Journal of Alzheimer's Disease - Volume 83, issue 2

Authors: Kapasi, Alifiya | Yu, Lei | Stewart, Christopher | Schneider, Julie A. | Bennett, David A. | Boyle, Patricia A.

Article Type: Research Article

Abstract: Background: Recent findings suggest that poor decision making and increased scam susceptibility are harbingers of Alzheimer’s disease (AD) dementia and may be among the earliest behavioral manifestations of pathologic cognitive aging. However, the degree to which poor decision making and scam susceptibility reflect accumulating Alzheimer’s disease (AD) pathology remains unclear. Objective: To investigate the associations of AD pathology with decision making and scam susceptibility in older adults without dementia. Methods: Data came from 198 deceased participants without clinical dementia (mean age at death = 90 years; 69%women) from two ongoing studies of aging. All underwent annual clinical evaluations, …completed assessments of healthcare and financial decision making and scam susceptibility, and brain donation. Neuropathologic evaluations quantified pathologic hallmarks of AD, amyloid-β and tau-tangles, Lewy body pathology, and TDP-43 proteinopathy. Results: In linear regression models adjusted for demographics, amyloid-β pathology was associated with lower decision making (estimate = –0.35; SE = 0.16, p  = 0.03), particularly healthcare decision making (estimate = –0.20; SE = 0.09, p  = 0.03), as well as greater scam susceptibility (estimate = 0.12; SE = 0.04, p  = 0.003); tau-tangle pathology was not related. Further, TDP-43 pathology was associated with greater scam susceptibility (estimate = 0.10; SE = 0.04; p  = 0.02). Conclusion: Accumulating AD pathology, particularly amyloid-β, is associated with poor decision making and increased scam susceptibility among older persons without overt cognitive impairment. These findings provide compelling evidence that decision making and scam susceptibility are sensitive to the earliest pathological changes of AD. Show more

Keywords: Aging, Alzheimer’s disease pathology, amyloid-beta, decision making, scam

DOI: 10.3233/JAD-210356

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 879-887, 2021

Authors: Liu, Xiao | Abudukeremu, Ayiguli | Jiang, Yuan | Cao, Zhengyu | Wu, Maoxiong | Sun, Runlu | Chen, Zhiteng | Chen, Yangxin | Zhang, Yuling | Wang, Jingfeng

Article Type: Research Article

Abstract: Background: Several kinds of motor dysfunction can predict future cognitive impairment in elderly individuals. However, the ability of the fine motor index (FINEA) and gross motor index (GROSSA) to predict the risk of cognitive impairment has not been assessed. Objective: We investigated the associations between FINEA/GROSSA and cognitive impairment. Methods: The data of 4,745 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). We first assessed the correlation between the FINEA/GROSSA and MMSE in a cross-sectional study. Then, we further investigated the predictive role …of the incidence of cognitive impairment in a prospective cohort study. Results: We found that both FINEA and GROSSA were negatively correlated with MMSE in both the unadjusted (FINEA: B  = –1.00, 95%confidence intervals (CI): –1.17, –0.83, t  = –11.53, p  < 0.001; GROSSA: B  = –0.85, 95%CI: –0.94, –0.76, t  = –18.29, p  < 0.001) and adjusted (FINEA: B  = –0.63, 95%CI: –0.79, –0.47, t  = –7.77, p  < 0.001; GROSSA: B  = –0.57, 95%CI: –0.66, –0.48, t  = –12.61, p  < 0.001) analyses in a cross-sectional study. In a prospective cohort study, both high FINEA and high GROSSA were associated with an increased incidence of cognitive function impairment (FINEA: adjusted odds ratios (OR) = 2.35, 95%CI: 1.05, 5.23, p  = 0.036; GROSSA adjusted OR = 3.00, 95%CI: 1.49, 6.03, p  = 0.002) after 2 years of follow-up. Conclusion: Higher FINEA and GROSSA scores were both associated with an increased incidence of cognitive impairment. FINEA or GROSSA might be a simple tool for identifying patients with cognitive impairment. Show more

Keywords: Cognitive impairment, fine motor index, gross motor index, the Irish longitudinal study on ageing

DOI: 10.3233/JAD-210704

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 889-896, 2021

Authors: Qin, Wei | Li, Wenwen | Wang, Qi | Gong, Min | Li, Tingting | Shi, Yuqing | Song, Yang | Li, Ying | Li, Fangyu | Jia, Jianping

Article Type: Research Article

Abstract: Background: The global race-dependent association of Alzheimer’s disease (AD) and apolipoprotein E (APOE ) genotype is not well understood. Transethnic analysis of APOE could clarify the role of genetics in AD risk across populations. Objective: This study aims to determine how race and APOE genotype affect the risks for AD. Methods: We performed a systematic search of PubMed, Embase, Web of Science, and the Cochrane Library since 1993 to Aug 25, 2020. A total of 10,395 reports were identified, and 133 were eligible for analysis with data on 77,402 participants. Studies contained AD clinical …diagnostic and APOE genotype data. Homogeneous data sets were pooled in case-control analyses. Odds ratios and 95% confidence intervals for developing AD were calculated for populations of different races and APOE genotypes. Results: The proportion of APOE genotypes and alleles differed between populations of different races. Results showed that APOE ɛ 4 was a risk factor for AD, whereas APOE ɛ 2 protected against it. The effects of APOE ɛ 4 and ɛ 2 on AD risk were distinct in various races, and they were substantially attenuated among Black people. Sub-group analysis found a higher frequency of APOE ɛ 4/ɛ 4 and lower frequency of APOE ɛ 3/ɛ 3 among early-onset AD than late-onset AD in a combined group and different races. Conclusion: Our meta-analysis suggests that the association of APOE genotypes and AD differ among races. These results enhance our understanding of APOE -related risk for AD across race backgrounds and provide new insights into precision medicine for AD. Show more

Keywords: Alzheimer’s disease, APOE genotype, race, risk

DOI: 10.3233/JAD-210549

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 897-906, 2021

Authors: Tsapanou, Angeliki | Zoi, Panagiota | Kalligerou, Faidra | Blekou, Patra | Sakka, Paraskevi

Article Type: Research Article

Abstract: Background: The impact of the new coronavirus disease (COVID-19) is deteriorating as time passes and the virus keeps spreading, with people with dementia and their caregivers being affected significantly. Objective: The aim of this study was to examine the effect of prolonged isolation because of the COVID-19 pandemic on people with dementia and their caregivers. Methods: Caregivers answered online questions regarding their own physical and psychological burden, and of the person they take care of. Participants were mostly members of online seminars of the Athens Alzheimer’s Association. Questions referred to their own burden, the overall decline …of the persons they take care of, and changes in specific domains as well. Further, participants were asked about any changes between the two major lockdown periods. Analysis was performed including the total sample and then, by three different stages of dementia. Results: A total of 339 caregivers took part in the study. Results indicated significant decline, both in an overall aspect of the people with dementia, and in specific domains (mostly communication and mood). Regarding the caregivers, they reported having significantly increased physical and psychological burden, and also, noticing an overall change between the two lockdown periods in their own burden. Analysis by dementia-stage group indicated that significant decline occurred both in the middle-stage and the late-stage group. Conclusion: An urgency for further support of both the people with neurodegenerative disorders and their caregivers is needed. Collaboration among care workers, online programs, governmental support, and day-care centers should be planned to ensure continuity of care for those in need during the pandemic. Show more

Keywords: Caregivers, COVID-19, dementia

DOI: 10.3233/JAD-210702

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 907-913, 2021

Authors: Edgar, Chris J. | Siemers, Eric | Maruff, Paul | Petersen, Ronald C. | Aisen, Paul S. | Weiner, Michael W. | Albala, Bruce | for the Alzheimer’s Disease Neuroimaging Initiative

Article Type: Research Article

Abstract: Background: There is a need for feasible, scalable assessments to detect cognitive impairment and decline. The Cogstate Brief Battery (CBB) is validated for Alzheimer’s disease (AD) and in unsupervised and bring your own device contexts. The CBB has shown usability for self-completion in the home but has not been employed in this way in a multisite clinical trial in AD. Objective: The objective of the pilot was to evaluate feasibility of at-home, self-completion of the CBB in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) over 24 months. Methods: The CBB was included as a pilot for cognitively …normal (CN) and mild cognitive impairment (MCI) participants in ADNI-2, invited to take the assessment in-clinic, then at at-home over a period of 24 months follow-up. Data were analyzed to explore acceptability/usability, concordance of in-clinic and at-home assessment, and validity. Results: Data were collected for 104 participants (46 CN, 51 MCI, and 7 AD) who consented to provide CBB data. Subsequent analyses were performed for the CN and MCI groups only. Test completion rates were 100%for both the first in-clinic supervised and first at-home unsupervised assessments, with few repeat performances required. However, available follow-up data declined sharply over time. Good concordance was seen between in-clinic and at-home assessments, with non-significant and small effect size differences (Cohen’s d between -0.04 and 0.28) and generally moderate correlations (r  = 0.42 to 0.73). Known groups validity was also supported (11/16 comparisons with Cohen’s d ≥0.3). Conclusion: These data demonstrate the feasibility of use for the CBB for unsupervised at-home, testing, including MCI groups. Optimal approaches to the application of assessments to support compliance over time remain to be determined. Show more

Keywords: Alzheimer’s disease, clinical trials as a topic, cognition, digital technology, healthcare research

DOI: 10.3233/JAD-210201

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 915-925, 2021

Authors: Tadokoro, Koh | Yamashita, Toru | Kimura, Shuhei | Nomura, Emi | Ohta, Yasuyuki | Omote, Yoshio | Takemoto, Mami | Hishikawa, Nozomi | Morihara, Ryuta | Morizane, Yuki | Abe, Koji

Article Type: Research Article

Abstract: Background: Cost-effective and noninvasive methods for in vivo imaging of amyloid deposition are needed to screen Alzheimer’s disease (AD). Although retinal amyloid is a possible diagnostic marker of AD, there are very few studies on in vivo retinal amyloid imaging. Objective: To examine the usefulness of in vivo imaging of retinal amyloid in AD patients. Methods: To examine amyloid deposition, 30 Japanese subjects (10 normal control (NC), 7 with mild cognitive impairment (MCI), and 13 with AD) underwent a complete ophthalmic examination, including fundus imaging by scanning laser ophthalmoscopy before and after oral …curcumin intake. Results: Retinal amyloid deposition was greater in AD than in NC subjects (* p  < 0.05) while MCI showed a slight but insignificant increase of retinal amyloid deposition relative to NC subjects. Retinal amyloid deposition was correlated with whole gray matter atrophy (r  = 0.51, * p  < 0.05) but not with the cognitive score of the Mini-Mental State Examination, nor with medial temporal lobe atrophy. Conclusion: The present noninvasive in vivo detection of retinal amyloid deposition is useful for screening AD patients. Show more

Keywords: Alzheimer’s disease, amyloid, mild cognitive impairment, retina

DOI: 10.3233/JAD-210327

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 927-934, 2021

Authors: Perry, George

Article Type: Book Review

DOI: 10.3233/JAD-210744

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 935-935, 2021

Article Type: Correction

DOI: 10.3233/JAD-219009

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 937-937, 2021