Alzheimer Disease & Associated Disorders最新文献

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.

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.

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.

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.

Background: Carers of people with dementia manually handle the care recipients (eg, repetitive lifting, transferring, and pulling) as part of the care service, increasing the musculoskeletal injury risk to themselves.

Objective: We aimed to determine the prevalence of musculoskeletal injuries among informal and formal carers of people with dementia and the perceived associated risk factors.

Methods: Primary carers of people with dementia (26 males and 141 females) from Dementia Care Centers and Home Care programs completed a questionnaire providing information about (a) the carers' and their care recipients' characteristics, (b) musculoskeletal symptoms (via the Nordic Musculoskeletal Questionnaire) and related aspects, and (c) the caregiving activities exposing the carers to risk of musculoskeletal injury.

Results: Our results showed that 69.7% of informal and 86.7% of formal carers reported having more than 1 musculoskeletal injury, while 63.1% and 61.5%, respectively, reported having a musculoskeletal injury in the last year. Lower back had the highest injury prevalence (>10% for both groups). The 2 carer groups were not different in any of the variables.

Conclusions: Our results reinforce calls for education and support of carers, regardless of their formal status, to enable injury-free and prolonged service provision.

Introduction: Formal educational attainment, or years of schooling, has a well-established positive effect on cognitive health across the life course. We hypothesized that the content and difficulty of the curriculum influence this relationship, such that more challenging curricula in high school lead to higher levels of socioeconomic attainment in adulthood and, in turn, to better cognitive outcomes in older adulthood.

Methods: We estimated multilevel structural equation models (MSEMs) in data from 2,405 individuals who attended one of 1,312 US high schools in 1960 and participated in the Project Talent Aging Study in 2018.

Results: A college preparatory curriculum and a greater number of semesters of math and science in high school were positively related to word recall and verbal fluency at an average age of 75. Effects were robust to controlling for adolescent cognitive ability, academic performance, socioeconomic background, and school characteristics.

Discussion: We discuss the implications of these findings for educational policy.

Attrition is a particular concern in studies examining the efficacy of a treatment for Alzheimer disease. Analyzing reasons for withdrawal in Alzheimer studies is crucial to ruling out attrition bias, which can undermine a study's validity. In contrast, attrition in studies using repetitive transcranial magnetic stimulation (rTMS) has received much less attention. Our goal was to identify any commonalities between participants who withdrew for the same reasons. Three independent coders rated each response concerning the reasons for withdrawal, and frequency tables were generated to characterize the participants within each category. This study was conducted on the 28 withdrawn cases from a 7-month study investigating the short-term and long-term therapeutic effects of rTMS for Alzheimer disease among 156 participants across 3 sites of the study. Seven reasons for withdrawal were identified, with health and medical changes being the most commonly reported reason (7 participants). Personal issues involving family or caregivers were the next most common (5 participants), and the remaining 5 categories consisted of 3 participants each. Although the limited sample size prevented the use of inferential statistics, our findings highlight the need for more transparent reporting of attrition rates and withdrawal reasons by rTMS researchers.

Objective: Cognitive training may benefit older adults with mild cognitive impairment (MCI), but the prognostic factors are not well-established.

Methods: This study analyzed data from a 78-week trial with 107 participants with MCI, comparing computerized cognitive training (CCT) and computerized crossword puzzle training (CPT). Outcomes were changes in cognitive and functional measures from baseline. Linear mixed-effect models were used to identify prognostic factors for each intervention.

Results: Baseline neuropsychological composite z-score was positively associated with cognitive and functional improvements for both interventions in univariable models, retaining significance in the final multivariable model for functional outcome in CPT ( P < 0.001). Apolipoprotein E e4 carriers had worse cognitive ( P = 0.023) and functional ( P = 0.001) outcomes than noncarriers for CPT but not CCT. African Americans showed greater functional improvements than non-African Americans in both CPT ( P = 0.001) and CCT ( P = 0.010). Better baseline odor identification was correlated with cognitive improvements in CPT ( P = 0.006) and functional improvements in CCT ( P < 0.001).

Conclusion: Baseline cognitive test performance, African American background, and odor identification ability are potential prognostic factors for improved outcomes with cognitive interventions in older adults with MCI. Apolipoprotein E e4 is associated with poor outcomes. Replication of these findings may improve the selection of cognitive interventions for individuals with MCI.

Handedness has been a topic of scientific interest for many years. However, false and misleading ideas have dominated this field with a still limited amount of research into the association with clinical disorders like Alzheimer disease (AD). In accordance with PRISMA guidelines, PubMed, Embase, and Cochrane Library were searched for studies regarding the association of handedness and AD. Twelve articles were included. Case-control studies show that left-handedness is not a risk factor for late-onset AD (LOAD). However, nonright handedness was found to be more prevalent in patients with early-onset AD (EOAD). Moreover, handedness does not seem to affect neuropsychological performance. We also show that collapsing versus separating mixed and left-handedness may yield different results. Future research on the relation between handedness and AD may provide new insight into disease pathogenesis, improve rehabilitation, and help identify patients who will progress, aiding the design of prevention trials.

Alzheimer disease and allergic diseases are common health problems. The aim of the study was to check the hypothesis that older patients with IgE-mediated allergies have a higher prevalence of Alzheimer disease. It was a retrospective, multicenter cohort observation. In total, 7129 people were examined, including 3566 women and 2558 men (mean 64.9±6.9 y). The diagnosis of Alzheimer disease is based on the ICD-10 code and appropriate medical documentation. The proportion of patients with confirmed Alzheimer disease in the group of patients with diagnosed allergy compared to the group of those without allergy was as follows: 13.9% (168) versus 8.2% (484) with P=0.001. There was a positive correlation between the presence of Alzheimer disease and high serum total IgE, eosinophilia, and asthma or the presence of atopic polymorphic disease (P<0.05). IgE-dependent allergic diseases, in particular allergic asthma, and the presence of high serum IgE levels may favor the development of Alzheimer disease.