Alzheimer's & Dementia最新文献

{"title":"Independent associations of high-density lipoprotein cholesterol and triglyceride levels with Alzheimer's disease and related dementias","authors":"Erin L. Ferguson,&nbsp;Scott C. Zimmerman,&nbsp;Chen Jiang,&nbsp;Minhyuk Choi,&nbsp;Travis J. Meyers,&nbsp;Thomas J. Hoffmann,&nbsp;Paola Gilsanz,&nbsp;Akinyemi Oni-Orisan,&nbsp;Jingxuan Wang,&nbsp;Rachel A. Whitmer,&nbsp;Neil Risch,&nbsp;Ronald M. Krauss,&nbsp;Catherine A. Schaefer,&nbsp;M. Maria Glymour","doi":"10.1002/alz.14575","DOIUrl":"https://doi.org/10.1002/alz.14575","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>We evaluated the independent associations between high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels with Alzheimer's disease and related dementias (ADRD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>Among 177,680 members of Kaiser Permanente Northern California who completed a survey on health risks, we residualized TGs and HDL-C conditional on age, sex, and body mass index. We included these residuals individually and concurrently in Cox models predicting ADRD incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Low (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.02–1.10) and high quintiles (HR 1.07, 95% CI 1.03–1.12) of HDL-C residuals were associated with an increased risk of ADRD compared to the middle quintile. Additional adjustment for TGs attenuated the association with high HDL-C (HR 1.03, 95% CI 0.99–1.08). Low TG residuals were associated with an increased ADRD risk (HR 1.10, 95% CI 1.06–1.15); high TG residuals were protective (HR 0.92, 95% CI 0.88–0.96). These estimates were unaffected by HDL-C adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>Low HDL-C and TG levels are independently associated with increased ADRD risk. The correlation with low TG level explains the association of high HDL-C with ADRD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Strong correlations between lipid levels are important considerations when investigating lipids as late-life risk factors for Alzheimer's disease and related dementias (ADRD).</li>\u0000 \u0000 <li>Low levels of high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs) were independently associated with an increased risk of ADRD.</li>\u0000 \u0000 <li>We found no evidence for an association between high HDL-C and increased ADRD risk after adjustment for TGs.</li>\u0000 \u0000 <li>High levels of TGs were consistently associated with a decreased risk of ADRD.</li>\u0000 \u0000 <li>There may be interaction between TG and HDL-C levels, where both low HDL-C and TG levels increase the risk of ADRD compared to average levels of both.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.14575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior cingulate cortex microRNA dysregulation differentiates cognitive resilience, mild cognitive impairment, and Alzheimer's disease","authors":"Scott E. Counts,&nbsp;John S. Beck,&nbsp;Bryan Maloney,&nbsp;Michael Malek-Ahmadi,&nbsp;Stephen D. Ginsberg,&nbsp;Elliott J. Mufson,&nbsp;Debomoy K. Lahiri","doi":"10.1002/alz.70019","DOIUrl":"https://doi.org/10.1002/alz.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>MicroRNA (miRNA) activity is increasingly appreciated as a key regulator of pathophysiologic pathways in Alzheimer's disease (AD). However, the role of miRNAs during the progression of AD, including resilience and prodromal syndromes such as mild cognitive impairment (MCI), remains underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>We performed miRNA-sequencing on samples of posterior cingulate cortex (PCC) obtained <i>post mortem</i> from Rush Religious Orders Study participants diagnosed <i>ante mortem</i> with no cognitive impairment (NCI), MCI, or AD. NCI subjects were subdivided as low pathology (Braak stage I/II) or high pathology (Braak stage III/IV), suggestive of resilience. Bioinformatics approaches included differential expression, messenger RNA (mRNA) target prediction, interactome modeling, functional enrichment, and AD risk modeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>We identified specific miRNA groups, mRNA targets, and signaling pathways distinguishing AD, MCI, resilience, <i>ante mortem</i> neuropsychological test performance, <i>post mortem</i> neuropathological burden, and AD risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>These findings highlight the potential of harnessing miRNA activity to manipulate disease-modifying pathways in AD, with implications for precision medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>MicroRNA (MiRNA) dysregulation is a well-established feature of Alzheimer's disease (AD).</li>\u0000 \u0000 <li>Novel miRNAs also distinguish subjects with mild cognitive impairment and putative resilience.</li>\u0000 \u0000 <li>MiRNAs correlate with cognitive performance and neuropathological burden.</li>\u0000 \u0000 <li>Select miRNAs are associated with AD risk with age as a significant covariate.</li>\u0000 \u0000 <li>MiRNA pathways include insulin, prolactin, kinases, and neurite plasticity.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complexity of developing a nationwide model for a dementia registry in Egypt: A qualitative study","authors":"Shimaa A. Heikal,&nbsp;Ghada Barsoum,&nbsp;Mohamed Salama","doi":"10.1002/alz.70011","DOIUrl":"https://doi.org/10.1002/alz.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>The increased interest in evidence-based medicine has led to the emergence of disease registries worldwide to help tackle the impact of chronic diseases. A national dementia registry in Egypt would provide a valuable source of patient data that will significantly advance the disease management strategies, quality of patient care, and impact health policy- and decision making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>This study investigates the complexity of creating a disease registry for dementia in Egypt by interviewing 24 experts to provide recommendations for the most appropriate registry model to be developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Several core themes emerged from the analysis discussing many points that should direct the creation of any registry in Egypt in terms of functionality, planning, comprehension, governance, ethics, and challenges to avoid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>Developing such a dataset is beneficial to the Egyptian health-care system, which makes the investment worthwhile. Support and collaborative work from all stakeholders, along with suitable funding, are essential elements of the proper implementation of the project.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Building a dementia registry is essential to progress research in understudied populations</li>\u0000 \u0000 <li>Qualitative analysis of 24 experts interviews provided insightful plan for dementia registry</li>\u0000 \u0000 <li>Core domains to address include: functionality, planning, comprehension, governance, ethics, and challenges to avoid.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early presentations of dementia in a diverse population","authors":"Sedigheh Zabihi,&nbsp;Jonathan P Bestwick,&nbsp;Mark Jitlal,&nbsp;Phazha LK Bothongo,&nbsp;Qiqi Zhang,&nbsp;Christine Carter,&nbsp;Moïse Roche,&nbsp;Sarah Morgan-Trimmer,&nbsp;Yvonne Birks,&nbsp;Mark Wilberforce,&nbsp;Ruth Dobson,&nbsp;Alastair J Noyce,&nbsp;John Robson,&nbsp;Fiona M Walter,&nbsp;Claudia Cooper,&nbsp;Charles R Marshall","doi":"10.1002/alz.14578","DOIUrl":"https://doi.org/10.1002/alz.14578","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>Improved recognition of non-cognitive presentations of dementia could reduce inequalities in dementia diagnosis, particularly if sociocultural factors influence help-seeking for cognitive symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>We conducted a nested case-control study using electronic healthcare records from primary care practices in East London, United Kingdom, to assess associations between prediagnostic presentations to primary care and subsequent dementia diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>We included 4137 individuals with a dementia diagnosis and 15,754 controls in the matched analysis. In addition to memory difficulties, a range of symptoms were more common in the decade before diagnosis, including depression, anxiety, use of antipsychotics, insomnia, constipation, incontinence, hypotension, hearing loss, imbalance, and dizziness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>A range of non-cognitive presentations are seen during the prodromal period of dementia in a diverse population. Improved recognition of these associations and their variation by ethnicity could increase access to dementia diagnosis through improved recognition of early features in people from different sociocultural backgrounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Prediagnostic signs of dementia include cognitive and non-cognitive symptoms.</li>\u0000 \u0000 <li>Psychiatric symptoms are common up to a decade prior to a dementia diagnosis.</li>\u0000 \u0000 <li>Autonomic prediagnostic symptoms are more common among South Asian groups.</li>\u0000 \u0000 <li>The importance of prediagnostic symptoms of dementia varies by ethnicity.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.14578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eating and swallowing care disparities in persons with dementia: A conceptual framework","authors":"Raele Donetha Loy,&nbsp;Nicole Rogus-Pulia,&nbsp;Fred Ketchum,&nbsp;Michelle Troche,&nbsp;Anaïs Rameau,&nbsp;Harrison N. Jones,&nbsp;Luis Riquelme,&nbsp;Andrea Gilmore-Bykovskyi,&nbsp;Manish N. Shah,&nbsp;Amy Kind","doi":"10.1002/alz.70028","DOIUrl":"https://doi.org/10.1002/alz.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>Eating and swallowing difficulties are prevalent and distressing among persons living with dementia (PLWD). These challenges may be especially burdensome for PLWD in lower-resourced settings, where environmental factors such as social support, health-care infrastructure, and food access are critical for meeting quality standards of eating and swallowing care. However, clinical practices and research methods have not sufficiently focused on the lived environment to promote high-quality, socially and culturally aligned management approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>To address this gap, we developed a conceptual framework informed by the literature, grounded in ecological systems and fundamental cause theories, and refined through iterative discussion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Our framework highlights individual-, system-, and community-level factors and resources influencing person-centered eating and swallowing care for PLWD. It identifies areas at risk for inequitable care along the swallowing management continuum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>We propose future research areas to help health-care providers reconcile the demands of eating and swallowing care with the lived realities of PLWD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>There are eating/swallowing care disparities among persons living with dementia.</li>\u0000 \u0000 <li>We introduce a conceptual framework applying social and structural determinants of health to eating/swallowing care.</li>\u0000 \u0000 <li>We also recommend areas to address disparities and improve eating/swallowing care.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual and joint associations between sleep duration and physical activity with cognitive function: a longitudinal analysis among middle-aged and older adults in China","authors":"Zhiyi Zhang","doi":"10.1002/alz.70049","DOIUrl":"https://doi.org/10.1002/alz.70049","url":null,"abstract":"&lt;p&gt;I read the article written by Hongwei Liu and his colleagues with interest, and I would like to commend the author for conducting such a comprehensive longitudinal study, examining the relationship between sleep time, physical activity, and cognitive function among middle-aged and elderly people in China.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The research provides valuable insights into the potential effects of lifestyle factors, specifically sleep and physical activity, on cognitive aging. However, I would like to offer several suggestions and comments for consideration.&lt;/p&gt;&lt;p&gt;First, although the study considered sleep duration, it did not delve into the impact of sleep quality.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; Research has shown that sleep quality has a significant impact on cognitive function, and analyzing solely based on sleep duration may overlook other important factors that affect cognitive function, such as sleep interruption, lack of deep sleep, etc., which may have an impact on cognition and, thus, affect the accuracy of research results.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Although this study employed lagged time series models to examine causal relationships, the possibility of reverse causation cannot be completely ruled out, particularly since early-stage cognitive decline may influence both sleep patterns and physical activity levels.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Specifically, deteriorating cognitive function could alter individuals' sleep habits and physical activity behaviors, making it challenging to fully disentangle the direction of causality. Future research should implement methodological approaches that minimize the potential impact of reverse causation to ensure greater validity of findings.&lt;span&gt;&lt;sup&gt;6-8&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;While this study thoroughly examined the relationships between sleep and physical activity, it may not have adequately addressed the potential non-linear effects of these variables. For instance, moderate physical activity might enhance cognitive function, whereas excessive physical activity could potentially yield adverse effects.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; The analyses conducted in this study may not have fully captured such non-linear relationships. Furthermore, the lack of detailed categorization of physical activity types and intensities represents another limitation, as different forms of exercise (such as aerobic exercise and strength training) may differentially impact cognitive function, potentially affecting the precision of our findings.&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Based on our findings, we propose implementing a three-tiered response system for cognitive health management. The first tier focuses on broad public health education, promoting awareness of cognitive health through campaigns that emphasize the importance of proper sleep habits and appropriate physical activity levels. The second tier targets high-risk populations, such as elderly individuals and those with family history of cognitive decline, providing","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education and midlife cognitive functioning: Evidence from the High School and Beyond cohort","authors":"Chandra Muller,&nbsp;Eric Grodsky,&nbsp;Adam M. Brickman,&nbsp;Jennifer J. Manly,&nbsp;Koit Hung,&nbsp;Michael J. Culbertson,&nbsp;John Robert Warren","doi":"10.1002/alz.70015","DOIUrl":"https://doi.org/10.1002/alz.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>Educational attainment is associated with midlife cognitive functioning. However, degree attainment is the culmination of complex and unequal processes involving students’ backgrounds, the opportunities that schools provide them, and their performance within those schools─all of which may <i>also</i> shape midlife cognition. What do educational gradients in midlife cognition look like using a richer conceptualization and measures of “education?”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>We use data from High School and Beyond (HS&amp;B:80)─a large, nationally representative sample of Americans followed from high school through age ∼60─to assess the role of education in stratifying midlife cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>High schools’ academic and socioeconomic environments predict midlife cognition primarily through their associations with their students’ academic performance. Student academic performance strongly predicts midlife cognition, partially through its association with degree attainment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>Inequalities in educational opportunities and in students’ performance in schools shape midlife cognition─even among students with the same attained degrees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Degree attainment predicts midlife cognitive functioning, but a large portion of that association is accounted for by students’ high school academic performance as measured by test scores, grades, and course completion.</li>\u0000 \u0000 <li>High school contexts and learning opportunities predict midlife cognition mainly because they play a role in shaping students’ academic performance.</li>\u0000 \u0000 <li>Understanding the potential benefits of education for later-life cognitive functioning requires attention to broader schooling processes and to students’ academic performance beyond degree attainment.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma p-tau217 identifies cognitively normal older adults who will develop cognitive impairment in a 10-year window","authors":"Yara Yakoub,&nbsp;Fernando Gonzalez-Ortiz,&nbsp;Nicholas J. Ashton,&nbsp;Christine Déry,&nbsp;Cherie Strikwerda-Brown,&nbsp;Frédéric St-Onge,&nbsp;Valentin Ourry,&nbsp;Michael Schöll,&nbsp;Maiya R. Geddes,&nbsp;Simon Ducharme,&nbsp;Maxime Montembeault,&nbsp;Pedro Rosa-Neto,&nbsp;Jean-Paul Soucy,&nbsp;John C. S. Breitner,&nbsp;Henrik Zetterberg,&nbsp;Kaj Blennow,&nbsp;Judes Poirier,&nbsp;Sylvia Villeneuve,&nbsp;PREVENT−AD Research Group","doi":"10.1002/alz.14537","DOIUrl":"https://doi.org/10.1002/alz.14537","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>We assessed the prognostic accuracy of plasma p-tau217 in predicting the progression to mild cognitive impairment (MCI) in cognitively unimpaired (CU) individuals over a mean follow-up of 5.65 years after plasma collection (range 1.01–10.47).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>We included 215 participants from the PREVENT−AD cohort with plasma Aβ_42/40 and p-tau217, 159 with cerebrospinal fluid (CSF) Aβ_42/40 and p-tau217, and 155 with ¹⁸F-NAV4694 and ¹⁸F-flortaucipir PET scans. MCI progression was determined by multidisciplinary consensus among memory experts blind to biomarker and genetic information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Cox proportional hazard models indicated a greater progression rate in A+T+_plasma and A−T+_plasma compared to A−T−_plasma individuals (HR = 7.81 [95% CI = 3.92 to 15.59] and HR = 4.25 [1.60–11.31] respectively). Similar results were found with CSF (HR = 3.63 [1.72–7.70]) and PET (HR = 9.30 [3.67–23.55]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>Plasma p-tau217 is a prognostic marker for identifying individuals who will develop cognitive impairment within ten years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Elevated plasma p-tau217 levels in CU individuals indicate future clinical progression.</li>\u0000 \u0000 <li>Adding plasma Aβ_42/40 status to p-tau markers did not improve the prediction to MCI.</li>\u0000 \u0000 <li>All individuals with abnormal tau PET measured in a temporal meta-ROI progressed to MCI.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.14537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with dementia in Lesotho: A cross-sectional, population-based study","authors":"Natalie E. Johnson,&nbsp;Jennifer M. Belus,&nbsp;Felix Gerber,&nbsp;Tristan T. Lee,&nbsp;Irene Ayakaka,&nbsp;Pearl Letsoela,&nbsp;Manthabiseng Molulela,&nbsp;Frédérique Chammartin,&nbsp;Alain Amstutz,&nbsp;Niklaus D. Labhardt","doi":"10.1002/alz.14614","DOIUrl":"https://doi.org/10.1002/alz.14614","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>Limited research has examined dementia prevalence and associated factors in Lesotho. This study investigates dementia prevalence and the associated factors in Lesotho.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>A survey in Lesotho included 1738 participants screened for dementia and potential associated factors with a focus on modifiable factors. Associations were evaluated using logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>The median age was 66 years, with 54.83% women. The prevalence of dementia was 4.89%. Those with depressive symptoms (adjusted odds ratio [aOR]: 3.97, 95% confidence interval [CI]: 1.39–11.30), age ≥ 75 (aOR: 2.68, 95% CI: 1.42–5.04), and underweight (aOR 2.30, 95% CI: 1.23–4.29) had increased odds of dementia. Those with moderate (aOR: 0.32, 95% CI: 0.17–0.58) to high (aOR: 0.35, 95% CI: 0.16–0.77) physical activity and obesity (aOR: 0.30, 95% CI: 0.11–0.80) presented lower odds for dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>This study provides a contemporary estimate of dementia prevalence in Lesotho, highlighting an association with modifiable factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>In Lesotho there is a probable dementia prevalence of 4.89%, aligning with regional estimates for Africa.</li>\u0000 \u0000 <li>Depression, older age, being underweight, and low physical activity were associated with increased odds of dementia.</li>\u0000 \u0000 <li>Moderate to high physical activity and obesity were associated with lower dementia odds.</li>\u0000 \u0000 <li>Further study of the association of dementia with potentially modifiable factors in low- and middle-income countries is warranted.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.14614","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of comorbidity between Alzheimer's disease and pain","authors":"Kaifang Yao,&nbsp;Shenjun Wang,&nbsp;Zhifang Xu,&nbsp;Zezhi Fan,&nbsp;Zhihan Chen,&nbsp;Peng Jia,&nbsp;Shiwei Tu,&nbsp;Yangyang Liu,&nbsp;Xiaowei Lin,&nbsp;Yuan Xu,&nbsp;Yuxing Fang,&nbsp;Baomin Dou,&nbsp;Yi Guo","doi":"10.1002/alz.14605","DOIUrl":"https://doi.org/10.1002/alz.14605","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Clinical studies have revealed a significant correlation between pain and neurodegenerative diseases, particularly Alzheimer's disease (AD). However, due to cognitive and speech impairments, AD patients, especially those in moderate to severe stages, are often overlooked in pain management. The challenges in obtaining pain-related information from this population exacerbate the issue. Although recent clinical research has increasingly recognized the comorbidity of AD and pain, the pathological alterations and interactive mechanisms underlying this relationship remain inadequately explored. This review provides a comprehensive analysis of the clinical features and pathological mechanisms of AD with and without pain comorbidity. It examines underlying processes, including neuroinflammation, peripheral-central immune interactions, and neurotransmitter dynamics. Furthermore, it highlights current pain assessment and management strategies in AD patients. By offering a theoretical framework, this review aims to support the development of effective pain management approaches and serve as a reference for clinical interventions targeting AD-associated pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>The comorbidity between AD and CP encompasses multiple interrelated biological pathways, such as neurodegeneration and inflammatory responses.</li>\u0000 \u0000 <li>The damage to neurons and synapses in AD patients influences the brain regions responsible for processing pain, thereby reducing the pain response.</li>\u0000 \u0000 <li>Neuroinflammation plays a vital role in the development of both AD and CP. Enhanced inflammatory responses have an impact on the CNS and promote sensitization.</li>\u0000 \u0000 <li>Common neurotransmitter alterations exist in the comorbidity of AD and CP, influencing cognition, emotion, and pain perception.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.14605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}