2 years. The cumulative conversion rate to dementia was 22.2% (21/95) and the annualized conversion rate was 3.3% per year of follow-up. The majority of subjects who had converted had multidomain MCI (66%). Only white matter changes on MRI brain revealed correlation with baseline neuropsychology tests. The multivariate logistic regression analysis revealed the utility of lower baseline list recognition (adjusted odds ratio: 0.735 [95% confidence interval: 0.589-0.916]; p 0.006), lower immediate logical memory (0.885 [0.790-0.990]; p 0.03), and high perseverative error scores on set shifting (3.116 [1.425-6.817]; p 0.004) as predictors of conversion. A model score of +2.615 could predict conversion with sensitivity of 72% and specificity of 98% over 6.4 years follow-up.
Conclusion: There was a higher risk of conversion associated with multidomain MCI. Logistic regression-based estimations of dementia risk utilizing domain-based neuropsychology test scores in MCI have high specificity for diagnosis at baseline.
{"title":"Baseline Predictors of Longitudinal Cognitive Outcomes in Persons with Mild Cognitive Impairment.","authors":"Prashanth Poulose, Ravi Prasad Varma, Meenu Surendran, Sushama S Ramachandran, P G Rajesh, Bejoy Thomas, Chandrasekaran Kesavadas, Ramshekhar N Menon","doi":"10.1159/000529255","DOIUrl":"https://doi.org/10.1159/000529255","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to explore longitudinal cognitive outcomes and to ascertain predictors of conversion to dementia in a hospital-based mild cognitive impairment (MCI) cohort classified according to the neuropsychological phenotype at baseline.</p><p><strong>Materials and methods: </strong>Subjects aged >55 years who had a clinical diagnosis of MCI at initial visit between 2010 and 2018, with at least one formal neuropsychological assessment at baseline and follow-up of a minimum of 2 years were included. The prospective study was completed based on evaluation at last follow-up to gauge conversion to dementia, quantification of performance on activities of daily living and when available, longitudinal neuropsychological test scores.</p><p><strong>Results: </strong>Ninety-five patients with MCI met the inclusion criteria with a mean age of 68.4 ± 6.4 years at baseline and a mean duration of follow-up for 6.4 ± 3.2 years. The cumulative conversion rate to dementia was 22.2% (21/95) and the annualized conversion rate was 3.3% per year of follow-up. The majority of subjects who had converted had multidomain MCI (66%). Only white matter changes on MRI brain revealed correlation with baseline neuropsychology tests. The multivariate logistic regression analysis revealed the utility of lower baseline list recognition (adjusted odds ratio: 0.735 [95% confidence interval: 0.589-0.916]; p 0.006), lower immediate logical memory (0.885 [0.790-0.990]; p 0.03), and high perseverative error scores on set shifting (3.116 [1.425-6.817]; p 0.004) as predictors of conversion. A model score of +2.615 could predict conversion with sensitivity of 72% and specificity of 98% over 6.4 years follow-up.</p><p><strong>Conclusion: </strong>There was a higher risk of conversion associated with multidomain MCI. Logistic regression-based estimations of dementia risk utilizing domain-based neuropsychology test scores in MCI have high specificity for diagnosis at baseline.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stepping into the Role of Editor-In-Chief.","authors":"John B Kwok","doi":"10.1159/000529404","DOIUrl":"https://doi.org/10.1159/000529404","url":null,"abstract":"","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Keshinisuthan Kirubalingam, Paul Nguyen, Daniel Newsted, Sudeep S Gill, Allison De La Lis, Jason A Beyea
Introduction: Hearing loss (HL) is considered a potentially modifiable risk factor for dementia. We aimed to examine the relationship between HL and incident dementia diagnosis in a province-wide population-based cohort study with matched controls.
Methods: Administrative healthcare databases were linked to generate a cohort of patients who were aged ≥40 years at their first claimed hearing amplification devices (HAD) between April 2007 and March 2016 through the Assistive Devices Program (ADP) (257,285 with claims and 1,005,010 controls). The main outcome was incident dementia diagnosis, ascertained using validated algorithms. Dementia incidence was compared between cases and controls using Cox regression. Patient, disease, and other risk factors were examined.
Results: Dementia incidence rates (per 1,000 person-years) were 19.51 (95% confidence interval [CI]: 19.26-19.77) and 14.15 (95% CI: 14.04-14.26) for the ADP claimants and matched controls, respectively. In adjusted analyses, risk of dementia was higher in ADP claimants compared with controls (hazard ratio [HR]: 1.10 [95% CI: 1.09-1.12, p < 0.001]). Subgroup analyses showed a dose-response gradient, with risk of dementia higher among patients with bilateral HADs (HR: 1.12 [95% CI: 1.10-1.14, p < 0.001]), and an exposure-response gradient, with increasing risk over time from April 2007-March 2010 (HR: 1.03 [95% CI: 1.01-1.06, p = 0.014]), April 2010-March 2013 (HR: 1.12 [95% CI: 1.09-1.15, p < 0.001]), and April 2013-March 2016 (HR: 1.19 [95% CI: 1.16-1.23, p < 0.001]).
Conclusion: In this population-based study, adults with HL had an increased risk of being diagnosed with dementia. Given the implications of HL on dementia risk, understanding the effect of hearing interventions merits further investigation.
听力损失(HL)被认为是痴呆的一个潜在的可改变的危险因素。我们的目的是在一个全省范围的人群为基础的队列研究中检查HL和痴呆发病率之间的关系。方法:通过辅助装置计划(ADP),将2007年4月至2016年3月期间首次声称使用听力放大装置(HAD)的年龄≥40岁的行政卫生保健数据库连接起来(257,285名有索赔的患者和1,005,010名对照组)。主要结果是使用经过验证的算法确定的偶发性痴呆诊断。采用Cox回归比较病例与对照组的痴呆发病率。检查患者、疾病和其他危险因素。结果:ADP患者和对照组的痴呆发病率(每1000人年)分别为19.51(95%可信区间[CI]: 19.26-19.77)和14.15 (95% CI: 14.04-14.26)。在调整分析中,与对照组相比,ADP患者患痴呆的风险更高(风险比[HR]: 1.10 [95% CI: 1.09-1.12, p <0.001])。亚组分析显示了剂量-反应梯度,双侧HADs患者发生痴呆的风险更高(HR: 1.12 [95% CI: 1.10-1.14, p <0.001])和暴露-反应梯度,2007年4月至2010年3月(风险比:1.03 [95% CI: 1.01-1.06, p = 0.014]), 2010年4月至2013年3月(风险比:1.12 [95% CI: 1.09-1.15, p <0.001]), 2013年4月至2016年3月(HR: 1.19 [95% CI: 1.16-1.23, p <0.001])。结论:在这项基于人群的研究中,患有HL的成年人被诊断为痴呆的风险增加。鉴于HL对痴呆风险的影响,理解听力干预的影响值得进一步研究。
{"title":"Hearing Loss and Dementia: A Population-Based Cohort Study.","authors":"Keshinisuthan Kirubalingam, Paul Nguyen, Daniel Newsted, Sudeep S Gill, Allison De La Lis, Jason A Beyea","doi":"10.1159/000530757","DOIUrl":"https://doi.org/10.1159/000530757","url":null,"abstract":"<p><strong>Introduction: </strong>Hearing loss (HL) is considered a potentially modifiable risk factor for dementia. We aimed to examine the relationship between HL and incident dementia diagnosis in a province-wide population-based cohort study with matched controls.</p><p><strong>Methods: </strong>Administrative healthcare databases were linked to generate a cohort of patients who were aged ≥40 years at their first claimed hearing amplification devices (HAD) between April 2007 and March 2016 through the Assistive Devices Program (ADP) (257,285 with claims and 1,005,010 controls). The main outcome was incident dementia diagnosis, ascertained using validated algorithms. Dementia incidence was compared between cases and controls using Cox regression. Patient, disease, and other risk factors were examined.</p><p><strong>Results: </strong>Dementia incidence rates (per 1,000 person-years) were 19.51 (95% confidence interval [CI]: 19.26-19.77) and 14.15 (95% CI: 14.04-14.26) for the ADP claimants and matched controls, respectively. In adjusted analyses, risk of dementia was higher in ADP claimants compared with controls (hazard ratio [HR]: 1.10 [95% CI: 1.09-1.12, p < 0.001]). Subgroup analyses showed a dose-response gradient, with risk of dementia higher among patients with bilateral HADs (HR: 1.12 [95% CI: 1.10-1.14, p < 0.001]), and an exposure-response gradient, with increasing risk over time from April 2007-March 2010 (HR: 1.03 [95% CI: 1.01-1.06, p = 0.014]), April 2010-March 2013 (HR: 1.12 [95% CI: 1.09-1.15, p < 0.001]), and April 2013-March 2016 (HR: 1.19 [95% CI: 1.16-1.23, p < 0.001]).</p><p><strong>Conclusion: </strong>In this population-based study, adults with HL had an increased risk of being diagnosed with dementia. Given the implications of HL on dementia risk, understanding the effect of hearing interventions merits further investigation.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10244787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-04-20DOI: 10.1159/000530271
Gurpreet Kaur Hansra, Hazel Lim, Chin Yee Cheong, Philip Yap
Introduction: This paper provides a summary of findings on the public's knowledge and attitudes towards dementia. We aim to investigate if the attitudes of Singaporeans towards dementia have changed over the years by adopting a questionnaire used in a similar study in 2012.
Methods: A cross-sectional, descriptive study was conducted through the dissemination of an existing, online questionnaire to participants above 16 years of age. Out of 1,500 subjects, results from 1,373 participants were analysed. Descriptive statistics were used to analyse and compare results from the 2012 study while a latent class analysis was performed to understand the categories of study participants based on varying levels of attitudes, knowledge and stigma.
Results: The mean age of study participants was 43.8 (SD = 15.7). Majority of the participants were females (76.5%), between 51 and 60 years of age (29.6%) and belonged to the Chinese ethnic group (77.8%). Results demonstrated that there were significant differences in attitudes towards dementia between 2012 and 2021. There was a 70.2% improvement in stigma-associated attitudes and an increase in correct responses to 4 out of 5 questions in the knowledge section.
Conclusion: Findings of this study suggest that the general public has a better knowledge and more positive attitude towards dementia. This could have been attributed to higher literacy levels of the current study population and effectiveness of established outreach initiatives in Singapore. However, further research with a more balanced representation of ethnic and cultural groups would offer more comprehensive insights into dementia health literacy.
{"title":"Knowledge and Attitudes towards Dementia among the General Public in Singapore: A Comparative Analysis.","authors":"Gurpreet Kaur Hansra, Hazel Lim, Chin Yee Cheong, Philip Yap","doi":"10.1159/000530271","DOIUrl":"10.1159/000530271","url":null,"abstract":"<p><strong>Introduction: </strong>This paper provides a summary of findings on the public's knowledge and attitudes towards dementia. We aim to investigate if the attitudes of Singaporeans towards dementia have changed over the years by adopting a questionnaire used in a similar study in 2012.</p><p><strong>Methods: </strong>A cross-sectional, descriptive study was conducted through the dissemination of an existing, online questionnaire to participants above 16 years of age. Out of 1,500 subjects, results from 1,373 participants were analysed. Descriptive statistics were used to analyse and compare results from the 2012 study while a latent class analysis was performed to understand the categories of study participants based on varying levels of attitudes, knowledge and stigma.</p><p><strong>Results: </strong>The mean age of study participants was 43.8 (SD = 15.7). Majority of the participants were females (76.5%), between 51 and 60 years of age (29.6%) and belonged to the Chinese ethnic group (77.8%). Results demonstrated that there were significant differences in attitudes towards dementia between 2012 and 2021. There was a 70.2% improvement in stigma-associated attitudes and an increase in correct responses to 4 out of 5 questions in the knowledge section.</p><p><strong>Conclusion: </strong>Findings of this study suggest that the general public has a better knowledge and more positive attitude towards dementia. This could have been attributed to higher literacy levels of the current study population and effectiveness of established outreach initiatives in Singapore. However, further research with a more balanced representation of ethnic and cultural groups would offer more comprehensive insights into dementia health literacy.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9422747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Élodie Toulouse, Daphnée Carrier, Marie-Pier Villemure, Jessika Roy-Desruisseaux, Christian M Rochefort
Introduction: Depression is often under-detected in long-term care (LTC) patients with major neurocognitive disorders (MNCD) and is associated with important morbidity, mortality, and costs. Observer-rated outcome measures (ObsROMs) could help resolve this problematic; however, evidence on their accuracy is scattered in the literature. This systematic review aimed at summarizing this evidence.
Methods: A literature search was conducted in 7 databases using keywords, MeSHs, and bibliographic searches. We included studies published before January 2022 and reporting on the accuracy of a depression ObsROM used in LTC patients with MNCD. Data extraction, analysis, synthesis, and study methodological quality assessments were done by two authors, and discrepancies were resolved by consensus.
Results: Among 9,660 articles retrieved, 8 studies reporting on 11 depression measures were included. Scales were classified as patient-reported outcome measures used as Obs-ROMs or true ObsROMs. Among the first category, the Cornell Scale for Depression in Dementia (CSDD) and the Montgomery-Asberg Depression Rating Scale (MADRS) performed best (area under the curve [AUC]: 0.73-0.87), although both presented with low positive predictive values and high negative predictive values. Among the second category, the Nursing Homes Short Depression Inventory (NH-SDI) performed best, with an AUC of 0.93 and ≥85% sensitivity, specificity, and predictive values.
Conclusion: The CSDD and MADRS may be useful to rule out depression in LTC patients with MNCD, whereas the NH-SDI may be useful to rule in and out depression within this same population. Before recommending their use, adequately powered studies to further examine their accuracy in different contexts are necessary.
导语:抑郁症在患有严重神经认知障碍(MNCD)的长期护理(LTC)患者中往往未被发现,并且与重要的发病率、死亡率和成本相关。观察者评价的结果测量(obsrom)可以帮助解决这个问题;然而,关于其准确性的证据在文献中是分散的。本系统综述旨在总结这一证据。方法:采用关键词、mesh、书目检索等方法对7个数据库进行文献检索。我们纳入了2022年1月之前发表的研究,并报道了LTC合并MNCD患者使用抑郁ObsROM的准确性。数据提取、分析、综合和研究方法学质量评估由两位作者完成,差异通过共识解决。结果:在检索到的9660篇文章中,8项研究报告了11种抑郁措施。量表分为患者报告的结果测量,用作obs - rom或真正的obs - rom。在第一类中,康奈尔痴呆抑郁量表(Cornell Scale for Depression in Dementia, CSDD)和蒙哥马利-阿斯伯格抑郁评定量表(Montgomery-Asberg Depression Rating Scale, MADRS)表现最好(曲线下面积[AUC]: 0.73-0.87),但两者的阳性预测值较低,阴性预测值较高。在第二类中,疗养院短期抑郁量表(NH-SDI)表现最好,AUC为0.93,敏感性、特异性和预测值≥85%。结论:CSDD和MADRS可能有助于排除LTC合并MNCD患者的抑郁,而NH-SDI可能有助于排除同一人群中的抑郁。在推荐使用它们之前,有必要进行充分有力的研究,进一步检查它们在不同背景下的准确性。
{"title":"Accuracy of Observer-Rated Measurement Scales for Depression Assessment in Patients with Major Neurocognitive Disorders Residing in Long-Term Care Centers: A Systematic Review.","authors":"Élodie Toulouse, Daphnée Carrier, Marie-Pier Villemure, Jessika Roy-Desruisseaux, Christian M Rochefort","doi":"10.1159/000529396","DOIUrl":"https://doi.org/10.1159/000529396","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is often under-detected in long-term care (LTC) patients with major neurocognitive disorders (MNCD) and is associated with important morbidity, mortality, and costs. Observer-rated outcome measures (ObsROMs) could help resolve this problematic; however, evidence on their accuracy is scattered in the literature. This systematic review aimed at summarizing this evidence.</p><p><strong>Methods: </strong>A literature search was conducted in 7 databases using keywords, MeSHs, and bibliographic searches. We included studies published before January 2022 and reporting on the accuracy of a depression ObsROM used in LTC patients with MNCD. Data extraction, analysis, synthesis, and study methodological quality assessments were done by two authors, and discrepancies were resolved by consensus.</p><p><strong>Results: </strong>Among 9,660 articles retrieved, 8 studies reporting on 11 depression measures were included. Scales were classified as patient-reported outcome measures used as Obs-ROMs or true ObsROMs. Among the first category, the Cornell Scale for Depression in Dementia (CSDD) and the Montgomery-Asberg Depression Rating Scale (MADRS) performed best (area under the curve [AUC]: 0.73-0.87), although both presented with low positive predictive values and high negative predictive values. Among the second category, the Nursing Homes Short Depression Inventory (NH-SDI) performed best, with an AUC of 0.93 and ≥85% sensitivity, specificity, and predictive values.</p><p><strong>Conclusion: </strong>The CSDD and MADRS may be useful to rule out depression in LTC patients with MNCD, whereas the NH-SDI may be useful to rule in and out depression within this same population. Before recommending their use, adequately powered studies to further examine their accuracy in different contexts are necessary.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The Memory Complaint Scale (MCS-15) is a 15-item instrument to explore frequent forgetfulness in daily life in people with possible cognitive impairment. However, knowledge about its psychometric performance is limited.
Objective: The objective of this study was to know the dimensionality and internal consistency of the MCS-15 in Colombian older adults.
Methods: A probabilistic sample of 1,957 older adults from the general Colombian population was taken, aged between 60 and 98 years (mean = 71.0 ± 7.9), and 62.2% were women. Internal consistency (Cronbach's alpha and McDonald's omega) and dimensionality (exploratory and confirmatory factor analysis) were calculated for the original and ten-item versions.
Results: The 15-item version showed Cronbach's alpha and McDonald's omega of 0.91, and one dimension accounted for 45.3% of the variance. A version of ten items showed Cronbach's alpha and McDonald's omega of 0.89 and a single factor that explained 50.9% of the variance with better indicators in the confirmatory factor analysis. Convergence with the shortened Mini-Mental State Examination was rs = 0.43 (p < 0.001), and the Montreal Cognitive Assessment test was rs = 0.38 (p < 0.001). The nomological validity with the geriatric depression scale was rs = 0.44 (p < 0.001), and women scored higher than men (p < 0.001).
Conclusions: The MCS-15 shows high internal consistency with poor dimensionality. However, a ten-item version shows high internal consistency and a clear one-dimensional structure. More research is needed: testing the performance against a structured interview for major cognitive impairment.
{"title":"Psychometric Performance of the Memory Complain Scale among Colombian Individuals of 60 Years and Older.","authors":"Adalberto Campo-Arias, Carlos Alfonso Reyes-Ortiz","doi":"10.1159/000528281","DOIUrl":"https://doi.org/10.1159/000528281","url":null,"abstract":"<p><strong>Introduction: </strong>The Memory Complaint Scale (MCS-15) is a 15-item instrument to explore frequent forgetfulness in daily life in people with possible cognitive impairment. However, knowledge about its psychometric performance is limited.</p><p><strong>Objective: </strong>The objective of this study was to know the dimensionality and internal consistency of the MCS-15 in Colombian older adults.</p><p><strong>Methods: </strong>A probabilistic sample of 1,957 older adults from the general Colombian population was taken, aged between 60 and 98 years (mean = 71.0 ± 7.9), and 62.2% were women. Internal consistency (Cronbach's alpha and McDonald's omega) and dimensionality (exploratory and confirmatory factor analysis) were calculated for the original and ten-item versions.</p><p><strong>Results: </strong>The 15-item version showed Cronbach's alpha and McDonald's omega of 0.91, and one dimension accounted for 45.3% of the variance. A version of ten items showed Cronbach's alpha and McDonald's omega of 0.89 and a single factor that explained 50.9% of the variance with better indicators in the confirmatory factor analysis. Convergence with the shortened Mini-Mental State Examination was rs = 0.43 (p < 0.001), and the Montreal Cognitive Assessment test was rs = 0.38 (p < 0.001). The nomological validity with the geriatric depression scale was rs = 0.44 (p < 0.001), and women scored higher than men (p < 0.001).</p><p><strong>Conclusions: </strong>The MCS-15 shows high internal consistency with poor dimensionality. However, a ten-item version shows high internal consistency and a clear one-dimensional structure. More research is needed: testing the performance against a structured interview for major cognitive impairment.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9569845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}