Frontiers in Dementia最新文献

{"title":"The need to better understand aging and risk factors for dementia","authors":"Zoe Arvanitakis","doi":"10.3389/frdem.2023.1346281","DOIUrl":"https://doi.org/10.3389/frdem.2023.1346281","url":null,"abstract":"","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"29 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446302","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":"The usability of virtual reality to train individuals in responding to behaviors related to dementia","authors":"Linda Garcia, Annie Robitaille, Stéphane Bouchard, Marie-Christine Rivard, Lynn McCleary","doi":"10.3389/frdem.2023.1237127","DOIUrl":"https://doi.org/10.3389/frdem.2023.1237127","url":null,"abstract":"Dementia is associated with several behavioral changes globally referred to as Behavioral and Psychological Symptoms of Dementia (BPSD) of which many are recognized to be the expression of unmet needs triggered by environmental factors. BPSD are an extreme source of stress for family care partners and health care providers alike and can be the reason why people living with dementia (PLWD) are placed in long-term care homes (LTCH). The overall goal of this project was to examine whether a virtual environment that includes a virtual LTCH resident with dementia in a lifelike situation could be useful and usable for health care providers and care partners to identify potential triggers to BPSDs while being engaged emotionally with the scenario.Twenty-three health care professionals working with PLWD, 25 care partners to PLWD, 27 students in a health-related field, and 11 university/community college faculty members teaching courses relevant to gerontology tested the application which depicted a meal-time scenario. In addition to being asked about the behavioral triggers in the scene, participants were asked about the usefulness and usability of the tool for training. Presence and simulator sickness were also measured.Results suggest that participants generally felt present and emotionally engaged. They could identify the potential triggers for the observed behaviors in the virtual human with dementia as well as suggest some solutions. The majority (87% of participants) found the tool easy to use. Many participants identified the inability to interact with the virtual humans as a shortfall, and few reported mild to moderate levels of simulator sickness.As the behavioral changes associated with dementia can cause extreme stress for those interacting with PLWD, developing an effective and efficient training tool could significantly improve well-being for all involved. The investigators see the development and testing of an interactive version of this virtual environment as a next step in making this a clinically relevant training tool.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"41 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139448191","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":"BPSDiary study protocol: a multi-center randomized controlled trial to compare the efficacy of a BPSD diary vs. standard care in reducing caregiver's burden","authors":"F. Pozzi, Luisa Calì, F. D’Antonio, Arianna Ida Altomare, Micaela Sepe Monti, Massimiliano Panigutti, Adolfo Di Crosta, R. Palumbo, L. Bonanni, Valentina Carlucci, Cinzia Bussè, Annachiara Cagning, D. Urso, D. Vilella, Giancarlo Logroscino, M. Alberoni, Angelo Bellinvia, Elisabetta Farina, F. de Rino, Armando Gavazzi, Marta Zuffi, Giuseppe Bruno, Valentina Bessi, M. Cotta Ramusino, G. Perini, Alfredo Costa, C. Ferrarese, I. Appollonio, L. Tremolizzo","doi":"10.3389/frdem.2023.1301280","DOIUrl":"https://doi.org/10.3389/frdem.2023.1301280","url":null,"abstract":"Behavioral and Psychological Symptoms of Dementia (BPSD) are a heterogeneous set of psychological and behavioral abnormalities seen in persons with dementia (PwD), significantly impacting their quality of life and that of their caregivers. Current assessment tools, such as the Neuropsychiatric Inventory (NPI), are limited by recall bias and lack of direct observation. This study aims to overcome this limitation by making caregiver reports more objective through the use of a novel instrument, referred to as the BPSDiary. This randomized controlled trial will involve 300 caregiver-PwD dyads. The objective is to evaluate whether the use of the BPSDiary could significantly reduce caregiver burden, assessed using the Zarit Burden Interview (ZBI), compared to usual care. The study will include adult PwD, caregivers living with or close to the patient, and BPSD related to the HIDA (hyperactivity, impulsivity, irritability, disinhibition, aggression, agitation) domain. Caregivers randomized to the intervention arm will use the BPSDiary to record specific BPSD, including insomnia, agitation/anxiety, aggression, purposeless motor behavior, and delusions/hallucinations, registering time of onset, severity, and potential triggers. The primary outcome will be the change in ZBI scores at 3 months, with secondary outcomes including changes in NPI scores, olanzapine equivalents, NPI-distress scores related to specific BPSD domains, and caregiver and physician satisfaction. The study will be conducted in 9 Italian centers, representing diverse geographic and sociocultural contexts. While potential limitations include the relatively short observation period and the focus on specific BPSD disturbances, the BPSDiary could provide physicians with objective data to tailor appropriate non-pharmacological and pharmacological interventions. Additionally, it may empower caregivers by encouraging reflection on BPSD triggers, with the potential to improve the quality of life for both PwD and their caregivers.NCT05977855.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"20 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139175752","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":"Using participatory research to co-produce an education and training e-resource to support care home staff to meet the sexuality, intimacy and relationship needs of care home residents with and without dementia","authors":"Maria Horne, J. Youell, Christine Brown Wilson, Laura J E Brown, Paul Simpson, Tommy Dickinson","doi":"10.3389/frdem.2023.1235517","DOIUrl":"https://doi.org/10.3389/frdem.2023.1235517","url":null,"abstract":"To present the methodological approach and research methods chosen in a research study designed to enable the collaborative creation of an education and training e-resource designed to facilitate and support care home staff to address the sexuality, intimacy and relationship needs of older care home residents.Co-production using community-based participatory approach.Four participatory workshops with care home staff, residents and their significant others.Workshops 1 and 2 identified and developed real-world case scenarios related to sexuality, intimacy and relationship needs and identified care staff training needs in this area. Then workshop 3 provided valuable feedback on the prototype training e-resource, and the final workshop identified care home staff engagement with and implementation of the e-resource in practice.The findings provide evidence that using participatory approaches, such as co-production, to develop education and training resources in a sensitive subject area with care home residents, significant others, carers and care home staff, was a useful approach in engaging a vulnerable population group, in a sensitive area. However, this approach is not without challenges in care home communities.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"16 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138979894","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":"Can a translational science approach change the dementia narrative in medical education?","authors":"Alison Warren","doi":"10.3389/frdem.2023.1288817","DOIUrl":"https://doi.org/10.3389/frdem.2023.1288817","url":null,"abstract":"","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139239801","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":"Prediction of progression from mild cognitive impairment to Alzheimer's disease with longitudinal and multimodal data","authors":"Huitong Ding, Biqi Wang, Alexander P. Hamel, Mark Melkonyan, T. F. Ang, Rhoda Au, Honghuang Lin","doi":"10.3389/frdem.2023.1271680","DOIUrl":"https://doi.org/10.3389/frdem.2023.1271680","url":null,"abstract":"Accurate prediction of the progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD) within a certain time frame is crucial for appropriate therapeutic interventions. However, it is challenging to capture the dynamic changes in cognitive and functional abilities over time, resulting in limited predictive performance. Our study aimed to investigate whether incorporating longitudinal multimodal data with advanced analytical methods could improve the capability to predict the risk of progressing to AD.This study included participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI), a large-scale multi-center longitudinal study. Three data modalities, including demographic variables, neuropsychological tests, and neuroimaging measures were considered. A Long Short-Term Memory (LSTM) model using data collected at five-time points (baseline, 6, 12, 18, and 24-month) was developed to predict the risk of progression from MCI to AD within 2 years from the index exam (the exam at 24-month). In contrast, a random forest model was developed to predict the risk of progression just based on the data collected at the index exam.The study included 347 participants with MCI at 24-month (age: mean 75, SD 7 years; 39.8% women) from ADNI, of whom 77 converted to AD over a 2-year follow-up period. The longitudinal LSTM model showed superior prediction performance of MCI-to-AD progression (AUC 0.93 ± 0.06) compared to the random forest model (AUC 0.90 ± 0.09). A similar pattern was also observed across different age groups.Our study suggests that the incorporation of longitudinal data can provide better predictive performance for 2-year MCI-to-AD progression risk than relying solely on cross-sectional data. Therefore, repeated or multiple times routine health surveillance of MCI patients are essential in the early detection and intervention of AD.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"4 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139240566","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":"Association between acoustic features and brain volumes: the Framingham Heart Study","authors":"Huitong Ding, Alexander P. Hamel, C. Karjadi, T. F. Ang, Sophia Lu, Robert J. Thomas, Rhoda Au, Honghuang Lin","doi":"10.3389/frdem.2023.1214940","DOIUrl":"https://doi.org/10.3389/frdem.2023.1214940","url":null,"abstract":"Although brain magnetic resonance imaging (MRI) is a valuable tool for investigating structural changes in the brain associated with neurodegeneration, the development of non-invasive and cost-effective alternative methods for detecting early cognitive impairment is crucial. The human voice has been increasingly used as an indicator for effectively detecting cognitive disorders, but it remains unclear whether acoustic features are associated with structural neuroimaging.This study aims to investigate the association between acoustic features and brain volume and compare the predictive power of each for mild cognitive impairment (MCI) in a large community-based population. The study included participants from the Framingham Heart Study (FHS) who had at least one voice recording and an MRI scan. Sixty-five acoustic features were extracted with the OpenSMILE software (v2.1.3) from each voice recording. Nine MRI measures were derived according to the FHS MRI protocol. We examined the associations between acoustic features and MRI measures using linear regression models adjusted for age, sex, and education. Acoustic composite scores were generated by combining acoustic features significantly associated with MRI measures. The MCI prediction ability of acoustic composite scores and MRI measures were compared by building random forest models and calculating the mean area under the receiver operating characteristic curve (AUC) of 10-fold cross-validation.The study included 4,293 participants (age 57 ± 13 years, 53.9% women). During 9.3 ± 3.7 years follow-up, 106 participants were diagnosed with MCI. Seven MRI measures were significantly associated with more than 20 acoustic features after adjusting for multiple testing. The acoustic composite scores can improve the AUC for MCI prediction to 0.794, compared to 0.759 achieved by MRI measures.We found multiple acoustic features were associated with MRI measures, suggesting the potential for using acoustic features as easily accessible digital biomarkers for the early diagnosis of MCI.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139242678","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":"Elevated gonadotropin levels are associated with increased biomarker risk of Alzheimer's disease in midlife women","authors":"Matilde Nerattini, Federica Rubino, Steven Jett, Caroline Andy, Camila Boneu, Camila Zarate, Caroline Carlton, Susan Loeb-Zeitlin, Y. Havryliuk, S. Pahlajani, Schantel Williams, Valentina Berti, Paul Christos, Matthew Fink, Jonathan P. Dyke, R. Brinton, Lisa Mosconi","doi":"10.3389/frdem.2023.1303256","DOIUrl":"https://doi.org/10.3389/frdem.2023.1303256","url":null,"abstract":"In preclinical studies, menopausal elevations in pituitary gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), trigger Alzheimer's disease (AD) pathology and synaptic loss in female animals. Herein, we took a translational approach to test whether gonadotropin elevations are linked to AD pathophysiology in women.We examined 191 women ages 40–65 years, carrying risk factors for late-onset AD, including 45 premenopausal, 67 perimenopausal, and 79 postmenopausal participants with clinical, laboratory, cognitive exams, and volumetric MRI scans. Half of the cohort completed 11C-Pittsburgh Compound B (PiB) amyloid-β (Aβ) PET scans. Associations between serum FSH, LH and biomarkers were examined using voxel-based analysis, overall and stratified by menopause status. Associations with region-of-interest (ROI) hippocampal volume, plasma estradiol levels, APOE-4 status, and cognition were assessed in sensitivity analyses.FSH levels were positively associated with Aβ load in frontal cortex (multivariable adjusted P ≤ 0.05, corrected for family wise type error, FWE), an effect that was driven by the postmenopausal group (multivariable adjusted PFWE ≤ 0.044). LH levels were also associated with Aβ load in frontal cortex, which did not survive multivariable adjustment. FSH and LH were negatively associated with gray matter volume (GMV) in frontal cortex, overall and in each menopausal group (multivariable adjusted PFWE ≤ 0.040), and FSH was marginally associated with ROI hippocampal volume (multivariable adjusted P = 0.058). Associations were independent of age, clinical confounders, menopause type, hormone therapy status, history of depression, APOE-4 status, and regional effects of estradiol. There were no significant associations with cognitive scores.Increasing serum gonadotropin levels, especially FSH, are associated with higher Aβ load and lower GMV in some AD-vulnerable regions of midlife women at risk for AD. These findings are consistent with preclinical work and provide exploratory hormonal targets for precision medicine strategies for AD risk reduction.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"181 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244799","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":"BPSD reconsidered: diagnostic considerations to preserve personhood in persons with dementia","authors":"Alison Warren","doi":"10.3389/frdem.2023.1272400","DOIUrl":"https://doi.org/10.3389/frdem.2023.1272400","url":null,"abstract":"BPSD is relatively common but profoundly disturbing to persons with dementia, their family, and caregivers. Growing recognition of the impact of BPSD on quality of life has improved recently, but assessment and management approaches are still lacking. Considerable controversy surrounding the label of BPSD has garnered a great deal of attention, with implications of its contribution to the already pervasive dementia-related stigma experienced by persons with dementia and their caregivers. This brief review aims to summarize salient viewpoints, controversies, and considerations of the assessment, management, and perception of BPSD, in an effort to offer potential recharacterizations of BPSD to promote and prioritize personhood in persons with dementia.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"401 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139247466","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":"Testing central auditory processing abilities in older adults with and without dementia using the consonant-vowel dichotic listening task","authors":"J. Littlejohn, Daniel J. Blackburn, A. Venneri","doi":"10.3389/frdem.2023.1207546","DOIUrl":"https://doi.org/10.3389/frdem.2023.1207546","url":null,"abstract":"Hearing loss and dementia are linked, although the roles of peripheral and central auditory dysfunction are not well defined. Many behavioral measures of hearing are confounded by the overlapping cognitive functions required to perform the tests.To collect pilot data to identify how central auditory function, measured using a dichotic listening test that indexes both auditory and cognitive components under different attentional conditions, differs among people with mild cognitive impairment (MCI), dementia and controls, and how performance relates to neuropsychological results.Fifty-eight participants (17 MCI, 11 dementia and 30 controls) undertook hearing screening, the Bergen consonant-vowel dichotic listening paradigm, and a short battery of neuropsychological tests chosen to index attention and executive control. Dichotic listening was assessed under three attentional conditions (non-forced, forced right ear and forced left) amongst older adults with normal cognitive function, MCI and dementia.We report two main findings: (a) The expected right ear advantage under non-forced conditions, was seen in controls and patients with dementia but not in people with MCI, who showed equal numbers of correct responses from both ears (i.e., a lack of asymmetry); (b) Performance under forced attentional conditions was significantly associated with disease progression (i.e., control > MCI > dementia) and performance on the cognitive tasks.The reduction in asymmetry on dichotic listening tasks may be a marker of MCI and reflect underlying compensatory mechanisms. Use of this test could aid stratification of patients with memory disorders. Whether abnormalities could predict dementia onset needs longitudinal investigation in a larger sample.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"53 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139265322","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}