Frontiers in dementia最新文献

Introduction: Deregulation of the cerebrovascular system has been linked to neurodegeneration, part of a putative causal pathway into etiologies such as Alzheimer's disease (AD). In medical imaging, time-of-flight magnetic resonance angiography (TOF-MRA) and perfusion MRI are the most common modalities used to study this system. However, due to lack of resources, many large-scale studies of AD are not acquiring these images; this creates a conundrum, as the lack of evidence limits our knowledge of the interaction between the cerebrovascular system and AD. Deep learning approaches have been used in recent developments to generate synthetic medical images from existing contrasts. In this review, we study the use of artificial intelligence in the generation of synthetic TOF-MRA and perfusion-related images from existing neuroanatomical and neurovascular acquisitions for the study of the cerebrovascular system.

Method: Following the PRISMA reporting guidelines we conducted a scoping review of 729 studies relating to image synthesis of TOF-MRA or perfusion imaging, from which 13 met our criteria.

Results: Studies showed that T1-w, T2-w, and FLAIR can be used to synthesize perfusion map and TOF-MRA. Other studies demonstrated that synthetic images could have a greater signal-to-noise ratio compared to real images and that some models trained on healthy subjects could generalize their outputs to an unseen population, such as stroke patients.

Discussion: These findings suggest that generating TOF-MRA and perfusion MRI images holds significant potential for enhancing neurovascular studies, particularly in cases where direct acquisition is not feasible. This approach could provide valuable insights for retrospective studies of several cerebrovascular related diseases such as stroke and AD. While promising, further research is needed to assess their sensitivity and specificity, and ensure their applicability across diverse populations. The use of models to generate TOF-MRA and perfusion MRI using commonly acquired data could be the key for the retrospective study of the cerebrovascular system and elucidate its role in the development of dementia.

The aim of this discussion paper is to show the way to the outdoors by shedding light on conditions in the physical environment enabling outdoor stays for older adults living in residential care facilities (RCFs). The origin was that outdoor stays is a basic human need and applies to everyone. However, despite extensive research on the health-promoting values of contact with the outdoors, it seems that for older adults in RCFs this is not met because they often have difficulty getting outdoors on their own. Therefore, the access to and the conditions of outdoor environments are discussed and exemplified through two cases based on evidence-based approaches, namely the principal model of four zones of contact with the outdoors, and the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM). An interdisciplinary team, including both researchers and practitioners highlights future directions by showing the way to the outdoors on a national level with six suggested points. As a reader, you will gain increased knowledge about environmental qualities that support outdoor stays as well as initiatives that are needed to achieve equal conditions related to outdoor stays in RCFs.

The aggregation of α-synuclein in the nervous system leads to a class of neurodegenerative disorders termed α-synucleinopathies. A form of primary degenerative dementia called Lewy body dementia (LBD) often develops when these aggregations develop into intracellular inclusions called Lewy bodies (LB) and Lewy neurites (LN). Although high frequency of LBD are the leading cause of dementia after Alzheimer's disease (AD), limited information has been discovered about its pathological pathway or diagnostic criteria. In this report, we attempt to address such shortcomings via utilizing a proteomic approach to identify the proteome changes following intrastriatal injection of α-synuclein pre-formed fibril (α-syn PFF). Using mass spectrometry, we have identified a total of 179 proteins that were either up- or down-regulated at different time points, with the four proteins-TPP3, RAB10, CAMK2A, and DYNLL1, displaying the most significant changes throughout the timeframe. Through further examining the modulated proteins with network-based enrichment analyses, we have found that (1) the most significantly associated neurodegenerative pathways were Parkinson's (pV = 3.0e-16) and Huntington's (pV = 1.9e-15) disease, and (2) the majority of molecular functions specific to the pathology only appeared at later time points. While these results do not expose a conclusive biomarker for LBD, they suggest a framework that is potentially applicable to diagnose and differentiate LBD pathology from other forms of dementia by focusing on the cortical proteome changes which occur in a later time span.

Introduction: Caring for a person with Alzheimer's disease or dementia has been correlated with poor dietary patterns in caregivers. Dietary patterns like The Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet have the potential to reduce the negative health outcomes associated with caregiving. Our objective was to assess capabilities, opportunities, and motivation of caregivers to follow the MIND diet using the COM-B model approach.

Method: Female caregivers (n = 299, m _age = 37.7 ± 13.7) participated in an online survey. Majority were White (72%) and cared for someone with Alzheimer's disease (42.6%). The survey included at least one question for each of the 6 COM-B subcomponents: psychological capability, physical capability, social opportunity, physical opportunity, reflective motivation, and automatic motivation.

Results: Most caregivers were not consuming the MIND diet as only 8.4% reported normally eating the MIND diet items. Caregivers (36.5%) were slightly confident or not confident at all in cooking and eating the MIND diet. Participants (67.1%) reported that consuming the MIND diet would somewhat to very much be supported by friends and family. Budget, time, and transportation were selected as the main barriers. Budget, cooking skills, access to food and stores, and family support were the main facilitators.

Discussion: Strategies to increase capability, opportunities, and motivation for the MIND diet are needed to improve caregivers' health. Future MIND diet interventions should improve budget planning and cooking skills of caregivers (capabilities), make MIND diet food items accessible to them (opportunity) and incorporate social support from family and friends (motivation).

Introduction: Prior research identified four neurochemical cerebrospinal fluid (CSF) biomarkers, Aβ1-42, Aβ1-40, tTau, and pTau(181), as core diagnostic markers for Alzheimer's disease (AD). Determination of AD biomarkers using immunoassays can support differential diagnosis of AD vs. several neuropsychiatric disorders, which is important because the respective treatment regimens differ. Results of biomarker determination can be classified according to the Amyloid/Tau/Neurodegeneration (ATN) system into profiles. Less is known about the clinical performance of chemiluminescence immunoassays (ChLIA) measuring specific biomarkers in CSF samples from patients suffering from neuropsychiatric impairments with various underlying causes.

Methods: Chemiluminescence immunoassays (ChLIAs, EUROIMMUN) were used to determine Beta-Amyloid (1-40), Beta-Amyloid (1-42), Total-Tau, and pTau(181) concentrations in precharacterized cerebrospinal fluid (CSF) samples from 219 AD patients, 74 patients with mild cognitive impairment (MCI), and 220 disease control (DC) patients.

Results: 83.0% of AD patients had ATN profiles consistent with AD, whereas 85.5% of DC patients and 77.0% of MCI patients had profiles inconsistent with AD. AD patients showed significantly lower amyloid ratio Aβ1-42/Aβ1-40 (mean: 0.07) and significantly higher concentrations of tTau (mean: 901.6 pg/ml) and pTau(181) (mean: 129 pg/ml) compared to DC and MCI patients (all p values < 0.0071).

Discussion: The ChLIAs effectively determined specific biomarkers and can support differential diagnostics of AD. Their quality was demonstrated in samples from 513 patients with cognitive impairments, representing a realistic mix of underlying causes for seeking treatment at a memory clinic.

Introduction: Challenging behavior and pain are common in nursing home residents with dementia. Challenging behavior and pain can be related and are stressful for residents, family caregivers and healthcare professionals. The STA OP! method provides a step-by-step protocol to manage challenging behavior and pain in nursing home residents with dementia. However, this method does not include a prominent and active role for family caregivers.

Methods: The STA OP! method was modified to include a role for family caregivers, in co-creation with family caregivers and healthcare professionals using elements of a realist approach. In separate meetings, two advisory groups comprised of family caregivers and professionals discussed ideas on how to involve family caregivers in STA OP!. Furthermore, barriers to involving family and possible solutions to overcome those barriers were discussed. Experts who had experience with the STA OP! method assessed the feasibility of the ideas in a nominal group technique meeting.

Results: Thirty-eight ideas emerged in the advisory groups. The two ideas that generated the most discussion were Inviting family for a multidisciplinary meeting, and Assessment of pain in collaboration with family caregivers. Eventually, 21 ideas and suggestions to overcome possible barriers were included in a manual for the training of healthcare professionals in the adapted method, now called STA OP! with family.

Conclusion: Healthcare professionals and family caregivers collaborated well to shape the involvement of family caregivers in this method for managing challenging behavior and pain. The collected ideas supported by all involved resulted in a modified method: STA OP! with family and can now be tested in daily practice.

Background: Low skeletal muscle volume may increase dementia risk through mechanisms affecting brain structure. However, it is unclear whether this relationship exists outside of sarcopenia and/or varies by other factors. We aimed to study the interplay between skeletal muscle volume and factors, such as age, sex, and body mass index (BMI), in explaining brain structure at midlife in a cohort without sarcopenia.

Methods: We used abdominal and brain magnetic resonance imaging (MRI) data from a population-based cohort enrolled in the UK Biobank. The following measures were derived: thigh fat-free muscle volume (FFMV), total brain volume (TBV), gray matter volume (GMV), white matter volume (WMV), total hippocampal volume (THV), and white matter hyperintensity volume (WMHV). Participants below sex-based grip strength thresholds suggesting probable sarcopenia were excluded. Linear regression analysis was used to study the interaction or mediation effects of age, sex, and BMI on the associations between FFMV and brain volumes.

Results: Data were available for 20,353 participants (median age 64 years, 53% female). We found interactions between thigh FFMV, BMI, and age (all p < 0.05). Greater thigh FFMV was associated with better brain volumes in those aged <64 years with normal (TBV: β = 2.0 ml/L, p = 0.004; GMV: β = 0.8 ml/L, p = 0.04; WMV: β = 1.1 ml/L, p = 0.006; WMHV: β = -0.2 ml/L, p = 3.7 × 10^-5) or low BMI (TBV: β = 21.2 ml/L, p = 0.003; WMV: β = 13.3 ml/L, p = 0.002, WMHV: β = -1.1 ml/L, p = 0.04).

Conclusion: Greater thigh muscle volume correlates with better brain volumes at midlife in people without sarcopenia, but this relationship weakens with greater age and BMI. Further study is required to investigate the underlying mechanisms to understand which components of body composition are potentially modifiable risk factors for dementia.

[This corrects the article DOI: 10.3389/frdem.2024.1422820.].