Journal of Alzheimer's Disease - Volume 100, issue 2

Authors: Huang, Xiangyuan | Hilal, Saima

Article Type: Research Article

Abstract: Background: Marital factor has been associated with dementia and Alzheimer’s disease, but there is limited evidence on the impact of holistic marital history over time. Objective: This study aimed to examine association of marital history with cognition. Methods: The study included 24,596 dementia-free participants from the Chinese Longitudinal Healthy Longevity Study (CLHLS). Holistic marital history was collected at baseline, categorizing participants into five groups: widow-single, widow-remarried, divorce-single, divorce-remarried and married based on the first two marriages. Dementia was collected at follow-up through self-report or from a delegate if the participant was deceased. For 15,355 participants, the …Chinese Mini-Mental Status Examination (CMMSE) was administered at both baseline and follow-ups. Cognitive impairment was defined as a follow-up CMMSE score below 18, and rate of cognitive change was calculated as the change in CMMSE score between consecutive visits divided by the duration. Results: Compared with married older adults, widow-single group had significantly higher risk of dementia (HR 1.28, 95% CI 1.05, 1.54), cognitive impairment (HR 1.31, 95% CI 1.17, 1.47) and significantly faster decline of MMSE score (β –0.09, 95% CI –0.17, –0.01). Meanwhile, widow-remarried group had significantly lower risk of dementia, cognitive impairment and slower MMSE score decline than widow-single group, although the differences were only significant among female but not male. Conclusions: In this prospective cohort, married older adults and those widowed but with a second marriage had significantly better cognition than widowed individuals who did not remarry. Show more

Keywords: Alzheimer’s disease, cognitive dysfunction, longitudinal studies, marriage, social isolation

DOI: 10.3233/JAD-240176

Citation: Journal of Alzheimer's Disease, vol. 100, no. 2, pp. 675-683, 2024

Authors: Sakharova, Tatyana | Mao, Siqi | Osadchuk, Mikhail

Article Type: Research Article

Abstract: Background: In recent years, researchers have focused on developing precise models for the progression of Alzheimer’s disease (AD) using deep neural networks. Forecasting the progression of AD through the analysis of time series data represents a promising approach. Objective: The primary objective of this research is to formulate an effective methodology for forecasting the progression of AD through the integration of multi-task learning techniques and the analysis of pertinent medical data. Methods: This study primarily utilized volumetric measurements obtained through magnetic resonance imaging (MRI), trajectories of cognitive assessments, and clinical status indicators. The research encompassed 150 …patients diagnosed with AD who underwent examination between 2020 and 2022 in Beijing, China. A multi-task learning approach was employed to train forecasting models using MRI data, trajectories of cognitive assessments, and clinical status. Correlation analysis was conducted at various time points. Results: At the baseline, a robust correlation was observed among the forecasting tasks: 0.75 for volumetric MRI measurements, 0.62 for trajectories of cognitive assessment, and 0.48 for clinical status. The implementation of a multi-task learning framework enhanced performance by 12.7% for imputing missing values and 14.8% for prediction accuracy. Conclusions: The findings of our study, indicate that multi-task learning can effectively predict the progression of AD. However, it is important to note that the study’s generalizability may be limited due to the restricted dataset and the specific population under examination. These conclusions represent a significant stride toward more precise diagnosis and treatment of this neurological disorder. Show more

Keywords: Alzheimer’s disease, clinical status, cognitive assessment, correlation, MRI, multi-task learning, prediction

DOI: 10.3233/JAD-240183

Citation: Journal of Alzheimer's Disease, vol. 100, no. 2, pp. 685-697, 2024

Authors: Musyimi, Christine W. | Muyela, Levi A. | Ndetei, David M. | Evans-Lacko, Sara | Farina, Nicolas

Article Type: Research Article

Abstract: Background: Dementia stigma has adverse effects on people with dementia and their carers. These effects can lead to poor quality of life among other negative impacts. Objective: The aim of this study is to develop and pilot a novel dementia stigma reduction intervention in rural Kenya, leveraging existing Community Health Workers (CHWs) for its delivery. Methods: The pre-post pilot study was conducted, utilizing a parallel mixed-methods design. Ten CHWs were trained to deliver a contextually developed dementia anti-stigma intervention. These CHWs delivered four workshops to 59 members of the general public in Makueni County, with each …workshop lasting between 1.5 to 2 hours. Focus group discussions and pre/post surveys were used as measures. Results: The intervention was well received amongst the participants, particularly in terms of its format and accessibility. We observed the largest effects in reducing negative beliefs related to treatment (η 2  = 0.34), living well with dementia (η 2  = 0.98), and care (η 2  = 0.56) for the general public post intervention. Improvements to attitudes were also observed in the CHWs, but the effect sizes were typically smaller. Conclusions: The intervention was accessible and feasible in rural Kenya, while also showing preliminary benefits to stigma related outcomes. The findings indicate that culturally sensitive interventions can be delivered in a pragmatic and context specific manner, thus filling an important knowledge gap in addressing stigma in low-resource settings. Future research is needed to ascertain the intervention’s long-term benefits and whether it tackles important behavioral outcomes and beliefs deeply ingrained within communities. Show more

Keywords: Alzheimer’s disease, anti-stigma, dementia, feasibility, general public, intervention

DOI: 10.3233/JAD-240192

Citation: Journal of Alzheimer's Disease, vol. 100, no. 2, pp. 699-711, 2024

Authors: Giuffrè, Guido Maria | Quaranta, Davide | Citro, Salvatore | Morganti, Tommaso Giuseppe | Martellacci, Noemi | Vita, Maria Gabriella | Rossini, Paolo Maria | Calabresi, Paolo | Marra, Camillo

Article Type: Research Article

Abstract: Background: The Free and Cued Selective Reminding Test (FCSRT), assessing verbal episodic memory with controlled learning and semantic cueing, has been recommended for detecting the genuine encoding and storage deficits characterizing AD-related memory disorders. Objective: The present study aims at investigating the ability of FCSRT in predicting cerebrospinal fluid (CSF) evidence of amyloid-β positivity in subjects with amnestic mild cognitive impairment (aMCI) and exploring its associations with amyloidopathy, tauopathy and neurodegeneration biomarkers. Methods: 120 aMCI subjects underwent comprehensive neurological and neuropsychological examinations, including the FCSRT assessment, and CSF collection; CSF Aβ42/40 ratio, p-tau181, and total-tau …quantification were conducted by an automated CLEIA method on Lumipulse G1200. Based on the Aβ42/40 ratio value, subjects were classified as either A+ or A–. Results: All FCSRT subitem scores were significantly lower in A+ group and significantly predicted the amyloid-β status, with Immediate Total Recall (ITR) being the best predictor. No significant correlations were found between FCSRT and CSF biomarkers in the A– aMCI group, while in the A+ aMCI group, all FCSRT subitem scores were negatively correlated with CSF p-tau181 and total-tau, but not with the Aβ42/40 ratio. Conclusions: FCSRT confirms its validity as a tool for the diagnosis of AD, being able to predict the presence of amyloid-β deposition with high specificity. The associations between FCSRT subitem scores and CSF p-tau-181 and total-tau levels in aMCI due to AD could further encourage the clinical use of this simple and cost-effective test in the evaluation of individuals with aMCI. Show more

Keywords: Alzheimer’s disease, amyloid-β , cerebrospinal fluid biomarkers, episodic memory, mild cognitive impairment, neurodegeneration

DOI: 10.3233/JAD-240150

Citation: Journal of Alzheimer's Disease, vol. 100, no. 2, pp. 713-723, 2024

Authors: Gareri, Pietro | Cotroneo, Antonino Maria | Montella, Roberta | Gaglianone, Matteo | Putignano, Salvatore

Article Type: Research Article

Abstract: Background: Citicoline is a naturally occurring compound with pleiotropic effects on neuronal function and cognitive processes. Objective: Based on previous studies, which shed light on the positive effects of citicoline 1 g when combined with acetylcholinesterase inhibitors (AChEIs) and/or memantine, we further investigated the benefits of citicoline in combination therapy in Alzheimer’s disease and mixed dementia. Methods: We integrated the datasets of CITIMEM and CITIDEMAGE, increasing the overall sample size to enhance statistical power. We analyzed data from these two investigator-initiated studies involving 295 patients. The primary outcome was the assessment over time of the effects of …combined treatment versus memantine given alone or AChEI plus memantine on cognitive functions assessed by Mini-Mental State Examination (MMSE). The secondary outcomes were the influence of combined treatment on daily life functions, mood, and behavioral symptoms assessed by activities of daily life (ADL) and instrumental ADL, Geriatric Depression Scale, and Neuropsychiatric Inventory Scale. One-hundred-forty-three patients were treated with memantine and/or AChEI (control group), and 152 patients were treated with memantine and/or AChEI plus citicoline 1 g/day orally (Citicoline group). Results: A significant difference in MMSE score was found in the average between the two groups of treatment at 6 and 12 months. Conclusions: This study confirmed the effectiveness of combined citicoline treatment in patients with mixed dementia and Alzheimer’s disease, with a significant effect on the increase of MMSE score over time. The treated group also showed a significant reduction in the Geriatric Depression Scale and a significant increase in the instrumental ADL scale. Show more

Keywords: Alzheimer’s disease, citicoline, cognitive impairment, dementia, older patients

DOI: 10.3233/JAD-240497

Citation: Journal of Alzheimer's Disease, vol. 100, no. 2, pp. 725-733, 2024

Authors: Perry, George | Castellani, Rudolph

Article Type: Book Review

DOI: 10.3233/JAD-249012

Citation: Journal of Alzheimer's Disease, vol. 100, no. 2, pp. 735-735, 2024

Article Type: Correction

DOI: 10.3233/JAD-249011

Citation: Journal of Alzheimer's Disease, vol. 100, no. 2, pp. 737-737, 2024

Article Type: Correction

DOI: 10.3233/JAD-249014

Citation: Journal of Alzheimer's Disease, vol. 100, no. 2, pp. 739-741, 2024