The Journal of Prevention of Alzheimer's Disease最新文献

{"title":"Social isolation, loneliness, and their joint effects on cognitive decline and incident Alzheimer's disease: Findings from the Chicago health and aging project.","authors":"Ted K S Ng, Todd Beck, Kyle R Dennis, Pankaja Desai, Kristin Krueger, Klodian Dhana, Robert S Wilson, Denis A Evans, Kumar B Rajan","doi":"10.1016/j.tjpad.2024.100046","DOIUrl":"https://doi.org/10.1016/j.tjpad.2024.100046","url":null,"abstract":"<p><strong>Background: </strong>There has been contradictory evidence on the prospective associations between social isolation/loneliness (SI/L) and cognitive decline (CD). There is also a scarcity of large and diverse population-based cohort studies examining SI/L that have confirmed clinical diagnoses of Alzheimer's Disease (AD). Notably, beyond individual associations, whether the effects of SI/L compound and accelerate CD and incident AD are not known.</p><p><strong>Objectives: </strong>We hypothesized that SI and L, independently, would be associated with CD and incident AD to a similar extent, and the association of SI with CD and incident AD would be higher in lonely older adults.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Urban Chicago areas.</p><p><strong>Participants: </strong>We analyzed data in the Chicago Health and Aging Project (CHAP), which comprised 7,760 biracial community-dwelling older adults [mean age (standard deviation (SD))=72.3 (6.3); 64 % Black & 63 % women; mean (SD) of follow-up=7.9 (4.3) years].</p><p><strong>Intervention (if any): </strong>NA MEASUREMENTS: Linear mixed and logistic regression models were used to regress CD and incident AD separately on the SI index/L.</p><p><strong>Results: </strong>SI index and L were significantly associated with CD, with one-point increase of beta estimate (SE, p-value) = -0.002 (0.001,0.022) and -0.012 (0.003,<0.001), respectively. Given that the SI index ranges from 0 to 5 and the L from 0 to 1, they had similar effect sizes. Similarly, there were significant associations between SI index and incident AD, odds ratio (95 % CI, p-value) = 1.183 (1.016-1.379,0.029), and between L and incident AD, 2.117 (1.227-3.655,0.006). When stratified by loneliness status, compared to older adults who were not isolated and not lonely, older adults who reported being socially isolated and not lonely experienced accelerated CD, -0.003 (0.001,0.004), despite no significantly increased odds of incident AD.</p><p><strong>Conclusions: </strong>SI/L had significant associations with CD and incident AD. Notably, socially isolated older adults who reported not being lonely appeared to be most socially vulnerable to CD. These findings suggest a specific at-risk subgroup of socially vulnerable older adults for future targeted interventions to improve cognitive health.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"12 3","pages":"100046"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of digital screening tools in detecting cognitive impairment among community-dwelling elderly in Northern China: A large cohort study.","authors":"Xiaonan Zhang, Feifei Zhang, Sijia Hou, Chenxi Hao, Xiangmin Fan, Yarong Zhao, Wenjing Bao, Junpin An, Shuning Du, Guowen Min, Qiuyan Wang, Wencheng Zhu, Yang Li, Hui Zhang","doi":"10.1016/j.tjpad.2025.100080","DOIUrl":"10.1016/j.tjpad.2025.100080","url":null,"abstract":"<p><strong>Introduction: </strong>This study assessed the effectiveness of three digital screening tools in detecting cognitive impairment (CI) in a large cohort of community-dwelling elderly individuals and investigated the relationship between key digital features and plasma p-tau217 levels.</p><p><strong>Methods: </strong>This community-based cohort study included 1,083 participants aged 65 years or older, with 337 diagnosed with CI and 746 classified as normal controls (NC). We utilized two screening approaches: traditional methods (AD8, MMSE scale, and APOE genotyping) and digital tools (drawing, gait, and eye tracking). LightGBM-based machine learning models were developed for each digital screening tool and their combination, and their performance was evaluated. The correlation between key digital features and plasma p-tau217 levels was analyzed as well.</p><p><strong>Results: </strong>A total of 21 drawing, 71 gait, and 35 eye-tracking parameters showed significant differences between the two groups (all p < 0.05). The area under the curve (AUC) values for the drawing, gait, and eye-tracking models in distinguishing CI from NC were 0.860, 0.848, and 0.895, respectively. The combination of eye-tracking and drawing achieved the highest classification effectiveness, with an AUC of 0.958, and accuracy, sensitivity, and specificity all exceeded 85%. The fusion model achieved an AUC of 0.928 in distinguishing mild cognitive impairment (MCI) from NC. Additionally, several digital features (including two drawing, ten gait, and one eye-tracking parameters) were significantly correlated with plasma p-tau217 levels (all |r| > 0.3, p < 0.001).</p><p><strong>Discussion: </strong>Digital screening tools offer objective, accurate, and efficient alternatives for detecting CI in community settings, with the fusion of drawing and eye-tracking providing the best performance (AUC = 0.958).</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100080"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for an intergenerational randomized controlled trial to enhance physical activity in older adults at risk for Alzheimer's disease.","authors":"Caitlin S Walker, Adrián E Noriega de la Colina, Linda Li, Carolynn Boulanger, Nagashree Thovinakere, Alix Noly-Gandon, Garance Barnoin, Mitchell Bennett, Jillian Caplan, Laurence Côté, Sarah Elbaz, Shania Fock Ka Bao, Ryan Kara, Nicolas Lavoie, Maggie Nguyen, Franciska Otaner, Helen Pallett-Wiesel, Johanie Victoria Piché, Andreanne Powers, Sofia Ricciardelli, Kayla Williams, Christine Déry, Jennifer Tremblay-Mercier, Judes Poirier, Sylvia Villeneuve, Arthur F Kramer, Maiya R Geddes","doi":"10.1016/j.tjpad.2024.100039","DOIUrl":"10.1016/j.tjpad.2024.100039","url":null,"abstract":"<p><strong>Background: </strong>Physical inactivity is one of the most important modifiable risk factors for Alzheimer's disease in North America. Despite this, most older adults are physically inactive. It is currently unknown how to successfully motivate physical activity behavior in older adults at risk for Alzheimer's disease, and this knowledge is crucial for early and effective disease prevention. Prior research has shown that intergenerational social engagement and prosocial behaviours can enhance the health and well-being of older adults.</p><p><strong>Objectives: </strong>This manuscript describes the design of a randomized controlled trial that will test the efficacy of a behavioral intervention to enhance physical activity in older adults at risk for Alzheimer's disease.</p><p><strong>Design/setting: </strong>This is a single-blinded, two-arm stratified randomized controlled trial that incorporates a hybrid efficacy and implementation design. Participants are randomized to an intervention or control condition in a 1:1 ratio and are stratified by a multimodal Alzheimer's disease risk score. All study visits are conducted remotely through videoconferencing.</p><p><strong>Participants: </strong>The study aims to recruit 60 older adults with a first-degree family history of Alzheimer's disease from the PREVENT-AD cohort and 30 younger adults who are paired with older adults in the intervention condition.</p><p><strong>Intervention: </strong>Older participants in the intervention group will be paired with younger study partners and receive positive, daily messages over four weeks using a novel technology platform. The daily messages combine intergenerational social engagement (growing a virtual garden with a younger study partner) and prosocial goals (donations to charity after reaching step count goals).</p><p><strong>Measurements: </strong>The primary outcome is change in step count compared to baseline measured using a wrist-worn triaxial accelerometer. Secondary outcomes include time spent physically active, mood, generativity, loneliness, and cognition. Target mechanisms (social support and generativity) of physical activity engagement will be examined. Ease of use, acceptability, and feasibility of the technology as well as barriers and facilitators of participation will be assessed.</p><p><strong>Conclusions: </strong>This research will advance our understanding of mechanisms and individual differences underlying successful physical activity engagement in older adults who are at risk for Alzheimer's disease. This knowledge will contribute to strategies for promoting health behaviours that can prevent the risk of Alzheimer's disease.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"12 3","pages":"100039"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifiable risk factors for early- and late-onset dementia using the Korean national health insurance service database.","authors":"Dougho Park, Myeonghwan Bang, Hyoung Seop Kim, Jong Hun Kim","doi":"10.1016/j.tjpad.2024.100032","DOIUrl":"10.1016/j.tjpad.2024.100032","url":null,"abstract":"<p><strong>Background: </strong>Early-onset dementia (EOD) and late-onset dementia (LOD) may have distinct modifiable risk-factor profiles.</p><p><strong>Objective: </strong>To identify and compare factors associated with EOD and LOD using a nationwide cohort database.</p><p><strong>Design: </strong>Nationwide two nested case-control studies.</p><p><strong>Setting: </strong>We used the National Health Insurance Service-National Sample Cohort database (2004-2019).</p><p><strong>Participants: </strong>The initial sample size was 514,866; 5157 EOD and 39,326 LOD cases were matched 1:1 with controls based on age, sex, and the Charlson Comorbidity Index.</p><p><strong>Measurements: </strong>Socioeconomic status, residential area, body mass index, alcohol consumption, smoking status, physical activity, blood pressure, and laboratory findings were analyzed. Multivariable logistic regression models were used to identify the risk factors.</p><p><strong>Results: </strong>Higher socioeconomic status and increased frequency of physical activity were associated with a lower risk of both EOD and LOD. Rural residence, heavy alcohol consumption, and higher fasting blood sugar levels were associated with an increased risk of LOD, although there was no significant association with EOD. Overall, these factors impacted LOD more strongly than EOD. Demographic and lifestyle factors had a greater effect on LOD than blood pressure and relevant laboratory findings.</p><p><strong>Conclusion: </strong>Modifiable risk factors were associated with LOD and EOD. The influence of some modifiable risk factors was more pronounced in the LOD group than in the EOD group. Identifying modifiable risk factors associated with dementia can aid in the development of preventive strategies, underscoring the clinical importance of our findings.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100032"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of ischemic heart disease with brain glymphatic MRI indices and risk of Alzheimer's disease.","authors":"Ming-Liang Wang, Meng-Meng Yu, Zheng Sun, Jun-Jie Zhang, Jing-Kun Zhang, Xue Wu, Xiao-Er Wei, Yue-Hua Li","doi":"10.1016/j.tjpad.2024.100045","DOIUrl":"https://doi.org/10.1016/j.tjpad.2024.100045","url":null,"abstract":"<p><strong>Background: </strong>The impact of ischemic heart disease (IHD) on the brain glymphatic MRI indices and risk of Alzheimer's disease (AD) remains largely unclear. This study aimed to investigate the associations between IHD, brain glymphatic MRI indices and risk of AD.</p><p><strong>Methods: </strong>A total of 1385 non-dementia subjects (55.2 % male, mean age 73.53) were included. Diffusivity along the perivascular space (DTI-ALPS), free water (FW) and choroid plexus volume were used to reflect glymphatic function. The associations of IHD with MRI derived glymphatic indices, PET amyloid, tau and cognitive performance were explored by multiple regression analysis. IHD were tested as predictors of clinical progression using cox proportional hazards modeling. The mediation effect of MRI derived glymphatic indices on the relationship between IHD and cognitive changes was investigated.</p><p><strong>Results: </strong>Individuals with IHD exhibited glymphatic dysfunction revealed by lower DTI-ALPS (p = 0.035), higher FW (p < 0.001), and higher choroid plexus volume (p = 0.019). IHD had poorer cognitive performance in MMSE (p = 0.022), ADNI-MEM (p = 0.001) and ADNI-MF (p = 0.006), and more amyloid deposition (p = 0.007). IHD had a higher diagnostic conversion risk (HR = 1.321, 95 % CI = 1.003-1.741). IHD was associated with longitudinal cognitive decline in all cognitive tests (p < 0.05 for all) and FW (β = 0.012, 95 % CI 0.001, 0.023, p = 0.038). FW demonstrated an indirect effect (β = -0.0009, 95 % CI: -0.0034, -0.0001) and mediated 13.85 % effect for the relationship between IHD and ADNI-EF decline.</p><p><strong>Conclusion: </strong>IHD is independently associated with AD risk, and brain glymphatic dysfunction may partially mediate this relationship.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"12 3","pages":"100045"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain health clinics - An evolving clinical pathway?","authors":"Anneka F Butters, Jonathan Blackman, Hannah Farouk, Saba Meky, Margaret A Newson, Tomas Lemke, Natalie Rosewell, James A Selwood, Nicholas L Turner, Elizabeth J Coulthard, Hilary A Archer","doi":"10.1016/j.tjpad.2024.100051","DOIUrl":"10.1016/j.tjpad.2024.100051","url":null,"abstract":"<p><strong>Background: </strong>Dementia clinics traditionally focus on diagnosis and post-diagnostic care. Awareness is increasing that attention to risk factors and their prevention also forms a key part of dementia management.</p><p><strong>Objectives: </strong>To describe our Bristol Brain Health clinic including 1) Clinical pathway 2) Patient population 3) Patient experience 4) Evaluation in line with published gold standards.</p><p><strong>Design/ setting: </strong>Observational, (longitudinal/retrospective) clinical cohort study of patients attending the North Bristol NHS Trust's Brain Health Service.</p><p><strong>Participants: </strong>One-hundred and ten patients with mild cognitive disorders attending clinic between 2017- 2023.</p><p><strong>Measurements: </strong>We collected data from medical records including clinical assessments, cerebrospinal fluid (CSF) for biomarkers of Alzheimer's Disease (AD), and a lifestyle questionnaire. Descriptive statistics were performed and a clinic evaluation was carried out using recommendations from The European Task Force for Brain Health Services.</p><p><strong>Results: </strong>Average age was 63.9 years (SD: 11.2). 74 patients were male (62.8 %). The mean baseline Montreal Cognitive Assessment (MoCA) score was 24.4 (SD: 3.6). 73 patients (66.4 %) received a preventative lifestyle intervention with a review of risk and protective factors for dementia, and development of a bespoke risk reduction plan. Commonly identified risk factors; low mood; n = 61 (55.5 %), hypertension; n = 54 (49.1 %), high cholesterol; n = 42 (47.3 %), and hearing loss; n = 44 (40 %). CSF testing for AD was carried out in 38 individuals and was positive in 17 cases. At last review, one fifth of patients had progressed to dementia. Most common diagnoses; AD; n = 22 (20 %), Functional Cognitive Disorder; n = 16 (14.6 %), Vascular; n = 8 (7.3 %). Patient feedback was good, with all responders recommending the clinic and more than three-quarters of patients being 'extremely likely\" to. Clinic evaluation highlighted 'Risk Assessment' and 'Personalised Intervention' as brain health pillar strengths. 'Cognitive Enhancement' was an area for further development.</p><p><strong>Conclusions: </strong>Our patients had access to a range of cutting-edge, diagnostic assessments, in addition to a preventative lifestyle intervention. Our population had a high rate of dementia risk factors and a heterogeneous range of diagnoses. CSF biomarker testing was helpful for differentiating between those with early AD, and others with a multi-factorial presentation. The attendance rates for our preventative intervention suggests patients are receptive to taking a proactive approach to managing risk. This population merits further investigation and continued targeting with preventative measures.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100051"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a single nonpharmacological intervention on cognitive functioning in older adults with mild-to-moderate Alzheimer's disease: A meta-analysis of randomized controlled trials.","authors":"Kejin Chen, Xiaoyan Zhao, Jingwen Zhou","doi":"10.1016/j.tjpad.2024.100050","DOIUrl":"https://doi.org/10.1016/j.tjpad.2024.100050","url":null,"abstract":"<p><p>Most studies of nonpharmacological interventions have used a combination of medications in experimental and control groups to improve cognitive functioning or to control symptoms, but the results have been inconsistent with respect to the effects of single nonpharmacological interventions on cognitive functioning in older patients with Alzheimer's disease. The aim of this study was to assess the effect of a single nonpharmacological intervention on cognitive functioning in older adults with mild-to-moderate Alzheimer's disease. We conducted a systematic review and meta-analysis in the first week of January 2024, searching eight electronic databases for articles that reflect on non-pharmacological interventions in Alzheimer's disease published between January 1, 1986, and December 31, 2023. All included articles had to be randomized controlled trials. The primary measure was the change in cognitive function before and after the intervention. Data were extracted by two authors and quality was assessed using the Cochrane Handbook. With the exception of the Montreal Cognitive Assessment (MoCA) scale [MD=2.99, 95% CI (-0.66,6.63)], the differences between the intervention group and the control group were significant for all the remaining scales, namely, the Mini-Mental State Examination (MMSE) [SMD=0.65, 95% CI (0.15,1.15)], Activity of Daily Living Scale (ADL) [MD=-2.30, 95% CI (-3.63,0.97)], Quality of Life in Alzheimer's Disease Scale (QoL-AD) [MD=5.03, 95% CI (2.27,7.78)], Neuropsychiatric Inventory (NPI) [MD=-2.16, 95% CI (-3.86,0.46)], and Alzheimer's Disease Assessment Scale-cognitive score (ADAS-cog) [MD=-5.21, 95% CI (-7.89,2.54)]. Subgroup analysis revealed that the most effective intervention was exercise therapy, followed by repetitive transcranial magnetic stimulation. On the other hand, music therapy was not found to be effective. Current evidence suggests that nonpharmacological interventions can be used to improve cognitive functioning in older adults with mild-to-moderate Alzheimer's disease. This study was registered in PROSPERO (registration number: CRD42024497247).</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"12 3","pages":"100050"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of glycemic status with dynamic disease trajectories of atrial fibrillation and dementia.","authors":"Chenglong Li, Daijun He, Yufan Liu, Chao Yang, Luxia Zhang, Rodica Pop-Busui","doi":"10.1016/j.tjpad.2024.100047","DOIUrl":"10.1016/j.tjpad.2024.100047","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) has been associated with elevated dementia risk, while few studies have examined the role of the optimal glycemic status in disease trajectories of AF and dementia.</p><p><strong>Objectives: </strong>We aim to evaluate associations between glycemic status with disease trajectories of AF and dementia, as well as major dementia subtypes, including Alzheimer's disease and vascular dementia.</p><p><strong>Design: </strong>Population-based cohort study.</p><p><strong>Setting: </strong>UK Biobank.</p><p><strong>Participants: </strong>A total of 458 368 participants who were free of prevalent dementia and AF at baseline, with complete glycemic status assessment.</p><p><strong>Measurements: </strong>Based on clinical recommendations, we categorized glycemic status as low-normal (glycated hemoglobin [HbA1c] <5.5 %), normal (HbA1c 5.5 to 5.9 %), pre-diabetes (HbA1c 6.0 to 6.4 %), diabetes with HbA1c<7 %, and diabetes with HbA1c≥7 %. Outcomes including AF, dementia (all-cause and sub-type dementia), and death were ascertained via linkage to external registry databases. A multi-state survival analysis was conducted to evaluate disease trajectories of AF and dementia.</p><p><strong>Results: </strong>Better glycemic status was consistently associated with decreased hazards of trajectories of AF and dementia, including progression from AF to the comorbidity of AF and dementia. Among people with diabetes, those with HbA1c<7 % had a 31 % lower hazard (hazard ratio [HR], 0.69; 95 % confidence intervals [CI], 0.51-0.93) of progression from incident AF to dementia comorbidity, compared to those with HbA1c≥7 %. Similar risk reductions were found in individuals with pre-diabetes, normal HbA1c, and low-normal HbA1c, respectively. Strong dose-response associations were observed, with each 1 % increment in HbA1c related to a 28 % higher hazard of progression from AF to dementia comorbidity (HR,1.28; 95 % CI, 1.19-1.37). The glycemic status was most relevant for associations with disease trajectories of AF and vascular dementia, compared to trajectories of AF and Alzheimer's disease.</p><p><strong>Conclusions: </strong>The better glycemic status was consistently associated with lower hazards of disease trajectories of AF and dementia, including the reduced risk of progression from incident AF to comorbidity of AF and dementia. These findings support the significance of reaching optimal glycemic status to alleviate the huge disease burden of both AF and dementia simultaneously.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100047"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MemScreen: A smartphone application for detection of mild cognitive impairment: A validation study: Smartphone App for MCI Detection.","authors":"Julien Dumurgier, Claire Paquet, Jacques Hugon, Vincent Planche, Sinead Gaubert, Stéphane Epelbaum, Stéphanie Bombois, Marc Teichmann, Richard Levy, Estelle Baudouin, Agathe Vrillon, Claire Hourrègue, Emmanuel Cognat, Séverine Sabia, Archana Singh-Manoux","doi":"10.1016/j.tjpad.2025.100077","DOIUrl":"10.1016/j.tjpad.2025.100077","url":null,"abstract":"<p><strong>Background and objectives: </strong>Primary care is often the first point of contact for patients with cognitive complaints, making initial cognitive screening an essential step to avoid delays in diagnosing Alzheimer's disease (AD) at an early stage. We developed MemScreen, a self-administered smartphone application that assesses overall cognition and verbal memory, and evaluated its ability to detect mild cognitive impairment (MCI) in both general and clinical populations.</p><p><strong>Methods: </strong>We conducted two validation cohort studies: (1) UK-based Whitehall II cohort study (13th wave, 2018-2022) involving a general population (MCI defined by poor performance on a global cognitive score), and (2) five French memory clinics involving patients without dementia (amnestic MCI defined by the Free and Cued Selective Reminding Test). MemScreen, MMSE, and TMT-A effectiveness was assessed using Area Under the Curve (AUC) values from unadjusted and adjusted logistic regression models.</p><p><strong>Results: </strong>In Whitehall II (n = 2118, mean age 75.9 years, 23.9 % women, 14.5 % MCI), median MemScreen completion time was 4 min 18 s. MemScreen had the highest AUC (0.87; 95 % CI: 0.82-0.89) for distinguishing MCI, outperforming MMSE (AUC = 0.79; 0.76-0.82; p = 0.018) and TMT-A (AUC = 0.77; 0.74-0.80; p = 0.023). MemScreen sensitivity and specificity were 78.6 % and 78.7 %, respectively. In memory clinics (n = 303, mean age 70.5 years, 53 % women, 46.9 % amnestic MCI), median completion time was 5 min 17 s. MemScreen showed superior performance (AUC = 0.87; 0.83-0.91) compared to MMSE (AUC = 0.72; 0.67-0.78; p < 0.001) and TMT-A (AUC = 0.63; 0.56-0.69; p < 0.001), with 93.0 % sensitivity and 54.0 % specificity for amnestic MCI.</p><p><strong>Discussion: </strong>MemScreen outperformed traditional tests in identifying MCI in both general and clinical populations. Its self-administration and short completion time suggest potential as an effective screening tool to optimize memory clinic referrals for AD diagnosis and treatment.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100077"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the multi-day Boston remote assessment of neurocognitive health (BRANCH) among cognitively impaired & unimpaired older adults.","authors":"Emma L Weizenbaum, Stephanie Hsieh, Cassidy Molinare, Daniel Soberanes, Caitlyn Christiano, Andrea M Román Viera, Juliana A U Anzai, Stephanie Moreno, Emily C Campbell, Hyun-Sik Yang, Gad A Marshall, Reisa A Sperling, Kathryn V Papp, Rebecca E Amariglio","doi":"10.1016/j.tjpad.2025.100057","DOIUrl":"10.1016/j.tjpad.2025.100057","url":null,"abstract":"<p><strong>Background: </strong>The multi-day Boston Remote Assessment of Neurocognitive Health (BRANCH) is a remote, web-based assessment designed to capture the earliest cognitive changes in the preclinical stage of Alzheimer's disease (AD). It has been validated in unimpaired older adults, but as individuals progress on the AD continuum, assessments need to remain feasible and valid at different clinical stages. The focus of this study was to assess feasibility and validity of multi-day BRANCH in participants with and without cognitive impairment.</p><p><strong>Methods: </strong>For seven days participants completed the BRANCH paradigm to capture a muti-day learning curve score. Participants also completed the mini-mental-status-exam (MMSE) and the Quick Dementia Rating Scale (QDRS). The primary cohort included 81 older adults: 38 with cognitive impairment (CI) and 43 cognitively-unimpaired (CU). A complementary replication cohort included 16 participants with consensus-defined mild cognitive impairment (MCI) and 47 demographically-matched cognitively unimpaired participants.</p><p><strong>Results: </strong>Multi-day BRANCH was feasibile with 92 % or participants completing all seven days of testing. More CI than CU reported nervousness and found tasks slightly less enjoyable on Day 1, but ratings increased at a similar rate in both groups. Convergent validity was confirmed by a positive association between BRANCH and total MMSE and QDRS scores. There was a large effect size of group status on BRANCH (CI vs. CU; Cohen's d = 0.83) and per logistic regression, BRANCH significantly predicted group status (β = -1.49, p < 0.001); even more so between MCI and CU in the replication cohort.</p><p><strong>Conclusions: </strong>Findings suggest that a remotely administered web-based assessment of multi-day learning is feasible and valid in participants with and without cognitive impairment.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100057"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}