Frontiers in dementia最新文献

[This corrects the article DOI: 10.3389/frdem.2025.1601462.].

Objective: The aim of this scoping review is to identify the range, extent and nature of evidence available in peer-reviewed and gray literature and to examine how the intersecting experiences and differences of post-migrants and ethnic minority groups influence preferences.

Methods: The Arksey and O'Malley methodological framework and the PRISMA-ScR for Scoping Reviews confirm the rigor of the scoping review. We systematically searched across electronic databases including PubMed, MEDLINE via Ovid, CINAHL, Scopus, Cochrane Library as well as gray literature between December 2023 and September 2024. We included the articles in English, German, and Turkish languages without any publication date restrictions. We analyzed the identified intersectional determinants of preferences using inductive content analysis.

Results: Limited studies focusing on the intersectional determinants of preferences of ethnic minority groups or post-migrants with dementia were found. After screening 1,404 studies, we identified 4 relevant papers through the search strategy. Additionally, we identified 18 records through hand-searching, gray literature, and reference list checks. In total, 22 articles were included in this review. Inductive content analysis allowed to reach six main-theme focusing on the preferences, which are preferences connected to informal care providers, expectations in nursing homes/care institutions, preferences of care setting, coping approaches and preferences, food preferences, and other daily preferences.

Discussion: Our findings highlight the complexity of personal care preferences, showing that expectations and practices are shaped by cultural values, traditions, language barriers, immigration processes, shifting socioeconomic positions, and gender roles. The lack of attention to the preferences of the diverse groups and the limited support for their unique wishes and needs indicates a significant challenge in the health system. Caregiving choices and daily living are shaped by intersecting structural determinants and differences. However, there are still gaps in research, healthcare practices, and public awareness, making it harder to meet their preferences.

Systematic review registration: Registration DOI: https://doi.org/10.17605/OSF.IO/Z8T9H.

Alzheimer's disease (AD) is characterized by a long preclinical phase lasting more than a decade before the onset of its clinical phase of mild cognitive impairment (MCI) or dementia. Recent advances in psychedelic research underscore numerous neuroplastogenic and anti-inflammatory alterations induced by these compounds, making them promising therapeutic candidates for AD. In this mini review, we will briefly summarize the existing literature using human cerebral organoids to study the molecular and metabolic changes caused by various psychedelic compounds, focusing on their potential therapeutic applications for AD.

Alzheimer's disease (AD) is a severe neurodegenerative brain disorder molecularly characterized by extracellular β-amyloid plaques, intraneuronal tau neurofibrillary tangles, cholinergic neuron death, neuroinflammation, vascular damage, and astroglial and microglial activation. AD is a complex disorder, with >99% of all cases being sporadic and typically occuring around the age of 65. Due to this intricate nature of the disorder, in vitro experiments have limitations; however, three-dimensional organotypic brain slices may offer the best alternative for studying the mechanisms involved in the progression of AD. This review provides an overview of how to study the general aspects of AD ex vivo, focusing on (a) β-amyloid plaques in brain slices, (b) tau pathology induced by chemical drugs, (c) cell death of cholinergic neurons and protection by nerve growth factor, (d) activation of astrocytes and microglia, and (e) vascular pathologies, including the role of platelets. Furthermore, we investigated (f) how microcontact printing on brain slices can be used to study the spread of β-amyloid and tau, and (g) how brain slices can help identify novel human AD biomarkers.

Introduction: Despite progress in dementia diagnosis and treatment, physician-held stigma remains a significant barrier to early recognition and effective care. Stigmatizing attitudes among healthcare professionals can negatively impact diagnosis rates, clinical interactions, and care quality for people living with dementia.

Methods: This scoping review was conducted following Arksey and O'Malley's framework. Peer-reviewed literature from 2014 to 2024 was systematically reviewed to identify and evaluate interventions aimed at reducing dementia-related stigma among physicians. A total of 14 studies met inclusion criteria, examining educational, skill-building, and person-centered approaches.

Results: Interventions included brief workshops, online modular training, and interdisciplinary methods integrating person-centered frameworks and behavior management tools. Validated outcome measures used in the studies included the Alzheimer's Disease Knowledge Scale (ADKS), the Dementia Negative Stereotype Scale (DNS), and the General Practitioners Confidence and Attitude Scale for Dementia (GPACS-D). Across studies, interventions were found to improve clinical confidence, reduce negative stereotypes, and enhance care quality.

Discussion: Findings highlight the importance of culturally sensitive and interdisciplinary interventions to address stigma, improve clinical confidence, and enhance care quality, particularly in low-resource settings. Notable gaps remain in understanding the long-term impact and scalability of such interventions. This review aims to contribute a deeper understanding of the barriers and facilitators to implementing dementia care practices, offering a conceptualization for enhanced physician education and improved health outcomes for persons with dementia. We offer recommendations for future research to develop tailored strategies that support stigma reduction and improve care delivery.

A long-standing theory for Alzheimer's disease (AD) has been that deterioration of synapses and depressed neuronal activity is a major contributing factor. We review the increasing evidence, in humans and in mouse models, that show that there is often neuronal hyperactivity at early stages rather than decreased activity. We discuss studies in mouse models showing that hyperexcitability can occur long before plaque deposition and memory impairment. In mouse models, a generator of the hyperactivity appears to be the dentate gyrus. We present evidence, based on mouse models, that inhibition of muscarinic cholinergic receptors or medial septal cholinergic neurons can prevent hyperactivity. Therefore, we hypothesize the novel idea that cholinergic neurons are overly active early in the disease, not depressed. In particular we suggest the medial septal cholinergic neurons are overly active and contribute to hyperexcitability. We further hypothesize that the high activity of cholinergic neurons at early ages ultimately leads to their decline in function later in the disease. We review the effects of a prenatal diet that increases choline, the precursor to acetylcholine and modulator of many other functions. In mouse models of AD, maternal choline supplementation (MCS) reduces medial septal cholinergic pathology, amyloid accumulation and hyperexcitability, especially in the dentate gyrus, and improves cognition.

Introduction: There is growing awareness of people living with diverse dementia syndromes, many of whom are younger in age, with distinct support needs. Planning for increasing numbers of people living with dementia and subsequent models of support has largely overlooked this population. To address this gap, the aim was to design a Theory of Change for multi-component rare dementia support.

Methods: Intervention development frameworks underpinned the construction of a Theory of Change informed by research evidence on rare dementia support and an iterative consultation process with people with lived experience, researchers, educators and health and social care practitioners.

Results: The Theory of Change illustrates pathways to activities for continuous and tailored support solutions, education and knowledge production. Characteristic features include relationship, connection and continuity for people with lived experience, training and networking for professionals, and relational support with a commitment to ongoing learning for the rare dementia support team.

Conclusion: The Theory of Change is positioned to flexibly support people affected by rare dementia, strengthen capacity within all sectors, improve service quality whilst maintaining a commitment to knowledge production and mobilization.

Engaging people living with dementia in interview research presents unique ethical, methodological, and practical challenges. In recent years there is an increased recognition of the importance and value of meaningfully including people with dementia in research, and of the epistemic injustice of systematic exclusion. While there are a growing number of research papers suggesting strategies for fostering ethical and meaningful inclusion, this area is still very much in development, theoretically and methodologically. This paper outlines how a theoretical perspective on selfhood in dementia, which incorporates the concept of the "Intentional Stance" (as per Sabat), may be a useful means of reaching people with dementia in a meaningful way via open, curious and personhood-supporting interactions. Embodying the "intentional stance" refers to operating under the assumption that all behavior and interactions do have meaning(s), even if it is not immediately or intuitively evident to the researcher what the meaning(s) are. Here, we draw on excerpts from an interview I conducted with a person living with dementia about his experiences of and perspectives on respite and day services, using the intentional stance, in conjunction with a range of other strategies for maximizing reciprocal communication. The analysis highlights instances where the intentional stance was central to connecting with the person, and temporarily entering their lifeworld. Adopting this stance is a means of reducing the epistemic injustice that people with dementia have faced, through longstanding omission and exclusion from research, and from social spheres more broadly.