Journal of Alzheimer's Disease - Volume 100, issue 4

Authors: Taylor, Morag E. | Kerckhaert, Luuk | Close, Jacqueline C.T. | van Schooten, Kimberley S. | Lord, Stephen R.

Article Type: Research Article

Abstract: Background: Cognitive impairment (CI) may impair the ability to accurately perceive physical capacity and fall risk. Objective: We investigated perceived (measured as concern about falls) and physiological fall risk in community-dwelling older people with CI, the characteristics of the aligned and misaligned groups and the impact of misaligned perceptions on falls. Methods: Participants (n = 293) with mild-moderate CI were classified into four groups based on validated physiological and perceived fall risk assessments: 1) vigorous: low perceived and physiological fall risk; 2) anxious: high perceived and low physiological fall risk; 3) unaware: low perceived and high physiological …fall risk; and 4) aware: high perceived and physiological fall risk. Groups were compared with respect to neuropsychological and physical function, activity and quality of life measures, and prospective falls (12-months). Results: The anxious (IRR = 1.70, 95% CI = 1.02–2.84), unaware (IRR = 2.00, 95% CI = 1.22–3.26), and aware (IRR = 2.53, 95% CI = 1.67–3.84) groups had significantly higher fall rates than the vigorous group but fall rates did not significantly differ among these groups. Compared with the vigorous group: the anxious group had higher depression scores and reduced mobility and quality of life; the unaware group had poorer global cognition, executive function and mobility and lower physical activity levels; and the aware group had an increased prevalence of multiple physical and cognitive fall risk factors. Conclusions: Fall rates were increased in participants who had increased perceived and/or physiological fall risk. Contrasting fall risk patterns were evident in those who under- and over-estimated their fall risk. Understanding these characteristics will help guide fall risk assessment and prevention strategies in community-dwelling older people with CI. Show more

Keywords: Accidental falls, aged, Alzheimer’s disease, cognitive dysfunction, dementia, fear of falling, perception, risk factors

DOI: 10.3233/JAD-240489

Citation: Journal of Alzheimer's Disease, vol. 100, no. 4, pp. 1389-1398, 2024

Authors: Kashibayashi, Tetsuo | Kanemoto, Hideki | Takahashi, Ryuichi | Fujito, Ryoko | Chadani, Yoshihiro | Tagai, Kenji | Shinagawa, Shunichiro | Ishii, Kazunari | Ikeda, Manabu | Kazui, Hiroaki

Article Type: Research Article

Abstract: Background: Aggression, a common symptom of Alzheimer’s disease (AD), can impose a significant burden on caregivers, necessitating early institutionalization. Objective: The current study examined the neural basis of aggression and its expression mechanism, to advance the development of effective treatment strategies for aggression in patients with AD. Methods: The study sample included 257 patients; 180 were diagnosed with AD and 77 with amnestic mild cognitive impairment (aMCI). Factor analysis of the neuropsychiatric inventory (NPI) aggression scores was performed, and the correlation between each factor and cerebral blood flow (CBF) was examined via diagnosis of AD or …aMCI using statistical parametric mapping. Results: Refusal of care was correlated with reduced CBF in the right hippocampus of patients with AD while no specific related regions could be identified in patients with aMCI. Violent behavior was associated with decreased CBF in the right temporal pole and medial frontal lobe of patients with AD and aMCI. Conclusions: These findings suggest that aggression, measured using NPI includes two distinct symptoms, refusal of care and violent behavior, having different underlying neural bases. Show more

Keywords: Aggression, agitation, Alzheimer’s disease, cerebral blood flow, mild cognitive impairment

DOI: 10.3233/JAD-240256

Citation: Journal of Alzheimer's Disease, vol. 100, no. 4, pp. 1399-1406, 2024

Authors: Halloway, Shannon | Volgman, Annabelle Santos | Barnes, Lisa L. | Schoeny, Michael E. | Wilbur, JoEllen | Pressler, Susan J. | Laddu, Deepika | Phillips, Shane A. | Vispute, Sachin | Hall, Gabriel | Shakya, Shamatree | Goodyke, Madison | Auger, Claire | Cagin, Kelly | Borgia, Jeffrey A. | Arvanitakis, Zoe A.

Article Type: Research Article

Abstract: Background: Vascular diseases, including atherosclerotic cardiovascular disease (ASCVD) and stroke, increase the risk of Alzheimer’s disease and cognitive impairment. Serum biomarkers, such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor 1 (IGF-1), may be indicators of cognitive health. Objective: We examined whether vascular risk was associated with levels of cognition and serum biomarkers in older women with cardiovascular disease (CVD). Methods: Baseline data from a lifestyle trial in older women (n  = 253) with CVD (NCT04556305) were analyzed. Vascular risk scores were calculated for ASCVD (ASCVD risk estimator) and stroke (CHA2 …DS2 -VASc) based on published criteria. Cognition-related serum biomarkers included BDNF, VEGF, and IGF-1. Cognition was based on a battery of neuropsychological tests that assessed episodic memory, semantic memory, working memory, and executive function. A series of separate linear regression models were used to evaluate associations of vascular risk scores with outcomes of cognition and serum biomarkers. All models were adjusted for age, education level, and racial and ethnic background. Results: In separate linear regression models, both ASCVD and CHA2 DS2 -VASc scores were inversely associated with semantic memory (β= –0.22, p  = 0.007 and β= –0.15, p  = 0.022, respectively), with no significant findings for the other cognitive domains. There were no significant associations between vascular risk scores and serum biomarkers. Conclusions: Future studies should prospectively examine associations between vascular risk and cognition in other populations and additionally consider other serum biomarkers that may be related to vascular risk and cognition. Show more

Keywords: Alzheimer’s disease, biomarkers, cardiovascular health, risk factors, stroke

DOI: 10.3233/JAD-240100

Citation: Journal of Alzheimer's Disease, vol. 100, no. 4, pp. 1407-1416, 2024

Authors: Fromm, Davida | Dalton, Sarah Grace | Brick, Alexander | Olaiya, Gbenuola | Hill, Sophia | Greenhouse, Joel | MacWhinney, Brian

Article Type: Research Article

Abstract: Background: Findings from language sample analyses can provide efficient and effective indicators of cognitive impairment in older adults. Objective: This study used newly automated core lexicon analyses of Cookie Theft picture descriptions to assess differences in typical use across three groups. Methods: Participants included adults without diagnosed cognitive impairments (Control), adults diagnosed with Alzheimer’s disease (ProbableAD), and adults diagnosed with mild cognitive impairment (MCI). Cookie Theft picture descriptions were transcribed and analyzed using CLAN. Results: Results showed that the ProbableAD group used significantly fewer core lexicon words overall than the MCI and Control groups. …For core lexicon content words (nouns, verbs), however, both the MCI and ProbableAD groups produced significantly fewer words than the Control group. The groups did not differ in their use of core lexicon function words. The ProbableAD group was also slower to produce most of the core lexicon words than the MCI and Control groups. The MCI group was slower than the Control group for only two of the core lexicon content words. All groups mentioned a core lexicon word in the top left quadrant of the picture early in the description. The ProbableAD group was then significantly slower than the other groups to mention a core lexicon word in the other quadrants. Conclusions: This standard and simple-to-administer task reveals group differences in overall core lexicon scores and the amount of time until the speaker produces the key items. Clinicians and researchers can use these tools for both early assessment and measurement of change over time. Show more

Keywords: Alzheimer’s disease, language, mild cognitive impairment, speech

DOI: 10.3233/JAD-230844

Citation: Journal of Alzheimer's Disease, vol. 100, no. 4, pp. 1417-1434, 2024