Stephanie Than, Chris Moran, R. Beare, A. Vincent, Emma M Lane, T. Collyer, M. Callisaya, V. Srikanth
{"title":"Cognitive trajectories during the menopausal transition","authors":"Stephanie Than, Chris Moran, R. Beare, A. Vincent, Emma M Lane, T. Collyer, M. Callisaya, V. Srikanth","doi":"10.3389/frdem.2023.1098693","DOIUrl":"https://doi.org/10.3389/frdem.2023.1098693","url":null,"abstract":"Aims Female sex is associated with an increased prevalence of dementia. Menopause may have a role to play in explaining sex differences in cognition, and possibly the risk of future dementia. We aimed to determine if the rate of cognitive decline differed between stages of the menopausal transition. Materials and methods Women with data on menopause and longitudinal cognitive function from the UK Biobank study were stratified into three groups: premenopausal, perimenopausal and postmenopausal. We studied associations of these menopause groups with rate of change in reaction time, verbal-numeric reasoning, prospective memory, visual memory and attention/working memory, adjusted for age, education, ethnicity and APOEε4 genotype. We also explored the effect of menopausal hormonal therapy (MHT) use and cross-sectional brain magnetic resonance imaging (MRI) volumes on these models. Results We included 15,486 women (baseline mean age 52 years) over a mean duration of 8 years. An interaction between menopausal group status and time was found for reaction time (p < 0.01). Compared with premenopausal women, the rate of increase (worsening) in reaction time was least in postmenopausal women (β = −1.07, p for interaction = 0.02). In general, compared with premenopausal women, perimenopausal and postmenopausal women had overall poorer performance in fluid intelligence and memory over the study duration, with no difference in rates of change. The models were unaffected by MHT use and brain volume measures. Conclusions Perimenopause and post-menopause are associated with cognitive changes. Psychomotor speed appears to be most sensitive to the menopause transition, whereas other cognitive functions may be less susceptible. More sensitive structural or functional brain imaging may be required to understand the underlying neural basis for these findings.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117170930","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":"Cultural adaptation in television technology for older adults with dementia in care settings","authors":"Karen Lok Yi Wong, Lillian Hung","doi":"10.3389/frdem.2022.1098446","DOIUrl":"https://doi.org/10.3389/frdem.2022.1098446","url":null,"abstract":"Introduction There is a lack of literature on the cultural adaptation of technologies for dementia care. This paper presents an example of the cultural adaptation of a television video about drinking water for older Chinese adults with dementia in care settings, in Vancouver, Canada. Method We refer to the cultural adaptation process (CAP) model to guide the cultural adaptation process by collecting and incorporating feedback from different parties into the culturally adapted video, including Phase 1 local consultations and information gathering, phase 2 iterative testing and adaptation, and phase 3 finalizing adaptation. Results We also referred to the Ecological Validity Model (EVM) to present the adjustments we made to the video from the cultural adaptation. We adjusted the video on seven domains suggested by the EVM: goal, context, content, language, people, concept, and method. Discussion We draw attention to the opportunities and challenges of the cultural adaptation of technology into a new community. Based on our lessons, we outline concrete suggestions about what aspects of, and how, cultural adaptation can be made to promote cultural inclusivity in technology development and implementation.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"186 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114749077","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}
Niels Hansen, S. Hirschel, B. Teegen, J. Wiltfang, B. Malchow
{"title":"Preserved visuoconstruction in patients with Alzheimer's pathology and anti-neural autoantibodies: A case control study","authors":"Niels Hansen, S. Hirschel, B. Teegen, J. Wiltfang, B. Malchow","doi":"10.3389/frdem.2022.975851","DOIUrl":"https://doi.org/10.3389/frdem.2022.975851","url":null,"abstract":"Background Alzheimer's disease (AD) is seldom reported to be associated with neural autoantibodies apart from those involved in axonal neurodegeneration and amyloidopathy in prior studies. Nevertheless, this is an under-investigated aspect of AD. As we do not know whether additional screening for autoantibodies in AD patients has additional diagnostic and therapeutic value, this study aims to shed light on whether visuoconstructive or figural memory capacities might distinguish these patient populations. Methods In this pilot case series, we investigated eight patients suffering from cognitive impairment associated with cerebrospinal fluid (CSF)-based Alzheimer pathology (AP) and with verified anti-neural autoantibodies (AP Aab+) compared to eight AD patients presenting no autoantibodies (Aab–) (AD Aab–). Patients files were reviewed retrospectively regarding their neuropsychological profile assessed via the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) test battery and psychopathology measured by the AMDP (Manual for the Assessment and Documentation of Psychopathology in Psychiatry) system. We also relied on diagnostic parameters as in the CSF and magnetic resonance images. Results All patients shared the same pattern of dysfunctional word-list learning and word-list recall resembling a hippocampus-dependent memory dysfunction. Furthermore, both patient groups revealed a CSF profile concurring with Alzheimer's disease. However, visuoconstructive capacity, but not figure recall was preserved in AP Aab+ patients, but not in AD Ab-patients with the shared hippocampus-based memory dysfunction. We observed no relevant differences between the AP Aab+ and AD Aab– groups in CSF cell-counts or intrathecal IgG synthesis. The relative frequency of hippocampal and focal atrophy did not differ either between AP Aab+ and AD Aab– groups. Discussion Our pilot findings are encouraging us to conduct large-scale studies to replicate our discovery of preserved visuoconstruction in AP Aab+ patients with hippocampus-based memory dysfunction. The role of anti-neural autoantibodies is still not fully understood. The detection of these autoantibodies might imply another disease pathology that could be either neuroprotective or be affecting other brain regions, i.e., less pronounced disease activity in the right temporo-parietal regions mainly involved in visuoconstruction.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127771956","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":"Views and experiences on the use of voice assistants by family and professionals supporting people with cognitive impairments","authors":"Ana-Maria Salai, A. Kirton, G. Cook, L. Holmquist","doi":"10.3389/frdem.2022.1049464","DOIUrl":"https://doi.org/10.3389/frdem.2022.1049464","url":null,"abstract":"The use of voice assistants (e.g., Amazon Alexa, Google Home) is being widely advocated as part of supporting people living with dementia at home. The development of this technology is largely driven by industry, and there is little research to determine how family carers and professionals use voice assistants with people with dementia. This paper presents the findings from further analysis of data from two studies: Study 1—a qualitative study that aimed to explore the views and expectations of family carers and professionals who use voice assistants to support people with a cognitive impairment at home, and Study 2—a qualitative enquiry aiming to identify the views and barriers on using voice assistants by family carers of people with dementia and professionals, together with a pilot case study evaluating a prototype that addresses barriers identified during the enquiry, entitled IntraVox. Based on processing of smart home sensor data, IntraVox uses a personalised human voice to send prompts and reminders to end-users to conduct daily life activities and to activate smart home processes using voice assistants. The results of the qualitative studies indicate that family carers and professionals use voice assistants in their caring role for home automation, skills maintenance and development, prompts and reminders, behaviour and environment monitoring, and for leisure and social interaction support. The findings also show that family carers and professionals have specific challenges that need to be overcome for them to realise the benefits that may be gained through the use of voice assistants within technology enabled care. The pilot case study also provided a useful demonstration that interoperability can be achieved to enable exchanges between IntraVox and voice assistants, with the aim of providing customised and personalised technological solutions that address some of the barriers that people with dementia and their carers face in the use of this technology.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"602 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123203516","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":"“People are more afraid of a dementia diagnosis than of death”: The challenges of supporting advance care planning for persons with dementia in community settings","authors":"T. Sussman, Bianca Tétrault","doi":"10.3389/frdem.2022.1043661","DOIUrl":"https://doi.org/10.3389/frdem.2022.1043661","url":null,"abstract":"Improving early uptake of advance care planning (ACP) for persons with dementia and their families requires that staff in community-based settings feel armed and equipped to encourage and support this process. Yet few studies have explored whether staff within non-medical environments feel prepared to support early ACP engagement for persons with early-stage dementia and their families. Our qualitative interpretivist study aimed to fill this gap by facilitating, transcribing and thematically analyzing deliberations from three focus groups with 17 community-based staff. Our findings revealed four key barriers to ACP activation in community settings: (1) the stigma associated with the condition; (2) lack of knowledge about end-of-life concerns for persons with dementia; (3) uncertainties about managing complex family dynamics and (4) worries that opening up conversations about future care may lead to the expression of wishes that could not be actualized (e.g., dying at home). Our findings further revealed that ACP engagement was facilitated when staff expressed confidence in their capacities to gauge readiness, viewed themselves as guides rather than experts and had access to resources to supplement their knowledge. Reflexive training opportunities and access to materials and resources around end-of-life care for persons with dementia, could equip staff in these non-medical settings with the skills to engage in ongoing dialogue about future care issues with persons living with dementia and their families.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132418519","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}
Maria Cachide, L. Carvalho, I. Rosa, J. Wiltfang, A. G. Henriques, O. A. B. da Cruz e Silva
{"title":"BIN1 rs744373 SNP and APOE alleles specifically associate to common diseases","authors":"Maria Cachide, L. Carvalho, I. Rosa, J. Wiltfang, A. G. Henriques, O. A. B. da Cruz e Silva","doi":"10.3389/frdem.2022.1001113","DOIUrl":"https://doi.org/10.3389/frdem.2022.1001113","url":null,"abstract":"APOE ε4 and BIN1 are the two main genetic risk factors for sporadic Alzheimer's Disease (AD). Among several BIN1 variants, the rs744373 is frequently associated with AD risk by contributing to tau pathology and poor cognitive performance. This study addressed the association of APOE and BIN1 rs744373 to specific characteristics in a Portuguese primary care-based study group, denoted pcb-Cohort. The study included 590 participants from five primary care health centers in the Aveiro district of Portugal. Individuals were evaluated and scored for cognitive and clinical characteristics, and blood samples were collected from the volunteers meeting the inclusion and exclusion criteria (N = 505). APOE and BIN1 genotypes were determined, and their association with cognitive characteristics and other diseases that might contribute to cognitive deficits, namely depression, hypertension, type 2 diabetes, dyslipidemia, osteoarticular diseases, gastrointestinal diseases, cardiovascular and respiratory diseases, was assessed. The diseases attributed to the study group were those previously diagnosed and confirmed by specialists. The results generated through multivariate analysis show that APOE ε4 carriers significantly associated with poorer cognitive performance (OR = 2.527; p = 0.031). Additionally, there was a significant risk of dyslipidemia for APOE ε4 carriers (OR = 1.804; p = 0.036), whereas BIN1 rs744373 risk-allele carriers were at a significantly lower risk of having dyslipidemia (OR = 0.558; p = 0.006). Correlations were evident for respiratory diseases in which APOE ε4 showed a protective tendency (OR = 0.515; p = 0.088), and BIN1 had a significative protective profile (OR = 0.556; p = 0.026). Not of statistical significance, APOE ε2 showed a trend to protect against type 2 diabetes (OR = 0.342; p = 0.093), in contrast BIN1 rs744373 risk-allele carriers were more likely to exhibit the disease (OR = 1.491; p = 0.099). The data here presented clearly show, for the first time, that the two top genetic risk factors for sporadic AD impact a similar group of common diseases, namely dyslipidemia, respiratory diseases, and type 2 diabetes.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134623723","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":"Heightened emotion processing as a compensatory mechanism in persons with Alzheimer's disease: Psychological insights from the tri-network model","authors":"A. Warren","doi":"10.3389/frdem.2022.983331","DOIUrl":"https://doi.org/10.3389/frdem.2022.983331","url":null,"abstract":"Social and emotional communication is an integral tenant of life quality and well-being. Aberrations in functional connectivity can alter social emotional behavior in numerous disease states, including dementia. This paper aims to review the major network changes observed in Alzheimer's disease, with a focus on the tri-network model. The central executive network, default mode network, and principally the salience network will be discussed as they relate to both pathology and compensatory behavioral manifestations in persons with dementia. The psychological and behavioral correlates of these network changes will be reviewed with the intent of increasing understanding about the conscious experience and communication modalities utilized by persons with dementia, the understanding of which may promote meaningful communication with care providers and loved ones. This paper further seeks to reframe social emotional communication methods used by persons with dementia by marrying current knowledge of neuroscience, psychology, and person-centered care. In this way, a perspective is offered that considers the heightened emotional states experienced by persons with dementia as a potential compensatory mechanism that may hold practical value under some circumstances. The many ways in which the brain adapts to physical and psychological changes, aging, and injury are still under exploration. Emotion processing may provide clinical insight into the subjective experience of dementia in this regard. Emotions, therefore, may serve to promote social bonds, provide an avenue for non-verbal communication, and act as a construct to maintain agency in persons who ultimately lose autonomy.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128504940","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}
I. Tunnard, Juliet Gillam, C. Harvey, N. Davies, V. Vickerstaff, C. Ellis-Smith, C. Evans
{"title":"The acceptability and effectiveness of eHealth interventions to support assessment and decision-making for people with dementia living in care homes: A systematic review","authors":"I. Tunnard, Juliet Gillam, C. Harvey, N. Davies, V. Vickerstaff, C. Ellis-Smith, C. Evans","doi":"10.3389/frdem.2022.977561","DOIUrl":"https://doi.org/10.3389/frdem.2022.977561","url":null,"abstract":"Introduction As dementia progresses, care needs increase leading many to require 24-h care in care homes. eHealth interventions have the potential to improve care processes of assessment and decision-making for people with dementia. However, little is known on the acceptability and effectiveness in care homes. Aim To identify and explore the components, acceptability and effectiveness of eHealth interventions for people with dementia, families and staff to support assessment and decision-making in care homes. Methods A mixed methods systematic review using narrative synthesis. Four databases were searched (Embase, PsycINFO, MEDLINE, and CINAHL) from 2000 to July 2021. Quality appraisal used validated assessment tools appropriate for the study design. Results Twenty-six studies met eligibility criteria. Study designs and interventions were heterogeneous. Overall quality was high to moderate. Interventions that promoted supportive, practical learning through integrated working and provided staff with language to communicate resident symptoms were favored by staff. We found evidence that indicated residents were willing to use video consultations; however, families preferred face-to-face consultations. Fifteen studies considered effectiveness. Use of eHealth interventions indicates an improvement in resident outcomes in appropriate prescribing and advance care planning. Staff knowledge, confidence, and wellbeing were also improved. Hospitalisations were reduced when a video consultation component was implemented. Discussion Care home staff require support to meet the often multiple and changing care needs of residents with dementia. eHealth interventions can improve outcomes for staff and residents and facilitate integrated working with external professionals to support assessment and management of care. Further work is required to understand acceptability for residents and their families and effectiveness on family outcomes, particularly in non-Western cultures and low-middle income countries. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=254967, identifier: CRD42021254967.","PeriodicalId":408305,"journal":{"name":"Frontiers in Dementia","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126817421","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}