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

While regular physical-activity (PA) is beneficial, multimorbid individuals at increased dementia risk may exhibit reduced PA levels. Thus, a more comprehensive understanding of mediating factors responsible for inactivity in this population is needed. This study investigated the impact of a multimodal intervention on PA changes at 24-month follow-up and associated mediating factors among community-dwelling patients aged 60-77, with increased dementia risk determined by the CAIDE Dementia Risk Score. Of 1030 participants recruited, 819 completed the assessment. Thus, a generalized estimating equations model initially assessed differences in PA over 24 months, followed by a tree analysis identifying mediating factors influencing PA changes post-intervention. While no significant effect on regular PA was found during the follow-up (P = .674), subgroup analysis revealed improved self-efficacy (P = .000) associated with increased engagement in PA. Incorporating self-efficacy elements into future strategies is crucial for promoting PA among individuals with multimorbidity and at increased dementia risk.

Study recruitment of persons with dementia is challenging. We aimed to assess facilitators, barriers, and strategies to identify and approach persons with dementia for recruitment to dementia care studies. We systematically searched MEDLINE/PubMed, CINAHL, Web of Science, and other sources (ORRCA [Online Resource for Research in Clinical triAls]; pertinent evidence syntheses; citation searching) and narratively summarised the results (PROSPERO CRD42022342600). Facilitators and barriers consisted of "characteristics of participants, researchers, clinical contact persons", "study characteristics", and "communication with participants". The highest number of participants were recruited by study information in electronic and print formats, as well as by networking and collaboration. Advertisements proved to be the most expensive way of recruitment. There is limited evidence on the impact of recruitment strategies to identify persons with dementia for recruitment to dementia care studies. Our analysis of facilitators and barriers may inform research teams in designing strategies to identify persons with dementia for recruitment purposes.

ObjectivesTo examine the relationship between hearing impairment and cognitive function and the mediating role of social isolation and depression. Methods: Data came from the 2018 China Health and Retirement Longitudinal Study wave. A self-reported item, a composite index, the 10-item Center for Epidemiological Studies Depression Scale, and the Mini-Mental State Exam were used to measure hearing impairment, social isolation, depression, and cognitive function, respectively. Mediation analysis was performed. Results: 6799 participants were included. For participants reporting mild hearing impairment and severe hearing impairment, there were significant direct and indirect effects on cognitive function. Social isolation mediated 2.75% and 6.33% of the relationship between mild hearing impairment, severe hearing impairment, and cognitive function, respectively. The direct effect of hearing impairment outweighed the mediation effect of social isolation on cognitive function. Conclusions: Decreased cognitive function linked to hearing impairment might benefit from addressing hearing impairment and social isolation in older adults.

Objectives: This study aimed to examine the effects of location-tracking devices on persons living with cognitive impairment, investigate facilitators of and barriers to using the devices, and provide future directions for the use of the devices.

Methods: An integrative review was conducted using 5 databases: PubMed, Embase, Web of Science, CINAHL, and Scopus. From the 1429 initially identified studies, 10 were included in the review.

Results: Location-tracking devices benefited persons living with cognitive impairment and their informal caregivers. The devices brought more independence to persons living with cognitive impairment, allowing them to go outside and feel safer there. Furthermore, the devices reduced the caregivers' worries about their loved ones being lost.

Conclusions: Location-tracking devices have the potential to increase independence in persons living with cognitive impairment and to decrease psychological stress in informal caregivers. In the future, ways to minimize the barriers to using location-tracking devices need to be determined.

Background: The staff working at day-care centers and nursing homes are in a key frontline for early detection of older people living with dementia, however, whether the staff were well prepared and if they were appropriately trained were still little known.

Method: A cross-sectional survey was conducted and the validated questionnaires exploring the awareness of dementia care, in terms of knowledge, attitude and preventive practice domain, were given to the staff working at day-care centers and nursing homes in Macao.

Results: 272 samples were approached and scores of knowledge was 76.23 ± 19.62, attitude was 80.05 ± 8.92 and preventive practice was 75.59 ± 13.88, among which knowledge and preventive practice were positively related to attitude, and knowledge, attitude and preventive practice were negatively related to age. Health care assistants' knowledge were less than social workers, managers, health professionals and clerk. Attitude of health care assistants were less positive than social workers and health professionals.

Discussion: Health care assistants and older staff had less knowledge and less positive attitude. Trainings to improve knowledge, attitude and preventive practice amongst health care assistants and older staff were recommended strongly.

The goals of this exploratory pre-post pilot and feasibility study (NCT04916964) were to assess the feasibility and effectiveness of an adapted Test-and-Exercise home-based exercise program on basic functional mobility and executive functions in persons with prodromal or mild Alzheimer's disease. Participants followed an 8 week exercise program at home, once per week with a physiotherapist and twice per week with their usual caregiver or independently. Functional mobility and executive functions were assessed before and after the intervention. Feasibility criteria were recruitment opportunity, participation agreement rate, cost adequacy, and drop-out rate. Twelve participants aged 80.83 ± 4.65 years took part in the study. All the basic functional mobility measures showed small effect sizes. Concerning executive functions, 5 measures showed small to moderate effect sizes. The 4 feasibility criteria were met. A larger scale study would, however, need adaptations and prior research on the ability of this population to use touch-screen technology.

Alzheimer's disease (AD) is the most common cause of dementia. Epileptic seizures or epileptic activity have been detected in AD, and people with epilepsy have a higher risk of dementia compared to the general population. This suggests that seizures or epileptic activity might often coexist with AD. It is increasingly evident that epileptic activity or seizures are common but often overlooked comorbidities of AD. However, the causal relationship between seizures, epileptic activity and cognitive decline remains uncertain. Experimental data show that amyloid-β (Aβ) and Tau protein can cause neuronal hyperexcitability and has epileptogenic effects. Neural network hyperexcitation regulates the ratio of Aβ isoforms and is linked to the initiation of AD, indicating a shared mechanism. Clinical studies suggest that cognitive impairment accelerates in AD patients with seizures or epileptic activity. This review discusses the relationship between epileptic seizures and AD, the impact of epileptic activity in AD, and potential treatments.

Institutionalized persons with dementia often lack access to meaningful activity, which can lead to agitation, loneliness, and depression. Engagement in activity may improve negative symptoms but is difficult in most settings. In this study, we investigated the degree to which the Reading Buddies Program, in which occupational therapy graduate students read books with residents with dementia, engaged residents. We further assessed whether the level of engagement was affected by various parameters, including those related to interaction, environment, attention, attitude, and activity. The primary outcome measure was engagement percentage-duration of time the book was read divided by duration of time the person with dementia engaged with the book. As expected, increased attention, attitude, and activity parameters were associated with increased engagement. None of the environmental parameters significantly affected engagement. Overall, we found that reading with persons with dementia led to a very high level of engagement and appeared to reduce negative symptoms.

Home-dwelling people with dementia rely on their family members to be able to stay at home. This affects the family caregivers' quality of life (QoL). However, less is known about how male and female caregivers differ in their QoL. Our study aimed to investigate gender differences in caregivers' quality of life (QoL), whether emotional relationships influence QoL, and how their QoL changes over time. The study applied a cross-sectional and a longitudinal design to examine a total of 208 caregivers, 158 female and 50 male caregivers, and their family member with dementia. Regression analysis and t-tests were performed to identify what characteristics about caregivers and care receivers influence male and female QoL, and whether caregivers' QoL developed after one year. Both male and female caregivers' depression influenced their QoL. For females, their own social distress influenced their QoL, and for males, their experience of their care receivers' overemotional attitude influenced their QoL. From baseline to one-year follow-up their QoL decreased while their distress and experience of care receivers' emotional attitudes was stable. Significant gender-specific differences were found, indicating that gender must be considered when approving caregivers' needs and planning interventions for caregivers.

Dysregulation of the peripheral immune system is be involved in the neuroinflammation in Alzheimer disease (AD) and accelerate the disease progression. The contribution of immune cells, particularly B cells, to AD pathogenesis has gained attention in recent research. In this study, we investigated the role of Peripheral Blood Memory B cells (PBMBs) and their secreted Migration Inhibition Factor (MIF) in driving macrophage behavior in AD based on the scRNA-seq technique, immunofluorescence and flow cytometry. We discovered that MIF binds to the CD74-CD44 receptor complex on macrophages, influencing their behavior. The dysregulated macrophage response hampers the clearance of amyloid-beta (Aβ) plaques, exacerbating AD pathology. Targeting the MIF-CD74-CD44 signal pathway may hold therapeutic potential in modulating macrophage activity and mitigating neuroinflammation in AD. This study provides a further understanding of peripheral immune cells dysregulated in AD.