Journal of Alzheimer's Disease - Volume 86, issue 2

Authors: Wang, Carol Sheei-Meei | Wu, Jia-Yun | Hsu, Wen-Tzu | Chien, Pei-Fang | Chen, Pai-Lien | Huang, Ying-Che | Cheng, Kuo-Sheng

Article Type: Research Article

Abstract: Background: The earlier detection of dementia is needed as cases increase yearly in the aging populations of Taiwan and the world. In recent years, the global internet usage rate has gradually increased among older people. To expand dementia screening and provide timely medical intervention, a simple self-administrated assessment tool to assist in easily screening for dementia is needed. Objective: The two-part goal of this pilot study was, first, to develop a Game-Based Cognitive Assessment (GBCA) tool, and then, to evaluate its validity at early screening for patients with cognitive impairment. Method: The researchers recruited 67 patients …with neurocognitive disorders (NCDs) and 57 healthy controls (HCs). Each participant underwent the GBCA and other clinical cognitive assessments (CDR, CASI, and MMSE), and filled out a questionnaire evaluating their experience of using the GBCA. Statistical analyses were used to measure the validity of the GBCA at screening for degenerative dementia. Results: The average GBCA scores of the HC and NCD groups were 87 (SD = 7.9) and 52 (SD = 21.7), respectively. The GBCA correlated well with the CASI (r 2  = 0.90, p  < 0.001) and with the MMSE (r2  = 0.92, p  < 0.001), indicating concurrent validity. The GBCA cut-off of 75/76 corresponded to measurements of sensitivity, specificity, and area under curve of 85.1%, 91.5%, and 0.978, respectively. The positive predictive value was 91.9%, and the negative predictive value was 84.4%. The results of the user-experience questionnaire for the HC and NCD groups were good and acceptable, respectively. Conclusion: The GBCA is an effective and acceptable tool for screening for degenerative dementia. Show more

Keywords: Computerized cognitive assessment, dementia, screening, validity

DOI: 10.3233/JAD-215142

Citation: Journal of Alzheimer's Disease, vol. 86, no. 2, pp. 877-890, 2022

Authors: Di Vita, Antonella | Vecchione, Francesca | Boccia, Maddalena | Bocchi, Alessia | Cinelli, Maria Cristina | Mirino, Pierandrea | Teghil, Alice | D’Antonio, Fabrizia | de Lena, Carlo | Piccardi, Laura | Giannini, Anna Maria | Guariglia, Cecilia

Article Type: Research Article

Abstract: Background: Detecting the beginning of cognitive decay is crucial to guarantee good management and the possible prevention of dementia progression. The present study arises from observations collected during an educational event to promote mental and physical health in which incidental neuropsychological data gathered on 290 citizens showed the importance of routine neuropsychological examination in detecting early signs of cognitive decay, since many individuals were unaware of the decrease in their cognitive efficiency. Accordingly, the availability of a screening tool that is computerized, portable, self-administrable, and sensitive to the main neurocognitive changes testifying the progression towards pathological aging is critical. …Objective: To this aim, we developed a computerized battery for the early, preclinical Diagnosis of Neurocognitive disease (DiaNe), that can be self-administered and performed autonomously by using a tablet. Methods: DiaNe includes tests expected to evaluate the main cognitive domains involved in neurodegenerative diseases (memory, attention, executive functions) with a detailed assessment of visuospatial memory in particular. Results: DiaNe is not just the translation of standard tests into telematics, rather it is a new tool that provides both accuracy and response time measurements, aimed to screen cognitive profile and monitor it over time, being able to detect changes in still normal performances that may be suggestive of an ongoing onset of neurocognitive disorders. Conclusion: Here we present an investigation of DiaNe concurrent validity showing that its results are comparable to those obtained by existing paper-and-pencil neuropsychological tests, and propose that DiaNe could be a useful, quick, and economical instrument for the monitoring of cognitive aging. Show more

Keywords: Aging, Alzheimer’s disease, computerized test battery, dementia, episodic memory, mild cognitive impairment, neuropsychology, spatial memory, subjective cognitive decline, verbal memory

DOI: 10.3233/JAD-215294

Citation: Journal of Alzheimer's Disease, vol. 86, no. 2, pp. 891-904, 2022

Authors: Fitzhugh, Megan C. | Pa, Judy

Article Type: Research Article

Abstract: Background: Hearing loss was recently identified as a modifiable risk factor for dementia although the potential mechanisms explaining this relationship are unknown. Objective: The current study examined longitudinal change in resting-state fMRI functional connectivity and gray matter volume in individuals who developed a hearing impairment compared to those whose hearing remained normal. Methods: This study included 440 participants from the UK Biobank: 163 who had normal hearing at baseline and impaired hearing at follow-up (i.e., converters, mean age = 63.11±6.33, 53% female) and 277 who had normal hearing at baseline and maintained normal hearing at follow-up (i.e., non-converters, …age = 63.31±5.50, 50% female). Functional connectivity was computed between a priori selected auditory seed regions (left and right Heschl’s gyrus and cytoarchitectonic subregions Te1.0, Te1.1, and Te1.2) and select higher-order cognitive brain networks. Gray matter volume within these same regions was also obtained. Results: Converters had increased connectivity from left Heschl’s gyrus to left anterior insula and from right Heschl’s gyrus to right anterior insula, and decreased connectivity between right Heschl’s gyrus and right hippocampus, compared to non-converters. Converters also had reduced gray matter volume in left hippocampus and left lateral visual cortex compared to non-converters. Conclusion: These findings suggest that conversion to a hearing impairment is associated with altered brain functional connectivity and gray matter volume in the attention, memory, and visual processing regions that were examined in this study. Show more

Keywords: Alzheimer’s disease risk factor, functional neuroimaging, hearing impairment, hearing loss

DOI: 10.3233/JAD-215288

Citation: Journal of Alzheimer's Disease, vol. 86, no. 2, pp. 905-918, 2022

Authors: Lei, Qiqi | Tian, Hongdou | Xiao, Zhenxu | Wu, Wanqing | Liang, Xiaoniu | Zhao, Qianhua | Ding, Ding | Deng, Wei

Article Type: Research Article

Abstract: Background: The relationship between body mass index (BMI) and dementia is inconclusive. Undesirable loss of fat-free mass is a risk factor for cognitive decline while obesity is also a risk factor for cardio-metabolic disorders among the older adults. Objective: This study aimed to examine the association between BMI and incident all-cause dementia among Chinese older adults using a prospective study. Methods: Participants were 1,627 community residents aged 60 or older without dementia from the Shanghai Aging Study. Cox regression models, incorporated with restricted cubic splines, were used to explore a nonlinear association between baseline BMI and …risk of all-cause dementia as measured by hazard ratio (HR) using both frequentist and Bayesian approach. Results: We diagnosed 136 incident dementia cases during the mean follow-up of 5.3 years. Compared with moderate BMI (18.5–24.0 kg/m2 ), low BMI (< 18.5 kg/m2 ) were related to an increased risk of dementia with the HR as 3.38 (95% CI 1.50–7.63), while high BMI (≥24.0 kg/m2 ) showed a decreased risk of dementia without statistical significance (HR = 0.91, 95% CI 0.60 to 1.39). Sensitivity analysis in participants without central obesity indicated that the association was still significant with even higher HR. Bayesian approach presented the similar results. Conclusion: Our result indicates that low BMI may contribute to high risk of incident dementia, even in individuals without central obesity. Show more

Keywords: Body mass index, cognitive dysfunction, dementia, proportional hazards models, prospective studies

DOI: 10.3233/JAD-215517

Citation: Journal of Alzheimer's Disease, vol. 86, no. 2, pp. 919-929, 2022

Authors: Bakker, Els D. | van Maurik, Ingrid S. | Mank, Arenda | Zwan, Marissa D. | Waterink, Lisa | van den Buuse, Susanne | van den Broeke, Jennifer R. | Gillissen, Freek | van de Beek, Marleen | Lemstra, Evelien | van den Bosch, Karlijn A. | van Leeuwenstijn, Mardou | Bouwman, Femke H. | Scheltens, Philip | van der Flier, Wiesje M.

Article Type: Research Article

Abstract: Background: The COVID-19 pandemic poses enormous social challenges, especially during lockdown. People with cognitive decline and their caregivers are particularly at risk of lockdown consequences. Objective: To investigate psychosocial effects in (pre-)dementia patients and caregivers during second lockdown and compare effects between first and second lockdown. Methods: We included n  = 511 (pre-)dementia patients and n  = 826 caregivers from the Amsterdam Dementia Cohort and via Alzheimer Nederland. All respondents completed a self-designed survey on psychosocial effects of COVID-19. We examined relations between experienced support and psychosocial and behavioral symptoms using logistic regression. In a subset of patients …and caregivers we compared responses between first and second lockdown using generalized estimating equation (GEE). Results: The majority of patients (≥58%) and caregivers (≥60%) reported that family and friends, hobbies, and music helped them cope. Support from family and friends was strongly related to less negative feelings in patients (loneliness: OR = 0.3[0.1–0.6]) and caregivers (loneliness: OR = 0.2[0.1–0.3]; depression: OR = 0.4[0.2–0.5]; anxiety: OR = 0.4[0.3–0.6]; uncertainty: OR = 0.3[0.2–0.5]; fatigue: OR = 0.3[0.2–0.4]; stress: OR = 0.3[0.2–0.5]). In second lockdown, less psychosocial and behavioral symptoms were reported compared to first lockdown (patients; e.g., anxiety: 22% versus 13%, p  = 0.007; apathy: 27% versus 8%, p  < 0.001, caregivers; e.g., anxiety: 23% versus 16%, p  = 0.033; patient’s behavioral problems: 50% versus 35%, p  < 0.001). Patients experienced more support (e.g., family and friends: 52% versus 93%, p  < 0.001; neighbors: 28% versus 66%, p  < 0.001). Conclusion: During second lockdown, patients and caregivers adapted to challenges posed by lockdown, as psychosocial and behavioral effects decreased, while patients experienced more social support compared to first lockdown. Support from family and friends is a major protective factor for negative outcomes in patients and caregivers. Show more

Keywords: Behavioral effects, caregiver, COVID-19, dementia, experienced support, lockdown, mild cognitive impairment, psychosocial effects, subjective cognitive decline

DOI: 10.3233/JAD-215342

Citation: Journal of Alzheimer's Disease, vol. 86, no. 2, pp. 931-939, 2022

Article Type: Correction

DOI: 10.3233/JAD-229001

Citation: Journal of Alzheimer's Disease, vol. 86, no. 2, pp. 941-941, 2022