Alzheimer's & Dementia最新文献

{"title":"Correlations between monoaminergic biomarkers, classical biomarkers and the BPSD‐DSII behavioral scale in Down individuals with and without Alzheimer's dementia","authors":"Charlotte Jacob, Hanane Kachar, Annelies Heylen, Marleen Tollenaere, Inge M.W. Verberk, Charlotte Teunissen, Peter Paul De Deyn, Debby Van Dam","doi":"10.1002/alz.092217","DOIUrl":"https://doi.org/10.1002/alz.092217","url":null,"abstract":"BackgroundDown syndrome (DS, trisomy 21) is the most frequent genetic cause of intellectual disability (ID), prevalent in approximately 1 in 900 live births (Loane et al., 2013). People with DS are at high risk to develop Alzheimer’s disease dementia (AD) (Lott & Head, 2001). Onset of clinical symptoms varies substantially in time. Consequently, predicting and monitoring decline and onset of dementia is a diagnostic challenge, while it is of essence in daily care and support. Behavioral and Psychological Symptoms of Dementia are an important and easily accessible tool for the prediction of dementia onset in the DS population. The BPSD‐DSII scale was developed to identify behavioral changes between the last six months and pre‐existing life‐long characteristic behavior in an (AD‐)DS population. Changes are assessed with the use of different behavior‐specific questions (items) which are categorized in different clusters (sections) (Dekker et al., 2018). We used the BPSD‐DSII to assess these symptoms and predict a potential diagnosis of dementia. BPSD‐DSII results are correlated with the serum levels of monoaminergic (epinephrine, norepinephrine, dopamine, serotonin and their metabolic products) and classical biomarkers, such as Ab40, Ab42, total tau, phosphorylated tau and neurofilament light chain.MethodWe used reversed‐phase ultra‐high performance liquid chromatography with electrochemical detection to determine the levels of epinephrine, norepinephrine, dopamine, serotonin and their metabolic products in serum. The Simoa platform was applied to detect the levels of Ab40, Ab42, total tau, phosphorylated tau and neurofilament light chain. Finally, we worked together with the caregivers of the (AD‐)DS individuals for the collection of BPSD‐DSII data.ResultPreliminary data suggests correlations between different sections of the BPSD‐DSII questionnaire and serotonin levels, as well as correlations between different sections of the BPSD‐DSII questionnaire and classical biomarker levels. In addition, complementary data regarding the correlation between the different items of the BPSD‐DSII questionnaire and the different serum‐based biomarkers will be presented at the conference.ConclusionThe results per section of the BPSD‐DSII correlate with the levels of monoamines and classical biomarkers in (AD‐)DS individuals. And could therefore be used as potential biomarkers for the development of AD within the population of DS patients.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"74 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and analytical validation of AB40, AB42, A‐Syn, CD33, P‐Tau 181, Tau, and TREM2 in human serum, plasma, or CSF","authors":"Jacqueline Surls, Robyn Vega Ibanez, Lindsey Brown, Josh Kemp","doi":"10.1002/alz.089257","DOIUrl":"https://doi.org/10.1002/alz.089257","url":null,"abstract":"BackgroundMeasurement of blood‐based biomarkers for Alzheimer disease is simpler and more accessible when compared to CSF. We report the development and validation of seven Simoa® immunoassays for the detection of AB40, AB42, A‐Syn, CD33, P‐Tau 181, Tau, and TREM2 in human serum, plasma, or CSF.MethodUsing the Quanterix® Simoa® technology (SR‐X) platform, AB40, AB42, A‐Syn, CD33, P‐Tau 181, Tau, and TREM2 were developed and analytically validated in human serum, plasma, or CSF per CLSI standards.ResultWe have developed and analytically validated Simoa® immunoassays to detect AB40, AB42, A‐Syn, CD33, P‐Tau 181, Tau, and TREM2 in human serum, plasma, or CSF. The assays met acceptance criteria for sensitivity, precision, stability, interference, and parallelism. The calibration curves in serum/plasma were linear from 16‐2000 pg/mL for AB40, 18‐40,000 pg/mL for AB42, 0.13‐80 ng/mL for A‐Syn, 0.012‐60 ng/mL for CD33, 0.60‐3000 pg/mL for P‐Tau 181, 0.12‐600 pg/mL for Tau, and 0.30‐38 ng/mL for TREM2. For CSF, the linear ranges were from 626‐80,000 pg/mL for AB40, 72‐160,000 pg/mL for AB42, 0.013‐8.0 ng/mL for A‐Syn, 0.012‐60 ng/mL for CD33, 30‐150,000 pg/mL for P‐Tau 181, 0.30‐1500 pg/mL for Tau, and 0.60‐76 ng/mL for TREM2. The three quality controls met inter assay precision with %CV ≤16% for levels 1 and 2, and ≤20% for level 3 across all analytes. No interference was observed with bilirubin, hemoglobin, or triglyceride. The sensitivity of the assays in human serum/plasma was demonstrated by the LLOQ values of 28 pg/mL, 47 pg/mL, 0.20 ng/mL, 0.11 ng/mL, 2.8 pg/mL, 0.22 pg/mL, and 0.59 ng/mL for AB40, AB42, A‐Syn, CD33, P‐Tau 181, Tau, and TREM2, respectively. For human CSF, the LLOQ values of 1139 pg/mL, 187 pg/mL, 0.020 ng/mL, 0.11 ng/mL, 142 pg/mL, 0.56 pg/mL, and 1.2 ng/mL for AB40, AB42, A‐Syn, CD33, P‐Tau 181, Tau, and TREM2 in human CSF, respectively. The stability of the analytes was established under various conditions, such as freeze‐thaw cycles, short‐term and long‐term storage.ConclusionThese assays demonstrated acceptable performance for clinical implementation as research use only and may be useful for blood‐based biomarker studies in clinical trials.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"38 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between peripheral blood DNA methylation and FDG‐PET signal in AD individuals","authors":"Lavinia Perquim, Marco Antônio de Bastiani, Luiza Santos Machado, Wyllians Vendramini Borelli, Guilherme Povala, Thomas Hugentobler Schlickmann, Tharick A. Pascoal, Pedro Rosa‐Neto, Alexandre Santos Cristino, Eduardo R. Zimmer","doi":"10.1002/alz.092675","DOIUrl":"https://doi.org/10.1002/alz.092675","url":null,"abstract":"BackgroundEpigenetics plays a crucial role in regulating genetic transcription and responding to environmental and lifestyle changes without altering the DNA sequence. Their dysregulation is associated with AD, presenting potential as blood biomarkers. However, no study has evaluated whether peripheral blood (PB) epigenetic biomarkers are associated with brain metabolism, indexed by FDG‐PET, a classic Imaging AD biomarker. Thus, we explore the associations between PB DNA methylation and FDG‐PET signal in the brain of cognitively unimpaired (CU) and AD individuals.MethodWe evaluated CU=43 and AD=122 individuals from the ADNI cohort who underwent FDG‐PET imaging and PB DNA methylation analysis. Methylation data were analyzed using the minfi R package. Correlation analysis was performed with the statistically significant differentially methylated regions (DMRs) (p<0.005) and the regional FDG‐PET standardized uptake value ratio (SUVRs) values extracted with the DKT atlas. Voxel‐wise associations between FDG‐PET and DMRs were tested using linear regressions accounting for group, gender, age, and APOE4 status. The analysis was corrected for multiple comparisons using cluster‐wise RFT (p<0.05).ResultWe identified 478 DMRs (Figure 1), multiple of them significantly associated with regional FDG‐PET SUVRs (Figure 2). The voxel‐based analysis demonstrated that DMR cg02041677, located in the ATE1 gene, was negatively associated with FDG‐PET signal in the left hippocampus, right orbitofrontal gyrus, and right medial temporal gyrus (tmax=‐4.28, ‐4.04, ‐3.58, respectively; p‐value<0.001). The cg11128212, in the intron, nearby two lncRNA (ENSG00000289046, ENSG00000274591), was positively associated with brain metabolism in the left hippocampus, left temporal pole, and left middle temporal gyrus (tmax=4.08, 3.98, 3.80, respectively; p‐value<0.001) while the cg11901271, located in intron, nearby of a LncRNA (ENSG00000287358), showed positive correlations with FDG‐PET in the Left hippocampus (tmax=5.35, respectively; p‐value<0.001) (Figure 3).ConclusionHere, we show that PB DMRs exhibited a significant pattern of association with brain glucose metabolism in vulnerable AD regions. LncRNAs are important transcriptional regulators, the methylation could impact gene expression in AD and present potential as blood biomarkers.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"6 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognition Four Decades After High School: Does School Context Matter for Cognitive Disparities at Midlife?","authors":"Jennifer J. Manly, Koit Hung, Adam M. Brickman, Eric Grodsky, Chandra Muller, John Robert Warren, Michael Culbertson","doi":"10.1002/alz.091879","DOIUrl":"https://doi.org/10.1002/alz.091879","url":null,"abstract":"BackgroundStructural racism shapes educational quality by perpetuating unequal access to school resources, creating disproportionate exposure to disciplinary actions, and limiting access to advanced courses among racially minoritized children. School quality is linked to later life ADRD risk, but the benefit may vary across groups. We asked 1) whether the same high school social contexts and academic resources predict midlife cognitive functioning across race, ethnicity, and gender, and 2) how much could disparities in midlife cognitive function be narrowed if everyone had equal access to high quality high schools?MethodData was from the nationally representative High School and Beyond cohort, which prospectively followed 12,530 Americans from high school through age ∼60 and administered telephone‐ and web‐based measures of memory, language, and attention in 2021‐22. Extensive information about family, high school social and academic context, and student achievements was gathered directly from students and their schools in 1980‐1982. OLS regression models estimated associations between specific school variables and an IRT‐derived cognitive composite, before and after adjustment for confounders in race, ethnicity, and sex stratified models.ResultHigher average SES of students in each high school predicted better midlife cognitive test scores among White people and Latina women, but not among Latino men or Black participants. This association weakened after adding school academic context variables. A composite measure capturing school‐level academic engagement and rigor (academic press) predicted better cognition among White and Latinx participants but not among Black participants. If everyone had access to high schools of the same quality as the group with the highest test scores (White women), and adjusting for family confounders, disparities between White women and participants from racially minoritized groups would be substantially reduced (by 9% among Black women, 5% among Black men, and 6% among Latino men and Latina women).ConclusionInvestment in high schools that serve Black and Latinx children could meaningfully narrow disparities in cognition four decades later, particularly among Black women. Later life cognitive benefit of specific aspects of school context, such as high SES peers and academic rigor, had differential benefit depending on race, ethnicity, and sex.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"69 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Self‐Perceptions of Cognitive Decline on Cognitive Assessment Outcomes in the Women’s Alzheimer’s Movement Prevention Center at Cleveland Clinic","authors":"Nikki L Kaplan, Emily Post, Taylor F Levine, Jessica ZK Caldwell","doi":"10.1002/alz.092611","DOIUrl":"https://doi.org/10.1002/alz.092611","url":null,"abstract":"BackgroundThe Women’s Alzheimer’s Movement Prevention Center (WAMPC) at Cleveland Clinic evaluates women’s risk factors for developing Alzheimer’s disease and provides personalized recommendations for reducing risk. Previous research has established that up to 40% of Alzheimer’s disease (AD) cases might be prevented when modifiable risk factors are addressed. To better understand individual risk profiles, a wealth of information is collected, including self‐reported health conditions (both personal and familial), lifestyle factors (e.g. alcohol and tobacco use, exercise, social support), a brief cognitive test battery, and blood tests. WAMPC takes a holistic approach in helping women combat modifiable risks for AD.Method207 women from the WAMPC who consented to have their clinical data used for research purposes were assessed (mean age = 53.39, SD = 9.53). Requirements for participation include normal cognition and family history of Alzheimer’s disease. Patients completed the Mini Mental State Exam (MMSE), selected tests from the NIH Toolbox (Oral‐Symbol Digit, Processing Speed, Picture Vocabulary, Card Sort, and Flanker), Controlled Oral Word Association Test‐FAS (COWAT: FAS, Animal Naming), and the Trail Making Test Part B. Patients also completed the Subjective Cognitive Decline Questionnaire (SCDQ), a self‐report assessment of perceived cognitive changes. We transformed SCDQ total scores into cohort‐based z‐scores to create three SCDQ groups (“fewer cognitive concerns” = bottom third, “average cognitive concerns” = middle third, and “above average cognitive concerns” = top third. We evaluated the relationship between performance on cognitive tests and women’s perceived cognitive decline on SCDQ. We ran 9 individual ANCOVAs, one for each cognitive test, using education and age as covariates.ResultOf the tests evaluated, the SCDQ significantly predicted scores on Animal Naming (F(2,190) = 3.602, p = .029) and NIH Toolbox Card Sorting (F(2,190) = 3.597, p = .029). No other tests demonstrated significant relationships with self‐perceptions of cognitive decline per the SCDQ.ConclusionPerceived cognitive decline in daily life predicted concurrent poorer performance on selected tests of language and executive function, in women who are cognitively normal, yet at increased risk for AD based on family history. Further work is needed to understand whether subjective cognitive concerns may represent risk for cognitive decline in this cohort of women with family history of AD.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"27 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do patients with early‐stage cognitive impairment have an increased risk to have a reduction in walking speed? A cross‐sectional study","authors":"Pedro de Castro Lopes, Amanda Aparecida Oliveira Leopoldino, João Carlos Barbosa Machado, Maira Tonidandel Barbosa, Luana Rodrigues Garcia, Bianca Pessoa Aguiar, Júlia Caroline Barbosa de Souza, João Pedro Neres Antunes Ferreira","doi":"10.1002/alz.089259","DOIUrl":"https://doi.org/10.1002/alz.089259","url":null,"abstract":"BackgroundGait speed is an important measure in the evaluation of elderly patients. The gait speed reduction is associated with high‐impact outcomes such as: loss of functionality, frailty and increased mortality. Several clinical conditions lead to a reduction in gait speed. In patients with advanced dementia, it could be associated with disability. However, the relationship between cognition and motor function is not well known, especially in the early stages of dementia and further studies are needed. It is also important to understand whether patients with mild cognitive impairment have increased risk of a worse gait speed.MethodThis is a cross‐sectional study in which 87 community‐dwelling elderly people were included and evaluated in relation to the presence of cognitive impairment and gait speed. Patients with severe cognitive impairment, assessed by a score less than 6 in the CS‐10 (Point Cognitive Screening) were excluded. Individuals with a score between 6 and 7 on the CS‐10 were considered to have mild or moderate cognitive impairment and participants with a score greater than 7 on this test were considered to have no cognitive impairment. In order to evaluate gait speed, individuals were stimulated to walk for 4 meters, and those with a walking speed lower than 0.82 m/s were considered to have it reduced. With the aim of estimate the association between the characteristics, Pearson’s chi‐square test was used. If the p‐value was lower than the significance level of 0.05, it is possible to conclude the association between the lower walking speed and a worse score in CS‐10.ResultStatistical analysis showed an association between the reduction in gait speed and CS‐10 score (p‐value 0.041). Patients who had lower score on the cognitive assessment are likely to have a lower gait speed. The mean CS‐10 score for patients with gait impairment is 7.91, while for patients without gait impairment is 8.95 points. The Kruskal‐Wallis test indicates that there is a significant difference in the results (p‐value 0.016).ConclusionIndividuals with mild cognitive impairment have an increased risk of developing reduced gait speed.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"2 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Biomarker Discordance: MRI and PET Phenotypes Shed Light on Alzheimer’s Pathology","authors":"Tamil Iniyan Gunasekaran, Annie J. Lee, Patrick J. Lao, Jose Gutierrez, Jennifer J. Manly, Yian Gu, Adam M. Brickman, Lawrence S. Honig, Badri N. Vardarajan, Richard Mayeux","doi":"10.1002/alz.095708","DOIUrl":"https://doi.org/10.1002/alz.095708","url":null,"abstract":"BackgroundPlasma biomarkers for Alzheimer’s disease (AD) are indicators of neuropathological changes. Biomarker cutoffs may not consistently indicate the presence or absence of a pathology. Discrepant biomarker levels are observed in some cognitively normal subjects and patients with clinically diagnosed AD, with some asymptomatic individuals having biomarker evidence of AD pathophysiology and some symptomatic individuals without evidence of AD pathophysiology. The purpose of this study is to understand the discordant biomarker levels among CN and AD using phenotypes from MRI and PET images.MethodWe measured phosphorylated tau 181 (P‐tau181) in plasma from 685 individuals in the Washington Heights Inwood Columbia Aging Project (WHICAP; Mean age = 76.52; women = 64.59%; non‐Hispanic Whites = 29.61%, African Americans = 30.62%; Caribbean Hispanics = 37.30%) and characterized them as biomarker positive based on a ptau181 cutoff of 2.648 pg/mL: 556 cognitively normal (CN, 241 biomarker+), 59 mild cognitively impaired (MCI, 26 biomarker+), and 70 had clinical AD (40 biomarker+). We used MRI (n = 685) and [18F] Florbetaben (FBB) Aβ PET in 167 (24.2%) individuals, and [18F]‐MK‐6420 tau PET 23 (3.36%) individuals) to compare white matter hyperintensity volume (WMH), hippocampus volume, number of silent brain infarcts (SBI), Aβ standard uptake value ratios (SUVR), and tau SUVR among the six biomarker groups (CN‐, CN+, MCI‐, MCI+, AD‐, AD+) with ANCOVA model adjusting for age, sex, and ethnicity.ResultThe AD+ group had larger WMH volume (<jats:italic>P</jats:italic> = 2.81×10<jats:sup>−26</jats:sup>), smaller hippocampus volume (<jats:italic>P</jats:italic> = 5.34×10<jats:sup>−04</jats:sup>), higher Aβ SUVR (<jats:italic>P</jats:italic> = 2.26×10<jats:sup>−03</jats:sup>) and tau SUVR (<jats:italic>P</jats:italic> = 8.11×10<jats:sup>−04</jats:sup>) compared to the CN‐. The AD‐ group had larger WMH volumes (<jats:italic>P</jats:italic> = 1.96×10<jats:sup>−04</jats:sup>) and smaller hippocampal volume (<jats:italic>P</jats:italic> = 0.039) to CN‐. When compared to the AD‐ group, the AD+ group had larger WMH volume (<jats:italic>P</jats:italic> = 4.34×10<jats:sup>−03</jats:sup>). The CN+ group had a larger WMH volume (<jats:italic>P</jats:italic> = 4.17×10<jats:sup>−03</jats:sup>) and smaller hippocampal volume (<jats:italic>P</jats:italic> = 4.13×10<jats:sup>−05</jats:sup>) than CN‐ group. Both MCI+ (<jats:italic>P</jats:italic> = 0.048) and MCI‐ (<jats:italic>P</jats:italic> = 0.022) groups showed smaller hippocampal volume compared with the CN‐ group. Except for hippocampal volume, no other phenotypes demonstrated statistical significance in the MCI+ and MCI‐ groups.ConclusionMRI and PET phenotypes exhibited a strong association with pathophysiological changes in the AD+ group. Specifically, MRI phenotypes such as WMH volume and hippocampal volume could be instrumental in characterizing AD pathophysiology, even with discrepancies in biomarker profiles.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"41 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting the Care Partner Hospital Assessment Tool for Dementia Care","authors":"Beth Fields","doi":"10.1002/alz.085916","DOIUrl":"https://doi.org/10.1002/alz.085916","url":null,"abstract":"BackgroundCare partners commonly support patients living with dementia (PLWD) during and post‐hospitalization, however, they frequently report feeling excluded from care and unprepared for their caregiving tasks. While the evidence‐informed and validated Care Partner Hospital Assessment Tool (CHAT) was designed to better include and prepare family members and friends, it has not yet been adapted for the growing number of care partners supporting PLWD.ObjectiveTo adapt and finalize the CHAT for care partners of hospitalized PLWD.SettingHospitals in the United States.Study PopulationWe selected hospital‐based clinicians who had at least 5 years of professional experience working with PLWD and their family/friends, and care partners who were at least 18 years old and provided support to a PLWD who experienced a hospitalization. A total of 7 clinicians and 5 care partners were recruited. Clinicians were White (100%), female (85%), and represented social work, nursing, occupational therapy, medicine, and pharmacy. Care partners ranged in age from 41 to 73 years, were White (100%), female (100%), and provided support to a mother or mother‐in‐law (30%), spouse/partner (20%), and other relative (50%).MethodsTwo design teams each consisting of clinicians and care partners respectively—were formed to suggest adaptations to CHAT and share satisfaction with the final tool. Teams completed 5 co‐design videoconference sessions, with 2‐3 weeks between each session. Sessions lasted approximately 60 minutes and were audio recorded. The Rapid Identification of Themes from Audio‐recordings method was used to identify suggestions for adaptation between sessions, and thematic analysis was used to code the transcripts in NVivo.ResultsAdaptations to the CHAT included (a) providing options for dementia specific educational resources, (b) identifying power of attorney and care partner roles and responsibilities (c) using more comprehensive response options and simple language. After making adaptations, participants (100%) reported that they were satisfied or very satisfied with the final Dementia CHAT (i.e., D‐CHAT). Participants described the D‐CHAT as ‘empowering’, ‘comprehensive’, ‘collaborative’, and ‘helpful’.ConclusionThe converged‐upon D‐CHAT is ready for feasibility testing in the hospital setting and may help guide clinicians’ inclusion and preparation of care partners of PLWD.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"55 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping culturally sensitive assessment and care for Moroccan migrants with dementia in Spain","authors":"Mohamed Taiebine","doi":"10.1002/alz.086802","DOIUrl":"https://doi.org/10.1002/alz.086802","url":null,"abstract":"BackgroundGiven the context of globalization, epidemiological and health disparities create socio‐cultural barriers to specialized and appropriate care for people living with dementia in non‐Western countries, particularly in Spain, where Moroccan migrants maintain their position as the largest registered foreign community. We aimed to map cultural, clinical, and linguistic challenges and facilitators of dementia assessment and care for this population.MethodsWe investigated articles published in English, Spanish, and Arabic in different medical, allied health, social, and human sciences databases that addressed assessment and care for Moroccan migrants with dementia (MMWD) and their caregivers in Spain. Demographic, epidemiological, clinical, linguistic, socio‐cultural, and socio‐economic features as well as facilitators and barriers to assessment and care were summarized.ResultsThe main findings emphasized the importance of embracing the socio‐cultural values of the host country, as well as maintaining bi‐cultural and bilingual status. The principal challenges included lack of translating and interpreting services, paucity of neurocognitive tools in Moroccan Arabic, and dearth of bi‐cultural and bilingual practitioners, while the facilitators were mainly the training of healthcare staff about dementia and capitalizing on cross‐cultural translation and adaptation of best evidence‐based interventions and assessment tools in dementia in Moroccan Arabic and Spanish.ConclusionsEnabling cultural appreciation, inclusion and cross‐cultural competency should encourage stakeholders, practitioners, caregivers, and clients to respond culturally and linguistically to the unique features of elderly Moroccan Arabic migrants or those who are well‐established as Moroccan‐Spanish citizens. Implementing person‐centered care and culturally salutogenic approaches might erase frontiers in language, care, culture, and place of origin.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"1 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The DICE Approach to Intervene the Behavioral and Psychological Symptoms of Dementia: a Study Protocol","authors":"Yaonan Zheng, Xingyu Zhang, Mengmeng Xia, Huali Wang","doi":"10.1002/alz.093194","DOIUrl":"https://doi.org/10.1002/alz.093194","url":null,"abstract":"BackgroundThe “Describe‐Investigate‐Create‐Evaluate” (DICE) approach has been considered as a guide for managing behavioral and psychological symptoms of dementia (BPSD). However, the implementation of DICE approach may be limited by few available resources. With the development of AI technology, the effectiveness of AI‐aided DICE algorithm for BPSD management has yet to be determined. Therefore, this study aims to examine the effectiveness of the AI‐aided DICE algorithm for managing BPSD in low‐resource setting.MethodsThe cluster randomized controlled trial will be conducted in 12 medical facilities where geriatric psychiatrists are not fully installed. One hundred and eighty‐four persons with mild and moderate BPSD will be enrolled and randomized to the AI‐aided DICE group (n = 92) and usual care group (n = 92). In the AI‐aided DICE group, all participants will receive comprehensive assessment on a digital triage platform to identify individualized needs and target symptoms, be prescribed with personalized management plan based on the AI‐aided decision process, be monitored about the implementation of management plan, and receive follow‐up assessment to evaluate the effectiveness. The neuropsychiatric inventory questionnaire and caregiver burden inventory will be used to measure primary and secondary outcomes. assess caregiver burden, records of care and adverse event. The study duration for each participant will be 12 weeks.DiscussionWe expect that the study will examine the effectiveness of the AI‐aided DICE algorithm for managing BPSD in low‐resource setting. The findings will support the implementation of AI‐aided algorithm and leverage the practice for quality care for dementia.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"9 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}