Dementia and Geriatric Cognitive Disorders最新文献

{"title":"Physical Activity and Frontotemporal Dementia: A Narrative Review of Mechanisms and Clinical Evidence.","authors":"Jacob Steinbeck, Nicholas Viggiano, Diana Speelman","doi":"10.1159/dem/aciag003","DOIUrl":"10.1159/dem/aciag003","url":null,"abstract":"<p><strong>Background: </strong>Frontotemporal dementia (FTD) is a progressive neurodegenerative disorder marked by early-onset behavioral and cognitive impairments with no current disease-specific treatment. As traditional pharmacologic interventions provide only symptomatic relief and carry significant limitations, nonpharmacologic strategies such as physical activity (PA) are gaining attention as potential disease-modifying approaches.</p><p><strong>Summary: </strong>This narrative review synthesizes emerging evidence on the neuroprotective effects of PA in FTD, including its possible relationship to neurotrophic signaling, neuroinflammation, mitochondrial function, and axonal integrity. Relevant literature was identified through a review of preclinical and clinical studies of PA and FTD.</p><p><strong>Key messages: </strong>Preclinical and clinical studies suggest that PA may be associated with slower symptom progression and mild behavioral and cognitive improvements in patients with FTD. Although limited by small sample sizes, observational studies, and variability in study design, preliminary data suggest that further studies on PA and FTD are warranted, including mechanistic investigations. Randomized controlled trials are needed to establish guidelines for exercise prescriptions that can be tailored to FTD patients. Until then, supervised PA in FTD care may be considered a potential adjunct pending further validation due to its accessibility, low risk, and potential for broad therapeutic benefit.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Symptom Severity, Caregiver Distress, and Caregiver Burden in Dementia Outpatients.","authors":"Masahiro Uzawa, Maiko Itami, Masako Komatsu, Haruka Tanabe","doi":"10.1159/dem/aciag002","DOIUrl":"10.1159/dem/aciag002","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric symptoms are major contributors to caregiver burden in older adults with cognitive disorders. The Neuropsychiatric Inventory Questionnaire (NPI-Q) measures both symptom severity and caregiver distress, but whether caregiver distress conveys information beyond symptom severity remains unclear.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of consecutive first-visit patients at a dementia outpatient clinic in Japan between April 2020 and October 2025. Caregiver burden was assessed with the 22-item Zarit Burden Interview (ZBI-22). Excess distress was defined as the residual from a linear regression of NPI-Q distress on NPI-Q severity. Associations with ZBI-22 were examined using multivariable linear regression adjusted for demographic and clinical covariates. Missing data were handled with multiple imputation by chained equations.</p><p><strong>Results: </strong>The cohort included 538 participants (mean age 81.4 ± 8.6 years; 61.5% female). In complete-case analyses (n = 400), excess distress was independently associated with higher ZBI-22 scores (B = 1.08, 95% confidence interval 0.46-1.71, p < 0.001) and improved model fit beyond severity alone (adjusted R² 0.289 to 0.308). Multiple-imputation analyses were similar. In analyses restricted to spouse and child caregivers (n = 326), child caregivers had higher burden than spouse caregivers, but interaction by caregiver relationship was not supported.</p><p><strong>Conclusions: </strong>Caregiver distress beyond neuropsychiatric symptom severity was independently associated with caregiver burden in this dementia outpatient cohort. Assessing excess distress may provide supplementary information during the initial outpatient evaluation of caregiver burden.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Staging of Alzheimer's Disease Dementia with Addenbrooke Cognitive Examination-III: Evidence for Subtype-Specific Cognitive Thresholds.","authors":"Anna Barczak","doi":"10.1159/dem/aciag001","DOIUrl":"10.1159/dem/aciag001","url":null,"abstract":"<p><strong>Introduction: </strong>Translating cognitive test results into clinically meaningful measures of dementia severity remains challenging in real-world settings, where biomarkers are limited and functional assessment may occasionally be confounded by noncognitive factors. Although the Addenbrooke's Cognitive Examination-III (ACE-III) is widely used for detecting Alzheimer's disease (AD), its role in severity staging is less established. This study evaluated the usefulness of ACE-III for functionally anchored staging and compared it with the Mini-Mental State Examination (MMSE).</p><p><strong>Methods: </strong>In a retrospective real-world cohort of 1,170 patients with AD dementia (late-onset, early onset, and mixed), severity was classified using the Functional Assessment Staging Tool (FAST). Receiver operating characteristic analyses were used to derive cut-offs for differentiating adjacent stages (FAST 4 vs. 5; FAST 5 vs. 6). Domain-level and subtype-specific analyses were conducted.</p><p><strong>Results: </strong>ACE-III showed excellent discrimination between FAST 4 and 5 (area under the ROC curve [AUC] = 0.92; cut-off ≤56) and moderate discrimination between FAST 5 and 6 (AUC = 0.77; cut-off ≤42), outperforming MMSE in later stages (AUC = 0.63). Attention contributed most to earlier transitions, whereas later stages showed broader domain involvement. Cut-offs varied across AD subtypes.</p><p><strong>Conclusion: </strong>ACE-III provides clinically meaningful estimates of dementia severity and may help overcome limitations of functional assessment in real-world settings, supporting its use for staging and monitoring in routine clinical practice.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Nomogram for Predicting Cognitive Impairment in Older Adults with Multimodal Sensory Impairments: A Study Based on National Health and Nutrition Examination Survey.","authors":"Shuangyue Liu, Shuangchun Ai, Tirupapuliyur Damodaran","doi":"10.1159/000552805","DOIUrl":"10.1159/000552805","url":null,"abstract":"<p><strong>Introduction: </strong>Sensory impairments across multiple modalities, including vision, hearing, smell, and taste, are critically linked to cognitive dysfunction in older adults. This study aimed to develop and validate a nomogram to assess cognitive impairment (CI) risk specifically among older Americans with diverse sensory disabilities.</p><p><strong>Methods: </strong>We analyzed data from 2,897 participants (aged ≥60 years) from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Sensory disability was defined as the presence of impairment in at least one of four modalities: vision, hearing, olfaction, or taste. Predictors were identified via least absolute shrinkage and selection operator regression and multivariable logistic regression. Model performance was evaluated using the area under the curve (AUC), calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Participants were randomly partitioned into a training set (n = 2,317) and a validation set (n = 580). The final nomogram incorporated ten key predictors: age, sex, race, education, poverty-income ratio, physical activity (PA), total fat intake, depression, cardiovascular disease, and antihistamine use. The model achieved high discriminative power, with AUCs of 0.818 (95% CI: 0.804-0.832) and 0.816 (95% CI: 0.778-0.851) in the training and validation cohorts, respectively. Calibration curves demonstrated strong agreement between predicted and observed outcomes, while DCA confirmed the model's significant clinical utility for early risk assessment.</p><p><strong>Conclusion: </strong>This novel nomogram provides a precise and accessible tool for predicting CI in older adults with sensory deficits across multiple modalities. By integrating readily available demographic and clinical factors, the model facilitates early risk stratification and supports the development of targeted preventive strategies in geriatric public health.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-20"},"PeriodicalIF":2.5,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconceptualizing the Mini-Mental State Examination Sentence-Writing Item: From Binary Scoring to a Written-Language Sample.","authors":"Takahiro Kowari, Atsushi Shinonaga, Masahiro Ikeno","doi":"10.1159/000553525","DOIUrl":"10.1159/000553525","url":null,"abstract":"","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-3"},"PeriodicalIF":2.5,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indoor Air Pollution and Neurocognitive Disorders in Younger and Older Adults in a Marginalized District of Lima, Peru.","authors":"Alexandra Elena Chang Tamayo, Esteban Chávez Caroy, Marleny Nolasco, Serggio Lanata, Nilton Custodio, Monica M Diaz, Eder Herrera-Perez","doi":"10.1159/000553139","DOIUrl":"10.1159/000553139","url":null,"abstract":"<p><strong>Introduction: </strong>Air pollution is an emerging risk factor for neurocognitive disorders (NCDs), yet the impact of indoor exposures in urban-marginalized areas of Latin America remains understudied. We examined the association between indoor air pollution and cognitive impairment among adults in Puente Piedra, Lima, Peru.</p><p><strong>Methods: </strong>We assessed NCDs using validated Peruvian versions of the Addenbrooke's Cognitive Examination (for adults aged 30-59) and the Rowland Dementia Assessment Scale (for those ≥60). Indoor air pollution was defined by the use and duration of pollutant-emitting cooking fuels.</p><p><strong>Results: </strong>Among 1,052 participants (736 younger, 316 older adults), 16% of younger and 13.3% of older adults reported exposure. NCD prevalence was 21.9% and 36.1%, respectively. No significant association was found between indoor pollution and NCD in either group.</p><p><strong>Discussion: </strong>While findings suggest no relationship, further research using objective exposure measures is warranted to better understand environmental risks for cognitive health.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theory of Mind Deficits and Awareness in Alzheimer's Disease.","authors":"Fern Emma Rodgers, Jonathan Huntley, Andrew McWilliams, Andrew Sommerlad","doi":"10.1159/000553343","DOIUrl":"10.1159/000553343","url":null,"abstract":"<p><strong>Introduction: </strong>Social cognition (SC) is often impaired by dementia, contributing to difficulties with relationships and social isolation. Additionally, people with dementia frequently have impaired awareness of their impairments, which may worsen distress for them, their family, and friends. We investigated SC in people with Alzheimer's disease (PwAD), awareness of SC, and whether PwAD overestimate SC abilities compared to healthy controls (HC).</p><p><strong>Methods: </strong>Participants completed the Interpersonal Reactivity Index perspective-taking subscale (IRI-PT), a self-report measure of SC, and The Awareness of Social Inference Test (short form) (TASIT-S), a task-based measure of SC. Insight was evaluated by comparing self-assessment with TASIT-S performance. The Addenbrooke's Cognitive Examination (version 3; ACE-III) measured general cognition.</p><p><strong>Results: </strong>We recruited 70 PwAD (mean age = 78.13; mean ACE-III = 71.80) and 17 HC (mean age = 71.53; mean ACE-III = 96.65). PwAD self-reported lower theory of mind (ToM) (IRI-PT = -2.16, 95% CI = -0.33 to 4.64, p = 0.09) and performed worse on TASIT-S emotion recognition (-2.04, 95% CI = -2.89 to -1.20, p < 0.001), sarcasm recognition (-0.91, 95% CI = -1.66 to -0.16, p = 0.02), and ToM assessments (-1.42, 95% CI = -2.27 to -0.57, p = 0.001). There was no significant relationship between IRI-PT and TASIT-S ToM in either group, nor in the participant group as a whole. We categorised \"under-estimators\" (low IRI-PT, high TASIT-S ToM), \"over-estimators\" (high IRI-PT, low TASIT-S ToM), and \"congruent-estimators\" and found that lower ACE-III was associated with ToM over-estimation.</p><p><strong>Conclusion: </strong>Differences in self-reported and task-assessed SC were observed between PwAD and HC, but self-estimated and task-assessed ToM were not associated, suggesting that SC self-estimation is unreliable in PwAD and possibly in healthy older adults.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-9"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Longitudinal Analysis of Frontotemporal Dementia Patients in Spain throughout the COVID-19 Pandemic: A Descriptive Study.","authors":"Verónica Puertas Martín, Sara LLamas-Velasco, Marta González-Sánchez, Víctor Blanco Palmero, Alberto García Redondo, David Pérez Martínez, Alberto Villarejo","doi":"10.1159/000553064","DOIUrl":"10.1159/000553064","url":null,"abstract":"<p><strong>Introduction: </strong>Frontotemporal dementia (FTD) comprises a heterogeneous group of neurodegenerative syndromes characterized by diverse behavioural, cognitive, and language profiles. Longitudinal data describing its clinical course progression using FTD-specific instruments remain limited. This study aimed to characterize the functional, cognitive, and behavioural trajectories of FTD clinical syndromes in a Spanish cohort, including assessments performed remotely during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Sixty-seven patients diagnosed with behavioural variant FTD (bvFTD), non-fluent variant primary progressive aphasia, or semantic variant PPA (svPPA) were prospectively followed at Hospital Universitario 12 de Octubre (Madrid, Spain). Functional and neuropsychiatric status were assessed with the Frontotemporal Dementia Rating Scale (FTD-FRS), the Interview for Deterioration in Daily Activities in Dementia (IDDD), the Neuropsychiatric Inventory (NPI), and the telephone Mini-Mental State Examination (t-MMSE). Thirty-three assessments were conducted remotely during pandemic restrictions.</p><p><strong>Results: </strong>Over a mean follow-up of 3.1 years, significant declines were observed in FTD-FRS, IDDD, and t-MMSE (p < 0.001), whereas NPI scores remained stable. The svPPA group exhibited the greatest cognitive and functional decline, while bvFTD showed more heterogeneous progression. Twelve participants (18%) died during follow-up, predominantly older men with poorer baseline performance.</p><p><strong>Conclusion: </strong>Functional and cognitive decline in FTD varies across clinical variants, with the semantic subtype showing the most rapid progression in our cohort. Remote assessments are feasible and represent a valid approach for longitudinal monitoring.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-18"},"PeriodicalIF":2.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Discrepancies and Predictors of Self- versus Proxy-Rated Quality of Life in Chinese Community-Dwelling Older Adults with Mild Dementia: A Cross-Sectional Study.","authors":"Dandan Xue, Jinling Peng, Ling Yue, Wenwen Qi","doi":"10.1159/000553237","DOIUrl":"https://doi.org/10.1159/000553237","url":null,"abstract":"<p><strong>Background: </strong>Accurate evaluation of quality of life (QoL) is essential for optimal dementia management, yet notable discrepancies exist between patient self-rated and proxy-rated QoL. This study aimed to analyse the discrepancies and agreement between self-rated and proxy-rated QoL and identify their independent predictors among community-dwelling persons with mild dementia (PwMD).</p><p><strong>Methods: </strong>This cross-sectional study included 129 PwMD and their primary caregivers. Assessments included sociodemographic information, the QoL-Alzheimer's Disease scale, Mini-Mental State Examination, Geriatric Depression Scale, Activities of Daily Living, Functional Activities Questionnaire and Neuropsychiatric Inventory Questionnaire. Differences and agreement were analyzed using Wilcoxon tests, Spearman correlations, and intraclass correlation coefficients (ICC). Independent predictors were identified through multiple linear regression.</p><p><strong>Results: </strong>Patients rated their QoL significantly higher than their caregivers did, with poor-to-fair agreement at the total, dimensional and item levels (ICC = 0.11-0.50). Higher depressive symptoms (β = -0.354, p = 0.001), lower severity of elation (β = 0.214, p = 0.013), and greater disinhibition (β = -0.174, p = 0.041) independently predicted poorer self-rated QoL. By contrast, greater neuropsychiatric symptom severity (β = -0.283, p < 0.001), poorer Activities of Daily Living function (β = -0.230, p = 0.006), and polypharmacy (β = -0.208, p = 0.009) predicted lower proxy-rated QoL.</p><p><strong>Conclusion: </strong>Self- and proxy-rated QoL reflect distinct evaluative perspectives in PwMD. Self-reports are influenced by emotional and psychological states, whereas proxy ratings are shaped by observable symptoms, functional dependency and treatment burden. These findings suggest the need to integrate both assessment perspectives in clinical practice.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-19"},"PeriodicalIF":2.5,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Investigation of the Psychometric Properties of the Farsi Version of the Saint Louis University Mental Status Examination.","authors":"Fariba Faghani, Mahgol Tavakoli, Tayebeh Makaremi, Javad Abbasi Jondani","doi":"10.1159/000552580","DOIUrl":"10.1159/000552580","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the psychometric properties of the Farsi version of the Saint Louis University Mental Status (SLUMS) examination, marking the first such investigation.</p><p><strong>Methods: </strong>The sample comprised 200 participants: 75 with normal cognition, 74 with mild cognitive impairment (MCI), and 51 with dementia. Concurrent validity was assessed using the MMSE and NUCOG; divergent validity employed the GDS-15.</p><p><strong>Results: </strong>Exploratory factor analysis showed a unidimensional structure. Internal consistency (Cronbach's α = 0.719) and test-retest reliability (intraclass correlation coefficient = 0.717) were satisfactory. SLUMS correlated highly with MMSE (r = 0.787) and NUCOG (r = 0.861), but moderately with GDS-15 (r = -0.376). It effectively discriminated dementia from MCI but showed limited ability to differentiate normal cognition from MCI.</p><p><strong>Conclusion: </strong>The Farsi SLUMS is a suitable screening tool for detecting dementia, though caution is advised when distinguishing MCI from normal cognition.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}