Journal of Alzheimer's Disease - Volume 100, issue 3

Authors: Ge, Sanyu | Kitamura, Tetsuhisa | Zha, Ling | Komatsu, Masayo | Komukai, Sho | Murata, Fumiko | Maeda, Megumi | Gon, Yasufumi | Kimura, Yasuyoshi | Kiyohara, Kosuke | Sobue, Tomotaka | Fukuda, Haruhisa

Article Type: Research Article

Abstract: Background: Previous studies have shown a possible association between statin use and a decreased risk of dementia, but the association has not been sufficiently established, especially in the super-aging society of Japan. Objective: This study aimed to determine the association between statin use and the risk of dementia among Japanese participants aged> =65 years old. Methods: Data from the Longevity Improvement and Fair Evidence (LIFE) Study were utilized, including medical and long-term care (LTC) claim data from 17 municipalities between April 2014 and December 2020. A nested case-control study was conducted with one case matched to …five controls based on age, sex, municipality, and year of cohort entry. We used a conditional logistic regression model to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: This study included 57,302 cases and 283,525 controls, with 59.7% of the participants being woman. After adjusting for potential confounders, statin use was associated with a lower risk of dementia (OR, 0.70; 95% CI: 0.68–0.73) and Alzheimer’s disease (OR: 0.66; 95% CI: 0.63–0.69). Compared with non-users, the ORs of dementia were as follows: 1.42 (1.34–1.50) for 1–30 total standardized daily dose (TSDD), 0.91 (0.85–0.98) for 31–90 TSDD, 0.63 (0.58–0.69) for 91–180 TSDD, and 0.33 (0.31–0.36) for >180 TSDD in dose-analysis. Conclusions: Statin use is associated with a reduced risk of dementia and Alzheimer’s disease among older Japanese adults. A low cumulative statin dose is associated with an increased risk of dementia, whereas a high cumulative statin dose is a protective factor against dementia. Show more

Keywords: Alzheimer’s disease, dementia, Japanese older adults, LIFE study, statin

DOI: 10.3233/JAD-240113

Citation: Journal of Alzheimer's Disease, vol. 100, no. 3, pp. 987-998, 2024

Authors: Han, Kaiyue | Liu, Guangliang | Liu, Nan | Li, Jiangyi | Li, Jianfeng | Cui, Lihua | Cheng, Ming | Long, Junzi | Liao, Xingxing | Tang, Zhiqing | Liu, Ying | Liu, Jiajie | Chen, Jiarou | Lu, Haitao | Zhang, Hao

Article Type: Research Article

Abstract: Background: The current application effects of computerized cognitive intervention are inconsistent and limited to hospital rehabilitation settings. Objective: To investigate the effect of mobile intelligent cognitive training (MICT) on patients with post-stroke cognitive impairment (PSCI). Methods: This study was a multicenter, prospective, open-label, blinded endpoint, cluster-randomized controlled trial (RCT). 518 PSCI patients were stratified and assigned to four rehabilitation settings, and then patients were randomized into experimental and control groups in each rehabilitation setting through cluster randomization. All patients received comprehensive management for PSCI, while the experimental group additionally received MICT intervention. Treatment was 30 minutes …daily, 5 days per week, for 12 weeks. Cognitive function, activities of daily living (ADL), and quality of life (QOL) were assessed before the treatment, at weeks 6 and 12 post-treatment, and a 16-week follow-up. Results: Linear Mixed Effects Models showed patients with PSCI were better off than pre-treatment patients on each outcome measure (p  < 0.05). Additionally, the improvement of these outcomes in the experimental group was significantly better than in the control group at week 6 post-treatment and 16-week follow-up (p  < 0.05). The rehabilitation setting also affected the cognitive efficacy of MICT intervention in improving PSCI patients, and the degree of improvement in each outcome was found to be highest in hospital, followed by community, nursing home, and home settings. Conclusions: Long-term MICT intervention can improve cognition, ADL, and QOL in patients with PSCI, with sustained effects for at least one month. Notably, different rehabilitation settings affect the cognitive intervention efficacy of MICT on PSCI patients. However, this still needs to be further determined in future studies. Show more

Keywords: Alzheimer’s disease, cognitive impairment, mobile intelligent cognitive training, rehabilitation, stroke

DOI: 10.3233/JAD-240356

Citation: Journal of Alzheimer's Disease, vol. 100, no. 3, pp. 999-1015, 2024

Authors: Portal, Benjamin | Södergren, Moa | Parés i Borrell, Teo | Giraud, Romain | Metzendorf, Nicole G. | Hultqvist, Greta | Nilsson, Per | Lindskog, Maria

Article Type: Research Article

Abstract: Background: Alzheimer’s disease (AD) is the most common neurodegenerative disease. Unfortunately, efficient and affordable treatments are still lacking for this neurodegenerative disorder, it is therefore urgent to identify new pharmacological targets. Astrocytes are playing a crucial role in the tuning of synaptic transmission and several studies have pointed out severe astrocyte reactivity in AD. Reactive astrocytes show altered physiology and function, suggesting they could have a role in the early pathophysiology of AD. Objective: We aimed to characterize early synaptic impairments in the App NL -F knock-in mouse model of AD, especially to understand the contribution …of astrocytes to early brain dysfunctions. Methods: The App NL -F mouse model carries two disease-causing mutations inserted in the amyloid precursor protein gene. This strain does not start to develop amyloid-β plaques until 9 months of age. Thanks to electrophysiology, we investigated synaptic function, at both neuronal and astrocytic levels, in 6-month-old animals and correlate the synaptic activity with emotional behavior. Results: Electrophysiological recordings in the hippocampus revealed an overall synaptic mistuning at a pre-plaque stage of the pathology, associated to an intact social memory but a stronger depressive-like behavior. Astrocytes displayed a reactive-like morphology and a higher tonic GABA current compared to control mice. Interestingly, we here show that the synaptic impairments in hippocampal slices are partially corrected by a pre-treatment with the monoamine oxidase B blocker deprenyl or the fast-acting antidepressant ketamine (5 mg/kg). Conclusions: We propose that reactive astrocytes can induce synaptic mistuning early in AD, before plaques deposition, and that these changes are associated with emotional symptoms. Show more

Keywords: Alzheimer’s disease, App knock-in mice, depression, LTP, MAO-B, synapse

DOI: 10.3233/JAD-231461

Citation: Journal of Alzheimer's Disease, vol. 100, no. 3, pp. 1017-1037, 2024

Authors: García-Martínez, María | Pozueta-Cantudo, Ana | Lage, Carmen | Martínez-Dubarbie, Francisco | López-García, Sara | Fernández-Matarrubia, Marta | Corrales-Pardo, Andrea | Bravo, María | Cavada, Nadia C. | Anuarbe, Pedro | Infante, Jon | López-Higuera, José Miguel | Rodríguez-Cobo, Luis | Rodríguez-Rodríguez, Eloy | Butler, Christopher R. | Sánchez-Juan, Pascual

Article Type: Research Article

Abstract: Background: With the arrival of disease-modifying treatments, it is mandatory to find new cognitive markers that are sensitive to Alzheimer’s disease (AD) pathology in preclinical stages. Objective: To determine the utility of a newly developed Learning and Associative Memory face test: LAM test. This study examined the relationship between AD cerebrospinal fluid (CSF) biomarkers and performance on LAM test, and assessed its potential clinical applicability to detect subtle changes in cognitively healthy subjects at risk for AD. Methods: We studied eighty cognitively healthy volunteers from the Valdecilla cohort. 61% were women and the mean age was …67.34 years (±6.416). All participants underwent a lumbar puncture for determination of CSF biomarkers and an extensive neuropsychological assessment, including performance on learning and associative memory indices of the LAM-test after 30 min and after 1 week, and two classic word lists to assess verbal episodic memory: the Rey Auditory Verbal Learning Test (RAVLT) and the Free and Cued Selective Reminding Test (FCSRT). We analyzed cognitive performance according to amyloid status (A+ versus A–) and to ATN model (A–T–N–; A+T–N–; A+T+N–/A+T+N+). Results: Performance on the LAM-test was significantly correlated with CSF Aβ ratio. A+ participants performed worse on both learning (mean difference = 2.19, p  = 0.002) and memory LAM measures than A– (mean difference = 2.19, p  = 0.004). A decline in performance was observed along the Alzheimer’s continuum, with significant differences between ATN groups. Conclusions: Our findings suggest that LAM test could be a useful tool for the early detection of subjects within the AD continuum, outperforming classical memory tests. Show more

Keywords: Alzheimer’s disease, associative memory, cognitive markers, early detection, long-term forgetting, neuropsychological assessment, preclinical Alzheimer’s disease

DOI: 10.3233/JAD-240067

Citation: Journal of Alzheimer's Disease, vol. 100, no. 3, pp. 1039-1053, 2024

Authors: Frank, Brandon | Walsh, Michael | Hurley, Landon | Groh, Jenna | Blennow, Kaj | Zetterberg, Henrik | Tripodis, Yorghos | Budson, Andrew E. | O’Connor, Maureen K. | Martin, Brett | Weller, Jason | McKee, Ann | Qiu, Wendy | Stein, Thor D. | Stern, Robert A. | Mez, Jesse | Henson, Rachel | Long, Justin | Aschenbrenner, Andrew J. | Babulal, Ganesh M. | Morris, John C. | Schindler, Suzanne | Alosco, Michael L.

Article Type: Research Article

Abstract: Background: Neuropsychiatric symptoms (NPS) can be an early manifestation of Alzheimer’s disease (AD). However, the associations among NPS, cognition, and AD biomarkers across the disease spectrum are unclear. Objective: We analyzed cross-sectional mediation pathways between cerebrospinal fluid (CSF) biomarkers of AD (Aβ1-42 , p-tau181 ), cognitive function, and NPS. Methods: Primary models included 781 participants from the National Alzheimer’s Coordinating Center (NACC) data set who had CSF analyzed for AD biomarkers using Lumipulse. NPS were assessed with the Neuropsychiatric Inventory Questionnaire (NPI-Q). We assessed cognition with the harmonized MMSE/MoCA, as well as neuropsychological tests sensitive to …AD pathology: story recall, naming, animal fluency, and Trails B. The Clinical Dementia Rating (CDR® ) scale assessed dementia severity. Mediation models were estimated with Kemeny metric covariance in a structural equation model framework, controlling for age, education, sex, and APOE ɛ 4. Results: The sample was older adults (M  = 73.85, SD  = 6.68; 49.9% male, 390; 27.9% dementia, 218) who were predominantly white (n  = 688, 88.1%). Higher p-tau181 /Aβ1-42 ratio predicted higher NPI-Q, which was partially mediated by the MMSE/MoCA and, in a second model, story recall. No other pathway was statistically significant. Both the MMSE/MoCA and NPI-Q independently mediated the association between p-tau181 /Aβ1-42 ratio and CDR global impairment. With dementia excluded, p-tau181 /Aβ1-42 ratio was no longer associated with the NPI-Q. Conclusions: NPS may be secondary to cognitive impairment and AD pathology through direct and indirect pathways. NPS independently predict dementia severity in AD. However, AD pathology likely plays less of a role in NPS in samples without dementia. Show more

Keywords: Alzheimer’s disease, amyloid, biomarkers, cerebrospinal fluid, cognition, neuropsychiatric symptoms, p-tau

DOI: 10.3233/JAD-240125

Citation: Journal of Alzheimer's Disease, vol. 100, no. 3, pp. 1055-1073, 2024

Authors: Arenson, Melanie | Bahorik, Amber | Xia, Feng | Peltz, Carrie | Cohen, Beth | Yaffe, Kristine

Article Type: Research Article

Abstract: Background: Black and Hispanic older adults have greater incidence of Alzheimer’s disease and related dementias relative to White adults, but factors underlying these disparities are not well understood, limiting the ability to address them. Objective: To determine the impact of demographics, cardiovascular disease (CVD) and risk factors, social determinants of health (SDOH), and neuropsychiatric risk factors on racial/ethnic disparities in dementia risk among Veterans. Methods: We examined a random sample of 1,579,919 older Veterans (age ≥55) without dementia who received care from the VHA from October 1, 1999 to September 30, 2021. All variables were extracted …from national VHA data. We used Cox proportional hazard regression models to examine change in variance in risk of dementia across racial/ethnic groups. Results: During follow up (mean 11.1 years), 13% of Veterans developed dementia. Relative to White Veterans, the adjusted hazard ratios (AHRs) for developing dementia in sex-adjusted models with age as timescale were 1.65 (95% CI, 1.63–1.67) for Black Veterans and 1.50 (95% CI, 1.44–1.56) for Hispanic Veterans. In the model examining CVD and risk factors, AHRs were 1.53 (95% CI, 1.50–1.55) for Black Veterans and 1.38 (95% CI, 1.33–1.44) for Hispanic Veterans. In the model examining SDOH, AHRs were 1.46 (95% CI, 1.43–1.49) for Black Veterans and 1.34 (95% CI, 1.29–1.40) for Hispanic Veterans. Conclusions: SDOH and CVD and risk factors accounted for the greatest amount of variance in racial/ethnic disparities in dementia risk. Cardiovascular disease and SDOH are strong possible targets for interventions designed to reduce these disparities. Show more

Keywords: Alzheimer’s disease, dementia, risk factors, social determinants of health, Veterans

DOI: 10.3233/JAD-240181

Citation: Journal of Alzheimer's Disease, vol. 100, no. 3, pp. 1075-1082, 2024

Authors: Zhai, Weijie | Zhao, Anguo | Wei, Chunxiao | Xu, Yanjiao | Cui, Xinran | Zhang, Yan | Meng, Lingjie | Sun, Li

Article Type: Research Article

Abstract: Background: Although observational studies indicated connections between fatty acids (FAs) and Alzheimer’s disease and dementia, uncertainty persists regarding how these relationships extend to dementia with Lewy bodies (DLB). Objective: To explore the potential causal relationships between FAs and the development of DLB, thus clarifying these associations using genetic instruments to infer causality. Methods: We applied a two-sample Mendelian randomization (MR) and multivariable Mendelian randomization (MVMR) approach. Genetic data were obtained from a DLB cohort, comprising 2,591 cases and 4,027 controls of European descent. Eight FAs, including linoleic acid, docosahexaenoic acid, monounsaturated fatty acid, omega-3 fatty acid, …omega-6 fatty acid, polyunsaturated fatty acid, saturated fatty acid, and total fatty acid, were procured from a comprehensive GWAS of metabolic biomarkers of UK Biobank, conducted by Nightingale Health in 2020 (met-d), involving 114,999 individuals. Our analysis included inverse-variance weighted, MR-Egger, weighted-median, simple mode, and weighted-mode MR estimates. Cochran’s Q-statistics, MR-PRESSO, and MR-Egger intercept test were used to quantify the heterogeneity and horizontal pleiotropy of instrumental variables. Results: Only linoleic acid showed a significant genetic association with the risk of developing DLB in the univariate MR. The odds ratio for linoleic acid was 1.337 with a 95% confidence interval of 1.019–1.756 (pIVW  = 0.036). Results from the MVMR showed that no FAs were associated with the incidence of DLB. Conclusions: The results did not support the hypothesis that FAs could reduce the risk of developing DLB. However, elucidating the relationship between FAs and DLB risk holds potential implications for informing dietary recommendations and therapeutic approaches in DLB. Show more

Keywords: Alzheimer’s disease, dementia, dementia with Lewy bodies, fatty acids, linoleic acid, Mendelian randomization

DOI: 10.3233/JAD-240267

Citation: Journal of Alzheimer's Disease, vol. 100, no. 3, pp. 1083-1097, 2024