BackgroundTraining programmes and workshops for Early Career Researchers (ECR) in dementia research are frequently expensive and inaccessible. This means that under resourced institutions, researchers and countries (LMIC) are unable to provide adequate training facilities for researchers focused on analyses for dementia outcomes. The result is that only elite institutions are provided high level training facilities for their researchers and those who are not represented in these institutions are underrepresented. Dementias Platform UK (DPUK) provides free and affordable training opportunities for all academic and industry researchers across the world.MethodThe DPUK training programme includes:1. Datathon workshops which enable researchers from across the world to access large cohort datasets on the DPUK Data Portal and work alongside other global researchers on a dementia‐focused research question.2. Academies for both elementary and advanced longitudinal data analysis are conducted twice a year.3. A 12‐week mentoring programme is provided after the Datathon workshop ‐ led by DPUK and aimed at producing a publishable output from their Datathon attendance.ResultOver 200 researchers across 11 countries have attended the DPUK Training events over the last 5 years.ConclusionProviding affordable or free training for the current and next generation of ECRs is possible by using the resources provided by a Trusted Research Environment (TRE) such as DPUK.
背景：早期职业研究人员（ECR）在痴呆症研究方面的培训项目和讲习班往往昂贵且难以获得。这意味着资源不足的机构、研究人员和国家（LMIC）无法为专注于分析痴呆症结果的研究人员提供足够的培训设施。其结果是，只有精英机构为其研究人员提供高水平的培训设施，而那些在这些机构中没有代表的人则被低估了。英国痴呆症平台（DPUK）为世界各地的学术和行业研究人员提供免费和负担得起的培训机会。方法DPUK培训方案包括：数据马拉松研讨会，使来自世界各地的研究人员能够访问DPUK数据门户网站上的大型队列数据集，并与其他全球研究人员一起研究以痴呆症为重点的研究问题。各院校对初级和高级纵向数据分析每年进行两次。在DPUK领导的数据马拉松研讨会之后，将提供为期12周的指导计划，旨在从他们的数据马拉松出席中产生可发表的产出。结果在过去的5年中，来自11个国家的200多名研究人员参加了DPUK培训活动。结论利用DPUK等可信研究环境（Trusted Research Environment， TRE）提供的资源，为当前和下一代ecr提供负担得起或免费的培训是可能的。
{"title":"Democratising Early Career Researcher (ECR) Training for Dementia Research","authors":"Sarah Bauermeister","doi":"10.1002/alz.093305","DOIUrl":"https://doi.org/10.1002/alz.093305","url":null,"abstract":"BackgroundTraining programmes and workshops for Early Career Researchers (ECR) in dementia research are frequently expensive and inaccessible. This means that under resourced institutions, researchers and countries (LMIC) are unable to provide adequate training facilities for researchers focused on analyses for dementia outcomes. The result is that only elite institutions are provided high level training facilities for their researchers and those who are not represented in these institutions are underrepresented. Dementias Platform UK (DPUK) provides free and affordable training opportunities for all academic and industry researchers across the world.MethodThe DPUK training programme includes:1. Datathon workshops which enable researchers from across the world to access large cohort datasets on the DPUK Data Portal and work alongside other global researchers on a dementia‐focused research question.2. Academies for both elementary and advanced longitudinal data analysis are conducted twice a year.3. A 12‐week mentoring programme is provided after the Datathon workshop ‐ led by DPUK and aimed at producing a publishable output from their Datathon attendance.ResultOver 200 researchers across 11 countries have attended the DPUK Training events over the last 5 years.ConclusionProviding affordable or free training for the current and next generation of ECRs is possible by using the resources provided by a Trusted Research Environment (TRE) such as DPUK.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"14 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940416","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}
Louisa I. Thompson, Molly Lawrence, Jennifer A Rosenbaum, Stephanie Czech, David C Anthony, Rabin F Chandran, Arnold R Goldberg, Andrey Vyshedskiy, Anashua R Elwy, Charles B Eaton
BackgroundNew immunotherapies for early‐stage Alzheimer’s disease (AD) have ushered in fresh hope for AD research and clinical care, but also highlight barriers to AD screening and timely diagnosis in the US. Digital cognitive assessments could potentially streamline screening and referrals for AD treatment and/or clinical trials. We report preliminary data on the feasibility and acceptability of three digital cognitive approaches for older adults completing Annual Wellness or routine follow‐up visits with a primary care provider (PCP).MethodsData were collected for an ongoing primary care‐based study in Rhode Island. Cognitive screening approaches included: 1) remote online screening with the Boston Online Cognitive Assessment (BOCA) prior to the PCP appointment, 2) self‐administered screening with the BOCA in the waiting room immediately before or after the appointment, and 3) provider‐administered screening during the appointment using the Digital Clock and Recall (Linus Health DCRTM). Participants also completed a 30‐minute, in‐clinic cognitive health consultation including the Montreal Cognitive Assessment (as a reference standard) to receive feedback and referral options. Five PCPs aided in protocol development through focus groups and participated in data collection. Potential participants were identified via EMR. Recruitment included mailings, MyChart messages and phone calls, and direct referrals from PCPs. Exclusion criteria: dementia or other neurological disease, score of <13 on the telephone version of the MoCA.Results34 older adults were screened, 23 enrolled, and 2 withdrew. The sample is currently 52% female, 81% White, and mean age is 66. Most participants completed remote BOCA screening on a smartphone. Most reported that they preferred screening at home compared to in the clinic. 11 out of 11 participants completed at least one instance of the BOCA screening online prior to their PCP appointment. DCR tablet screening was successful in 9 out of 11 PCP appointments. PCP time constraints and technological issues were reasons for incomplete administration. In‐clinic self‐administered BOCA screening was discontinued due to space and time constraints, and the lack of a designated coordinator onsite.ConclusionsBoth remote online screening and tablet‐based, provider‐administered screening in‐clinic may be feasible and acceptable approaches to cognitive screening for older adults in primary care.
早期阿尔茨海默病（AD）的新免疫疗法为阿尔茨海默病的研究和临床护理带来了新的希望，但也凸显了美国阿尔茨海默病筛查和及时诊断的障碍。数字认知评估可能会简化阿尔茨海默病治疗和/或临床试验的筛选和转诊。我们报告了三种数字认知方法的可行性和可接受性的初步数据，用于老年人完成年度健康或与初级保健提供者（PCP）的常规随访。方法收集罗德岛州正在进行的一项基于初级保健的研究的数据。认知筛查方法包括：1)在PCP预约之前使用波士顿在线认知评估（BOCA）进行远程在线筛查，2)在预约之前或之后在候诊室使用BOCA进行自我筛查，以及3)在预约期间使用数字时钟和回忆（Linus Health DCRTM）进行提供者管理的筛查。参与者还完成了30分钟的临床认知健康咨询，包括蒙特利尔认知评估（作为参考标准），以获得反馈和转诊选择。五个pcp通过焦点小组协助制定方案并参与数据收集。通过电子病历确定潜在参与者。招聘方式包括邮寄、MyChart信息和电话，以及从pcp直接推荐。排除标准：痴呆或其他神经系统疾病，MoCA电话版评分≥13分。结果筛选34名老年人，23人入组，2人退出。目前样本中52%为女性，81%为白人，平均年龄为66岁。大多数参与者通过智能手机完成远程BOCA筛查。大多数人报告说，与在诊所相比，他们更喜欢在家里进行筛查。11名参与者中有11人在预约PCP之前至少完成了一次在线BOCA筛查。DCR片剂筛选在11个PCP预约中有9个成功。PCP时间限制和技术问题是不完全给药的原因。由于空间和时间的限制，临床自我管理的BOCA筛查被终止，并且缺乏指定的现场协调员。结论：远程在线筛查和基于片剂的、由提供者管理的临床筛查可能是初级保健老年人认知筛查的可行和可接受的方法。
{"title":"Feasibility and Acceptability of Digital Cognitive Screening Approaches for Older Adults in Primary Care","authors":"Louisa I. Thompson, Molly Lawrence, Jennifer A Rosenbaum, Stephanie Czech, David C Anthony, Rabin F Chandran, Arnold R Goldberg, Andrey Vyshedskiy, Anashua R Elwy, Charles B Eaton","doi":"10.1002/alz.092820","DOIUrl":"https://doi.org/10.1002/alz.092820","url":null,"abstract":"BackgroundNew immunotherapies for early‐stage Alzheimer’s disease (AD) have ushered in fresh hope for AD research and clinical care, but also highlight barriers to AD screening and timely diagnosis in the US. Digital cognitive assessments could potentially streamline screening and referrals for AD treatment and/or clinical trials. We report preliminary data on the feasibility and acceptability of three digital cognitive approaches for older adults completing Annual Wellness or routine follow‐up visits with a primary care provider (PCP).MethodsData were collected for an ongoing primary care‐based study in Rhode Island. Cognitive screening approaches included: 1) remote online screening with the Boston Online Cognitive Assessment (BOCA) prior to the PCP appointment, 2) self‐administered screening with the BOCA in the waiting room immediately before or after the appointment, and 3) provider‐administered screening during the appointment using the Digital Clock and Recall (Linus Health DCR<jats:sup>TM</jats:sup>). Participants also completed a 30‐minute, in‐clinic cognitive health consultation including the Montreal Cognitive Assessment (as a reference standard) to receive feedback and referral options. Five PCPs aided in protocol development through focus groups and participated in data collection. Potential participants were identified via EMR. Recruitment included mailings, MyChart messages and phone calls, and direct referrals from PCPs. Exclusion criteria: dementia or other neurological disease, score of <13 on the telephone version of the MoCA.Results34 older adults were screened, 23 enrolled, and 2 withdrew. The sample is currently 52% female, 81% White, and mean age is 66. Most participants completed remote BOCA screening on a smartphone. Most reported that they preferred screening at home compared to in the clinic. 11 out of 11 participants completed at least one instance of the BOCA screening online prior to their PCP appointment. DCR tablet screening was successful in 9 out of 11 PCP appointments. PCP time constraints and technological issues were reasons for incomplete administration. In‐clinic self‐administered BOCA screening was discontinued due to space and time constraints, and the lack of a designated coordinator onsite.ConclusionsBoth remote online screening and tablet‐based, provider‐administered screening in‐clinic may be feasible and acceptable approaches to cognitive screening for older adults in primary care.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"13 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936712","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}
Tammi Albrecht, Sarah Endicott, Kristen E Kehl‐Floberg, Molly Schroeder, Noelia Sayavedra, Jane Mahoney, Cynthia M. Carlsson, Art Walaszek
BackgroundThe majority of persons living with moderate to severe dementia live in their homes despite the challenges of increasing care needs as dementia progresses. Caregivers are not prepared to understand and manage common medical concerns, such as incontinence, dehydration, and impaired mobility. Health care clinicians need training and tools to better prepare caregivers for these responsibilities. The goal of this program was to address this need by developing an educational program for home health clinicians who treat and support persons living with moderate to severe dementia in their homes.MethodsParticipants included registered nurses, physical therapists, occupational therapists, speech therapists, and social workers from two home health agencies. Trainings were held throughout a two‐year period. Outcomes measured included clinician knowledge, attitudes, and self‐efficacy gathered via surveys at baseline, immediately after training, and six‐months post‐training. Outcomes measured also included caregiver burden, caregiver self‐efficacy, and use of medical services and community resources gathered via surveys at baseline and six‐months post‐training.ResultsTwenty‐one clinicians were trained; 19 completed the baseline survey and 11 completed the post‐training survey. The clinicians implemented the caregiver training with 29 caregivers; 24 completed the baseline survey and 11 completed the six‐month post‐training survey. Clinicians demonstrated improvements in knowledge and self‐efficacy post‐training. Clinicians experienced significant improvements in attitudes as measured by the Dementia Attitudes Scale post‐training, especially in comfort and familiarity with caring for persons living with dementia. Caregivers reported similar levels of caregiver burden and self‐efficiency at baseline and six‐months post‐training. Caregivers reported overall satisfaction with the training they received from home health clinicians.ConclusionPersons living with dementia and their caregivers are impacted by changes in cognition, function, and physical health as dementia progresses. Home health clinicians are well‐positioned to help address these needs. The training provided to clinicians led to improvement in attitudes and confidence in the care of persons with dementia. Family caregivers reported a high level of satisfaction with the training; however, a small sample size and the effects of the COVID‐19 pandemic affected the ability to identify changes in caregiver burden, caregiver self‐efficacy, and use of medical and social services.
{"title":"Preparing home health clinicians to educate caregivers of persons living with dementia","authors":"Tammi Albrecht, Sarah Endicott, Kristen E Kehl‐Floberg, Molly Schroeder, Noelia Sayavedra, Jane Mahoney, Cynthia M. Carlsson, Art Walaszek","doi":"10.1002/alz.087818","DOIUrl":"https://doi.org/10.1002/alz.087818","url":null,"abstract":"BackgroundThe majority of persons living with moderate to severe dementia live in their homes despite the challenges of increasing care needs as dementia progresses. Caregivers are not prepared to understand and manage common medical concerns, such as incontinence, dehydration, and impaired mobility. Health care clinicians need training and tools to better prepare caregivers for these responsibilities. The goal of this program was to address this need by developing an educational program for home health clinicians who treat and support persons living with moderate to severe dementia in their homes.MethodsParticipants included registered nurses, physical therapists, occupational therapists, speech therapists, and social workers from two home health agencies. Trainings were held throughout a two‐year period. Outcomes measured included clinician knowledge, attitudes, and self‐efficacy gathered via surveys at baseline, immediately after training, and six‐months post‐training. Outcomes measured also included caregiver burden, caregiver self‐efficacy, and use of medical services and community resources gathered via surveys at baseline and six‐months post‐training.ResultsTwenty‐one clinicians were trained; 19 completed the baseline survey and 11 completed the post‐training survey. The clinicians implemented the caregiver training with 29 caregivers; 24 completed the baseline survey and 11 completed the six‐month post‐training survey. Clinicians demonstrated improvements in knowledge and self‐efficacy post‐training. Clinicians experienced significant improvements in attitudes as measured by the Dementia Attitudes Scale post‐training, especially in comfort and familiarity with caring for persons living with dementia. Caregivers reported similar levels of caregiver burden and self‐efficiency at baseline and six‐months post‐training. Caregivers reported overall satisfaction with the training they received from home health clinicians.ConclusionPersons living with dementia and their caregivers are impacted by changes in cognition, function, and physical health as dementia progresses. Home health clinicians are well‐positioned to help address these needs. The training provided to clinicians led to improvement in attitudes and confidence in the care of persons with dementia. Family caregivers reported a high level of satisfaction with the training; however, a small sample size and the effects of the COVID‐19 pandemic affected the ability to identify changes in caregiver burden, caregiver self‐efficacy, and use of medical and social services.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"204 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936713","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}
Anna R. Schönberger, Annika Steinmetz, Ann‐Katrin Schild, Lucrezia Hausner, Gloria Spielmann‐Benson, Lutz Frölich, Frank Jessen
BackgroundValue‐based healthcare (VBHC) is a novel concept derived from economic research which is recently implemented in various medical departments and facilities. Additionally to an improvement of patient care, it postulates a reduction of expenses by providing patients with what they really need. Value in this context is defined as outcomes achieved for patients relative to the required costs. In VBHC collecting patient‐reported outcome measures (PROM) and patient‐reported experience measures (PREM) is essential to clarify patients’ needs. According to the VBHC approach, a modification of patient care based on PROM and PREM achieves a higher value and more efficient treatment for patients.We have implemented the VBHC approach at two German memory clinics to test its applicability in this novel setting. We expect to gain concrete aspects for improving the diagnostic process for patients, relatives, and employees.MethodsIn each memory clinic we interviewed 25 patient‐relative dyads with regard to PREM and PROM. In addition, we conducted an employee survey about current problems and potential suggestions for improvement. Based on these results, respective modifications of the diagnostic process took place in both memory clinics. Thereafter a second evaluation, interviewing another set of 25 dyads was carried out.ResultsIn the first evaluation the majority of patients of both memory clinics quoted the length of the diagnostic process as main negative experience. The duration from the first visit to the final diagnosis took several months which was experienced as highly stressful for patients and their relatives. Hence, the diagnostic process was shortened to a duration of approx. 3‐4 weeks. In the second evaluation preliminary data indicate a significantly better experience of patients and family members with the diagnostic process (PREM) after modification. Other aspects reported by patients, relatives as well as employees offer additional perspectives for improvement.ConclusionsThis is the first study implementing the VBHC approach in a memory clinic setting. We found that VBHC can indeed improve patient care and may contribute in establishing a standardized and optimized procedure in the diagnostic processes.
{"title":"How value‐based healthcare can improve the work of memory clinics","authors":"Anna R. Schönberger, Annika Steinmetz, Ann‐Katrin Schild, Lucrezia Hausner, Gloria Spielmann‐Benson, Lutz Frölich, Frank Jessen","doi":"10.1002/alz.089190","DOIUrl":"https://doi.org/10.1002/alz.089190","url":null,"abstract":"BackgroundValue‐based healthcare (VBHC) is a novel concept derived from economic research which is recently implemented in various medical departments and facilities. Additionally to an improvement of patient care, it postulates a reduction of expenses by providing patients with what they really need. Value in this context is defined as outcomes achieved for patients relative to the required costs. In VBHC collecting patient‐reported outcome measures (PROM) and patient‐reported experience measures (PREM) is essential to clarify patients’ needs. According to the VBHC approach, a modification of patient care based on PROM and PREM achieves a higher value and more efficient treatment for patients.We have implemented the VBHC approach at two German memory clinics to test its applicability in this novel setting. We expect to gain concrete aspects for improving the diagnostic process for patients, relatives, and employees.MethodsIn each memory clinic we interviewed 25 patient‐relative dyads with regard to PREM and PROM. In addition, we conducted an employee survey about current problems and potential suggestions for improvement. Based on these results, respective modifications of the diagnostic process took place in both memory clinics. Thereafter a second evaluation, interviewing another set of 25 dyads was carried out.ResultsIn the first evaluation the majority of patients of both memory clinics quoted the length of the diagnostic process as main negative experience. The duration from the first visit to the final diagnosis took several months which was experienced as highly stressful for patients and their relatives. Hence, the diagnostic process was shortened to a duration of approx. 3‐4 weeks. In the second evaluation preliminary data indicate a significantly better experience of patients and family members with the diagnostic process (PREM) after modification. Other aspects reported by patients, relatives as well as employees offer additional perspectives for improvement.ConclusionsThis is the first study implementing the VBHC approach in a memory clinic setting. We found that VBHC can indeed improve patient care and may contribute in establishing a standardized and optimized procedure in the diagnostic processes.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"48 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936884","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}
Julie A Saugstad, Ursula S Sandau, Jack Wiedrick, Trevor J. McFarland, Douglas R. Galasko, Joseph F Quinn
BackgroundAlzheimer’s disease (AD) is the most common cause of dementia, and the fifth leading cause of death for those 65 and older. Brain changes in AD begin 10‐20 years before symptoms appear, yet markers for early brain changes are lacking. We discovered and validated miRNAs in human cerebrospinal fluid (CSF) that differentiate AD from Controls. However, as blood is a preferred biofluid for biomarker profiling, we evaluated 1) the intraindividual longitudinal stability of human miRNAs in plasma, then 2) expression of the CSF AD miRNAs in plasma.MethodFor the longitudinal stability study, blood was collected by venipuncture biweekly over 3 months from 22 donors who had fasted overnight. For the CSF‐plasma miRNA correlation, we obtained 320 donor‐ and date‐ matched CSF and plasma AD and Control samples from the AD Neuroimaging Initiative. We isolated total RNA from 1) 200 µL of platelet‐free plasma or 2) 250 µL of CSF and plasma. MiRNA expression was assessed by qPCR using custom TaqMan human arrays. All studies were approved by OHSU IRB00009707.Result1) For the longitudinal stability study, of 134 miRNAs amplified, 74 had high test‐retest reliability and low percentage level drift. Importantly, 13 candidate miRNA biomarkers for AD were stable in plasma over 3 months, and we found that hemolysis and tobacco use had the greatest impact on miRNA levels and variance. 2) For the CSF‐plasma study, the data revealed that individual plasma miRNAs are more predictive than CSF for AD, and a combination of plasma miRNAs are more predictive for AD than CSF. In addition, the highest‐probability plasma model for AD contains 2 complementary miRNAs, one positive (increased log fold change in expression), and one negative for fold change (decreased log fold change in expression).ConclusionThese studies revealed plasma miRNAs that are stable over the 3‐month time, including candidate AD biomarkers. They also revealed miRNAs that are not stable over the 3‐month time, including miRNAs previously reported as biomarkers AD. In addition, the CSF‐plasma studies validated that AD CSF miRNAs differentiate AD from Controls in plasma, supporting the use of plasma for further development of AD miRNA biomarkers for clinical assays.
阿尔茨海默病（AD）是痴呆症最常见的原因，也是65岁及以上人群的第五大死因。阿尔茨海默病的大脑变化在症状出现前10 - 20年就开始了，但缺乏早期大脑变化的标志物。我们发现并验证了人脑脊液（CSF）中区分AD与对照组的miRNAs。然而，由于血液是生物标志物分析的首选生物流体，我们评估了1)血浆中人类miRNAs的个体纵向稳定性，然后评估了2)血浆中CSF AD miRNAs的表达。方法对22例禁食过夜的献血者进行纵向稳定性研究，每两周静脉穿刺采血，为期3个月。为了研究脑脊液与血浆miRNA的相关性，我们从阿尔茨海默病神经成像倡议组织获得了320份供体和日期匹配的脑脊液和血浆阿尔茨海默病和对照样本。我们从1)200µL无血小板血浆或2)250µL脑脊液和血浆中分离总RNA。使用自定义的TaqMan人阵列，通过qPCR评估MiRNA表达。结果1)在纵向稳定性研究中，扩增的134个mirna中，74个具有高测试-重测信度和低水平漂移百分比。重要的是，13种AD候选miRNA生物标志物在血浆中稳定超过3个月，我们发现溶血和吸烟对miRNA水平和方差的影响最大。2)对于脑脊液-血浆研究，数据显示单个血浆mirna比脑脊液更能预测AD，血浆mirna组合比脑脊液更能预测AD。此外，AD的最高概率血浆模型包含2个互补mirna，一个为阳性（表达增加对数倍变化），一个为阴性（表达减少对数倍变化）。这些研究揭示了血浆mirna在3个月的时间内是稳定的，包括候选AD生物标志物。他们还揭示了在3个月的时间内不稳定的mirna，包括先前报道的作为AD生物标志物的mirna。此外，CSF -血浆研究证实了AD CSF miRNA在血浆中区分AD和对照，支持血浆进一步开发用于临床分析的AD miRNA生物标志物。
{"title":"Validation that miRNAs altered in Alzheimer’s disease in human cerebrospinal fluid also function as miRNA biomarkers for Alzheimer’s disease in human plasma","authors":"Julie A Saugstad, Ursula S Sandau, Jack Wiedrick, Trevor J. McFarland, Douglas R. Galasko, Joseph F Quinn","doi":"10.1002/alz.094980","DOIUrl":"https://doi.org/10.1002/alz.094980","url":null,"abstract":"BackgroundAlzheimer’s disease (AD) is the most common cause of dementia, and the fifth leading cause of death for those 65 and older. Brain changes in AD begin 10‐20 years before symptoms appear, yet markers for early brain changes are lacking. We discovered and validated miRNAs in human cerebrospinal fluid (CSF) that differentiate AD from Controls. However, as blood is a preferred biofluid for biomarker profiling, we evaluated 1) the intraindividual longitudinal stability of human miRNAs in plasma, then 2) expression of the CSF AD miRNAs in plasma.MethodFor the longitudinal stability study, blood was collected by venipuncture biweekly over 3 months from 22 donors who had fasted overnight. For the CSF‐plasma miRNA correlation, we obtained 320 donor‐ and date‐ matched CSF and plasma AD and Control samples from the AD Neuroimaging Initiative. We isolated total RNA from 1) 200 µL of platelet‐free plasma or 2) 250 µL of CSF and plasma. MiRNA expression was assessed by qPCR using custom TaqMan human arrays. All studies were approved by OHSU IRB00009707.Result1) For the longitudinal stability study, of 134 miRNAs amplified, 74 had high test‐retest reliability and low percentage level drift. Importantly, 13 candidate miRNA biomarkers for AD were stable in plasma over 3 months, and we found that hemolysis and tobacco use had the greatest impact on miRNA levels and variance. 2) For the CSF‐plasma study, the data revealed that individual plasma miRNAs are more predictive than CSF for AD, and a combination of plasma miRNAs are more predictive for AD than CSF. In addition, the highest‐probability plasma model for AD contains 2 complementary miRNAs, one positive (increased log fold change in expression), and one negative for fold change (decreased log fold change in expression).ConclusionThese studies revealed plasma miRNAs that are stable over the 3‐month time, including candidate AD biomarkers. They also revealed miRNAs that are not stable over the 3‐month time, including miRNAs previously reported as biomarkers AD. In addition, the CSF‐plasma studies validated that AD CSF miRNAs differentiate AD from Controls in plasma, supporting the use of plasma for further development of AD miRNA biomarkers for clinical assays.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"85 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936891","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}
Julie D Ries, Claudia De Santis, Kaoutar Ouabicha, Mahederemariam Bayleyegn Dagne, Pallavi Sood, Patricia C Heyn
BackgroundExercise as an intervention to impact cognition in older adults with mild cognitive impairment and dementia is a well‐studied phenomenon. Recent proliferation of synthesis studies on this topic might be perceived as a positive contribution to the science of exercise as medicine, but research redundancy (defined here as multiple overlapping review studies utilizing the same randomized controlled trials [RCTs]) is not only unnecessary but can be harmful. Redundancy can create research waste and be detrimental to the ability to draw confident conclusions from the evidence. The purposes of this meta‐research are to (1) evaluate redundant representation of RCTs across published meta‐analyses (MAs) on the effects of exercise on older adults with cognitive impairment, and (2) discuss implications for interpretation of the evidence.MethodThis study was borne of a living evidence synthesis project, following standard synthesis methodology including PROSPERO registration, PRISMA guidelines, librarian‐assisted search strategy using multiple databases, and recurrent searches in 2015, 2018, 2020, and 2023.ResultThirty‐eight MAs met our inclusion criteria, referencing a total of 692 RCTs. Of the 692 studies cited in the MAs, only 267 (38.6%) are unique studies. One‐hundred‐forty‐nine of those unique studies were cited in only one MA, and 118 were cited in anywhere between 2‐17 different MAs. Thus, 425 (61.4%) of the total 692 RCTs recognized across the 38 MAs were redundant. Categorized by the number of MAs in which a study was represented, 37 RCTs (13.9%) were included in 2 MAs, 48 (18%) were represented in 3‐5 MAs, 26 (9.7%) were in 6‐10 MAs, and 7 of the unique studies (2.6%) were represented in 11‐17 MAs.ConclusionThe impact of exercise on cognition of older adults with cognitive impairment is an important topic being extensively researched. While replication is a common practice in research, excessive redundancy in research does not provide new contributions and may be wasteful. Additionally, there are negative implications for meaningful interpretation of evidence when there is significant redundancy across publications. Efforts to reduce research waste might include rigorous research protocol registration requirements and the use of artificial intelligence to aid in monitoring protocols and publications.
{"title":"Redundancy in systematic research of exercise interventions for older adults with cognitive impairment: Is more better?","authors":"Julie D Ries, Claudia De Santis, Kaoutar Ouabicha, Mahederemariam Bayleyegn Dagne, Pallavi Sood, Patricia C Heyn","doi":"10.1002/alz.095504","DOIUrl":"https://doi.org/10.1002/alz.095504","url":null,"abstract":"BackgroundExercise as an intervention to impact cognition in older adults with mild cognitive impairment and dementia is a well‐studied phenomenon. Recent proliferation of synthesis studies on this topic might be perceived as a positive contribution to the science of exercise as medicine, but research redundancy (defined here as multiple overlapping review studies utilizing the same randomized controlled trials [RCTs]) is not only unnecessary but can be harmful. Redundancy can create research waste and be detrimental to the ability to draw confident conclusions from the evidence. The purposes of this meta‐research are to (1) evaluate redundant representation of RCTs across published meta‐analyses (MAs) on the effects of exercise on older adults with cognitive impairment, and (2) discuss implications for interpretation of the evidence.MethodThis study was borne of a living evidence synthesis project, following standard synthesis methodology including PROSPERO registration, PRISMA guidelines, librarian‐assisted search strategy using multiple databases, and recurrent searches in 2015, 2018, 2020, and 2023.ResultThirty‐eight MAs met our inclusion criteria, referencing a total of 692 RCTs. Of the 692 studies cited in the MAs, only 267 (38.6%) are unique studies. One‐hundred‐forty‐nine of those unique studies were cited in only one MA, and 118 were cited in anywhere between 2‐17 different MAs. Thus, 425 (61.4%) of the total 692 RCTs recognized across the 38 MAs were redundant. Categorized by the number of MAs in which a study was represented, 37 RCTs (13.9%) were included in 2 MAs, 48 (18%) were represented in 3‐5 MAs, 26 (9.7%) were in 6‐10 MAs, and 7 of the unique studies (2.6%) were represented in 11‐17 MAs.ConclusionThe impact of exercise on cognition of older adults with cognitive impairment is an important topic being extensively researched. While replication is a common practice in research, excessive redundancy in research does not provide new contributions and may be wasteful. Additionally, there are negative implications for meaningful interpretation of evidence when there is significant redundancy across publications. Efforts to reduce research waste might include rigorous research protocol registration requirements and the use of artificial intelligence to aid in monitoring protocols and publications.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"82 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142937000","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}
Morgan Elizabeth Lambert, Paulino Ramirez, Wenyan Sun, Bess Frost
BackgroundRetrotransposon‐derived extrachromosomal circular DNA (eccDNA) was extracted and sequenced from brains with Alzheimer’s disease, progressive supranuclear palsy, or healthy controls. Retrotransposon‐derived DNA was visualized outside of the nucleus in these phenotypes with phospho‐STING. Drosophila were used as a model to study extranuclear retrotransposon DNA.MethodDNA was extracted from post‐mortem human patients with AD (n = 6), PSP (FTD) (n = 6), or no pathology (n = 6). The DNA was treated with exonucleases to degrade linear DNA and the circular DNA was isolated. Post‐mortem cryosections of AD, PSP, or healthy control brains were used for fluorescent in‐situ hybridization (FISH) of retrotransposon sequences. Co‐immunofluorescence of phospho‐STING was performed on FISH tissue. Drosophila brains were also used for FISH of retrotransposons. Digital qPCR was used to measure copy number of retrotransposons in human and fly tissue.ResultPreliminary data suggests an increase in phospho‐STING in AD and PSP brains compared to controls. Preliminary data also suggests an enrichment of retrotransposon DNA in circular DNA sequencing in tau pathology compared to controls.ConclusionRetrotransposon‐derived eccDNA may be an activator of the cGAS‐STING pathway in AD and PSP.
{"title":"Investigating retrotransposon‐derived eccDNA as a source of innate immune activation in tauopathy","authors":"Morgan Elizabeth Lambert, Paulino Ramirez, Wenyan Sun, Bess Frost","doi":"10.1002/alz.094614","DOIUrl":"https://doi.org/10.1002/alz.094614","url":null,"abstract":"BackgroundRetrotransposon‐derived extrachromosomal circular DNA (eccDNA) was extracted and sequenced from brains with Alzheimer’s disease, progressive supranuclear palsy, or healthy controls. Retrotransposon‐derived DNA was visualized outside of the nucleus in these phenotypes with phospho‐STING. <jats:italic>Drosophila</jats:italic> were used as a model to study extranuclear retrotransposon DNA.MethodDNA was extracted from post‐mortem human patients with AD (n = 6), PSP (FTD) (n = 6), or no pathology (n = 6). The DNA was treated with exonucleases to degrade linear DNA and the circular DNA was isolated. Post‐mortem cryosections of AD, PSP, or healthy control brains were used for fluorescent in‐situ hybridization (FISH) of retrotransposon sequences. Co‐immunofluorescence of phospho‐STING was performed on FISH tissue. <jats:italic>Drosophila</jats:italic> brains were also used for FISH of retrotransposons. Digital qPCR was used to measure copy number of retrotransposons in human and fly tissue.ResultPreliminary data suggests an increase in phospho‐STING in AD and PSP brains compared to controls. Preliminary data also suggests an enrichment of retrotransposon DNA in circular DNA sequencing in tau pathology compared to controls.ConclusionRetrotransposon‐derived eccDNA may be an activator of the cGAS‐STING pathway in AD and PSP.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"35 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936632","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}
sang Geun Kim, Yunyeong Jeong, chae Yeon Hwang, Kang‐Hyun Park
BackgroundParticipation in various social activities of elderly has a significant impact on overall health and quality of life, including physical and metal health. Therefore, in this study, we aim to analyze the types of social activity participation among community‐dwelling elderly and examine differences in characteristics, health status, and quality of life according to these types of participation of social activities. Thus, we purpose to utilize the findings of this study as a foundation basis for research aimed at promoting services and intervention related to social activities of elderly in community.MethodThis study utilized the 9th wave (2022) panel data from the Korean Longitudinal Study of Elderly Employment(KLoSA). Latent class analysis was utilized to explore types of social activities. To assess the goodness of fit of the latent model, χ² (Chi‐square) test, Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), Sample‐Size Adjusted Bayesian Information Criteria (SABIC) indices, and Lo‐Mendell‐Rubin adjusted Likelihood Ratio Test (LMR‐LRT) were employed. One‐way ANOVA was conducted to examine characteristics across different types.ResultThe study included a total of 6,057 elderly individuals aged 60 and above residing in the local community for analysis. The results demonstrate four distinct types of social activity participation among the elderly. These four groups were named based on the types of social activities they engaged in: “Religious and Social Activity Centered,” “Social and Leisure Activity Centered,” “Social Activity Centered,” and “Inactive.” The analysis of characteristics across these types showed statistically significant differences in demographic factors such as age, marital status, and religion. In terms of health‐related aspects, subjective health and overall quality of life indices exhibited statistically significant differences among the types.ConclusionSocial activities among the elderly were analyzed into four distinct types based on the activities they engaged in. The participation of elderly individuals in various social activities is considered a crucial indicator for improving health and quality of life. It is hoped that this study will serve as a foundational basis for developing services and intervention programs for elderly individuals in the community, aimed at facilitating their participation in diverse social activities.
{"title":"Analysis of the types of social activity participation of older adults living in the community and the health level and quality of life by types: Applying Latent Class Analysis","authors":"sang Geun Kim, Yunyeong Jeong, chae Yeon Hwang, Kang‐Hyun Park","doi":"10.1002/alz.094765","DOIUrl":"https://doi.org/10.1002/alz.094765","url":null,"abstract":"BackgroundParticipation in various social activities of elderly has a significant impact on overall health and quality of life, including physical and metal health. Therefore, in this study, we aim to analyze the types of social activity participation among community‐dwelling elderly and examine differences in characteristics, health status, and quality of life according to these types of participation of social activities. Thus, we purpose to utilize the findings of this study as a foundation basis for research aimed at promoting services and intervention related to social activities of elderly in community.MethodThis study utilized the 9th wave (2022) panel data from the Korean Longitudinal Study of Elderly Employment(KLoSA). Latent class analysis was utilized to explore types of social activities. To assess the goodness of fit of the latent model, χ² (Chi‐square) test, Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), Sample‐Size Adjusted Bayesian Information Criteria (SABIC) indices, and Lo‐Mendell‐Rubin adjusted Likelihood Ratio Test (LMR‐LRT) were employed. One‐way ANOVA was conducted to examine characteristics across different types.ResultThe study included a total of 6,057 elderly individuals aged 60 and above residing in the local community for analysis. The results demonstrate four distinct types of social activity participation among the elderly. These four groups were named based on the types of social activities they engaged in: “Religious and Social Activity Centered,” “Social and Leisure Activity Centered,” “Social Activity Centered,” and “Inactive.” The analysis of characteristics across these types showed statistically significant differences in demographic factors such as age, marital status, and religion. In terms of health‐related aspects, subjective health and overall quality of life indices exhibited statistically significant differences among the types.ConclusionSocial activities among the elderly were analyzed into four distinct types based on the activities they engaged in. The participation of elderly individuals in various social activities is considered a crucial indicator for improving health and quality of life. It is hoped that this study will serve as a foundational basis for developing services and intervention programs for elderly individuals in the community, aimed at facilitating their participation in diverse social activities.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"28 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142937001","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}
Shivangi Jain, Alina Lesnovskaya, Lu Wan, Cristina Molina‐Hidalgo, Haiqing Huang, Anna Marsland, George Grove, Lauren Oberlin, Chaeryon Kang, Arthur Kramer, Charles Hillman, Edward McAuley, Jeffrey M Burns, Eric D Vidoni, Brad Sutton, Kirk I. Erickson
BackgroundAging is associated with heightened systemic inflammation, decline in selective aspects of cognition, and an increase in white matter lesions (WMLs). Both WMLs and systemic inflammation have been related to cognition. However, it is not clear how they interdependently relate to cognitive aging. In this study we examined whether WMLs mediate the relation between markers of systemic inflammation and cognition in late adulthood.MethodBaseline data from the randomized clinical trial “Investigating Gains in Neurocognition in an Intervention Trial of Exercise” (IGNITE) were used, which included 598 healthy older adults (mean age=69.9±3.75 years). Interleukin 6 (IL‐6) and Tumor Necrosis Factor Alpha (TNF‐α) were included as markers of systemic inflammation. A confirmatory factor analysis of cognitive performance resulted in factors measuring episodic memory (EM), processing speed (PS), working memory (WM), attentional control (AC), and visuospatial function (VF). WML volumes were computed from FLAIR and T1 scans using UBO detector. Mediation models were run with age, sex, years of education, and study site included as covariates.ResultHigher levels of IL‐6 were associated with more WMLs (b = 0.12, p < 0.001) as well as lower scores on all cognitive factors (all p < 0.03). In contrast, higher levels of TNF‐ α were associated with more WMLs (b = 0.10, p < 0.05) but not with any of the cognitive measures (all p > 0.3). More WMLs were associated with poorer PS, WM, AC, and VF (all p < 0.03), but not EM (all p > 0.05). Further, associations between IL‐6 and measures of PS, WM, AC, and VF were statistically mediated by WMLs (all b = ‐0.01, all p < 0.05).ConclusionThese findings suggest that markers of systemic inflammation might lead to poorer cognitive performance by impacting WMLs. The differences between IL‐6 and TNF‐α with cognition highlight the need for more research to understand how different cytokine pathways relate to cognition. Our results are important for building a mechanistic framework to understand the interplay between inflammation, WMLs, and cognition and could inform the development of targeted interventions focusing on regulating cytokines to support brain health and cognitive aging.
{"title":"Relation Between Markers of Systemic Inflammation, White Matter Lesions, and Cognitive Performance in Late Adulthood","authors":"Shivangi Jain, Alina Lesnovskaya, Lu Wan, Cristina Molina‐Hidalgo, Haiqing Huang, Anna Marsland, George Grove, Lauren Oberlin, Chaeryon Kang, Arthur Kramer, Charles Hillman, Edward McAuley, Jeffrey M Burns, Eric D Vidoni, Brad Sutton, Kirk I. Erickson","doi":"10.1002/alz.087429","DOIUrl":"https://doi.org/10.1002/alz.087429","url":null,"abstract":"BackgroundAging is associated with heightened systemic inflammation, decline in selective aspects of cognition, and an increase in white matter lesions (WMLs). Both WMLs and systemic inflammation have been related to cognition. However, it is not clear how they interdependently relate to cognitive aging. In this study we examined whether WMLs mediate the relation between markers of systemic inflammation and cognition in late adulthood.MethodBaseline data from the randomized clinical trial “Investigating Gains in Neurocognition in an Intervention Trial of Exercise” (IGNITE) were used, which included 598 healthy older adults (mean age=69.9±3.75 years). Interleukin 6 (IL‐6) and Tumor Necrosis Factor Alpha (TNF‐α) were included as markers of systemic inflammation. A confirmatory factor analysis of cognitive performance resulted in factors measuring episodic memory (EM), processing speed (PS), working memory (WM), attentional control (AC), and visuospatial function (VF). WML volumes were computed from FLAIR and T1 scans using UBO detector. Mediation models were run with age, sex, years of education, and study site included as covariates.ResultHigher levels of IL‐6 were associated with more WMLs (b = 0.12, p < 0.001) as well as lower scores on all cognitive factors (all p < 0.03). In contrast, higher levels of TNF‐ α were associated with more WMLs (b = 0.10, p < 0.05) but not with any of the cognitive measures (all p > 0.3). More WMLs were associated with poorer PS, WM, AC, and VF (all p < 0.03), but not EM (all p > 0.05). Further, associations between IL‐6 and measures of PS, WM, AC, and VF were statistically mediated by WMLs (all b = ‐0.01, all p < 0.05).ConclusionThese findings suggest that markers of systemic inflammation might lead to poorer cognitive performance by impacting WMLs. The differences between IL‐6 and TNF‐α with cognition highlight the need for more research to understand how different cytokine pathways relate to cognition. Our results are important for building a mechanistic framework to understand the interplay between inflammation, WMLs, and cognition and could inform the development of targeted interventions focusing on regulating cytokines to support brain health and cognitive aging.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"14 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940156","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}
Yatian Li, Jingnan Wu, Zhixing Zhou, Nan Chen, Huanhuan Xia
BackgroundOlder adults with cognitive impairments will benefit from multicomponent interventions include cognitive training, exercise, and lifestyle modifications. However, many existing digital therapeutic products predominantly focus on computerized cognitive training, lacking effective approaches to other crucial interventions. We proposed a multidimensional comprehensive cognitive intervention training program – Brain and Body Rehab Training (BBRT), which integrates multidomain cognitive training with physical‐cognitive training and multidimensional lifestyle interventions and developed the digital therapeutic product – BBRT‐online based on WeChat mini‐program. The present study was to assess the effectiveness of BBRT in older adults with subjective memory impairments.MethodUsing the WeChat mini‐program platform, we developed the BBRT‐online digital therapeutics product. Prior to the intervention, users undergo Game‐based Cognitive Assessment – Three‐Minute Version (G3). Subsequently, an individualized training program is assigned consisting of completing four to five daily tasks, including cognitive training, physical‐cognitive training, lifestyle interventions, chronic disease/diet/sleep/emotion management, and traditional Chinese medicine non‐pharmacological interventions among others (Figure 1). The intervention duration ranges 15‐25 minutes per day, and task difficulty is dynamically adjusted based on individual task performance and periodic cognitive assessments. Additionally, remote online administration services and internet communities are strongly recommended to offer emotional support and enhance intervention effectiveness. Sixty older adults reporting subjective memory complaints were recruited, with 30 assigned to receive BBRT‐online training and the remainder serving as the control group. Cognitive function was evaluated using the G3 at baseline and three months later. T‐tests were conducted to assess the impact of BBRT‐online on cognitive function.ResultAt baseline, there was no significant difference in G3 scores between the BBRT group (53.5±10.87) and the control group (55.1±11.77, p = 0.583). Following three months of intervention, the BBRT group demonstrated a significantly higher G3 score (61.5±6.85) compared to baseline (p<0.001, Figure 2). Conversely, no such difference was observed in the control group (55.5 ± 9.34, p = 0.911).ConclusionThe BBRT digital therapeutics enabled cognitive assessment and individualized cognitive interventions and significantly improved cognitive function in older adults. Further studies are required to evaluate its effectiveness.
{"title":"A Multidimensional Comprehensive Cognitive Intervention Training Program: Introduction of a Non‐Pharmacological Digital Therapeutic and Preliminary Results of Effectiveness on Cognitive Function","authors":"Yatian Li, Jingnan Wu, Zhixing Zhou, Nan Chen, Huanhuan Xia","doi":"10.1002/alz.089572","DOIUrl":"https://doi.org/10.1002/alz.089572","url":null,"abstract":"BackgroundOlder adults with cognitive impairments will benefit from multicomponent interventions include cognitive training, exercise, and lifestyle modifications. However, many existing digital therapeutic products predominantly focus on computerized cognitive training, lacking effective approaches to other crucial interventions. We proposed a multidimensional comprehensive cognitive intervention training program – Brain and Body Rehab Training (BBRT), which integrates multidomain cognitive training with physical‐cognitive training and multidimensional lifestyle interventions and developed the digital therapeutic product – BBRT‐online based on WeChat mini‐program. The present study was to assess the effectiveness of BBRT in older adults with subjective memory impairments.MethodUsing the WeChat mini‐program platform, we developed the BBRT‐online digital therapeutics product. Prior to the intervention, users undergo Game‐based Cognitive Assessment – Three‐Minute Version (G3). Subsequently, an individualized training program is assigned consisting of completing four to five daily tasks, including cognitive training, physical‐cognitive training, lifestyle interventions, chronic disease/diet/sleep/emotion management, and traditional Chinese medicine non‐pharmacological interventions among others (Figure 1). The intervention duration ranges 15‐25 minutes per day, and task difficulty is dynamically adjusted based on individual task performance and periodic cognitive assessments. Additionally, remote online administration services and internet communities are strongly recommended to offer emotional support and enhance intervention effectiveness. Sixty older adults reporting subjective memory complaints were recruited, with 30 assigned to receive BBRT‐online training and the remainder serving as the control group. Cognitive function was evaluated using the G3 at baseline and three months later. T‐tests were conducted to assess the impact of BBRT‐online on cognitive function.ResultAt baseline, there was no significant difference in G3 scores between the BBRT group (53.5±10.87) and the control group (55.1±11.77, p = 0.583). Following three months of intervention, the BBRT group demonstrated a significantly higher G3 score (61.5±6.85) compared to baseline (p<0.001, Figure 2). Conversely, no such difference was observed in the control group (55.5 ± 9.34, p = 0.911).ConclusionThe BBRT digital therapeutics enabled cognitive assessment and individualized cognitive interventions and significantly improved cognitive function in older adults. Further studies are required to evaluate its effectiveness.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"45 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940296","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}
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