Journal of Alzheimer's Disease - Volume 101, issue 3

Authors: Liu, Shu | Li, Jiarui | Wang, Li | Zhang, Yi | Wei, Baojian | Li, Yushang

Article Type: Research Article

Abstract: Background: Ethylene oxide (EO) is a common organic compound associated with many adverse health outcomes. However, studies exploring the association between EO exposure and cognitive function are limited. Objective: This study aims to examine this relationship between EO exposure and cognition in older adults. Methods: This study enrolled 438 older adults from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle. EO exposure was quantified by the measurements of blood hemoglobin adducts of ethylene oxide (HbEO) concentrations. Cognitive function was measured by the Consortium to Establish a Registry for Alzheimer’s Disease battery (CREAD), the Animal …Fluency test (AFT), and the Digit Symbol Substitution Test (DSST). Linear regression model, generalized additive model, and smooth curve fitting were applied to examine the linear and nonlinear relationship between EO exposure and cognitive function. We used a two-piecewise linear regression model to detect the threshold effect of EO exposure on cognitive function. Results: Participants with higher HbEO levels had lower AFT and DSST scores than those with lower HbEO levels. After adjusting for all confounding factors, log2-transformed HbEO levels were negatively associated with AFT score. The smooth curve fitting demonstrated the nonlinear relationship between EO exposure and DSST scores. When log-2 transformed HbEO levels >4.34 pmol/g Hb, EO exposure was negatively associated with DSST score. Conclusions: This study indicated that high levels of HbEO were associated with cognitive decline in US older adults. Future cohort studies are needed to verify our findings. Show more

Keywords: Alzheimer’s disease, cognition, ethylene oxide, NHANES, older adults

DOI: 10.3233/JAD-240662

Citation: Journal of Alzheimer's Disease, vol. 101, no. 3, pp. 951-959, 2024

Authors: Allé, Mélissa C. | Joseph, Christelle | Antoine, Pascal

Article Type: Research Article

Abstract: Background: Alzheimer’s disease (AD) is characterized by severe memory alterations, affecting especially memories of personal past events. Until now, autobiographical memory impairments have been characterized using formal memory assessments, requiring patients to strategically and deliberately recall past events. However, contrary to this highly cognitively demanding mode of memory recall, autobiographical memories frequently come to mind unexpectedly based on automatic associative processes. The involuntary recall of personal memories is effortless and possibly represents a preserved way for AD patients to remember past events. Objective: This study aimed to investigate involuntary autobiographical memory in AD patients and compare the characteristics …of these memories with those of healthy controls. Methods: Involuntary autobiographical memory was measured in 24 AD patients and 24 matched control participants using self-report measures. Participants were asked to report the frequency with which involuntary autobiographical memories were experienced in their daily life and to describe and self-assess one example of an involuntary memory. Results: We showed that AD patients and control participants did not differ in terms of the frequency or subjective characteristics of their involuntary autobiographical memories in daily life, except for feelings of intrusiveness. Compared to control participants, AD patients reported their involuntary autobiographical memories as being more intrusive. In addition, more negative and vague involuntary autobiographical memories were associated with greater depressive symptoms. Conclusions: These findings open up a new avenue for research to better understand the extent to which involuntary autobiographical memory might be preserved in AD patients and why these memories may in turn become intrusive to patients. Show more

Keywords: Alzheimer’s disease, autobiographical memory, intrusiveness, involuntary retrieval

DOI: 10.3233/JAD-240180

Citation: Journal of Alzheimer's Disease, vol. 101, no. 3, pp. 961-969, 2024

Authors: Walsh, Michael | Uretsky, Madeline | Tripodis, Yorghos | Nowinski, Christopher J. | Rasch, Abigail | Bruce, Hannah | Ryder, Megan | Martin, Brett M. | Palmisano, Joseph N. | Katz, Douglas I. | Dwyer, Brigid | Daneshvar, Daniel H. | Walley, Alexander Y. | Kim, Theresa W. | Goldstein, Lee E. | Stern, Robert A. | Alvarez, Victor E. | Huber, Bertrand Russell | McKee, Ann C. | Stein, Thor D. | Mez, Jesse | Alosco, Michael L.

Article Type: Research Article

Abstract: Background: Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy more frequently found in deceased former football players. CTE has heterogeneous clinical presentations with multifactorial causes. Previous literature has shown substance use (alcohol/drug) can contribute to Alzheimer’s disease and related tauopathies pathologically and clinically. Objective: To examine the association between substance use and clinical and neuropathological endpoints of CTE. Methods: Our sample included 429 deceased male football players. CTE was neuropathologically diagnosed. Informant interviews assessed features of substance use and history of treatment for substance use to define indicators: history of substance use treatment (yes vs no, …primary variable), alcohol severity, and drug severity. Outcomes included scales that were completed by informants to assess cognition (Cognitive Difficulties Scale, BRIEF-A Metacognition Index), mood (Geriatric Depression Scale-15), behavioral regulation (BRIEF-A Behavioral Regulation Index, Barratt Impulsiveness Scale-11), functional ability (Functional Activities Questionnaire), as well as CTE status and cumulative p-tau burden. Regression models tested associations between substance use indicators and outcomes. Results: Of the 429 football players (mean age = 62.07), 313 (73%) had autopsy confirmed CTE and 100 (23%) had substance use treatment history. Substance use treatment and alcohol/drug severity were associated with measures of behavioral regulation (FDR-p -values<0.05, Δ R2  = 0.04–0.18) and depression (FDR-p -values<0.05, Δ R2  = 0.02–0.05). Substance use indicators had minimal associations with cognitive scales, whereas p-tau burden was associated with all cognitive scales (p -values <0.05). Substance use treatment had no associations with neuropathological endpoints (FDR-p -values>0.05). Conclusions: Among deceased football players, substance use was common and associated with clinical symptoms. Show more

Keywords: Alcohol use, Alzheimer’s disease, chronic traumatic encephalopathy, dementia, repetitive head impacts, substance use, traumatic brain injury

DOI: 10.3233/JAD-240300

Citation: Journal of Alzheimer's Disease, vol. 101, no. 3, pp. 971-986, 2024

Authors: Nowell, Joseph | Raza, Sanara | Livingston, Nicholas R. | Sivanathan, Shayndhan | Gentleman, Steve | Edison, Paul

Article Type: Research Article

Abstract: Background: Tau aggregation demonstrates close associations with hypometabolism in Alzheimer’s disease (AD), although differing pathophysiological processes may underlie their development. Objective: To establish whether tau deposition and glucose metabolism have different trajectories in AD progression and evaluate the utility of global measures of these pathological hallmarks in predicting cognitive deficits. Methods: 279 participants with amyloid-β (Aβ) status, and T1-weighted MRI scans, were selected from the Alzheimer’s Disease Neuroimaging Initiative (http://adni.loni.usc.edu ). We created the standard uptake value ratio images using Statistical Parametric Mapping 12 for [18 F]AV1451-PET (tau) and [18 F]FDG-PET (glucose metabolism) scans. Voxel-wise group …and single-subject level SPM analysis evaluated the relationship between global [18 F]FDG-PET and [18 F]AV1451-PET depending on the Aβ status. Linear models assessed whether tau deposition or glucose metabolism better predicted clinical progression. Results: There was a dissociation between global cerebral glucose hypometabolism and global tau load in amyloid-positive AD and amyloid-negative mild cognitive impairment (MCI) (p  > 0.05). Global hypometabolism was only associated with global cortical tau in amyloid-positive MCI. Voxel-level single subject tau load better predicted neuropsychological performance, Alzheimer’s disease assessment scale-cognitive (ADAS-Cog) 13 score, and one-year change compared with regional and global hypometabolism. Conclusions: A dissociation between tau pathology and glucose metabolism at a global level in AD could imply that other pathological processes influence glucose metabolism. Furthermore, as tau is a better predictor of clinical progression, these processes may have independent trajectories and require independent consideration in the context of therapeutic interventions. Show more

Keywords: Alzheimer’s disease, fluorodeoxyglucose F18, positron-emission tomography, tau proteins

DOI: 10.3233/JAD-240434

Citation: Journal of Alzheimer's Disease, vol. 101, no. 3, pp. 987-999, 2024

Authors: van de Schraaf, Sara A.J. | Rhodius-Meester, Hanneke F.M. | Rijnsent, Lindsey M. | Natawidjaja, Meyrina D. | van den Berg, Esther | Wolters, Frank J. | Visser-Meily, J.M. Anne | Biessels, Geert Jan | de Vugt, Marjolein | Muller, Majon | Hertogh, Cees M.P.M. | Sizoo, Eefje M.

Article Type: Research Article

Abstract: Background: Post-diagnostic care for people with vascular cognitive impairment (VCI) typically involves multiple professions and disjointed care pathways not specifically designed to aid VCI needs. Objective: Exploring perspectives of healthcare professionals on post-diagnostic care for people with VCI. Methods: We conducted a qualitative focus group study. We used purposive sampling to include healthcare professionals in different compositions of primary and secondary care professionals per focus group. Thematic saturation was reached after seven focus groups. Transcripts were iteratively coded and analyzed using inductive thematic analysis. Results: Forty participants were included in seven focus groups (4–8 …participants). Results showed knowledge and awareness of VCI as prerequisites for adequate post-diagnostic care, and for pre-diagnostic detection of people with VCI (theme 1). In light of perceived lack of differentiation between cognitive disorders, participants shared specific advice regarding post-diagnostic care for people with VCI and informal caregivers (theme 2). Participants thought current care for VCI was fragmented and recommended further integration of care and collaboration across settings (theme 3). Conclusions: People with VCI and their caregivers risk getting stuck in a “no man’s land” between post-diagnostic care pathways; challenges lie in acknowledgement of VCI and associated symptoms, and alignment between healthcare professionals. Education about the symptoms and consequences of VCI, to healthcare professionals, people with VCI and caregivers, may increase awareness of VCI and thereby better target care. Specific attention for symptoms common in VCI could further tailor care and reduce caregiver burden. Integration could be enhanced by combining expertise of dementia and stroke/rehabilitation pathways. Show more

Keywords: Aftercare, Alzheimer’s disease, cerebrovascular diseases, patient care management, post-stroke cognitive impairment, rehabilitation, vascular cognitive impairment, vascular dementia

DOI: 10.3233/JAD-240526

Citation: Journal of Alzheimer's Disease, vol. 101, no. 3, pp. 1001-1013, 2024

Authors: Zhu, Yongbin | Wu, Yueping | Shi, Liping | Yang, Yue | Wang, Yanrong | Pan, Degong | He, Shulan | Wang, Liqun | Li, Jiangping

Article Type: Research Article

Abstract: Background: The widespread exposure to plastic products and the increasing number of individuals with cognitive impairments have imposed a heavy burden on society. Objective: This study aims to investigate the relationship between plastic product exposure in daily life and cognitive function in older Chinese individuals. Methods: Data were obtained from the 2023 Ningxia Older Psychological Health Cohort, comprising 4045 participants aged 60 and above. Cognitive function was assessed using the Mini-Mental State Examination scale. A population-based plastic exposure questionnaire was used to calculate plastic exposure scores (PES). Binary logistic regression was employed to analyze the relationship …between PES and cognitive function, while restricted cubic splines were used to examine the dose-response relationship between PES and cognitive function. Latent profile analysis (LPA) was employed to explore the potential patterns of plastic exposure, and logistic regression was used to investigate the relationship between different exposure patterns and cognitive function. A linear regression model was utilized to investigate the relationship between PES and different dimensions of cognitive function. Results: Among the 4045 participants, 1915 individuals were assessed with mild cognitive impairment (MCI). After adjusting for all covariates, PES (OR = 1.04, 95% CI 1.02–1.06) was significantly associated with the risk of MCI and exhibited a dose-response relationship. LPA identified two potential categories of plastic exposure, with a higher risk of MCI observed in the group using plastic utensils. Conclusions: This study indicates a positive correlation between plastic exposure levels and MCI risk, particularly among individuals who frequently use plastic tableware. Show more

Keywords: Alzheimer’s disease, cognitive function, latent profile analysis, older adults, plastic exposure

DOI: 10.3233/JAD-240746

Citation: Journal of Alzheimer's Disease, vol. 101, no. 3, pp. 1015-1025, 2024