American journal of Alzheimer's disease and other dementias最新文献

Religiosity and spirituality (R/S) encompass organizational activity, private practice, and intrinsic beliefs, which may relate differently to cognitive and mental health outcomes in older adults. This study identified latent R/S profiles among South Korean older adults with mild cognitive impairment (MCI) and Alzheimer's disease (AD), and examined differences in cognitive function, psychological well-being, and depressive symptoms. Latent profile analysis using Duke University Religion Index indicators was conducted with 518 patients (MCI: n = 224; AD: n = 294). In MCI, three classes that differed in well-being and verbal fluency were identified; they showed no differences in depressive symptoms or other cognitive domains. In AD, four classes were identified that differed in the Short Blessed Test and Word List Recall; in these, well-being, depression, and other cognitive outcomes did not differ across classes. These findings underscore the relevance of diverse R/S patterns in individualized care for older adults with neurocognitive disorders.

Objective: Alzheimer's disease (AD) continues to be a major challenge because handling high-dimensional data is time-consuming and expensive due to its complexity. A large feature space often increases computational costs and reduces model interpretability. This study addresses this problem by evaluating and comparing multiple feature selection techniques to identify the most informative biomarkers for AD diagnosis.Methods: Our study used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to implement and test three feature selection approaches, visualization-based, filter-based, and wrapper-based, within a Naive Bayes (NB) classification framework.Results: Based on the results of the analysis, the wrapper method achieved 96.77% classification accuracy, outperforming both visualization and filter methods with 86.19 and 91.87%, respectively. Interestingly, even when over 92.5% of the original features were removed the classifier still performed well, indicating that only a small set of features is necessary to ensure reliable diagnosis.Discussion: This study illustrates that strategically selecting features improves diagnostic accuracy while reducing computational burden, providing a more efficient framework for machine learning applications in Alzheimer's disease research.

We aimed to explore the value and interpretability of a multimodal deep learning model integrating optical coherence tomography angiography (OCTA) and electronystagmography (ENG) for the early screening of Alzheimer's disease (AD) and mild cognitive impairment (MCI). A total of 250 subjects were retrospectively recruited. OCTA images, ENG signals and neurocognitive scores were collected from all subjects. The model had an area under curve of 0.85 for the independent validation cohort, with the sensitivity and specificity of 0.73 and 0.90 at the optimal cut-off of receiver operating characteristic curve, respectively. According to Gradient-weighted Class Activation Mapping analysis, the model focused on regions with reduced microvascular density. SHapley Additive exPlanations analysis revealed that saccade accuracy (left eye), saccade latency (right eye) and smooth pursuit gain (left eye) contributed the most to the model. The multimodal model effectively improves early, non-invasive screening of AD/MCI with good interpretability.

Subarachnoid hemorrhage (SAH) has been reported to cause glial scarring within a short timeframe. Due to the high mortality rate of SAH, there is limited research on its long-term effects and relation to neurodegenerative disorders. This report aims to investigate a combination of healed SAH and Alzheimer's Disease (AD) pathology. A 90-year-old female cadaver, in the anatomy laboratory, was found to have an irregular surgical scar in the right frontoparietal bone. Upon dissection, the right frontal lobe was discovered to be atrophic with a concavity. Histopathology exhibited significant gliosis and corpora amylacea (CA). The cause of death was AD, and past medical history revealed an aneurysmal SAH during childbirth 60 years ago. CA and gliosis are common findings in aging, ischemia, and AD. These findings contribute to the knowledge of the long-term effects of SAH and necessitate further research on the pathogenesis of AD in relation to cerebral ischemia.

This scoping review examines the impact of inappropriate sexual behaviors (ISBs) in people with dementia on their family caregivers. Through synthesizing 15 studies from 8 countries, 6 themes were identified: complex emotional responses, psychological distress, increased caregiver burden, practical caregiving challenges, impaired marital relationships, and social isolation. Findings reveal caregivers frequently experience helplessness, embarrassment, anger, anxiety, depression, and social withdrawal, exacerbated by societal taboos surrounding sexuality and limited professional support. Spousal caregivers are particularly affected, reporting increased emotional strain and marital distress. Practical caregiving difficulties, including safety and privacy concerns, limited access to care services, and challenging institutionalization decisions, further intensify caregiver burden. The review highlights significant research gaps, including the need for specialized assessment tools, broader and culturally diverse studies, and exploration of ISBs as distinct phenomena. Addressing these gaps is crucial for developing targeted interventions and adequately supporting caregivers, particularly within home-based and culturally sensitive dementia care services.

BackgroundPhysical activity is crucial for preventing cognitive decline in elders with mild cognitive impairment (MCI) or dementia, but increasing it in this group poses challenges.ObjectiveTo summarize and update barriers and facilitators to physical activity using the COM-B (Capability-Opportunity-Motivation-Behavior) model, and examine variations across settings, cognitive levels, and stakeholders' perspectives.MethodsEight databases (PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, China National Knowledge Network, Wanfang Data and VIP) were searched from inception to January 20, 2024. Barriers and facilitators were analyzed using directed content analysis based on the COM-B model.ResultsFrom 33 studies, 18 barriers and 15 facilitators were identified, spanning all COM-B domains, with variations across settings, cognitive levels, and stakeholders' perspectives.ConclusionThe findings provide a foundation for developing tailored physical activity promotion strategies for older adults with MCI/dementia, which should be differentiated based on residential settings, cognitive impairment levels, and stakeholders involved.

IntroductionThough Black Americans are twice as likely as White Americans to be diagnosed with Alzheimer's Disease, they may be excluded from the mental representation of a person with dementia.MethodsParticipants (N = 143, median age = 19) created visualized mental representations of a person, a man, a woman, a Black man, or a Black woman diagnosed with dementia by repeatedly selecting which among 12 faces looked most like each target category.ResultsThe visualized representation of a person with dementia was more similar to the representation of a man and a Black woman than to a Black man and a woman, respectively.DiscussionThese findings highlight how intersectionality shapes mental representations of dementia, revealing that certain combinations of marginalized identities are perceived differently rather than excluded entirely.

Most dementia caregiver programs focus on a single caregiver, overlooking diverse caregiving networks that include family, friends, and relatives who provide care. We conducted a scoping review of family-centered dementia caregiving programs (ie, interventions with at least 2 caregivers) to (1) describe program components; (2) identify how family members are included; (3) summarize family-level measurements used and the effectiveness of family-centered programs on these outcomes; and (4) explore if and how programs are culturally adapted. We identified 36 articles and 10 programs (individual-family programs, n = 8; multi-family group programs, n = 2). Programs included similar content and effectiveness was reported by the primary caregiver and measured at the individual level. To better support diverse caregiving networks, caregiving programs may benefit from identifying core components of caregiving programs, including best practices in engaging family caregivers, acknowledging varied family structures and the fluidity in caregiving, and measuring strengths and deficits at the family-level.

IntroductionCreutzfeldt-Jakob disease (CJD) is a fatal prion disorder marked by rapidly progressive dementia and neuropsychiatric features. Epidemiological data in Latin America are limited, and no incidence studies exist in Mexico. This study sought to quantify CJD incidence in a neurological reference center.MethodsA cross-sectional study was conducted at the National Institute of Neurology and Neurosurgery, Mexico City, during 2023-2024. Clinical and paraclinical findings were reviewed. Incidence was calculated per 1000 emergency visits, with relative risk (RR) and 95% confidence intervals.ResultsAmong 19 003 patients, 15 fulfilled probable CJD criteria. Incidence was 0.55/1000 in 2023 and 1.01/1000 in 2024 (RR 1.83; 95% CI 0.63-5.35; P = .309). Cognitive and behavioral symptoms predominated (psychosis in 68%). MRI revealed abnormalities in all cases, most often cortical ribboning (93%).ConclusionThis first incidence study highlights the presence of CJD in specialized Mexican centers, underscoring the need for systematic surveillance and improved diagnostic access.

Dementia is attributable to 12 known risk factors in 40% cases. This study aimed to assess the prevalence of defined risk factors among people living with dementia. 174 patients with dementia and caregivers were interviewed using semi-structured pro forma, risk factors provided by the Lancet Commission on Dementia (2020), and Dementia Severity Rating Scale (DSRS). The prevalence of 11 known risk factors and associations between the risk factors and dementia severity were assessed. The mean age of the participants was 73.9 years (SD = 8.34 years). The education below intermediate level was 83.3%, 17.8% had hearing loss, 37.9% had hypertension, 24.1% had diabetes, 25.9% and 55.2% had alcohol and nicotine harmful use respectively and 8% had a history of traumatic brain injury and obesity each. There is a substantial prevalence of risk factors among people living with dementia in Nepal but no associations between any of the risk factors and dementia severity.