Dementia has emerged as a critical public health issue on the global policy agenda. Over the past 25 years, China has increasingly recognized the significant challenges posed by dementia and has made substantial strides in formulating relevant policies. This study aims to analyze the strategic framework of China's dementia policy development to provide valuable insights for other low- and middle-income countries as they draft their national action plans.

Policy documents were systematically searched and retrieved from the official websites of pertinent policy agencies. The evolutionary phases of dementia policies were identified based on the timeline of policy issuance. A comparative thematic analysis was conducted to explore the evolution of policy content. Additionally, WordCloud analysis was utilized to examine the frequency of relevant terms within these documents. Co-occurrence network diagrams were then created to illustrate the evolving trends in the relationships among key terms and activities related to dementia care.

A total of 36 policy documents were included in this study. Three distinct phases were identified over the past 25 years: an incipient phase (2000-2014), a development phase (2015-2018), and a boom phase (2019-2024). Themes within dementia policies have progressively expanded and enriched across these phases. There has been a notable shift in focus from "intervention" during the incipient phase to "dementia prevention" in the boom phase, with themes such as "screening and evaluation" and "public education" gaining prominence. Stakeholder involvement has diversified to include entities like "community," "institutions," and "social workers." Moreover, the scope of potential beneficiaries has broadened from "patients" to encompass "family members" and "caregivers." The number of nodes related to dementia policies has increased, and their interconnections have strengthened over time.

Over 25 years, the themes, content, and stakeholders involved in China's dementia-related policies have expanded significantly. Furthermore, the interconnection among key terms and content has grown stronger. These findings offer valuable references for advancing national dementia initiatives and updating dementia action plans in low- and middle-income countries.

Jiangxi Province Key Research Base Program for Philosophy and Social Sciences (23ZXSKJD28) and Beijing Medical Award Foundation.

The objective of this systematic review was to synthesize evidence from randomized controlled trials (RCTs) regarding the efficacy of music-based interventions (MBIs) in improving anxiety and depression in older adults with dementia.

Relevant RCTs were identified through searches in electronic databases, including PubMed, Embase, EBSCOhost, Scopus, Web of Science, APA PsycINFO, and Google. The Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to evaluate the risk of bias in the included trials. A narrative synthesis of the included trials was conducted.

Nine RCTs involving 496 patients met the inclusion criteria; five trials evaluated the efficacy of MBIs for anxiety, and six trials evaluated their efficacy for depression in older adults with dementia. Of the nine trials, two reported significant improvements in anxiety in older adults with dementia following MBIs (Cohen's d = -1.71 to -2.48), while one trial reported significant improvements in depression (Cohen's d = -0.66).

Only a few trials support the efficacy of MBIs in alleviating negative emotions in older adults with dementia, as evidenced by three out of the nine trials. However, due to the small sample sizes and heterogeneity in dementia types, stages, and interventions, quantitative results were not pooled, making it challenging to draw reliable conclusions. Further validation and examination of the findings presented in this study are warranted to strengthen the evidence base for integrating MBIs into dementia care and treatment protocols.

Exercise has been widely recognized as an effective regimen in mitigating cognitive decline. However, the effect of multi-component exercise (i.e., combination of two or more types of exercise) on cognitive function and its subdomains in older adults remains unclear. This meta-analysis aimed to explore the effects of multi-component exercise on cognitive functions in elderly individuals with cognitive impairment and identify optimal prevention and treatment strategies. A systematic search was conducted on PubMed, EBSCOhost, Web of Science, and Embase to identify relevant randomized controlled trials assessing the effect of multi-component exercise on cognitive function in the elderly. Thirteen studies with 1,776 participants were included in the analysis using Revman 5.4 software. The results showed that multi-component exercise had a significant effect on mitigating cognitive function decline in the elderly, with a pooled effect size of SMD = 0.31 (95% CI: 0.08, 0.55; p = 0.009). The results of subgroup analysis showed that interventions with ≥3 days/week, 12-24 weeks duration, and ≤ 40 min/session were significantly superior to other frequencies, durations, and lengths, with all p-values <0.05. Additionally, multi-component exercise had the most pronounced effects on executive function, visual memory, and verbal memory in patients with mild cognitive impairment (MCI). In conclusion, multi-component exercise can delay the decline in cognitive function in the elderly, and the intervention effects are modulated by various variables. Optimal intervention effects were observed with an exercise frequency of three or more times per week, a duration of 12 to 24 weeks, and a time per session of 40 min or less, particularly for improving executive function, visual memory, and verbal memory in patients with MCI.

This study aims to investigate the association of global cognitive with chronic conditions, physical impairment, olfactory function, socio-demographics and other factors among older adults in the urban community, West Jakarta.

The cross-sectional study involved 334 older adults aged 60 years and older who resided in urban community Jakarta, Indonesia. Trained interviewers visited and evaluated the respondents in the sub-district office. Cognitive function is examined using Montreal Cognitive Assessment-Indonesian Version (MoCA-INA). Respondents were clinically examined using a standardized protocol, which included medical history, general physical examination, cognitive assessment, and blood test for diabetes.

Global cognitive impairment was significantly associated with being female (adjusted odd ratio [AOR]: 1.99, 95% CI: 1.14-3.50) and low education (AOR: 4.79, 95% CI: 2.80-8.18). Moreover diabetes, impaired balance, and olfactory dysfunction have AOR:3.23 (95% CI: 1.39-7.51), 2.55% (95% CI: 1.07-6.07), and 2.26 (95% CI: 1.32-3.85) respectively.

This paper highlights that cognitively impaired and diabetic as well as low education subject in urban community, West Jakarta, Indonesia. Global cognitive impairment was associated with being female, having obtained low levels of education, having diabetes, impaired balance and olfactory dysfunction.

Multimorbidity has become increasingly prevalent and poses challenges in managing cognitive function. This study aimed to (1) systematically review and perform a meta-analysis to understand the relationship between multimorbidity and the risk of dementia and (2) examine the impact of different multimorbidity patterns on this relationship.

A systematic review was conducted using PubMed, Embase, PsychINFO, CINAHL, and Cochrane Central to gather studies published up to December 16, 2023. For the meta-analysis, studies with consistent study designs, multimorbidity definitions, and stages of dementia were included. Heterogeneity was assessed using the I2 statistic, and Egger's and Begg's tests were used to evaluate publication bias.

Of the 12,074 studies identified, 11 were deemed suitable for systematic review, and eight were included in the meta-analysis. Meta-analysis of the longitudinal studies revealed that baseline multimorbidity was significantly associated with an increased risk of dementia compared with individuals without multimorbidity (HR: 1.34, 95 % CI: 1.08-1.68). Meta-analysis of the cross-sectional studies indicated that multimorbidity was significantly associated with a higher risk of being in the prodromal stages of dementia than in individuals without multimorbidity (OR: 1.32, 95 % CI: 1.16-1.51). The risk of dementia varied according to diverse multimorbidity patterns, and the cardiovascular-metabolic condition-related patterns were the most common and associated with high dementia risk.

Our findings provide quantitative evidence of a significant association between multimorbidity and the risk of dementia. To develop effective dementia prevention strategies, an in-depth understanding of specific multimorbidity patterns is invaluable for managing cognitive function.

The global rise in dementia prevalence poses a significant public health challenge, particularly in low- and middle-income countries where resources for diagnosis, treatment, and support are constrained. Addressing this issue, the World Health Organization's 2017-2025 global action plan on dementia envisions a future where dementia is preventable, and individuals with dementia and their caregivers receive dignified support.

Using a qualitative research design, this study explores stakeholder perspectives on dementia in Colombia, framed by the World Health Organization's global action plan. Semi-structured interviews were conducted with 12 key stakeholders from the academia, government, and the community. Data were analyzed using framework analysis.

The interviews revealed a lack of recognition and prioritization of dementia as a public health concern in Colombia. Stakeholders expressed consensus on several challenges, including inadequate community awareness, persistent stigma, insufficient services across care levels, a lack of education for healthcare professionals, and a deficit in research characterizing the dementia population. Paradoxically, participants noted a positive trend, indicating growing awareness among both scientific and non-scientific populations.

Dementia must urgently be recognized as a public health priority in Colombia. The identified barriers underscore the struggles faced by individuals with dementia and their families, emphasizing the critical need for increased community and governmental awareness.

Dementia is a neurological syndrome marked by cognitive decline. Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the common forms of dementia, each with distinct progression patterns. Early and accurate diagnosis of dementia cases (AD and FTD) is crucial for effective medical care, as both conditions have similar early-symptoms. EEG, a non-invasive tool for recording brain activity, has shown potential in distinguishing AD from FTD and mild cognitive impairment (MCI).

This study aims to develop a deep learning-based classification system for dementia by analyzing EEG derived scout time-series signals from deep brain regions, specifically the hippocampus, amygdala, and thalamus. Scout time series extracted via the standardized low-resolution brain electromagnetic tomography (sLORETA) technique are utilized. The time series is converted to image representations using continuous wavelet transform (CWT) and fed as input to deep learning models. Two high-density EEG datasets are utilized to validate the efficacy of the proposed method: the online BrainLat dataset (128 channels, comprising 16 AD, 13 FTD, and 19 healthy controls (HC)) and the in-house IITD-AIIA dataset (64 channels, including subjects with 10 AD, 9 MCI, and 8 HC). Different classification strategies and classifier combinations have been utilized for the accurate mapping of classes in both data sets.

The best results were achieved using a product of probabilities from classifiers for left and right subcortical regions in conjunction with the DenseNet model architecture. It yield accuracies of 94.17 % and 77.72 % on the BrainLat and IITD-AIIA datasets, respectively.

The results highlight that the image representation-based deep learning approach has the potential to differentiate various stages of dementia. It pave the way for more accurate and early diagnosis, which is crucial for the effective treatment and management of debilitating conditions.

Alzheimer's disease (AD) ranks among the leading causes of morbidity and mortality worldwide. The objective was to evaluate the burden of AD and other dementias among the countries of the Middle East and North Africa (MENA) region by age and sex from 1990 to 2021. The data were sourced from the Global Burden of Disease (GBD) study 2021. The estimates are presented as counts and age-standardised rates per 100,000 accompanied by 95% uncertainty intervals (UIs). In 2021, AD and other dementias recorded an age-standardised prevalence of 772.7 per 100,000 in the MENA region (95% UI 671.2-877.6 per 100,000). This rate decreased by 4.9% in comparison to 1990, marking a statistically significant change. AD and other dementias also accounted for approximately 73.79 thousand deaths in the region in 2021, with the age-standardised rate decreasing by 8.6% compared to 1990. Moreover, the disability-adjusted life years (DALY) rate was 476.3 per 100,000 population (95% UI 225.6-1004.2), representing a 7.7% decrease from 1990 to 2021. Lebanon registered the highest point prevalence per 100,000 at 828.25, while the United Arab Emirates recorded the lowest at 652.43. The age-standardised point prevalence decreased from 1990 to 2021 in 13 of the MENA countries, while no significant changes were observed in eight of countries. Additionally, in 2021, women experienced higher prevalence rates, DALYs, compared to men. In the MENA region, age-standardised dementia prevalence rose with age in both sexes. The burden of dementia in MENA has decreased from 1990 to 2021, but it remains higher than global estimates. Furthermore, the findings indicate that dementia imposes a greater burden on the female population compared to males. To achieve a more accurate estimation of the burden of Alzheimer's disease and other dementias, more systematic studies in low- to middle-income countries within the MENA region are required.

Identifying genetic causes of dementia in patients visiting memory clinics is important for patient care and family planning. Traditional clinical selection criteria for genetic testing may miss carriers of pathogenic variants in dementia-related genes. This study aimed identify how many carriers we are missing and to optimize criteria for selecting patients for genetic counseling in memory clinics.

In this clinical cohort study, we retrospectively genetically tested patients during 2.5 years (2010-2012) visiting the Alzheimer Center Amsterdam, a specialized memory clinic. Genetic tests consisted of a 54-gene dementia panel, focusing on Class IV/V variants per American College of Medical Genetics and Genomics guidelines, including APP duplications and the C9ORF72 repeat expansion. We determined the prevalence of pathogenic variants and propose new eligibility criteria for genetic testing in memory clinics. The eligibility criteria were prospectively applied for 1 year (2021-2022), and results were compared with the retrospective cohort.

Genetic tests were retrospectively performed in in 1,022 of 1,138 patients (90%) who consecutively visited the memory clinic. Among these, 1,022 patients analyzed (mean age 62.1 ± 8.9 years; 40.4% were female), 34 pathogenic variant carriers were identified (3.3%), with 24 being symptomatic. Previous clinical criteria would have identified only 15 carriers (44% of all carriers, 65% of symptomatic carriers). The proposed criteria increased identification to 22 carriers (62.5% of all carriers, 91% of symptomatic carriers). In the prospective cohort, 148 (28.7%) of 515 patients were eligible for testing under the new criteria. Of the 90 eligible patients who consented to testing, 13 pathogenic carriers were identified, representing a 73% increase compared with the previous criteria.

We found that patients who visit a memory clinic and carry a pathogenic genetic variant are often not eligible for genetic testing. The proposed new criteria improve the identification of patients with a genetic cause for their cognitive complaints. In systems without practical or financial barriers to genetic testing, the new criteria can enhance personalized care. In other countries where the health care systems differs and in other genetic ancestry groups, the performance of the criteria may be different.

This review explores the impact of physical exercise on brain-derived neurotrophic factor (BDNF) and its relationship with neurodegenerative diseases. The key role of BDNF in maintaining brain health is highlighted, and recent studies are analyzed that indicate an increase in BDNF levels following physical activity, particularly in young adults. Additionally, the interaction between the BDNF Val66Met genetic polymorphism and exercise on cognitive function is examined. The review emphasizes the possibility of exercise as a complementary therapy for neurodegenerative diseases, although further research is required to fully understand its effects.

In the context of research priority-setting, participants express their research priorities and ideas in various forms, ranging from narratives to explicit topics or questions. However, the transition from these expressions to well-structured research topics or questions is not always straightforward. Challenges intensify when research priorities pertain to interventions or diagnostic accuracy, requiring the conversion of narratives into the Participant, Intervention, Comparator, Outcome (PICO) format.

This project aimed to understand the challenges of engaging a diverse, multilingual population in setting oral health research priorities. While not a comprehensive priority-setting effort, we modified James Lind Alliance's (JLA) methods and used thematic analysis to establish a list of priority research topics and questions. This was accomplished by conducting interviews with 40 community participants and 14 dentists from various ethnic backgrounds in Malaysia. The interview language depended on participant preferences, including English, Malay, and Mandarin, with translations handled collaboratively by bilingual research assistants. The process involved thematic analysis, discussion with a research committee, and necessary modifications. Our interpretations revealed distinct categories of participant statements: explicit, complicated, implicit and incomplete. In this study, we identified a three-step approach to translate research ideas that are presented either as explicit statements or as complicated narratives.

Translating community research priorities poses inherent challenges. Our model, although not exhaustive, provides a valuable tool to assist research priority-setting groups in translating these priorities into meaningful research topics and questions, facilitating the equitable inclusion of diverse perspectives. Future research priority-setting endeavours should document their translation processes, thus aiding researchers in understanding and tackling the intricacies of this task.

Alzheimer's Disease (AD) is the most common dementia in clinics. Despite decades of progress in the study of the pathogenesis of AD, clinical treatment strategies for AD remain lacking. Apigenin, a natural flavonoid compound, is present in a variety of food and Chinese herbs and has been proposed to have a wide range of therapeutic effects on dementia.

To clarify the relevant pharmacological mechanism and therapeutic effect of apigenin on animal models of AD.

Computer-based searches of the PubMed, Cochrane Library, Embase, and Web of Science databases were used to identify preclinical literature on the use of apigenin for treating AD. All databases were searched from their respective inception dates until June 2023. The meta-analysis was performed with Review manager 5.4.1 and STATA 17.0.

Thirteen studies were eventually enrolled, which included 736 animals in total. Meta-analysis showed that apigenin had a positive effect on AD. Compared to controls, apigenin treatment reduced escape latency, increased the percentage of time spent in the target quadrant and the number of plateaus traversed; apigenin was effective in reducing nuclear factor kappa-B (NF-κB) p65 levels; apigenin effectively increased antioxidant molecules SOD and GSH-px and decreased oxidative index MDA; for ERK/CREB/BDNF pathway, apigenin effectively increased BDNF and pCREB molecules; additionally, apigenin effectively decreased caspase3 levels and the number of apoptotic cells in the hippocampus.

The results show some efficacy of apigenin in the treatment of AD models. However, further clinical studies are needed to confirm the clinical efficacy of apigenin.

To explore the perspectives and perceptions of persons with mild cognitive impairment (MCI), their caregivers, and healthcare professionals on computerized cognitive training (CCT).

Utilizing phenomenological research methods, 12 MCI patients, 11 caregivers, and 15 healthcare professionals were recruited. Data were collected through four focus group interviews and six semi-structured in-depth interviews conducted between March 2023 and June 2023. Colaizzi's analysis method was used to analyze the transcribed interviews.

The study identified three main themes: (1) perception of CCT treatment, (2) emotional experiences with CCT, and (3) coping strategies. These themes highlighted various barriers and facilitators to CCT acceptance and implementation.

Emphasizing the popularization of CCT for MCI treatment is crucial. The study underscores the importance of addressing patients' emotional needs, providing psychological and social support, and offering personalized, multidomain non-pharmacological guidance to maximize CCT's effectiveness.

Mild neurocognitive disorder (mNCD) is recognized as an early stage of dementia and is gaining attention as a significant healthcare problem due to current demographic changes and increasing numbers of patients. Timely detection of mNCD provides an opportunity for early interventions that can potentially slow down or prevent cognitive decline. Heart rate variability (HRV) may be a promising measure, as it has been shown to be sensitive to cognitive impairment. However, there is currently no evidence regarding the diagnostic accuracy of HRV measurements in the context of the mNCD population. This study aimed to evaluate the diagnostic accuracy of vagally-mediated HRV (vm-HRV) as a screening tool for mNCD and to investigate the relationship between vm-HRV with executive functioning and depression in older adults who have mNCD.

We retrospectively analyzed data from healthy older adults (HOA) and individuals with a clinical diagnosis of mNCD with a biomarker-supported characterization of the etiology of mNCD. Diagnostic accuracy was evaluated using receiver operating characteristic curve analysis based on the area under the curve. Sensitivity and specificity were calculated based on the optimal threshold provided by Youden's Index. Multiple linear regression analyses were conducted to investigate the relationship between vm-HRV and executive functioning and depression.

This analysis included 42 HOA and 29 individuals with mNCD. The relative power of high frequency was found to be increased in individuals with mNCD. The greatest AUC calculated was 0.68 (with 95% CI: 0.56, 0.81) for the relative power of high frequency. AUCs for other vm-HRV parameters were between 0.53 and 0.61. No consistent correlations were found between vm-HRV and executive functioning or depression.

It appears that vm-HRV parameters alone are insufficient to reliably distinguish between HOA and older adults with mNCD. Additionally, the relationship between vm-HRV and executive functioning remains unclear and requires further investigation. Prospective studies that encompass a broad range of neurocognitive disorders, HRV measurements, neuroimaging, and multimodal approaches that consider a variety of functional domains affected in mNCD are warranted to further investigate the potential of vm-HRV as part of a multimodal screening tool for mNCD. These multimodal measures have the potential to improve the early detection of mNCD in the future.

Inclusivity in research priority setting is fundamental to capturing the opinion of all stakeholders in a research area. Globally, experienced healthcare workers often have deep insights that could impactfully shape future research, and a lack of their involvement in formal research and publications could mean that their voices are insufficiently represented. We aimed to modify the well-established Child Health and Nutrition Research Initiative (CHNRI) methodology to address barriers to inclusivity, which are particularly relevant in healthcare that requires highly multidisciplinary care.

This global research priority-setting exercise for orofacial clefts adapted the CHNRI methodology to include research experts, clinicians from multiple disciplines, and non-technical stakeholders (i.e. patients and parents and non-governmental organisations (NGOs)) on a global basis. A multidisciplinary international steering group proposed and discussed methodological changes to improve inclusivity, including survey edits, subgroups for research questions, a demographics section, translation in French and Spanish, phrasing adaptation, and alternative dissemination techniques.

We received 412 responses and 1420 questions, spanning 78 different countries and 18 different specialties/groups. Challenges remain to improve representation of all groups, with the vast majority of answers (30%) being from surgeons and a comparatively small proportion from patient/parent groups (9%). This also includes managing responses in three languages, effective dissemination, and responses that were not worded as research questions.

This is one of the first CHNRI exercises to involve patients and parents, clinicians, and researchers in its first question submission stage, and the first ever to do so on a global scale. We describe our approach to addressing inclusivity challenges and report related demographic data to serve as a benchmark upon which we hope future CHNRI exercises will improve.

Older people reporting subjective memory complaints (SMCs) may have a greater risk of cognitive decline. Multidomain lifestyle interventions are a promising strategy for the prevention of cognitive decline. The aim of this study was to investigate whether the presence of SMCs affects the efficacy of a 2-year multidomain lifestyle intervention on cognition.

This study is part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) project. Participants (a subsample of 568 individuals, baseline age 60-77 years) were randomized (1:1) to receive a 2-year multidomain lifestyle intervention group including dietary advice, exercise, cognitive training, and vascular risk management, or regular health advice control group. Cognitive performance was assessed at baseline and at 1- and 2-year visits, using a neuropsychological test battery, including tests assessing memory, executive functions, and processing speed. Participants rated the frequency of SMCs using the Prospective and Retrospective Memory Questionnaire.

Having more retrospective SMCs was linked to a less favorable cognitive trajectory over 2 years. The difference between the intervention and control groups in annual change in tested memory performance was 0.077 (95% CI, 0.008-0.146) among those reporting more retrospective SMCs and -0.011 (-0.074 to 0.053) among those with less SMCs; interaction effect p = .019. No other interactions between SMCs and intervention allocation were observed.

A lifestyle intervention may be beneficial for older adults with and without SMCs. Persons having more retrospective SMCs may benefit more from the intervention regarding memory functioning. Clinical Trials Registration Number: NCT01041989.

Dementia, a major symptom of several neurodegenerative diseases, can be improved by acetylcholinesterase inhibitors (AChE); however, due to the complex etiology and long course of dementia, the efficacy of these drugs remains limited. Significant empirical evidence shows that traditional Chinese medicine (TCM) markedly ameliorates intractable disease; nevertheless, a suitable regimen has yet to be widely accepted, which is likely the result of gaps in the understanding of its causality. We propose that taking advantage of the TCM theory of collateral activation and prevention of accumulation by purgation may improve dementia treatment; thus, we designed the Xiaxue Kaiqiao formula (XKF) accordingly.

To explore the ameliorative effect and underlying mechanism of XKF on dementia in a Samp8 mouse model.

Samp8 mice were treated with XKF for eight weeks, and the amelioration of dementia was subsequently assessed using the novel object recognition, Barnes maze, and open-field behavioral tests. Neuropathological alterations were observed by immunofluorescence (IF) and Golgi staining of brain tissue. Drug safety was evaluated by blood biochemical tests, organ coefficients, and hematoxylin-eosin (H&E) staining. Proteomics analysis was performed on frozen brain tissue using liquid chromatography-tandem mass spectrometry (LC-MS/MS).

Behavioral testing revealed that the administration of XKF had significant ameliorative effects on memory discrimination, spatial learning memory, and anxiety in Samp8 mice. IF staining showed that XKF reduced the loss of postsynaptic density protein 95 (PSD95), myelin, neurons, and axons, as well as decreased the proliferation of astrocytes and microglia in the hippocampal and temporal lobe regions. Evaluation of drug safety demonstrated no abnormal organ morphology following XKF treatment.

XKF treatment improved the symptoms of dementia in Samp8 mice, indicating the potential for clinical application. The mechanism underlying the ameliorative effect of XKF on dementia is likely increased synaptic transmission between neurons. Our data provide reliable evidence for the TCM theory of collateral activation and prevention of accumulation by purgation.

Previous studies have documented the impact of intergenerational contact on cognitive function in Chinese adults, however, few have focused on the possible mediating pathways. This study aimed to test a hypothetical model in which functional disability and depressive symptoms mediate the association between intergenerational contact and cognitive function.

This longitudinal study included data of 3666 participants aged 45 years or older (mean age: 60.2 years) from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. Intergenerational contact was measured as the frequency of contact with children and categorized as frequent (≥ 1 time/week) or infrequent (< 1 time/week). Cognitive function was measured in two dimensions: episodic memory and executive function. Depressive symptoms and functional disability were assessed as continuous variables using the 10-item Center for Epidemiological Studies Depression Scale, Activities of Daily Living, and Instrumental Activities of Daily Living Scales. The mediating pathways were quantified using the SPSS PROCESS macro.

Frequent intergenerational contact correlated with a better cognitive function (coefficient: 0.73, 95%CI: 0.39 to 1.06), with plausible mediated pathways via functional disability without depressive symptoms (coefficient: 0.03, 95%CI: 0 to 0.06, proportion mediated: 4.11%), depressive symptoms without functional disability (coefficient: 0.04, 95%CI: 0.01 to 0.08, proportion mediated: 5.48%), and functional disability and depressive symptoms in a chain (coefficient: 0.01, 95%CI: 0 to 0.02, proportion mediated: 1.37%).

Functional disability and depressive symptoms may partly explain the association between intergenerational contact and cognitive function. Further research is needed to explore the mechanisms underlying the association between intergenerational contact and cognitive function.

For older adults with subjective cognitive decline (SCD), physical activity is now recognized as an effective means to reduce the risk of Alzheimer's disease. However, this population often exhibits lower levels of physical activity. This study aimed to establish physical activity promoting indicators system for older adults with SCD, providing comprehensive targets for interventions and promoting relevant policies.

A modified Delphi technique was used to seek opinions from experts about what should be used and prioritised as indicators of promoting physical activity in older adults with SCD. Expert consultations were conducted from January to March 2024. Data were analyzed using SPSS 27.0 and Excel software. Descriptive statistics were used for expert demographics, while coefficients were calculated to assess expert authority (Cr), and coordination (Kendall's W). Weights for indicators were determined through the order diagram.

Based on a literature review and the Wuli-Shili-Renli system framework, we initially identified 59 indicators, comprising primary (3 dimensions), secondary (11 items), and tertiary (45 items) indicators. Fifteen expert panelists were invited to participate in the study. Of these, 11 out of 18 completed round 1 (61.1% response rate), all 11 completed round 2 (100.0% response rate), and all 11 completed the third and final round (100.0% response rate). Ultimately, consensus was reached on 3 primary, 9 secondary, and 44 tertiary indicators. The order diagram determined weights for primary indicators as follows: foundational system (0.4242), operational system (0.2879), and personnel system (0.2879).

The system of 56 physical activity-promoting indicators constructed for older adults with SCD through the Delphi method provides theoretical support for policy formulation and allocation of funds to comprehensively promote physical activity behaviors among this population.

Traumatic brain injury (TBI) is a risk factor for neurodegenerative disease. We currently have no means to identify patients most at risk of neurodegenerative disease following injury and, resultantly, no means to target risk mitigation interventions. To address this, we explored the association between history of traumatic brain injury with cognitive performance and imaging measures of white matter integrity. From the UK Biobank imaging sub-study (n = 50 376), participants were identified with either self-reported (n = 177) or health record coded broad- (injury codes; n = 1096) or narrow-band (TBI specific codes; n = 274) TBI, or as controls with no such documented history (n = 49 280). Cognitive scores and imaging measures of corpus callosum white matter integrity were compared between injury participants (versus no injury), corrected for age, sex, socioeconomic status and medications. TBI was associated with poorer cognitive and imaging phenotypes. The strongest deleterious associations were for narrow-band injury (β difference 0.2-0.3; P < 0.01). All cognitive and imaging phenotypes were strongly inter-correlated (P < 0.001). This study provides insight into possible early biomarkers predating neurodegenerative disease following brain injury. Measures of cognition and white matter following injury may provide means to identify individuals most at risk of neurodegenerative disease, to which mitigation strategies might be targeted.

Dementia and mild cognitive impairment are significant contributors to disability and dependency in older adults. Current treatments for managing these conditions are limited. Exergaming, a novel technology-driven intervention combining physical exercise with cognitive tasks, is a potential therapeutic approach.

To assess the effects of exergaming interventions on physical and cognitive outcomes, and activities of daily living, in people with dementia and mild cognitive impairment.

On 22 December 2023, we searched the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP), CINAHL (EBSCOhost), Web of Science Core Collection (Clarivate), LILACS (BIREME), ClinicalTrials.gov, and the WHO (World Health Organization) meta-register the International Clinical Trials Registry Portal.

We included randomised controlled trials (RCTs) that recruited individuals diagnosed with dementia or mild cognitive impairment (MCI). Exergaming interventions involved participants being engaged in physical activity of at least moderate intensity, and used immersive and non-immersive virtual reality (VR) technology and real-time interaction. We planned to classify comparators as inactive control group (e.g. no treatment, waiting list), active control group (e.g. standard treatment, non-specific active control), or alternative treatment (e.g. physical activity, computerised cognitive training). Outcomes were to be measured using validated instruments.

Two review authors independently selected studies for inclusion, extracted data, assessed the risk of bias using the Cochrane risk of bias tool RoB 2, and assessed the certainty of the evidence using GRADE. We consulted a third author if required. Where possible, we pooled outcome data using a fixed-effect or random-effects model. We expressed treatment effects as standardised mean differences (SMDs) for continuous outcomes and as risk ratios (RRs) for dichotomous outcomes, along with 95% confidence intervals (CIs). When data could not be pooled, we presented a narrative synthesis.

We included 11 studies published between 2014 and 2023. Six of these studies were pre-registered. Seven studies involved 308 participants with mild cognitive impairment, and five studies included 228 individuals with dementia. One of the studies presented data for both MCI and dementia separately. Most comparisons exhibited a high risk or some concerns of bias. We have only low or very low certainty about all the results presented below. Effects of exergaming interventions for people with dementia Compared to a control group Exergaming may improve global cognitive functioning at the end of treatment, but the evidence is very uncertain (SMD 1.47, 95% 1.04 to 1.90; 2 studies, 113 participants). The evidence is very uncertain about the effects of exergaming at the end of treatment on global physical functioning (SMD -0.20, 95% -0.57 to 0.17; 2 studies, 113 participants) or activities of daily living (ADL) (SMD -0.28, 95% -0.65 to 0.09; 2 studies, 113 participants). The evidence is very uncertain about adverse effects due to the small sample size and no events. Findings are based on two studies (113 participants), but data could not be pooled; both studies reported no adverse reactions linked to the intervention or control group. Compared to an alternative treatment group At the end of treatment, the evidence is very uncertain about the effects of exergaming on global physical functioning (SMD 0.14, 95% -0.30 to 0.58; 2 studies, 85 participants) or global cognitive functioning (SMD 0.11, 95% -0.33 to 0.55; 2 studies, 85 participants). For ADL, only one study was available (n = 67), which provided low-certainty evidence of little to no difference between exergaming and exercise. The evidence is very uncertain about adverse effects of exergaming compared with alternative treatment (RR 7.50, 95% CI 0.41 to 136.52; 2 studies, 2/85 participants). Effects of exergaming interventions for people with mild cognitive impairment (MCI) Compared to a control group Exergaming may improve global cognitive functioning at the end of treatment for people with MCI, but the evidence is very uncertain, (SMD 0.79, 95% 0.05 to 1.53; 2 studies, 34 participants). The evidence is very uncertain about the effects of exergaming at the end of treatment on global physical functioning (SMD 0.27, 95% -0.41 to 0.94; 2 studies, 34 participants) and ADL (SMD 0.51, 95% -0.01 to 1.03; 2 studies, 60 participants). The evidence is very uncertain about the effects of exergaming on adverse effects due to a small sample size and no events (0/14 participants). Findings are based on one study. Compared to an alternative treatment group The evidence is very uncertain about global physical functioning at the end of treatment. Only one study was included (n = 45). For global cognitive functioning, we included four studies (n = 235 participants), but due to considerable heterogeneity (I² = 96%), we could not pool results. The evidence is very uncertain about the effects of exergaming on global cognitive functioning. No study evaluated ADL outcomes. The evidence is very uncertain about adverse effects of exergaming due to the small sample size and no events (n = 123 participants). Findings are based on one study.

Overall, the evidence is very uncertain about the effects of exergaming on global physical and cognitive functioning, and ADL. There may be an improvement in global cognitive functioning at the end of treatment for both people with dementia and people with MCI, but the evidence is very uncertain. The potential benefit is observed only when exergaming is compared with a control intervention (e.g. usual care, listening to music, health education), and not when compared with an alternative treatment with a specific effect, such as physical activity (e.g. standing and sitting exercises or cycling). The evidence is very uncertain about the effects of exergaming on adverse effects. All sessions took place in a controlled and supervised environment. Therefore, we do not know if exergaming can be safely used in a home environment, unsupervised.

Patient involvement is a critical component of dementia research priority-setting exercises to ensure that research benefits are relevant and acceptable to those who need the most. This systematic review synthesises research priorities and preferences identified by people living with dementia and their caregivers.

Guided by Joanna Briggs Institute methodology, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, we conducted a systematic search in five electronic databases: CINAHL, Medline, PsycINFO, Web of Science and Scopus. The reference lists of the included studies were also manually searched. We combined quantitative and qualitative data for synthesis and descriptive thematic analysis.

Eleven studies were included in this review. Findings are grouped into four main categories: Increase in knowledge, education, and awareness; Determining the cause; Sustainability of care; and Cure of dementia and related conditions.

There is a need to respond to the stigma associated with dementia, which limits access to care and the quality of life for both people living with dementia and their caregivers. We need to work on changing public, private and workplace attitudes about dementia and encourage supporting and participating in dementia research. Future research should involve people living with dementia and their primary caregivers from culturally and linguistically diverse communities in priority-setting exercises.

Promoting mental health, preventing and treating mental disorders are critically important in public health, and many randomised controlled trials (RCTs) evaluate intervention strategies for these objectives. However, distinguishing promotion from prevention and from treatment RCTs is challenging. A tool to place studies along the promotion-to-treatment continuum in mental health research does not exist, leaving it to researchers and policymakers to decide on how to classify individual RCTs, which hinders evidence synthesis.

We present a protocol for the development of a new tool to assist researchers in distinguishing RCTs along the promotion-to-treatment continuum. We will establish a Tool Development Group, and use the Population, Intervention, Comparison and Outcome framework to define constructs. We will generate, define, categorise and reduce the items in the tool using qualitative methods, including cognitive interviews and a Delphi exercise. Psychometric evaluation-including unidimensionality, local independence, monotonicity and item homogeneity-will include data collection, scoring, internal consistency checks and factor analysis of the tool's indicators for available RCTs. We will use standard Cohen's kappa statistics to assess the reliability of the tool.

This study involves data collection from the already published literature. However, this protocol has been approved by the ethics committee of the Università della Svizzera Italiana (CE 2024 04). The results of the present project will be disseminated in peer-reviewed journals and at international and national scientific meetings. Training materials for the application of the tool will also be developed and disseminated to the scientific community. The tool and all related implementation materials will be published on a website and will be freely accessible to the public.

Early detection of cognitive impairment is among the top research priorities aimed at reducing the global burden of dementia. Currently used screening tools have high sensitivity but lack specificity at their original cut-off, while decreasing the cut-off was repeatedly shown to improve specificity, but at the cost of lower sensitivity. In 2012, a new screening tool was introduced that aims to overcome these limitations - the Quick mild cognitive impairment screen (Qmci). The original English Qmci has been rigorously validated and demonstrated high diagnostic accuracy with both good sensitivity and specificity. We aimed to determine the optimal cut-off value for the German Qmci, and evaluate its diagnostic accuracy, reliability (internal consistency) and construct validity.

We retrospectively analyzed data from healthy older adults (HOA; n = 43) and individuals who have a clinical diagnosis of 'mild neurocognitive disorder' (mNCD; n = 37) with a biomarker supported characterization of the etiology of mNCD of three studies of the 'Brain-IT' project. Using Youden's Index, we calculated the optimal cut-off score to distinguish between HOA and mNCD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic accuracy based on the area under the curve (AUC). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Reliability (internal consistency) was analyzed by calculating Cronbach's α. Construct validity was assessed by analyzing convergent validity between Qmci-G subdomain scores and reference assessments measuring the same neurocognitive domain.

The optimal cut-off score for the Qmci-G was ≤ 67 (AUC = 0.96). This provided a sensitivity of 91.9% and a specificity of 90.7%. The PPV and NPV were 89.5% and 92.9%, respectively. Cronbach's α of the Qmci-G was 0.71 (CI95% [0.65 to 0.78]). The Qmci-G demonstrated good construct validity for subtests measuring learning and memory. Subtests that measure executive functioning and/or visuo-spatial skills showed mixed findings and/or did not correlate as strongly as expected with reference assessments.

Our findings corroborate the existing evidence of the Qmci's good diagnostic accuracy, reliability, and construct validity. Additionally, the Qmci shows potential in resolving the limitations of commonly used screening tools, such as the Montreal Cognitive Assessment. To verify these findings for the Qmci-G, testing in clinical environments and/or primary health care and direct comparisons with standard screening tools utilized in these settings are warranted.

The implementation of dementia policy is a complex process of translating policy goals to actions to address the changing needs of people living with dementia. Leveraging on others' experiences would help policy decision-makers and actors better prepare for the challenges.

This study explored the development, the implementation and the impact of the dementia policy in Macao, a "role model" recognized by the Alzheimer's Disease International.

A scoping review of policies, strategies, and news articles, as well as scholarly work from 6 scientific databases dated till March 2023 was conducted under the guidance of the Health Policy Triangle Framework.

According to 284 documents, the dementia policy in Macao, driven by government leadership and supported with public-private partnership, aimed to integrate health and social services to achieve the goals of "Early prevention, Early detection, Early diagnosis, Early treatment and Early support." Promoting the preparedness according to the dementia burden trajectory, empowering the public and the service providers with training and education, and encouraging services-related research were among the key actions. With major changes in dementia care configuration, a dementia service network, a dementia-friendly community and a one-stop service model for disease screening, diagnosis, treatment and support have been developed.

Reconfiguring existing resources in the health and social services to form an integrated service network at the community level could be considered a priority of action. Continuous engagement, collaboration and empowerment at different levels across these sectors is crucial for the sustainability of a dementia policy.

This study investigates the relationship between cognitive functioning and 59 modifiable and intrinsic factors at the cusp of midlife.

We analyzed data from 1221 participants in the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (CATSLife; Mage = 33.20, %Female = 52.74). We assessed the impact of 59 factors on cognitive functioning using regularized regression and co-twin control models, controlling for earlier-life cognitive functioning and gray matter volume.

Eight robust factors were identified, including education attainment, cognitive complexity, purpose-in-life, and smoking status. Twins reporting higher levels of cognitive complexity and purpose-in-life showed better cognitive performance than their cotwin, while smoking was negatively associated. Using meta-analytically derived effect size threshold, we additionally identified that twins experiencing more financial difficulty tend to perform less well compared with their cotwin.

The findings highlight the early midlife link between cognitive functioning and lifestyle/psychological factors, beyond prior cognitive performance, brain status, genetic and familial confounders. Our results further highlight the potential of established adulthood as a crucial window for dementia prevention interventions targeting lifestyle and psychosocial factors.

Cog complexity(+), purpose-in-life(+) were associated with cognition in early midlife.Smoking(-) was also associated with cognition in early midlife.Results were consistent controlling for genetic and environmental confounds.Association between EA and cognition might be mostly genetic and familial confounded.

Growing evidence links air pollution exposure to the risk of dementia. We hypothesized that hypertension may partially mediate this effect.

We previously documented an association between air pollution and dementia in the Ginkgo Evaluation of Memory Study, a randomized, placebo-controlled trial of 3069 adults ≥75 years across four US sites who were evaluated for dementia every 6 months from 2000-2008. We utilized a two-stage regression approach for causal mediation analysis to decompose the total effect of air pollution on dementia into its natural direct and indirect effect through prevalent hypertension. Exposure to air pollution in the 10 or 20 years before enrollment was assigned using estimates from fine-scale spatial-temporal models for PM2.5, PM10, and NO2. We used Poisson regression models for hypertension and Cox proportional hazard models for time-to-incident all-cause dementia, adjusting for a priori confounders.

Participants were free of mild cognitive impairment at baseline (n = 2564 included in analyses); 69% had prevalent hypertension at baseline. During follow-up, 12% developed all-cause dementia (Alzheimer's disease [AD] = 212; vascular dementia with or without AD [VaD/AD mixed] = 97). We did not find an adverse effect of any air pollutant on hypertension. Hypertension was associated with VaD/AD mixed (HR, 1.92 [95% CI = 1.14, 3.24]) but not AD. We did not observe mediation through hypertension for the effect of any pollutant on dementia outcomes.

The lack of mediated effect may be due to other mechanistic pathways and the minimal effect of air pollution on hypertension in this cohort of older adults.

Investigate the impact of combined computerized cognitive training and occupational therapy on individuals with mild cognitive impairment (MCI).

We randomly assigned 118 MCI patients into two groups: a combined intervention group (n = 37) and a control group (n = 81), the latter receiving standard nursing care. The intervention group additionally underwent 12 weeks of computerized cognitive training and occupational therapy. Blind assessors evaluated cognitive performance, anxiety, depression, and daily living activities before the intervention, post-intervention, and at a 3-month follow-up.

Repeated-measures analysis of variance showed that the sMoCA scores, HAMA scores, and ADL scores of the experimental group at T2 (post-intervention) and T3 (3-month follow-up) were higher than those of the control group, and the difference was statistically significant (p < 0.001, p < 0.001, p = 0.026).

Computerized cognitive training combined with occupational therapy can improve patients' cognitive status, enhance their compliance with continuing care, and maintain their anxiety and self-care ability at a stable level.

https://www.chictr.org.cn/index.html, identifier ChiCTR2200065014.

Sleep disturbances are a potentially modifiable risk factor for neurodegenerative dementia secondary to Alzheimer disease (AD) and Lewy body disease (LBD). Therefore, we need to identify the best methods to study sleep in this population.

This study will assess the feasibility and acceptability of various wearable devices, smart devices, and remote study tasks in sleep and cognition research for people with AD and LBD.

We will deliver a feasibility and acceptability study alongside a prospective observational cohort study assessing sleep and cognition longitudinally in the home environment. Adults aged older than 50 years who were diagnosed with mild to moderate dementia or mild cognitive impairment (MCI) due to probable AD or LBD and age-matched controls will be eligible. Exclusion criteria include lack of capacity to consent to research, other causes of MCI or dementia, and clinically significant sleep disorders. Participants will complete a cognitive assessment and questionnaires with a researcher and receive training and instructions for at-home study tasks across 8 weeks. At-home study tasks include remote sleep assessments using wearable devices (electroencephalography headband and actigraphy watch), app-based sleep diaries, online cognitive assessments, and saliva samples for melatonin- and cortisol-derived circadian markers. Feasibility outcomes will be assessed relating to recruitment and retention, data completeness, data quality, and support required. Feedback on acceptability and usability will be collected throughout the study period and end-of-study interviews will be analyzed using thematic analysis.

Recruitment started in February 2022. Data collection is ongoing, with final data expected in February 2024 and data analysis and publication of findings scheduled for the summer of 2024.

This study will allow us to assess if remote testing using smart devices and wearable technology is a viable alternative to traditional sleep measurements, such as polysomnography and questionnaires, in older adults with and without MCI or dementia due to AD or LBD. Understanding participant experience and the barriers and facilitators to technology use for research purposes and remote research in this population will assist with the development of, recruitment to, and retention within future research projects studying sleep and cognition outside of the clinic or laboratory.

DERR1-10.2196/52652.

People with dementia and their caregivers are prone to suicidal behaviors due to difficulty adjusting to their initial caregiving role and due to emotional disturbances resulting from deterioration of functioning. The present systematic review (1) explored the prevalence of and risk factors for suicidal behavior and (2) assessed the similarities and differences in the prevalence and risk factors for suicidal behavior between people with dementia and their caregivers.

A comprehensive literature search for research articles published between 1950 and 2023 was carried out using major databases, such as Google Scholar, Web of Science, PubMed, Scopus, PsycINFO, EMBASE, the Cochrane Library, and Medline.

A total of 40 research articles were selected for review. A total of 12 research articles revealed that the prevalence of suicidal behavior among caregivers ranged from 4.7% to 26%. However, the risk of suicidal behavior among people with dementia was inconsistent, as only 17 out of 28 selected studies reported the risk of suicidal behavior among people with dementia. The risk factors associated with suicidal behavior among caregivers of people with dementia could be both self-related and care receiver-related factors, whereas risk factors in people with dementia were self-related factors. Notably, greater cognitive decline, which impairs individuals' ability to carry out complex acts and planning, may lower their suicidal risk. Finally, assessment of the risk of bias indicated that 95% of the selected studies had unclear risk.

Self-related and care receiver-related factors should be assessed among caregivers of people with dementia to evaluate the risk of suicidal behavior. In addition, we recommend evaluating suicidal risk in people with dementia in the early phase of dementia when cognitive decline is less severe. However, as the majority of the selected studies had unclear risk of bias, future studies with improved methodologies are warranted to confirm our study findings.

Telehealth interventions have the potential to enhance access to care and improve efficiency while reducing the burden on patients. Although telehealth interventions are well accepted and adopted in physical therapy, their usage in occupational therapy for older adults is less common, and limited information exists regarding their setting and context.

To provide an inventory and synthesis of telehealth interventions in occupational therapy for older adults.

For published studies on telehealth-based occupational therapy interventions in older adults between 2000 and 2022, six databases were reviewed. Data extraction and analysis were guided by the taxonomies developed by Tulu, McColl and Law and informed by the Canadian Model of Occupational Performance and Engagement.

Twenty-three studies on telehealth interventions in occupational therapy for older adults were identified, mostly from North American authors (n = 11; 47.8%) and randomised clinical trials (n = 9; 39.1%). Most participants had a health problem (n = 20; 87.0%), mainly stroke (n = 9; 39.1%). Interventions focussed primarily on symptom management education (n = 12; 52.2%) of community-dwelling adults with health conditions, using videoconferencing systems or applications (n = 14; 60.7%). Interventions were delivered from the healthcare centre (n = 6; 26.1%) to the person's home (n = 18; 78.3%) synchronously (n = 19; 82.6%). About one third (n = 8; 34.8%) of the studies specified the therapist's location.

Published studies on telehealth interventions in occupational therapy with older adults have mainly focussed on the synchronous training and education of participants using videoconferencing systems or applications. According to these studies, the scope of interventions is limited and could be expanded, for example, through occupational development and environmental modification. To better understand and describe best practices in the use of telehealth in occupational therapy, future studies should provide more details about the interventions performed, the technology used and the environmental settings of the therapist.

Sleep disturbances are an early indicator of cognitive impairment and exacerbate its progression. While pharmacological treatments for sleep disorders exist, their side-effect profile includes an increased risk of falls and the potential to exacerbate cognitive impairment. Non-pharmacological treatments such as physical exercise should be considered. However, uncertainties persist. We aimed to assess the potential benefits of exercise interventions on sleep in patients with cognitive impairment and determine the specific effects of various exercise modalities.

A systematic search was performed on seven databases for eligible studies published before Nov 2022. Randomized controlled trials of exercise for patients with cognitive impairment (mild cognitive impairment and Alzheimer's disease) were included. All analyses were conducted using RevMan version 5.4. Meta-analysis and The Grading of Recommendations Assessment Development and Evaluations (GRADE) quality ratings were performed on sleep quality and objective sleep data.

A total of 8 randomized controlled trials were included with a sample size of 486 subjects. For patients with cognitive impairment, physical exercise had a beneficial effect on sleep quality [MD = -3.55 (-5.57, -1.32), Z = 3.13, p = 0.002] and total sleep time [MD = 33.77 (23.92, 43.62), Z = 6.72, P < 0.00001]. No improvement was found in sleep efficiency and nocturnal awakening time. Subgroup analysis showed that multi-component exercise produced superior results.

Physical exercise may improve sleep quality and total sleep time for patients with cognitive impairment. Multi-component exercise designed individually is more effective. Large-scale randomized controlled trials with objective sleep outcome measurements are warranted.Clinical trial registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022377221.

The advent of proteomics offers an unprecedented opportunity to predict dementia onset. We examined this in data from 52,645 adults without dementia in the UK Biobank, with 1,417 incident cases and a follow-up time of 14.1 years. Of 1,463 plasma proteins, GFAP, NEFL, GDF15 and LTBP2 consistently associated most with incident all-cause dementia (ACD), Alzheimer's disease (AD) and vascular dementia (VaD), and ranked high in protein importance ordering. Combining GFAP (or GDF15) with demographics produced desirable predictions for ACD (area under the curve (AUC) = 0.891) and AD (AUC = 0.872) (or VaD (AUC = 0.912)). This was also true when predicting over 10-year ACD, AD and VaD. Individuals with higher GFAP levels were 2.32 times more likely to develop dementia. Notably, GFAP and LTBP2 were highly specific for dementia prediction. GFAP and NEFL began to change at least 10 years before dementia diagnosis. Our findings strongly highlight GFAP as an optimal biomarker for dementia prediction, even more than 10 years before the diagnosis, with implications for screening people at high risk for dementia and for early intervention.

Numerous observational studies have documented a correlation between inflammatory bowel disease (IBD) and an increased risk of dementia. However, the causality of their associations remains elusive.

To assess the causal relationship between IBD and the occurrence of all-cause dementia using the two-sample Mendelian randomization (MR) method.

Genetic variants extracted from the large genome-wide association study (GWAS) for IBD (the International IBD Genetics Consortium, n = 34652) were used to identify the causal link between IBD and dementia (FinnGen, n = 306102). The results of the study were validated via another IBD GWAS (United Kingdom Biobank, n = 463372). Moreover, MR egger intercept, MR pleiotropy residual sum and outlier, and Cochran's Q test were employed to evaluate pleiotropy and heterogeneity. Finally, multiple MR methods were performed to estimate the effects of genetically predicted IBD on dementia, with the inverse variance wei-ghted approach adopted as the primary analysis.

The results of the pleiotropy and heterogeneity tests revealed an absence of significant pleiotropic effects or heterogeneity across all genetic variants in outcome GWAS. No evidence of a causal effect between IBD and the risk of dementia was identified in the inverse variance weighted [odds ratio (OR) = 0.980, 95%CI : 0.942-1.020, P value = 0.325], weighted median (OR = 0.964, 95%CI : 0.914-1.017, P value = 0.180), and MR-Egger (OR = 0.963, 95%CI : 0.867-1.070, P value = 0.492) approaches. Consistent results were observed in validation analyses. Reverse MR analysis also showed no effect of dementia on the development of IBD. Furthermore, MR analysis suggested that IBD and its subtypes did not causally affect all-cause dementia and its four subtypes, including dementia in Alzheimer's disease, vascular dementia, dementia in other diseases classified elsewhere, and unspecified dementia.

Taken together, our MR study signaled that IBD and its subentities were not genetically associated with all-cause dementia or its subtypes. Further large prospective studies are warranted to elucidate the impact of intestinal inflammation on the development of dementia.

Sleep disturbances are considered a hallmark of dementia, and strong evidence supports the association between alterations in sleep parameters and cognitive decline in patients with mild cognitive impairment and Alzheimer's disease (AD).

This systematic review aims to summarize the existing evidence on the longitudinal association between sleep parameters and cognitive decline, with the goal of identifying potential sleep biomarkers of AD-related neurodegeneration.

Literature search was conducted in PubMed, Web of Science, and Scopus databases from inception to 28 March 2023. Longitudinal studies investigating the association between baseline objectively-measured sleep parameters and cognitive decline were assessed for eligibility.

Seventeen studies were included in the qualitative synthesis. Sleep fragmentation, reduced sleep efficiency, reduced REM sleep, increased light sleep, and sleep-disordered breathing were identified as predictors of cognitive decline. Sleep duration exhibited a U-shaped relation with subsequent neurodegeneration. Additionally, several sleep microstructural parameters were associated with cognitive decline, although inconsistencies were observed across studies.

These findings suggest that sleep alterations hold promise as early biomarker of cognitive decline, but the current evidence is limited due to substantial methodological heterogeneity among studies. Further research is necessary to identify the most reliable sleep parameters for predicting cognitive impairment and AD, and to investigate interventions targeting sleep that can assist clinicians in the early recognition and treatment of cognitive decline. Standardized procedures for longitudinal studies evaluating sleep and cognition should be developed and the use of continuous sleep monitoring techniques, such as actigraphy or EEG headband, might be encouraged.

Neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD) present a major health burden to society. Changes in brain structure and cognition are generally only observed at the late stage of the disease. Although advanced magnetic resonance imaging (MRI) techniques such as diffusion imaging may allow identification of biomarkers at earlier stages of neurodegeneration, early diagnosis is still challenging. Magnetic resonance elastography (MRE) is a noninvasive MRI technique for studying the mechanical properties of tissues by measuring the wave propagation induced in the tissues using a purpose-built actuator. Here, we present a systematic review of preclinical and clinical studies in which MRE has been applied to study neurodegenerative diseases. Actuator systems for data acquisition, inversion algorithms for data analysis, and sample demographics are described and tissue stiffness measures obtained for the whole brain and internal structures are summarized. A total of six animal studies and eight human studies have been published. The animal studies refer to 123 experimental animals (68 AD and 55 PD) and 121 wild-type animals, while the human studies refer to 142 patients with neurodegenerative disease (including 56 AD and 17 PD) and 166 controls. The animal studies are consistent in the reporting of decreased stiffness of the hippocampal region in AD mice. However, in terms of disease progression, although consistent decreases in either storage modulus or shear modulus magnitude are reported for whole brain, there is variation in the results reported for the hippocampal region. The clinical studies are consistent in reports of a significant decrease in either whole brain storage modulus or shear modulus magnitude, in both AD and PD and with different brain structures affected in different neurodegenerative diseases. MRE studies of neurodegenerative diseases are still in their infancy, and in future it will be interesting to investigate potential relationships between brain mechanical properties and clinical measures, which may help elucidate the mechanisms underlying onset and progression of neurodegenerative diseases. EVIDENCE LEVEL: 1. TECHNICAL EFFICACY: Stage 2.

Alzheimer's disease (AD) is an onset and incurable neurodegenerative disorder that has been linked to various genetic, environmental, and lifestyle factors. Recent research has revealed several potential targets for drug development, such as the prevention of Aβ production and removal, prevention of tau hyperphosphorylation, and keeping neurons alive. Drugs that target numerous ADrelated variables have been developed, and early results are encouraging. This review provides a concise map of the different receptor signaling pathways associated with Alzheimer's Disease, as well as insight into drug design based on these pathways. It discusses the molecular mechanisms of AD pathogenesis, such as oxidative stress, aging, Aβ turnover, thiol groups, and mitochondrial activities, and their role in the disease. It also reviews the potential drug targets, in vivo active agents, and docking studies done in AD and provides prospects for future drug development. This review intends to provide more clarity on the molecular processes that occur in Alzheimer's patient's brains, which can be of use in diagnosing and preventing the condition.

Cognitive assessment is a key component of clinical evaluations for patients with dementia and Alzheimer's disease in primary health care (PHC) settings. The need for well-validated, culturally appropriate, and easy-to-use assessments is especially urgent in low- and middle-income countries (LMICs) that are experiencing rapid growth in their older adult populations.

To examine the feasibility and demographic determinants of performance for a tablet-based cognitive assessment tool (TabCAT) battery, which includes subtests for four cognitive domains, among older PHC patients in southeastNigeria.

A cross-sectional mixed-method descriptive study evaluating the useability and performance of TabCAT.

We enrolled 207 participants (mean age of 64.7±13.5 years; 52% with only primary, 41% secondary, and 7% tertiary education). Most (91%) who initiated the assessment were able to complete it, requiring 10-15 minutes to complete. More years of education was associated with better test scores across all tests (p < 0.001). Living in a rural location was also associated with better performance (p < 0.05). Male compared to female sex did not associate with performance on any of the tests (all ps > 0.05).

Tablet-based cognitive assessment was feasible in rural and urban settings of Nigeria. Better performance on cognitive subtests linked to more education and residing in a rural area; however, sex did not predict performance. Digital cognitive assessment tools hold potential for widespread use in healthcare and educational contexts, particularly in regions with varying levels of urbanization and educational access.