P. Li, W. Yang, J. Wang, Hong Zhu, A. Dove, Weili Xu
Background
Cognitive reserve (CR) has been linked to dementia and might be a predictor of aged-related outcomes. However, the association between CR and risk of other chronic diseases and mortality remains unclear.
Objectives
We aimed to investigate the association of CR with survival free from major chronic diseases.
Design, Setting and Participants
This community-based longitudinal study used data from the UK Biobank. A total of 412,509 participants (mean age 55.71±8.10) free of major chronic disease (including dementia, diabetes, cardiovascular diseases, chronic obstructive pulmonary disease, and cancer) completed the baseline examination between 2006 to 2010 and were followed for changes in health status.
Measurements
Latent class analysis was used to generate an indicator of CR (categorized as low, moderate, or high) based on education, occupation, television viewing time, confiding, social connection, and leisure activities. Major chronic diseases and survival status were ascertained through self-reported history and/or linkages to medical and death records. Chronic disease-free survival was defined as survival without any of the aforementioned chronic diseases. Effect modifications and interactions between the CR indicator and sex, age, and lifestyle factors (including smoking status, alcohol consumption, physical activity, and body mass index) were explored.
Results
Over a median follow-up of 12.49 (interquartile range 11.42–13.41, range 0.01–15.87) years, 112,190 (27.2%) participants died or developed at least one chronic disease. High CR indicator was associated with lower risk of chronic disease/death (hazard ratio 0.82, 95% confidence interval: 0.80–0.83) compared to low CR indicator. Chronic disease-free survival was prolonged by 1.33 (1.21–1.44) years among participants with high CR compared to low CR indicator. Furthermore, the association between the CR indicator and chronic disease-free survival was strengthened among individuals aged <60 years and current smokers.
Conclusion
High CR indicator is associated with a lower risk of chronic disease/death and may prolong chronic disease-free survival. Our findings underscore the importance of CR-enhancing lifestyle and experiences in health longevity, especially for younger individuals and current smokers.
{"title":"Association between Cognitive Reserve Indicator and Chronic Disease-Free Survival: A Large Community-Based Longitudinal Study","authors":"P. Li, W. Yang, J. Wang, Hong Zhu, A. Dove, Weili Xu","doi":"10.14283/jpad.2024.160","DOIUrl":"https://doi.org/10.14283/jpad.2024.160","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Cognitive reserve (CR) has been linked to dementia and might be a predictor of aged-related outcomes. However, the association between CR and risk of other chronic diseases and mortality remains unclear.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>We aimed to investigate the association of CR with survival free from major chronic diseases.</p><h3 data-test=\"abstract-sub-heading\">Design, Setting and Participants</h3><p>This community-based longitudinal study used data from the UK Biobank. A total of 412,509 participants (mean age 55.71±8.10) free of major chronic disease (including dementia, diabetes, cardiovascular diseases, chronic obstructive pulmonary disease, and cancer) completed the baseline examination between 2006 to 2010 and were followed for changes in health status.</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>Latent class analysis was used to generate an indicator of CR (categorized as low, moderate, or high) based on education, occupation, television viewing time, confiding, social connection, and leisure activities. Major chronic diseases and survival status were ascertained through self-reported history and/or linkages to medical and death records. Chronic disease-free survival was defined as survival without any of the aforementioned chronic diseases. Effect modifications and interactions between the CR indicator and sex, age, and lifestyle factors (including smoking status, alcohol consumption, physical activity, and body mass index) were explored.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Over a median follow-up of 12.49 (interquartile range 11.42–13.41, range 0.01–15.87) years, 112,190 (27.2%) participants died or developed at least one chronic disease. High CR indicator was associated with lower risk of chronic disease/death (hazard ratio 0.82, 95% confidence interval: 0.80–0.83) compared to low CR indicator. Chronic disease-free survival was prolonged by 1.33 (1.21–1.44) years among participants with high CR compared to low CR indicator. Furthermore, the association between the CR indicator and chronic disease-free survival was strengthened among individuals aged <60 years and current smokers.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>High CR indicator is associated with a lower risk of chronic disease/death and may prolong chronic disease-free survival. Our findings underscore the importance of CR-enhancing lifestyle and experiences in health longevity, especially for younger individuals and current smokers.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wendy R. Galpern, G. Triana-Baltzer, L. Li, K. Van Kolen, M. Timmers, K. Haeverans, L. Janssens, H. Kolb, P. Nandy, K. Aida, H. Shimizu, M. Mercken, H. Sun
<h3 data-test="abstract-sub-heading">Background</h3><p>JNJ-63733657 (posdinemab) is a humanized IgG1/kappa monoclonal anti-phospho tau antibody that binds with high affinity to phosphorylated amino acid 217 (pT217) in the proline-rich domain. The parent molecule, PT3, was raised against Alzheimer’s disease brain purified paired helical filament, and preclinical studies with the humanized version, JNJ-63733657, have demonstrated reductions in tau seeding. The results of the first-in-human clinical trial of JNJ-63733657 and a separate single ascending dose study in Japanese participants are presented.</p><h3 data-test="abstract-sub-heading">Objectives</h3><p>To evaluate the safety and tolerability, pharmacokinetics, immunogenicity, and pharmacodynamics of JNJ-63733657 after single and multiple intravenous dose administrations in healthy participants and participants with prodromal or mild Alzheimer’s disease.</p><h3 data-test="abstract-sub-heading">Design</h3><p>A two part first-in-human, phase 1, randomized, double-blind, placebo-controlled trial: Single ascending dose (Part 1) and multiple ascending dose (Part 2). And a phase 1, randomized, double-blind, placebo-controlled single ascending dose trial in healthy Japanese participants.</p><h3 data-test="abstract-sub-heading">Setting</h3><p>7 sites in Belgium, Netherlands, Spain, and Germany; 1 site in Japan.</p><h3 data-test="abstract-sub-heading">Participants</h3><p>A total of 40 healthy participants aged 55–75 were enrolled in Part 1 of the first-in-human study; a total of 16 healthy participants and 13 participants with prodromal or mild AD aged 55–80 years were enrolled in Part 2. In the Japanese trial, a total of 24 participants aged 55–75 were enrolled.</p><h3 data-test="abstract-sub-heading">Intervention</h3><p>In Part 1, single doses of 1, 3, 10, 30, or 60 mg/kg of JNJ-63733657 or placebo were administered to healthy participants. In Part 2, two dose levels of JNJ-63733657 (5 mg/kg or 50 mg/kg) or placebo were evaluated in healthy participants, and 2 dose levels (15 mg/kg or 30 mg/kg) or placebo were evaluated in participants with Alzheimer’s disease; doses were administered on Days 1, 29, and 57. In the Japanese trial, single doses of 3, 15, or 60 mg/kg of JNJ-63733675 or placebo were administered. All doses were administered intravenously.</p><h3 data-test="abstract-sub-heading">Measurements</h3><p>Safety assessments, serum and cerebrospinal fluid pharmacokinetic parameters, immunogenicity, and cerebrospinal fluid pharmacodynamic changes in free and total p217+tau, total tau, and p181tau were evaluated.</p><h3 data-test="abstract-sub-heading">Results</h3><p>JNJ-63733657 was generally safe and well-tolerated in healthy participants and participants with Alzheimer’s disease. In healthy participants and participants with Alzheimer’s disease, JNJ-63733657 demonstrated linear PK, and serum C<sub>max</sub> and AUC were approximately dose proportional following single and multiple doses. Dose-de
{"title":"Phase 1 Studies of the Anti-Tau Monoclonal Antibody JNJ-63733657 in Healthy Participants and Participants with Alzheimer’s Disease","authors":"Wendy R. Galpern, G. Triana-Baltzer, L. Li, K. Van Kolen, M. Timmers, K. Haeverans, L. Janssens, H. Kolb, P. Nandy, K. Aida, H. Shimizu, M. Mercken, H. Sun","doi":"10.14283/jpad.2024.163","DOIUrl":"https://doi.org/10.14283/jpad.2024.163","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>JNJ-63733657 (posdinemab) is a humanized IgG1/kappa monoclonal anti-phospho tau antibody that binds with high affinity to phosphorylated amino acid 217 (pT217) in the proline-rich domain. The parent molecule, PT3, was raised against Alzheimer’s disease brain purified paired helical filament, and preclinical studies with the humanized version, JNJ-63733657, have demonstrated reductions in tau seeding. The results of the first-in-human clinical trial of JNJ-63733657 and a separate single ascending dose study in Japanese participants are presented.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To evaluate the safety and tolerability, pharmacokinetics, immunogenicity, and pharmacodynamics of JNJ-63733657 after single and multiple intravenous dose administrations in healthy participants and participants with prodromal or mild Alzheimer’s disease.</p><h3 data-test=\"abstract-sub-heading\">Design</h3><p>A two part first-in-human, phase 1, randomized, double-blind, placebo-controlled trial: Single ascending dose (Part 1) and multiple ascending dose (Part 2). And a phase 1, randomized, double-blind, placebo-controlled single ascending dose trial in healthy Japanese participants.</p><h3 data-test=\"abstract-sub-heading\">Setting</h3><p>7 sites in Belgium, Netherlands, Spain, and Germany; 1 site in Japan.</p><h3 data-test=\"abstract-sub-heading\">Participants</h3><p>A total of 40 healthy participants aged 55–75 were enrolled in Part 1 of the first-in-human study; a total of 16 healthy participants and 13 participants with prodromal or mild AD aged 55–80 years were enrolled in Part 2. In the Japanese trial, a total of 24 participants aged 55–75 were enrolled.</p><h3 data-test=\"abstract-sub-heading\">Intervention</h3><p>In Part 1, single doses of 1, 3, 10, 30, or 60 mg/kg of JNJ-63733657 or placebo were administered to healthy participants. In Part 2, two dose levels of JNJ-63733657 (5 mg/kg or 50 mg/kg) or placebo were evaluated in healthy participants, and 2 dose levels (15 mg/kg or 30 mg/kg) or placebo were evaluated in participants with Alzheimer’s disease; doses were administered on Days 1, 29, and 57. In the Japanese trial, single doses of 3, 15, or 60 mg/kg of JNJ-63733675 or placebo were administered. All doses were administered intravenously.</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>Safety assessments, serum and cerebrospinal fluid pharmacokinetic parameters, immunogenicity, and cerebrospinal fluid pharmacodynamic changes in free and total p217+tau, total tau, and p181tau were evaluated.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>JNJ-63733657 was generally safe and well-tolerated in healthy participants and participants with Alzheimer’s disease. In healthy participants and participants with Alzheimer’s disease, JNJ-63733657 demonstrated linear PK, and serum C<sub>max</sub> and AUC were approximately dose proportional following single and multiple doses. Dose-de","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Lin, J.-X. Yu, W.-X. Zhang, F.-X. Lao, Han-Chang Huang
Alzheimer’s disease (AD) is an age-related degenerative disease, which is characteristic by the deposition of senile plaques (SP) outside the cells, the neurofibrillary tangles (NFTs) inside the neurons, and the loss of synapse and neurons. Neuroinflammation may play an important role in the pathogenesis of AD. Microglia are the immune cells in the central nervous system. However, microglia might become disease-related microglia (DAMs) when stimulated by the external environment. DAMs have been shown to be involved in a series of events of AD development including Aβ accumulation and tau phosphorylation. The triggering receptor expressed on myeloid cells 2 (TREM2) is a transmembrane receptor that is mainly expressed by microglia in the central nervous system (CNS). TREM2 plays an important role in the physiological function of microglia, and the dyshomeostasis of TREM2 is related to the development of late-onset AD. This article summarized the latest advances in TREM2 biology and its impact on the roles of microglia in AD development, with a particular emphasis on the structure, ligands, signal transduction, and the agonistic antibodies of TREM2 for AD treatment. We further discussed the survival, migration, phagocytosis, inflammation, and cellular metabolism of microglia, as well as the role of sTREM2 in neuroprotection and as a biomarker for AD. It provides a reference for further research on the molecular mechanism of microglial TREM2 in the occurrence and development of AD and on the therapeutic strategies targeted on the microglial TREM2.
阿尔茨海默病(AD)是一种与年龄有关的退行性疾病,其特征是细胞外沉积老年斑(SP)、神经元内沉积神经纤维缠结(NFT)以及突触和神经元的丧失。神经炎症可能在老年痴呆症的发病机制中扮演重要角色。小胶质细胞是中枢神经系统中的免疫细胞。然而,当受到外部环境刺激时,小胶质细胞可能会变成与疾病相关的小胶质细胞(DAMs)。已有研究表明,小胶质细胞参与了AD发展过程中的一系列事件,包括Aβ积累和tau磷酸化。髓系细胞上表达的触发受体 2(TREM2)是一种跨膜受体,主要由中枢神经系统(CNS)中的小胶质细胞表达。TREM2在小胶质细胞的生理功能中发挥着重要作用,而TREM2的失衡与晚发性AD的发病有关。本文总结了TREM2生物学的最新进展及其对小胶质细胞在AD发展中的作用的影响,特别强调了TREM2的结构、配体、信号转导和用于AD治疗的激动抗体。我们进一步讨论了小胶质细胞的存活、迁移、吞噬、炎症和细胞代谢,以及 sTREM2 在神经保护和作为 AD 生物标志物中的作用。它为进一步研究小胶质细胞TREM2在AD发生和发展中的分子机制以及针对小胶质细胞TREM2的治疗策略提供了参考。
{"title":"Roles of TREM2 in the Pathological Mechanism and the Therapeutic Strategies of Alzheimer’s Disease","authors":"M. Lin, J.-X. Yu, W.-X. Zhang, F.-X. Lao, Han-Chang Huang","doi":"10.14283/jpad.2024.164","DOIUrl":"https://doi.org/10.14283/jpad.2024.164","url":null,"abstract":"<p>Alzheimer’s disease (AD) is an age-related degenerative disease, which is characteristic by the deposition of senile plaques (SP) outside the cells, the neurofibrillary tangles (NFTs) inside the neurons, and the loss of synapse and neurons. Neuroinflammation may play an important role in the pathogenesis of AD. Microglia are the immune cells in the central nervous system. However, microglia might become disease-related microglia (DAMs) when stimulated by the external environment. DAMs have been shown to be involved in a series of events of AD development including Aβ accumulation and tau phosphorylation. The triggering receptor expressed on myeloid cells 2 (TREM2) is a transmembrane receptor that is mainly expressed by microglia in the central nervous system (CNS). TREM2 plays an important role in the physiological function of microglia, and the dyshomeostasis of TREM2 is related to the development of late-onset AD. This article summarized the latest advances in TREM2 biology and its impact on the roles of microglia in AD development, with a particular emphasis on the structure, ligands, signal transduction, and the agonistic antibodies of TREM2 for AD treatment. We further discussed the survival, migration, phagocytosis, inflammation, and cellular metabolism of microglia, as well as the role of sTREM2 in neuroprotection and as a biomarker for AD. It provides a reference for further research on the molecular mechanism of microglial TREM2 in the occurrence and development of AD and on the therapeutic strategies targeted on the microglial TREM2.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. LaForte, Stephanie Ruth Young, E. M. Dworak, M. A. Novack, A. J. Kaat, H. Adam, C. J. Nowinski, Z. Hosseinian, J. Slotkin, S. Amagai, M. V. Diaz, A. A. Correa, K. Alperin, M. Camacho, B. Landavazo, R. Nosheny, M. W. Weiner, R. M. Gershon
Background
Spelling assessments can provide a valuable marker of cognitive change in Alzheimer’s disease and related dementias (ADRD) and play an important role in ADRD research. However, most commercial assessments are not well-suited to the needs of researchers or participants; they are expensive and often require face-to-face administration by a trained examiner. To help overcome these barriers and foster progress in ADRD research, the National Institute on Aging (NIA)-funded Mobile Toolbox (MTB) offers a library of cognitive measures that can be self-administered remotely on a participant’s own smartphone, including a brand-new Spelling test.
Objective
The goal of this paper is to describe the design, piloting, calibration, and validation of the MTB Spelling test.
Design
We describe a pilot study, calibration study, and three validation studies, all of which use a cross-sectional design.
Setting
The pilot study, calibration study, and validation studies 2 and 3 were conducted remotely, while validation study 1 was conducted in the lab.
Participants
Participants for all of the studies were recruited from the general population by a thirdparty market research firm and the samples were stratified by age, gender, race, ethnicity, and education to represent the U.S. population. The pilot sample included 1,950 participants and the calibration study included 1335 participants over the age of 8. Validation study 1 included 92 participants ages 20 to 84, validation study 2 included 1021 participants ages 18 to 90, and validation study 3 included 168 participants ages 28 to 87.
Measurements
Participants in each of the studies completed the MTB Spelling test. Participants in validation studies 1 and 2 completed measures from the NIH Toolbox including Oral Reading Recognition as a measure of convergent validity, and Visual Reasoning and the Rey Auditory Verbal Learning as measures of divergent validity. As an additional measure of convergent validity, participants in study 1 also completed the Spelling subtest from the Wechsler Individual Achievement Test, 4th Edition.
Results
The MTB Spelling test demonstrated evidence of internal consistency (r=.79 to.83) convergent validity (r=.56 to.81, p<.01), discriminant validity (r =.23 to.36, p <.01), test-retest reliability (ICC=.63), and correlations with normal cognitive aging (r = −.06 to −.04, p >.01).
Conclusion
Findings suggest the MTB Spelling test is a reliable and valid measure of English spelling abilities in general population samples, and has potential in ADRD research.
{"title":"Development and Validation the Mobile Toolbox (MTB) Spelling Test","authors":"E. LaForte, Stephanie Ruth Young, E. M. Dworak, M. A. Novack, A. J. Kaat, H. Adam, C. J. Nowinski, Z. Hosseinian, J. Slotkin, S. Amagai, M. V. Diaz, A. A. Correa, K. Alperin, M. Camacho, B. Landavazo, R. Nosheny, M. W. Weiner, R. M. Gershon","doi":"10.14283/jpad.2024.158","DOIUrl":"https://doi.org/10.14283/jpad.2024.158","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Spelling assessments can provide a valuable marker of cognitive change in Alzheimer’s disease and related dementias (ADRD) and play an important role in ADRD research. However, most commercial assessments are not well-suited to the needs of researchers or participants; they are expensive and often require face-to-face administration by a trained examiner. To help overcome these barriers and foster progress in ADRD research, the National Institute on Aging (NIA)-funded Mobile Toolbox (MTB) offers a library of cognitive measures that can be self-administered remotely on a participant’s own smartphone, including a brand-new Spelling test.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>The goal of this paper is to describe the design, piloting, calibration, and validation of the MTB Spelling test.</p><h3 data-test=\"abstract-sub-heading\">Design</h3><p>We describe a pilot study, calibration study, and three validation studies, all of which use a cross-sectional design.</p><h3 data-test=\"abstract-sub-heading\">Setting</h3><p>The pilot study, calibration study, and validation studies 2 and 3 were conducted remotely, while validation study 1 was conducted in the lab.</p><h3 data-test=\"abstract-sub-heading\">Participants</h3><p>Participants for all of the studies were recruited from the general population by a thirdparty market research firm and the samples were stratified by age, gender, race, ethnicity, and education to represent the U.S. population. The pilot sample included 1,950 participants and the calibration study included 1335 participants over the age of 8. Validation study 1 included 92 participants ages 20 to 84, validation study 2 included 1021 participants ages 18 to 90, and validation study 3 included 168 participants ages 28 to 87.</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>Participants in each of the studies completed the MTB Spelling test. Participants in validation studies 1 and 2 completed measures from the NIH Toolbox including Oral Reading Recognition as a measure of convergent validity, and Visual Reasoning and the Rey Auditory Verbal Learning as measures of divergent validity. As an additional measure of convergent validity, participants in study 1 also completed the Spelling subtest from the Wechsler Individual Achievement Test, 4th Edition.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The MTB Spelling test demonstrated evidence of internal consistency (r=.79 to.83) convergent validity (r=.56 to.81, p<.01), discriminant validity (r =.23 to.36, p <.01), test-retest reliability (ICC=.63), and correlations with normal cognitive aging (r = −.06 to −.04, p >.01).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Findings suggest the MTB Spelling test is a reliable and valid measure of English spelling abilities in general population samples, and has potential in ADRD research.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Darlingtina K. Esiaka, C. Nwakasi, A. Q. Briggs, D. F. Conserve, R. J. Thorpe
Background
Past research suggests that subjective cognitive decline serves as an early and potentially important indicator that individuals may be at risk for future cognitive decline or neurodegenerative conditions. However, there is a dearth of studies on factors influencing the experience of subjective cognitive decline in Black Americans, especially in Black American men.
Objective
The current study explored correlates of subjective cognitive decline in Black American men.
Participants
A total of 117 Black American men, with a mean age of 38.5 (SD = 7.14) years, participated in the study.
Measurement
Participants completed a survey that assessed their demographic characteristics, self-rated health, neighborhood problems, length of residency in neighborhood, bodily symptoms, sleep comorbidities, sleep difficulties, and subjective cognitive decline. Linear regression analyses was performed and standardized beta coefficients were reported to describe the estimated independent effect of the predictor variables.
Results
We found that socioecomic status (β = −.222, p=.003), bodily symptoms (β =.246, p=.005), length of residency in neighborhood (β =.157, p=.029), and sleep difficulties (β =.305, p<.001) were significant correlates of subjective cognitive decline among Black American men.
Conclusion
These findings underscore the intricate roles of socioeconomic status, bodily symptoms, neighborhood factors, and sleep health in shaping subjective cognitive experiences in this population. Research on subjective cognitive decline can contribute to the early identification of individuals at risk for cognitive decline, allowing for timely interventions, lifestyle modifications, and potential preventive measures.
{"title":"Correlates of Subjective Cognitive Decline in Black American Men","authors":"Darlingtina K. Esiaka, C. Nwakasi, A. Q. Briggs, D. F. Conserve, R. J. Thorpe","doi":"10.14283/jpad.2024.162","DOIUrl":"https://doi.org/10.14283/jpad.2024.162","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Past research suggests that subjective cognitive decline serves as an early and potentially important indicator that individuals may be at risk for future cognitive decline or neurodegenerative conditions. However, there is a dearth of studies on factors influencing the experience of subjective cognitive decline in Black Americans, especially in Black American men.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>The current study explored correlates of subjective cognitive decline in Black American men.</p><h3 data-test=\"abstract-sub-heading\">Participants</h3><p>A total of 117 Black American men, with a mean age of 38.5 (SD = 7.14) years, participated in the study.</p><h3 data-test=\"abstract-sub-heading\">Measurement</h3><p>Participants completed a survey that assessed their demographic characteristics, self-rated health, neighborhood problems, length of residency in neighborhood, bodily symptoms, sleep comorbidities, sleep difficulties, and subjective cognitive decline. Linear regression analyses was performed and standardized beta coefficients were reported to describe the estimated independent effect of the predictor variables.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We found that socioecomic status (β = −.222, p=.003), bodily symptoms (β =.246, p=.005), length of residency in neighborhood (β =.157, p=.029), and sleep difficulties (β =.305, p<.001) were significant correlates of subjective cognitive decline among Black American men.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>These findings underscore the intricate roles of socioeconomic status, bodily symptoms, neighborhood factors, and sleep health in shaping subjective cognitive experiences in this population. Research on subjective cognitive decline can contribute to the early identification of individuals at risk for cognitive decline, allowing for timely interventions, lifestyle modifications, and potential preventive measures.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. B. E. Shields, H. Hust, S. D. Cooley, G. E. Cooper, R. N. Hart, B. C. Dennis, S. W. Freeman, J. F. Cain, W. Y. Shang, K. M. Wasz, A. T. Orr, C. B. Shields, S. S. Barve, Kenneth G. Pugh
Background and Objectives
On July 6, 2023 the U.S. Food and Drug Administration approved the anti-amyloid monoclonal antibody lecanemab (Leqembi®) for treatment of patients with mild cognitive impairment or mild dementia due to Alzheimer’s disease (AD). Our early experience and lessons learned with lecanemab in a regional community medical center are described.
Design, Setting, and Participants
This retrospective observational study highlights the first 71 patients treated with lecanemab at our multidisciplinary Norton Neuroscience Institute Memory Center. All patients had positive cerebrospinal fluid biomarkers for AD and underwent at least 1 lecanemab infusion. Two patients had additional amyloid PET scans which were positive.
Results
The mean age was 72 years (49–90 years), and 44 (62%) patients were female. Most were Caucasian (68 [96%]), and 54 [76%] were referred to our Memory Center by their primary care provider. Comorbidities were common, including hypertension (34 [48%]), hypercholesterolemia (51 [72%]), diabetes mellitus (17 [24%]), and cardiovascular disease excluding hypertension (22 [31%]). The mean body mass index was 27.0 (range: 17.8–45.0). A total of 36 (51%) patients were heterozygous for the ApoE4 genotype, and 9 (13%) were homozygous. A total of 61 [86%] patients had been treated with donepezil; 40 (56%) patients had received memantine. Of the 50 patients who completed 1 or more safety monitoring brain MRIs following infusion, 12 (24%) had amyloid-related imaging abnormalities (ARIA) detected: solitary ARIA-H (hemorrhage) in 5, solitary ARIA-E (edema) in 3, and both ARIA-H and ARIA-E in 4. Of the 12 patients with ARIA, 9 were asymptomatic, 4 were homozygous for the ApoE4 genotype, and 6 were heterozygous for the ApoE4 genotype. Of the 9 who were homozygous for the ApoE4 genotype in this study, 4 (44%) had evidence of ARIA. Of the 36 who were heterozygous for the ApoE4 genotype, 6 (17%) were diagnosed with ARIA. Twenty-six (37%) patients experienced infusion reactions after their first lecanemab infusion: headaches (12 patients) and shaking/chills/rigors (11 patients) were most common. Twenty-three (88%) of these 26 patients reported the side effects either at the infusion center or within the first 24 hours post-infusion. One patient died shortly after the first lecanemab infusion of a myocardial infarction. It is uncertain whether or not this death was related to lecanemab treatment.
Conclusion
Through our early experience with lecanemab, we have recognized several areas of improvement which have clarified and enhanced the lecanemab infusion experience.
{"title":"Initial Experience with Lecanemab and Lessons Learned in 71 Patients in a Regional Medical Center","authors":"L. B. E. Shields, H. Hust, S. D. Cooley, G. E. Cooper, R. N. Hart, B. C. Dennis, S. W. Freeman, J. F. Cain, W. Y. Shang, K. M. Wasz, A. T. Orr, C. B. Shields, S. S. Barve, Kenneth G. Pugh","doi":"10.14283/jpad.2024.159","DOIUrl":"https://doi.org/10.14283/jpad.2024.159","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background and Objectives</h3><p>On July 6, 2023 the U.S. Food and Drug Administration approved the anti-amyloid monoclonal antibody lecanemab (Leqembi®) for treatment of patients with mild cognitive impairment or mild dementia due to Alzheimer’s disease (AD). Our early experience and lessons learned with lecanemab in a regional community medical center are described.</p><h3 data-test=\"abstract-sub-heading\">Design, Setting, and Participants</h3><p>This retrospective observational study highlights the first 71 patients treated with lecanemab at our multidisciplinary Norton Neuroscience Institute Memory Center. All patients had positive cerebrospinal fluid biomarkers for AD and underwent at least 1 lecanemab infusion. Two patients had additional amyloid PET scans which were positive.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The mean age was 72 years (49–90 years), and 44 (62%) patients were female. Most were Caucasian (68 [96%]), and 54 [76%] were referred to our Memory Center by their primary care provider. Comorbidities were common, including hypertension (34 [48%]), hypercholesterolemia (51 [72%]), diabetes mellitus (17 [24%]), and cardiovascular disease excluding hypertension (22 [31%]). The mean body mass index was 27.0 (range: 17.8–45.0). A total of 36 (51%) patients were heterozygous for the ApoE4 genotype, and 9 (13%) were homozygous. A total of 61 [86%] patients had been treated with donepezil; 40 (56%) patients had received memantine. Of the 50 patients who completed 1 or more safety monitoring brain MRIs following infusion, 12 (24%) had amyloid-related imaging abnormalities (ARIA) detected: solitary ARIA-H (hemorrhage) in 5, solitary ARIA-E (edema) in 3, and both ARIA-H and ARIA-E in 4. Of the 12 patients with ARIA, 9 were asymptomatic, 4 were homozygous for the ApoE4 genotype, and 6 were heterozygous for the ApoE4 genotype. Of the 9 who were homozygous for the ApoE4 genotype in this study, 4 (44%) had evidence of ARIA. Of the 36 who were heterozygous for the ApoE4 genotype, 6 (17%) were diagnosed with ARIA. Twenty-six (37%) patients experienced infusion reactions after their first lecanemab infusion: headaches (12 patients) and shaking/chills/rigors (11 patients) were most common. Twenty-three (88%) of these 26 patients reported the side effects either at the infusion center or within the first 24 hours post-infusion. One patient died shortly after the first lecanemab infusion of a myocardial infarction. It is uncertain whether or not this death was related to lecanemab treatment.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Through our early experience with lecanemab, we have recognized several areas of improvement which have clarified and enhanced the lecanemab infusion experience.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marina Ritchie, R. Raman, K. Ernstrom, S. Wang, M. C. Donohue, P. Aisen, D. Henley, G. Romano, G. P. Novak, H. R. Brashear, R. A. Sperling, J. D. Grill
Background
Many cognitively unimpaired older adults are interested in learning their Alzheimer’s disease (AD) biomarker status, but little is known about motivations to undergo biomarker testing and result disclosure in the setting of preclinical AD trials.
Objectives
Examine whether motivations to undergo AD biomarker testing and disclosure differ for individuals who have elevated amyloid compared to those with not elevated amyloid, and whether disclosure of amyloid results impacts participants’ motivations.
Design, Setting, Participants
We conducted post-hoc analyses using data from the EARLY study, a preclinical AD trial of the beta-secretase inhibitor atabecestat. As part of the screening process of the trial, participants underwent biomarker testing and disclosure. We analyzed data from n=2241 participants.
Measurements
We analyzed data from the Views and Perceptions of Amyloid Imaging (VPAI), a 9-item questionnaire assessing how strongly participants agreed with motivating factors for undergoing amyloid testing. The VPAI was administered at the first screening visit and again after amyloid disclosure.
Results
Prior to amyloid disclosure, a greater proportion of participants in the elevated amyloid group responded at the two highest levels of endorsement for the items, “to confirm the feeling that I might already be developing symptoms of AD dementia” (p<0.001) and “to prepare my family for my possible illness in the future” (p=0.008), compared to participants in the not elevated amyloid group. Following disclosure, the not elevated amyloid group had higher odds of positive change in categorical VPAI item level scores for the items “to put mind at ease” (OR: 0.54; p<0.001), “to confirm the feeling that I might already be developing symptoms of AD dementia” (OR: 0.79; p=0.049), and “to prepare my family for my possible illness in the future” (OR: 0.67; p=<0.001), while the elevated amyloid group had higher odds of positive change for the item “curiosity” (OR:1.32; p=0.014).
Conclusions
Investigators might consider adjusting recruitment strategies for future trials to align with the motivations to undergo biomarker testing and disclosure most strongly endorsed by participants with elevated amyloid.
背景许多认知功能未受损的老年人对了解自己的阿尔茨海默病(AD)生物标志物状态很感兴趣,但在临床前AD试验中,人们对接受生物标志物检测和结果披露的动机知之甚少。目的探讨与淀粉样蛋白未升高者相比,淀粉样蛋白升高者接受AD生物标志物检测和结果披露的动机是否不同,以及淀粉样蛋白结果披露是否会影响参与者的动机。作为试验筛选过程的一部分,参与者接受了生物标志物检测并进行了信息披露。我们分析了2241名参与者的数据。我们分析了淀粉样蛋白成像的观点和看法(VPAI)的数据,这是一份由9个项目组成的问卷,评估参与者对接受淀粉样蛋白检测的动机因素的认同程度。结果与淀粉样蛋白未升高组的参与者相比,淀粉样蛋白升高组的参与者在 "确认我可能已经出现了AD痴呆症的症状"(p<0.001)和 "让我的家人为我将来可能患病做好准备"(p=0.008)这两个最高认可度的项目上,在淀粉样蛋白升高组的参与者中所占的比例更大。披露后,未升高淀粉样蛋白组在 "让我安心"(OR:0.54;p<0.001)、"确认我可能已经出现 AD 痴呆症状"(OR:0.79;p=0.049)和 "让我的家人为我将来可能患病做好准备"(OR:0.结论研究者可以考虑调整未来试验的招募策略,以符合淀粉样蛋白升高参与者最强烈认可的生物标记物检测和信息披露动机。
{"title":"Views and Perceptions of Amyloid Imaging in a Preclinical Alzheimer’s Disease Trial","authors":"Marina Ritchie, R. Raman, K. Ernstrom, S. Wang, M. C. Donohue, P. Aisen, D. Henley, G. Romano, G. P. Novak, H. R. Brashear, R. A. Sperling, J. D. Grill","doi":"10.14283/jpad.2024.157","DOIUrl":"https://doi.org/10.14283/jpad.2024.157","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Many cognitively unimpaired older adults are interested in learning their Alzheimer’s disease (AD) biomarker status, but little is known about motivations to undergo biomarker testing and result disclosure in the setting of preclinical AD trials.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>Examine whether motivations to undergo AD biomarker testing and disclosure differ for individuals who have elevated amyloid compared to those with not elevated amyloid, and whether disclosure of amyloid results impacts participants’ motivations.</p><h3 data-test=\"abstract-sub-heading\">Design, Setting, Participants</h3><p>We conducted post-hoc analyses using data from the EARLY study, a preclinical AD trial of the beta-secretase inhibitor atabecestat. As part of the screening process of the trial, participants underwent biomarker testing and disclosure. We analyzed data from n=2241 participants.</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>We analyzed data from the Views and Perceptions of Amyloid Imaging (VPAI), a 9-item questionnaire assessing how strongly participants agreed with motivating factors for undergoing amyloid testing. The VPAI was administered at the first screening visit and again after amyloid disclosure.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Prior to amyloid disclosure, a greater proportion of participants in the elevated amyloid group responded at the two highest levels of endorsement for the items, “to confirm the feeling that I might already be developing symptoms of AD dementia” (p<0.001) and “to prepare my family for my possible illness in the future” (p=0.008), compared to participants in the not elevated amyloid group. Following disclosure, the not elevated amyloid group had higher odds of positive change in categorical VPAI item level scores for the items “to put mind at ease” (OR: 0.54; p<0.001), “to confirm the feeling that I might already be developing symptoms of AD dementia” (OR: 0.79; p=0.049), and “to prepare my family for my possible illness in the future” (OR: 0.67; p=<0.001), while the elevated amyloid group had higher odds of positive change for the item “curiosity” (OR:1.32; p=0.014).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Investigators might consider adjusting recruitment strategies for future trials to align with the motivations to undergo biomarker testing and disclosure most strongly endorsed by participants with elevated amyloid.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Xu, G. Zhang, L. Yang, H. Qin, Z. Zhou, Q. Li, H. Liu, R. Wang, Z. Cai, L. Jing, Y. Li, Y. Yao, Z. Gong, P. Yuan, T. Fu, X. Zhao, Tao Peng, Yanjie Jia
Background
Shift work, the proven circadian rhythm-disrupting behavior, has been linked to the increased risk of Alzheimer’s disease (AD). However, the putative causal effect and potential mechanisms of shift work for AD were still unclear.
Methods
Mendelian randomization (MR) analysis was performed to discover the putative causal effect of shift work for AD. Expression quantitative trait loci (eQTLs) and transcriptome data were integrated to identify genes causally associated with AD from circadian-related genes. An in vitro experiment was also conducted to validate the expression of target genes. Based on the identified genes, a novel integrative program and 4,077 samples from 16 microarray datasets were leveraged to assess the extent of circadian rhythm disruption (CRD), defined as the clock deviation level (CDL).
Findings/Results
Shift work causally increased the risk of AD [odds ratio (OR) = 2.49, 95% CI = 1.79 - 3.19, p = 0.01]. Seven circadian-related genes were causally associated with AD, including CCS, CDS2, MYRIP, NRP1, PLEKHA5, POLR1D, and PPP4C. These genes were significantly correlated with the circadian rhythm pathway. CDL was higher in CRD mice group, shift work group, sleep restriction group, and AD patients compared to control mice group (p = 0.043), non-shift group (p = 0.004), sleep extension group (p = 0.025), and health controls (multiple cohorts, p < 0.05). Additionally, CDL was also significantly correlated with AD’s clinical biomarkers.
Interpretations/Conclusion
By combining GWAS and transcriptome data, this study demonstrated the causal role of CRD behavior in AD, identified the potential target genes in shift work-induced AD, and generated CDL to characterize CRD status, which provided evidence and prospects for disease prevention and future therapeutic interventions.
{"title":"Quantifying Personalized Shift-Work Molecular Portraits Underlying Alzheimer’s Disease through Computational Biology","authors":"Y. Xu, G. Zhang, L. Yang, H. Qin, Z. Zhou, Q. Li, H. Liu, R. Wang, Z. Cai, L. Jing, Y. Li, Y. Yao, Z. Gong, P. Yuan, T. Fu, X. Zhao, Tao Peng, Yanjie Jia","doi":"10.14283/jpad.2024.161","DOIUrl":"https://doi.org/10.14283/jpad.2024.161","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Shift work, the proven circadian rhythm-disrupting behavior, has been linked to the increased risk of Alzheimer’s disease (AD). However, the putative causal effect and potential mechanisms of shift work for AD were still unclear.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Mendelian randomization (MR) analysis was performed to discover the putative causal effect of shift work for AD. Expression quantitative trait loci (eQTLs) and transcriptome data were integrated to identify genes causally associated with AD from circadian-related genes. An in vitro experiment was also conducted to validate the expression of target genes. Based on the identified genes, a novel integrative program and 4,077 samples from 16 microarray datasets were leveraged to assess the extent of circadian rhythm disruption (CRD), defined as the clock deviation level (CDL).</p><h3 data-test=\"abstract-sub-heading\">Findings/Results</h3><p>Shift work causally increased the risk of AD [odds ratio (OR) = 2.49, 95% CI = 1.79 - 3.19, p = 0.01]. Seven circadian-related genes were causally associated with AD, including CCS, CDS2, MYRIP, NRP1, PLEKHA5, POLR1D, and PPP4C. These genes were significantly correlated with the circadian rhythm pathway. CDL was higher in CRD mice group, shift work group, sleep restriction group, and AD patients compared to control mice group (p = 0.043), non-shift group (p = 0.004), sleep extension group (p = 0.025), and health controls (multiple cohorts, p < 0.05). Additionally, CDL was also significantly correlated with AD’s clinical biomarkers.</p><h3 data-test=\"abstract-sub-heading\">Interpretations/Conclusion</h3><p>By combining GWAS and transcriptome data, this study demonstrated the causal role of CRD behavior in AD, identified the potential target genes in shift work-induced AD, and generated CDL to characterize CRD status, which provided evidence and prospects for disease prevention and future therapeutic interventions.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zohara Sternberg, R. Podolsky, J. Yu, S. Hua, S. Halvorsen, D. Hojnacki, B. J. Schaller
Background
Arterial hypertension contributes to both the development and progression of dementia due to both Alzheimer’s disease (A.D.) and vascular pathology. However, the effects of different classes of anti-hypertensives (A.H.T.s), on the rate of dementia progression and brain neuropathology are unknown.
Objective
To investigate the effect of each class of A.H.T., both as single and combined, on the rate of dementia progression. In addition, we analyzed the effect of A.H.T.s on brain neuropathology in AD participants, indicated by Braak staging, hippocampal atrophy, and baseline CSF levels of A-β42, total (T) tau, and P-181 tau.
Methods
We have used the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS).
Results
A.H.T.s were associated with reduced yearly increase in the CDR-SOB scores of 1.025 during a 10-year follow-up (P<0.001). The overall survival rate was higher in A.H.T. users than non-users [HR: 0.912: 0.860, 0.967) P=0.002]. These trends continued when stratifying participants by age, gender, and APOE4 allele. Participants who did not use A.H.T.s had a mean yearly increase of 1.71±1.7 in the CDR-SOB scores. This value was reduced to 1.48±1.6, P=0.006 and 1.45±1.6, P=0.024 for participants with documented use of βB and A.R.B.s, respectively. Combining diuretics with α1-AB or ACEI led to synergistic effects in reducing the rise in CDR-SOB scores. The proportion of participants who were diagnosed having AD postmortem with severe Braak staging was significantly lower in A.H.T.-users than non-users. The severity of Braak staging, and hippocampal atrophy differed in participants >70 vs. <70 years old, in both males and females. A significant relationship was observed between hippocampal atrophy and Braak staging; and between hippocampal atrophy and baseline CSF levels of P-181 tau.
Conclusion
Our results could have implications for halting the progression of dementia regardless of the etiology being related to AD or vascular pathology. The choice of combination of A.H.T. therapy should also consider the combination which would lead to an optimum benefit in slowing the progression of dementia. Additionally, our results underline a more complex A.D. disease model than previously thought, which opens new treatment options.
{"title":"Anti-Hypertensives Reduce the Rate of Alzheimer’s Disease Progression: A Cohort Study Linked with Genetic and Neuropathological Analyses","authors":"Zohara Sternberg, R. Podolsky, J. Yu, S. Hua, S. Halvorsen, D. Hojnacki, B. J. Schaller","doi":"10.14283/jpad.2024.156","DOIUrl":"https://doi.org/10.14283/jpad.2024.156","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Arterial hypertension contributes to both the development and progression of dementia due to both Alzheimer’s disease (A.D.) and vascular pathology. However, the effects of different classes of anti-hypertensives (A.H.T.s), on the rate of dementia progression and brain neuropathology are unknown.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To investigate the effect of each class of A.H.T., both as single and combined, on the rate of dementia progression. In addition, we analyzed the effect of A.H.T.s on brain neuropathology in AD participants, indicated by Braak staging, hippocampal atrophy, and baseline CSF levels of A-β42, total (T) tau, and P-181 tau.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We have used the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A.H.T.s were associated with reduced yearly increase in the CDR-SOB scores of 1.025 during a 10-year follow-up (P<0.001). The overall survival rate was higher in A.H.T. users than non-users [HR: 0.912: 0.860, 0.967) P=0.002]. These trends continued when stratifying participants by age, gender, and APOE4 allele. Participants who did not use A.H.T.s had a mean yearly increase of 1.71±1.7 in the CDR-SOB scores. This value was reduced to 1.48±1.6, P=0.006 and 1.45±1.6, P=0.024 for participants with documented use of βB and A.R.B.s, respectively. Combining diuretics with α1-AB or ACEI led to synergistic effects in reducing the rise in CDR-SOB scores. The proportion of participants who were diagnosed having AD postmortem with severe Braak staging was significantly lower in A.H.T.-users than non-users. The severity of Braak staging, and hippocampal atrophy differed in participants >70 vs. <70 years old, in both males and females. A significant relationship was observed between hippocampal atrophy and Braak staging; and between hippocampal atrophy and baseline CSF levels of P-181 tau.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Our results could have implications for halting the progression of dementia regardless of the etiology being related to AD or vascular pathology. The choice of combination of A.H.T. therapy should also consider the combination which would lead to an optimum benefit in slowing the progression of dementia. Additionally, our results underline a more complex A.D. disease model than previously thought, which opens new treatment options.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Saeedi, S. Hetjens, M. O. W. Grimm, Ben Barsties v. Latoszek
Background
The potential of biomarkers in the detection of Alzheimer’s disease (AD) is prominent. Acoustics may be useful in this context but the evaluation and weighting for specific acoustic parameters on continuous speech is missing. This meta-analysis aimed to explore the significance of acoustic parameters from acoustic speech analysis on continuous speech, as a diagnostic tool for clinical AD.
Methods
Applying PRISMA protocol, a comprehensive search was done in MEDLINE, Scopus, Web of Science, and CENTRAL, from 1960 to January 2024. Cross-sectional studies comparing the acoustic speech analysis between AD patients and healthy controls (HC), were taken into account. The bias risk of the included studies were examined via JBI checklist. Using Review Manager v.5.4.1, the mean differences of acoustic speech parameters among AD and HC were weighted, and the pooled analysis and the heterogeneity statistics were conducted.
Results
In total, 1112 records (without duplicates) were obtained, and 11 papers with 7 acoustic parameters were included for this study, and 8 from 11 studies were identified with a low level of bias. Five from 7 acoustic parameters revealed significant differences among the two groups (p-values ≤ 0.01), in which for all rate-related and interruption-related acoustic parameters were the most prominent and less in temporal-related acoustic parameters.
Conclusions
Although a small number of acoustic parameters on continuous speech could be evaluated in the detection of clinical AD, the greatest potential of acoustic biomarkers for AD appeared to exist in two of three categories. Further contributions of high-quality studies are needed to support evidence for acoustics as biomarkers for AD.
背景生物标志物在检测阿尔茨海默病(AD)方面的潜力十分突出。声学在这方面可能很有用,但对连续语音的特定声学参数的评估和权重却缺乏。本荟萃分析旨在探讨连续语音声学分析中的声学参数作为临床 AD 诊断工具的意义。方法采用 PRISMA 协议,在 1960 年至 2024 年 1 月期间的 MEDLINE、Scopus、Web of Science 和 CENTRAL 中进行了全面检索。纳入的研究均为横断面研究,比较了 AD 患者和健康对照组(HC)的语音声学分析。纳入研究的偏倚风险通过 JBI 核对表进行检查。使用 Review Manager v.5.4.1,对 AD 和 HC 之间的语音声学参数的平均差异进行加权处理,并进行汇总分析和异质性统计。7个声学参数中有5个在两组间存在显著差异(P值≤0.01),其中与语速相关的声学参数和与中断相关的声学参数最为突出,而与时间相关的声学参数则较少。结论虽然在检测临床AD时可以对连续语音的少量声学参数进行评估,但AD声学生物标志物的最大潜力似乎存在于三类中的两类。需要更多高质量的研究来支持声学作为AD生物标志物的证据。
{"title":"Acoustic Speech Analysis in Alzheimer’s Disease: A Systematic Review and Meta-Analysis","authors":"S. Saeedi, S. Hetjens, M. O. W. Grimm, Ben Barsties v. Latoszek","doi":"10.14283/jpad.2024.132","DOIUrl":"https://doi.org/10.14283/jpad.2024.132","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The potential of biomarkers in the detection of Alzheimer’s disease (AD) is prominent. Acoustics may be useful in this context but the evaluation and weighting for specific acoustic parameters on continuous speech is missing. This meta-analysis aimed to explore the significance of acoustic parameters from acoustic speech analysis on continuous speech, as a diagnostic tool for clinical AD.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Applying PRISMA protocol, a comprehensive search was done in MEDLINE, Scopus, Web of Science, and CENTRAL, from 1960 to January 2024. Cross-sectional studies comparing the acoustic speech analysis between AD patients and healthy controls (HC), were taken into account. The bias risk of the included studies were examined via JBI checklist. Using Review Manager v.5.4.1, the mean differences of acoustic speech parameters among AD and HC were weighted, and the pooled analysis and the heterogeneity statistics were conducted.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In total, 1112 records (without duplicates) were obtained, and 11 papers with 7 acoustic parameters were included for this study, and 8 from 11 studies were identified with a low level of bias. Five from 7 acoustic parameters revealed significant differences among the two groups (p-values ≤ 0.01), in which for all rate-related and interruption-related acoustic parameters were the most prominent and less in temporal-related acoustic parameters.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Although a small number of acoustic parameters on continuous speech could be evaluated in the detection of clinical AD, the greatest potential of acoustic biomarkers for AD appeared to exist in two of three categories. Further contributions of high-quality studies are needed to support evidence for acoustics as biomarkers for AD.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}