Pub Date : 2024-09-25DOI: 10.1097/WAD.0000000000000644
Jean-François Carmel, Doris Clerc, Vincent Couture, Isabelle Reid, Ali Filali, Juan Manuel Villalpando
Background: Psychosis in Alzheimer disease (AD) is a major burden for patients and their family. Identifying the characteristics of delusions and hallucinations in the AD population is key to understanding the interconnection between the psychiatric and cognitive symptoms in neurocognitive disorders. The aim of this study is to compare the cognitive profiles of AD patients with and without psychosis.
Methods: We conducted a rapid review to explore the relationship between psychotic symptoms and cognitive performances in patients with AD. We used MEDLINE, Embase, and PsychINFO literature databases between January 2015 and January 2023. This rapid review was guided by the Cochrane Rapid Reviews Methods Group.
Results: We identified 2909 records from the initial searches. After reviewing the titles, abstracts, and full texts, we selected 8 cross-sectional and 5 cohort studies for the qualitative analysis. Among them, 6 studies were included in the final quantitative analysis. Most studies suggested a correlation between general cognitive decline and the risk of presenting psychotic symptoms. Three studies found an association between hallucinations and deficits in the visuocognitive domains (visuospatial, visuoperceptual, and visuoconstructive skills). Two studies found a relationship between psychotic symptoms and executive dysfunction. Two studies also found a correlation between psychotic symptoms and language. Our results are in line with previous data in the literature, especially regarding the outcome of psychosis on executive function and visuocognitive abilities.
Conclusions: There appears to be an association between cognitive deficits and psychotic symptoms in AD, but the direction of causality is still unclear, and further studies using longitudinal designs would give more insight into the pathophysiological process of psychosis in AD.
{"title":"The Difference in Cognitive Profiles Between Patients With Alzheimer Dementia With and Without Psychosis: A Rapid Review.","authors":"Jean-François Carmel, Doris Clerc, Vincent Couture, Isabelle Reid, Ali Filali, Juan Manuel Villalpando","doi":"10.1097/WAD.0000000000000644","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000644","url":null,"abstract":"<p><strong>Background: </strong>Psychosis in Alzheimer disease (AD) is a major burden for patients and their family. Identifying the characteristics of delusions and hallucinations in the AD population is key to understanding the interconnection between the psychiatric and cognitive symptoms in neurocognitive disorders. The aim of this study is to compare the cognitive profiles of AD patients with and without psychosis.</p><p><strong>Methods: </strong>We conducted a rapid review to explore the relationship between psychotic symptoms and cognitive performances in patients with AD. We used MEDLINE, Embase, and PsychINFO literature databases between January 2015 and January 2023. This rapid review was guided by the Cochrane Rapid Reviews Methods Group.</p><p><strong>Results: </strong>We identified 2909 records from the initial searches. After reviewing the titles, abstracts, and full texts, we selected 8 cross-sectional and 5 cohort studies for the qualitative analysis. Among them, 6 studies were included in the final quantitative analysis. Most studies suggested a correlation between general cognitive decline and the risk of presenting psychotic symptoms. Three studies found an association between hallucinations and deficits in the visuocognitive domains (visuospatial, visuoperceptual, and visuoconstructive skills). Two studies found a relationship between psychotic symptoms and executive dysfunction. Two studies also found a correlation between psychotic symptoms and language. Our results are in line with previous data in the literature, especially regarding the outcome of psychosis on executive function and visuocognitive abilities.</p><p><strong>Conclusions: </strong>There appears to be an association between cognitive deficits and psychotic symptoms in AD, but the direction of causality is still unclear, and further studies using longitudinal designs would give more insight into the pathophysiological process of psychosis in AD.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1097/WAD.0000000000000645
Zachary G Baker, SeungYong Han, Justine S Sefcik, Darina V Petrovsky, Kris Pui Kwan Ma, Matthew Lee Smith, Juanita-Dawne R Bacsu, Zahra Rahemi, Joseph Saenz
Introduction: People with dementia can have many family and friends who might be affected by their deaths. Pursuing the long-term aim of understanding how dementia deaths affect close family and friends, this project lays groundwork through estimates of who those close family and friends are, with special attention to race and ethnicity.
Method: Regression models estimated associations between dementia, race/ethnicity, and close family and friend network size, controlling for age, sex, education, marital status, and household wealth for 1386 deceased people with dementia from the Health and Retirement Study (2004 to 2018).
Results: Persons with dementia had an average of 9.4 close family and friends at death. But patterns of close family and friends were different among non-Latino Black (10.8), Latino (9.9), and non-Latino White (9.2) people with dementia at death. Notably, non-Latino White persons with dementia had the fewest close family (3.7), followed by non-Latino Black (5.1), and Latino (7.7) persons with dementia.
Discussion: Knowing who might be affected by dementia deaths is the first step to explore how dementia-related deaths impact close family and friends. Future work can now sample bereaved family and friends of people with dementia to explore their experiences and develop culturally appropriate supports.
{"title":"Mapping the Landscape of Those Left Behind When a Person With Dementia Dies: Roles of Race and Ethnicity.","authors":"Zachary G Baker, SeungYong Han, Justine S Sefcik, Darina V Petrovsky, Kris Pui Kwan Ma, Matthew Lee Smith, Juanita-Dawne R Bacsu, Zahra Rahemi, Joseph Saenz","doi":"10.1097/WAD.0000000000000645","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000645","url":null,"abstract":"<p><strong>Introduction: </strong>People with dementia can have many family and friends who might be affected by their deaths. Pursuing the long-term aim of understanding how dementia deaths affect close family and friends, this project lays groundwork through estimates of who those close family and friends are, with special attention to race and ethnicity.</p><p><strong>Method: </strong>Regression models estimated associations between dementia, race/ethnicity, and close family and friend network size, controlling for age, sex, education, marital status, and household wealth for 1386 deceased people with dementia from the Health and Retirement Study (2004 to 2018).</p><p><strong>Results: </strong>Persons with dementia had an average of 9.4 close family and friends at death. But patterns of close family and friends were different among non-Latino Black (10.8), Latino (9.9), and non-Latino White (9.2) people with dementia at death. Notably, non-Latino White persons with dementia had the fewest close family (3.7), followed by non-Latino Black (5.1), and Latino (7.7) persons with dementia.</p><p><strong>Discussion: </strong>Knowing who might be affected by dementia deaths is the first step to explore how dementia-related deaths impact close family and friends. Future work can now sample bereaved family and friends of people with dementia to explore their experiences and develop culturally appropriate supports.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12DOI: 10.1097/WAD.0000000000000642
Zeinah Al-Darsani, Hailey R Banack, Mallory N Ziegler, Stephen R Rapp, Maria M Corrada, Andrew O Odegaard
Background: This study extends prior research from the MRI substudy of the Women's Health Initiative Memory Study (WHIMS-MRI) linking BMI to reduced brain atrophy and ischemic lesion load by examining DXA-based measurements of total body fat, total abdominal adipose tissue (TAT), abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue, gynoid fat, and overall leg fat.
Methods: The analytic sample consisted of 61 postmenopausal women (baseline mean age 69.5 [3.6]) enrolled in WHIMS-MRI who had undergone DXA scans. DXA scans were completed at years 0, 3, and 6, and MRI scans were conducted ~8 years after baseline. Adjusted linear regression models were used to analyze the association between adiposity averaged across the 3-time points and volumes of brain regions previously linked to dementia.
Results: Higher levels of total body fat, TAT, VAT, SAT, gynoid, and overall leg fat were associated with larger hippocampal volume (β 0.02 [95% CI, 0.004-0.04]; 0.11 [0.02-0.21]; 0.26 [0.04-0.47]; 0.18 [0.03-0.33]; 0.18 [0.05-0.30]; 0.07 [0.009-0.12], respectively). No other significant associations were observed.
Conclusion: Higher levels of adiposity were positively associated with hippocampal volume. Additional research with larger sample sizes is needed to ascertain the significance of this association.
{"title":"DXA-Measured Abdominal Adipose Depots and Structural Brain Integrity in Postmenopausal Women.","authors":"Zeinah Al-Darsani, Hailey R Banack, Mallory N Ziegler, Stephen R Rapp, Maria M Corrada, Andrew O Odegaard","doi":"10.1097/WAD.0000000000000642","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000642","url":null,"abstract":"<p><strong>Background: </strong>This study extends prior research from the MRI substudy of the Women's Health Initiative Memory Study (WHIMS-MRI) linking BMI to reduced brain atrophy and ischemic lesion load by examining DXA-based measurements of total body fat, total abdominal adipose tissue (TAT), abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue, gynoid fat, and overall leg fat.</p><p><strong>Methods: </strong>The analytic sample consisted of 61 postmenopausal women (baseline mean age 69.5 [3.6]) enrolled in WHIMS-MRI who had undergone DXA scans. DXA scans were completed at years 0, 3, and 6, and MRI scans were conducted ~8 years after baseline. Adjusted linear regression models were used to analyze the association between adiposity averaged across the 3-time points and volumes of brain regions previously linked to dementia.</p><p><strong>Results: </strong>Higher levels of total body fat, TAT, VAT, SAT, gynoid, and overall leg fat were associated with larger hippocampal volume (β 0.02 [95% CI, 0.004-0.04]; 0.11 [0.02-0.21]; 0.26 [0.04-0.47]; 0.18 [0.03-0.33]; 0.18 [0.05-0.30]; 0.07 [0.009-0.12], respectively). No other significant associations were observed.</p><p><strong>Conclusion: </strong>Higher levels of adiposity were positively associated with hippocampal volume. Additional research with larger sample sizes is needed to ascertain the significance of this association.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-08-23DOI: 10.1097/WAD.0000000000000638
Lei Lei Zhang, Katya Numbers, Henry Brodaty, Ben C P Lam, Gowsaly Mahalingam, Simone Reppermund
Objectives: Functional impairment can be an early indicator of cognitive decline. However, its predictive utility in cognitively normal (CN) older adults remains unclear. This study aimed to determine whether mild functional impairment (MFI) in CN older adults could predict incident dementia over 6 years, in addition to assessing its association with cognitive performance.
Design: A longitudinal study with a 6-year follow-up.
Participants: A cohort of 296 community-dwelling CN older adults.
Measurements: MFI was defined by cutoffs for impairment on an objective performance-based and/or subjective questionnaire-based functional assessment. Cox regression analysis was conducted to assess the relationship between MFI and risk of incident dementia and cognitive performances over 6 years. Linear regression analysis examined the association between MFI and baseline cognitive performance.
Results: There were no significant longitudinal associations between MFI and incident dementia or changes in cognitive performance over 6 years. Defining MFI using both performance-based and informant-reported assessments was predictive of dementia. Cross-sectional analyses demonstrated significant associations between MFI and poorer baseline global cognition and performance in attention, visuospatial ability, and executive functioning.
Conclusions: CN older adults with MFI were not at an increased risk of developing dementia over 6 years. A definition of functional impairment requiring both performance-based and informant-based assessments may be useful in predicting dementia.
{"title":"Does Mild Functional Impairment Predict Dementia in Older Adults With Normal Cognition?","authors":"Lei Lei Zhang, Katya Numbers, Henry Brodaty, Ben C P Lam, Gowsaly Mahalingam, Simone Reppermund","doi":"10.1097/WAD.0000000000000638","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000638","url":null,"abstract":"<p><strong>Objectives: </strong>Functional impairment can be an early indicator of cognitive decline. However, its predictive utility in cognitively normal (CN) older adults remains unclear. This study aimed to determine whether mild functional impairment (MFI) in CN older adults could predict incident dementia over 6 years, in addition to assessing its association with cognitive performance.</p><p><strong>Design: </strong>A longitudinal study with a 6-year follow-up.</p><p><strong>Participants: </strong>A cohort of 296 community-dwelling CN older adults.</p><p><strong>Measurements: </strong>MFI was defined by cutoffs for impairment on an objective performance-based and/or subjective questionnaire-based functional assessment. Cox regression analysis was conducted to assess the relationship between MFI and risk of incident dementia and cognitive performances over 6 years. Linear regression analysis examined the association between MFI and baseline cognitive performance.</p><p><strong>Results: </strong>There were no significant longitudinal associations between MFI and incident dementia or changes in cognitive performance over 6 years. Defining MFI using both performance-based and informant-reported assessments was predictive of dementia. Cross-sectional analyses demonstrated significant associations between MFI and poorer baseline global cognition and performance in attention, visuospatial ability, and executive functioning.</p><p><strong>Conclusions: </strong>CN older adults with MFI were not at an increased risk of developing dementia over 6 years. A definition of functional impairment requiring both performance-based and informant-based assessments may be useful in predicting dementia.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-08-23DOI: 10.1097/WAD.0000000000000631
Guerry M Peavy, Namkhuê Võ, Carolyn Revta, Anna T Lu, Jody-Lynn Lupo, Percival Nam, Khải H Nguyễn, Li-San Wang, Howard H Feldman
Introduction: The objective of this pilot study was to establish the feasibility of recruiting older Vietnamese Americans for research addressing genetic and nongenetic risk factors for Alzheimer disease (AD).
Methods: Twenty-six Vietnamese Americans were recruited from communities in San Diego. A Community Advisory Board provided cultural and linguistic advice. Bilingual/bicultural staff measured neuropsychological, neuropsychiatric, lifestyle, and medical/neurological functioning remotely. Saliva samples allowed DNA extraction. A consensus team reviewed clinical data to determine a diagnosis of normal control (NC), mild cognitive impairment (MCI), or dementia. Exploratory analyses addressed AD risk by measuring subjective cognitive complaints (SCC), depression, and vascular risk factors (VRFs).
Results: Twenty-five participants completed the study (mean age=73.8 y). Eighty percent chose to communicate in Vietnamese. Referrals came primarily from word of mouth within Vietnamese communities. Diagnoses included 18 NC, 3 MCI, and 4 dementia. Participants reporting SCC acknowledged more depressive symptoms and had greater objective cognitive difficulty than those without SCC. Eighty-eight percent of participants reported at least 1 VRF.
Discussion: This pilot study supports the feasibility of conducting community-based research in older Vietnamese Americans. Challenges included developing linguistically and culturally appropriate cognitive and neuropsychiatric assessment tools. Exploratory analyses addressing nongenetic AD risk factors suggest topics for future study.
{"title":"Asian Cohort for Alzheimer Disease (ACAD) Pilot Study: Vietnamese Americans.","authors":"Guerry M Peavy, Namkhuê Võ, Carolyn Revta, Anna T Lu, Jody-Lynn Lupo, Percival Nam, Khải H Nguyễn, Li-San Wang, Howard H Feldman","doi":"10.1097/WAD.0000000000000631","DOIUrl":"10.1097/WAD.0000000000000631","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this pilot study was to establish the feasibility of recruiting older Vietnamese Americans for research addressing genetic and nongenetic risk factors for Alzheimer disease (AD).</p><p><strong>Methods: </strong>Twenty-six Vietnamese Americans were recruited from communities in San Diego. A Community Advisory Board provided cultural and linguistic advice. Bilingual/bicultural staff measured neuropsychological, neuropsychiatric, lifestyle, and medical/neurological functioning remotely. Saliva samples allowed DNA extraction. A consensus team reviewed clinical data to determine a diagnosis of normal control (NC), mild cognitive impairment (MCI), or dementia. Exploratory analyses addressed AD risk by measuring subjective cognitive complaints (SCC), depression, and vascular risk factors (VRFs).</p><p><strong>Results: </strong>Twenty-five participants completed the study (mean age=73.8 y). Eighty percent chose to communicate in Vietnamese. Referrals came primarily from word of mouth within Vietnamese communities. Diagnoses included 18 NC, 3 MCI, and 4 dementia. Participants reporting SCC acknowledged more depressive symptoms and had greater objective cognitive difficulty than those without SCC. Eighty-eight percent of participants reported at least 1 VRF.</p><p><strong>Discussion: </strong>This pilot study supports the feasibility of conducting community-based research in older Vietnamese Americans. Challenges included developing linguistically and culturally appropriate cognitive and neuropsychiatric assessment tools. Exploratory analyses addressing nongenetic AD risk factors suggest topics for future study.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-08-05DOI: 10.1097/WAD.0000000000000628
Moslem Taheri Soodejani, Marjan Rasoulian Kasrineh, Seyyed Mohammad Tabatabaei
This is the first comprehensive national and subnational epidemiological study reporting the incidence of Alzheimer disease and related dementias (ADRD) in Iran from 2010 to 2019 and predictions for 2024. We extracted age-standardized incidence stratified by sex and provinces from the Institute for Health Measurement and Evaluation (IHME). Arc Map GIS was used to report the geographical distribution, and the Cochran-Armitage test was used for prediction. Predictions showed that the incidence of ADRD would reach 118 (women) and 109 (men) cases per 100,000 population in Iran in 2024. The most increasing incidence from 2010 to 2019 was reported among women in Qom, while Yazd had the most incidences among men and women in 2019. The results showed an increase in the incidence of ADRD in Iran in recent years, and the increase in life expectancy and population aging can be considered as an influential factor.
{"title":"Incidence of Alzheimer Disease and Related Dementias in Iran From 2010 to 2019.","authors":"Moslem Taheri Soodejani, Marjan Rasoulian Kasrineh, Seyyed Mohammad Tabatabaei","doi":"10.1097/WAD.0000000000000628","DOIUrl":"10.1097/WAD.0000000000000628","url":null,"abstract":"<p><p>This is the first comprehensive national and subnational epidemiological study reporting the incidence of Alzheimer disease and related dementias (ADRD) in Iran from 2010 to 2019 and predictions for 2024. We extracted age-standardized incidence stratified by sex and provinces from the Institute for Health Measurement and Evaluation (IHME). Arc Map GIS was used to report the geographical distribution, and the Cochran-Armitage test was used for prediction. Predictions showed that the incidence of ADRD would reach 118 (women) and 109 (men) cases per 100,000 population in Iran in 2024. The most increasing incidence from 2010 to 2019 was reported among women in Qom, while Yazd had the most incidences among men and women in 2019. The results showed an increase in the incidence of ADRD in Iran in recent years, and the increase in life expectancy and population aging can be considered as an influential factor.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-08-07DOI: 10.1097/WAD.0000000000000634
Yuqin Wang, Huimin Tao, Maohong Cao, Kefu Cai
Urinary Alzheimer-associated neuronal thread protein (AD7c-NTP) is regarded as a biomarker for β-amyloid protein deposition in Alzheimer disease (AD). The value of AD7c-NTP in predicting post-stroke cognitive recovery was worth exploring. In total, 224 patients with first-ever stroke were enrolled in this retrospective study. Cognitive assessment was evaluated by Mini-Mental State Examination (MMSE), and cognitive improvement was defined as MMSE scores ≥27 or 4-score elevation at 3-month follow-up after stroke. The AD7c-NTP level was 0.68±0.40 ng/mL in the 135 patients with cognitive improvement, while the AD7c-NTP level was 1.49±0.99 ng/mL in the 89 patients without improvement ( P <0.001). Those displaying better cognitive recovery also had younger ages, higher MMSE scores, and lower NIHSS scores on admission. In multivariable logistic regression analysis, AD7c-NTP concentration (OR=9.14, 95% CI: 4.52-18.49, P <0.001), age (OR=1.04, 95% CI: 1.01-1.08, P =0.012), and NIHSS score on admission (OR=1.17, 95% CI: 1.07-1.28, P <0.001) remained the independent risk factors affecting cognitive recovery. The area under the receiver operating characteristics curve for AD7c-NTP in predicting unfavorable cognitive function was 0.80 (sensitivity: 0.73 and specificity: 0.84). Urinary AD7c-NTP is a valuable biomarker associated with post-stroke cognitive recovery. It might be adopted to discriminate coexisting AD pathology from vascular cognitive impairment.
{"title":"Urinary AD7c-NTP is Associated With Cognitive Recovery After Ischemic Stroke.","authors":"Yuqin Wang, Huimin Tao, Maohong Cao, Kefu Cai","doi":"10.1097/WAD.0000000000000634","DOIUrl":"10.1097/WAD.0000000000000634","url":null,"abstract":"<p><p>Urinary Alzheimer-associated neuronal thread protein (AD7c-NTP) is regarded as a biomarker for β-amyloid protein deposition in Alzheimer disease (AD). The value of AD7c-NTP in predicting post-stroke cognitive recovery was worth exploring. In total, 224 patients with first-ever stroke were enrolled in this retrospective study. Cognitive assessment was evaluated by Mini-Mental State Examination (MMSE), and cognitive improvement was defined as MMSE scores ≥27 or 4-score elevation at 3-month follow-up after stroke. The AD7c-NTP level was 0.68±0.40 ng/mL in the 135 patients with cognitive improvement, while the AD7c-NTP level was 1.49±0.99 ng/mL in the 89 patients without improvement ( P <0.001). Those displaying better cognitive recovery also had younger ages, higher MMSE scores, and lower NIHSS scores on admission. In multivariable logistic regression analysis, AD7c-NTP concentration (OR=9.14, 95% CI: 4.52-18.49, P <0.001), age (OR=1.04, 95% CI: 1.01-1.08, P =0.012), and NIHSS score on admission (OR=1.17, 95% CI: 1.07-1.28, P <0.001) remained the independent risk factors affecting cognitive recovery. The area under the receiver operating characteristics curve for AD7c-NTP in predicting unfavorable cognitive function was 0.80 (sensitivity: 0.73 and specificity: 0.84). Urinary AD7c-NTP is a valuable biomarker associated with post-stroke cognitive recovery. It might be adopted to discriminate coexisting AD pathology from vascular cognitive impairment.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-08-08DOI: 10.1097/WAD.0000000000000630
Valentine Ucheagwu, Chiamaka Odilora, Rita Ugokwe-Joseph, Bruno Giordani
Background: Construct validation of cognitive batteries across Africa is imperative to understanding dementia in the region. We examined construct validity and internal consistency of the neuropsychological battery of Uniform Data Set version 3 (UDSNB 3.0) of the Alzheimer Coordinating Center in Nigeria older adults.
Method: Three hundred forty-nine (220 females; age: 65 to 85) community dwellers were recruited. UDSNB 3.0 with 12 subscales were used to measure cognition. Two sets of data were collected. First was for exploratory factor analysis (EFA) and second was confirmatory factor analysis (CFA). Four models were specified for CFA.
Result: EFA principal axis factor with varimax rotation yielded 4 factors: Executive function, memory, visual-spatial ability, and processing speed. Four CFA were performed based on 4 specified models, with only model 3 showing good model fit: CMIN/DF=2.13; confirmatory fit index=0.94; root mean square error of approximation=0.07. Model 3 had 5 latent variables: working memory, language, verbal memory, visual-spatial ability, and processing speed. UDSNB 3.0 had an overall Cronbach alpha of 0.73, suggesting strong internal reliability with ANOVA model F134,1619=183.65 significant at P<0.001 level of testing.
Conclusions: Our study showed that UDSNB 3.0 has construct validity and good internal consistency in our older adult population.
{"title":"Factor Structure and Internal Consistency of the National Alzheimer Coordinating Center's Uniform Data Set Version 3 Neuropsychological Test Battery (UDSNB 3.0): The Nigeria Sample.","authors":"Valentine Ucheagwu, Chiamaka Odilora, Rita Ugokwe-Joseph, Bruno Giordani","doi":"10.1097/WAD.0000000000000630","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000630","url":null,"abstract":"<p><strong>Background: </strong>Construct validation of cognitive batteries across Africa is imperative to understanding dementia in the region. We examined construct validity and internal consistency of the neuropsychological battery of Uniform Data Set version 3 (UDSNB 3.0) of the Alzheimer Coordinating Center in Nigeria older adults.</p><p><strong>Method: </strong>Three hundred forty-nine (220 females; age: 65 to 85) community dwellers were recruited. UDSNB 3.0 with 12 subscales were used to measure cognition. Two sets of data were collected. First was for exploratory factor analysis (EFA) and second was confirmatory factor analysis (CFA). Four models were specified for CFA.</p><p><strong>Result: </strong>EFA principal axis factor with varimax rotation yielded 4 factors: Executive function, memory, visual-spatial ability, and processing speed. Four CFA were performed based on 4 specified models, with only model 3 showing good model fit: CMIN/DF=2.13; confirmatory fit index=0.94; root mean square error of approximation=0.07. Model 3 had 5 latent variables: working memory, language, verbal memory, visual-spatial ability, and processing speed. UDSNB 3.0 had an overall Cronbach alpha of 0.73, suggesting strong internal reliability with ANOVA model F134,1619=183.65 significant at P<0.001 level of testing.</p><p><strong>Conclusions: </strong>Our study showed that UDSNB 3.0 has construct validity and good internal consistency in our older adult population.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-08-23DOI: 10.1097/WAD.0000000000000632
Andrew J Aschenbrenner, David B Carr, Tammie L S Benzinger, John C Morris, Ganesh M Babulal
Introduction: Alzheimer disease (AD) has a long preclinical phase in which AD pathology is accumulating without detectable clinical symptoms. It is critical to identify participants in this preclinical phase as early as possible since treatment plans may be more effective in this stage. Monitoring for changes in driving behavior, as measured with GPS sensors, has been explored as a low-burden, easy-to-administer method for detecting AD risk. However, driving is a complex, multifaceted process that is likely influenced by other factors, including personality traits, that may change in preclinical AD.
Methods: We examine the moderating influence of neuroticism and conscientiousness on longitudinal changes in driving behavior in a sample of 203 clinically normal older adults who are at varying risk of developing AD.
Results: Neuroticism moderated rates of change in the frequency of speeding as well as the number of trips taken at night. Conscientiousness moderated rates of change in typical driving space.
Conclusions: Personality traits change in early AD and also influence driving behaviors. Studies that seek to utilize naturalistic driving behavior to establish AD risk need to accommodate interpersonal differences, of which personality traits are one of many possible factors. Future studies should explicitly establish how much benefit is provided by including personality traits in predictive models of AD progression.
导言阿尔茨海默病(AD)有一个漫长的临床前阶段,在这一阶段中,AD 病理在不断积累,但却没有可检测到的临床症状。尽早发现处于临床前阶段的患者至关重要,因为在这一阶段制定治疗计划可能会更有效。通过 GPS 传感器监测驾驶行为的变化已被视为一种低负担、易操作的检测注意力缺失症风险的方法。然而,驾驶是一个复杂的、多方面的过程,很可能会受到其他因素的影响,包括人格特征,而这些因素在临床 AD 前期可能会发生变化:我们研究了神经质和自觉性对驾驶行为纵向变化的调节作用:神经质调节超速频率和夜间出行次数的变化率。结果:神经质调节了超速频率和夜间出行次数的变化率,而认真则调节了典型驾驶空间的变化率:结论:注意力缺陷早期的人格特质会发生变化,并影响驾驶行为。试图利用自然驾驶行为确定注意力缺失症风险的研究需要考虑人际差异,而人格特质是众多可能因素之一。未来的研究应明确确定将人格特质纳入AD进展预测模型的益处有多大。
{"title":"The Influence of Personality Traits on Driving Behaviors in Preclinical Alzheimer Disease.","authors":"Andrew J Aschenbrenner, David B Carr, Tammie L S Benzinger, John C Morris, Ganesh M Babulal","doi":"10.1097/WAD.0000000000000632","DOIUrl":"10.1097/WAD.0000000000000632","url":null,"abstract":"<p><strong>Introduction: </strong>Alzheimer disease (AD) has a long preclinical phase in which AD pathology is accumulating without detectable clinical symptoms. It is critical to identify participants in this preclinical phase as early as possible since treatment plans may be more effective in this stage. Monitoring for changes in driving behavior, as measured with GPS sensors, has been explored as a low-burden, easy-to-administer method for detecting AD risk. However, driving is a complex, multifaceted process that is likely influenced by other factors, including personality traits, that may change in preclinical AD.</p><p><strong>Methods: </strong>We examine the moderating influence of neuroticism and conscientiousness on longitudinal changes in driving behavior in a sample of 203 clinically normal older adults who are at varying risk of developing AD.</p><p><strong>Results: </strong>Neuroticism moderated rates of change in the frequency of speeding as well as the number of trips taken at night. Conscientiousness moderated rates of change in typical driving space.</p><p><strong>Conclusions: </strong>Personality traits change in early AD and also influence driving behaviors. Studies that seek to utilize naturalistic driving behavior to establish AD risk need to accommodate interpersonal differences, of which personality traits are one of many possible factors. Future studies should explicitly establish how much benefit is provided by including personality traits in predictive models of AD progression.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: It is estimated that 2% of dementia cases worldwide could be prevented with increases in physical activity. However, there is little evidence of the association between vigorous physical activity (VPA) and cognitive performance. This study aimed to investigate the association of moderate physical activity (MPA) and VPA with cognitive performance in older adults from the Brazilian Longitudinal Study of Aging (ELSI-Brasil).
Patients and methods: Data from 7954 participants were analyzed. Mean age was 61.8 ± 9.2 years, 61.8% were women, and 44.3% were mixed races. Cognitive performance evaluated the memory, temporal orientation, and verbal fluency domains. A global composite z-score was derived from the tests. Physical activity was assessed by self-report. We used linear regression models to verify the association of MPA and VPA with cognitive performance.
Results: Compared with participants who did not meet the guidelines for MPA (<150 min/wk), those who met the guidelines (150 to 299 min/wk) and those who performed more than 2x the recommended amount of MPA (300 min or more/wk) had better global cognitive performance (β = 0.163, 95% CI = 0.086, 0.241; P < 0.001; β = 0.180, 95% CI = 0.107, 0.253, P < 0.001, respectively). We found no association between VPA and cognitive performance.
Conclusion: There was no additional benefit of VPA for cognitive performance.
{"title":"Association of Moderate and Vigorous Physical Activity With Cognitive Performance: Evidence From Brazil.","authors":"Ingryd Mayara Nascimento Martins de Pais, Wendell Lima Rabelo, Naomi Vidal Ferreira, Cleusa Pinheiro Ferri, Claudia Kimie Suemoto, Natalia Gomes Gonçalves","doi":"10.1097/WAD.0000000000000637","DOIUrl":"10.1097/WAD.0000000000000637","url":null,"abstract":"<p><strong>Objective: </strong>It is estimated that 2% of dementia cases worldwide could be prevented with increases in physical activity. However, there is little evidence of the association between vigorous physical activity (VPA) and cognitive performance. This study aimed to investigate the association of moderate physical activity (MPA) and VPA with cognitive performance in older adults from the Brazilian Longitudinal Study of Aging (ELSI-Brasil).</p><p><strong>Patients and methods: </strong>Data from 7954 participants were analyzed. Mean age was 61.8 ± 9.2 years, 61.8% were women, and 44.3% were mixed races. Cognitive performance evaluated the memory, temporal orientation, and verbal fluency domains. A global composite z-score was derived from the tests. Physical activity was assessed by self-report. We used linear regression models to verify the association of MPA and VPA with cognitive performance.</p><p><strong>Results: </strong>Compared with participants who did not meet the guidelines for MPA (<150 min/wk), those who met the guidelines (150 to 299 min/wk) and those who performed more than 2x the recommended amount of MPA (300 min or more/wk) had better global cognitive performance (β = 0.163, 95% CI = 0.086, 0.241; P < 0.001; β = 0.180, 95% CI = 0.107, 0.253, P < 0.001, respectively). We found no association between VPA and cognitive performance.</p><p><strong>Conclusion: </strong>There was no additional benefit of VPA for cognitive performance.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}