Publications by authors named "Adam Dyer"

Introduction: Plasma phosphorylated tau (p-tau)217 is a leading blood-biomarker for the detection of amyloid beta (Aβ) pathology. We assessed the performance of a fully automated plasma p-tau217 immunoassay to detect Aβ pathology in mild cognitive impairment (MCI)/mild dementia.

Methods: Paired plasma and cerebrospinal fluid (CSF) samples were obtained at time of diagnostic lumbar puncture (LP) in a specialist memory service.

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Article Synopsis
  • The study aims to explore patient eligibility for lecanemab therapy for Alzheimer's Disease (AD) at a Regional Specialist Memory Clinic, emphasizing the importance of timely treatment in early AD cases.
  • A retrospective analysis was conducted on 188 new patients over a year, assessing their diagnostic data and biomarker status to determine eligibility based on Appropriate Use Criteria (AUC) and clinical trial standards.
  • Results showed only 5.9% of the patients were eligible according to AUC, with a higher eligibility rate of 26.2% among those with biomarker positive Alzheimer's, highlighting major barriers like lack of biomarker confirmation and cognitive ineligibility.
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  • Midlife cardiovascular risk factors, like Type 2 Diabetes (T2DM) and obesity, may lead to cognitive impairment and dementia, with systemic inflammation being a potential link.
  • A study assessed middle-aged individuals with and without uncomplicated T2DM, measuring their cognitive abilities and levels of certain inflammatory markers (like IL-17A) over four years.
  • Results showed that higher levels of IL-17A were correlated with poorer executive function, regardless of T2DM status, suggesting this inflammatory marker may play a role in cognitive decline in midlife.
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Background: An integrated haemodynamic response during standing may serve as an integrative marker of neuro-cardiovascular function. Individual components of both heart rate (HR) and blood pressure (BP) responses to active stand (AS) have been linked with cardiovascular disease (CVD) and mortality. We assessed longitudinal associations between entire HR/BP response curves during AS, incident CVD and mortality over 12 years.

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Article Synopsis
  • Plasma p-tau217 is identified as a promising blood-based marker for detecting Alzheimer Disease (AD) pathology, particularly in memory clinic patients undergoing lumbar punctures.
  • A study involving 108 participants found that plasma p-tau217 levels were significantly higher in those with detected amyloid (Aβ) pathology compared to those without, indicating its strong potential for diagnosis.
  • The analysis showed that plasma p-tau217 had excellent performance metrics for Aβ detection (AUC: 0.91), outperforming other biomarkers and suggesting it could be a reliable tool in Alzheimer's diagnostics.
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Midlife risk factors such as type 2 diabetes mellitus (T2DM) confer a significantly increased risk of cognitive impairment in later life with executive function, memory, and attention domains often affected first. Spatiotemporal gait characteristics are emerging as important integrative biomarkers of neurocognitive function and of later dementia risk. We examined 24 spatiotemporal gait parameters across five domains of gait previously linked to cognitive function on usual-pace, maximal-pace, and cognitive dual-task gait conditions in 102 middle-aged adults with (57.

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  • Immunosuppressive treatment for rheumatic diseases helps maintain remission but raises infection risk and diminishes response to SARS-CoV-2 vaccination.
  • The study evaluated immune responses to SARS-CoV-2 in two patient groups: one during acute infection and one post-vaccination, comparing results among those exposed to rituximab, other immunosuppressive treatments, and non-immunosuppressed individuals.
  • Results showed that while non-immunosuppressed patients had stronger T cell responses during infection, those on immunosuppression had reduced activation, with rituximab-treated patients showing preserved T cell responses but poor antibody production post-vaccination.
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Background: Although type 2 diabetes mellitus (T2DM) is an established risk factor for cognitive impairment, the underlying mechanisms remain poorly explored. One potential mechanism may be through effects of T2DM on cerebral perfusion. The current study hypothesized that T2DM is associated with altered peripheral and central hemodynamic responses to orthostasis, which may in turn be associated with cognitive impairment in T2DM.

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Alzheimer's Disease (ad) is the most common cause of dementia, and in addition to cognitive decline, it directly contributes to physical frailty, falls, incontinence, institutionalisation and polypharmacy in older adults. Increasing availability of clinically validated biomarkers including cerebrospinal fluid and positron emission tomography to assess both amyloid and tau pathology has led to a reconceptualisation of ad as a clinical-biological diagnosis, rather than one based purely on clinical phenotype. However, co-pathology is frequent in older adults which influence the accuracy of biomarker interpretation.

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Purpose: Antipsychotic use in Alzheimer disease (AD) is associated with adverse events and mortality. Whilst postulated to cause/exacerbate orthostatic hypotension (OH), the exact relationship between antipsychotic use and OH has never been explored in AD-a group who are particularly vulnerable to neuro-cardiovascular instability and adverse effects of medication on orthostatic blood pressure (BP) behaviour.

Methods: We analysed longitudinal data from an 18-month trial of Nilvadipine in mild-moderate AD.

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Introduction: Alzheimer's disease and other dementias affect >50 million individuals globally and are characterised by broad clinical and biological heterogeneity. Cohort and biobank studies have played a critical role in advancing the understanding of disease pathophysiology and in identifying novel diagnostic and treatment approaches. However, further discovery and validation cohorts are required to clarify the real-world utility of new biomarkers, facilitate research into the development of novel therapies and advance our understanding of the clinical heterogeneity and pathobiology of neurodegenerative diseases.

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Studies examining the relationships between chronic inflammation, cognitive function and cognitive decline in older adults have yielded conflicting results. In a large cohort of older adults free from established dementia (n = 3270; 73.1 ± 7.

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Patients with decompensated liver cirrhosis, in particular those classified as Childs-Pugh class C, are at increased risk of severe coronavirus disease-2019 (COVID-19) upon infection with severe acute respiratory coronavirus 2 (SARS-CoV-2). The biological mechanisms underlying this are unknown. We aimed to examine the levels of serum intrinsic antiviral proteins as well as alterations in the innate antiviral immune response in patients with decompensated liver cirrhosis.

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Background: Over 55 million adults are living with dementia globally, which is projected to reach 157 million by 2050. Mild cognitive impairment (MCI), a syndrome of memory impairment with intact activities of daily living, may precede dementia by several years. Around 5-15% of individuals with MCI convert to dementia annually.

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Apathy is a complex multi-dimensional syndrome that affects up to 70% of individuals with Alzheimer's disease (AD). Whilst many frameworks to define apathy in AD exist, most include loss of motivation or goal-directed behaviour as the central feature. Apathy is associated with significant impact on persons living with AD and their caregivers and is also associated with accelerated cognitive decline across the AD spectrum.

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Background: Mucopolysaccharidosis IIIC (MPSIIIC) is one of four Sanfilippo diseases sharing clinical symptoms of severe cognitive decline and shortened lifespan. The missing enzyme, heparan sulfate acetyl-CoA: α-glucosaminide-N-acetyltransferase (HGSNAT), is bound to the lysosomal membrane, therefore cannot cross the blood-brain barrier or diffuse between cells. We previously demonstrated disease correction in MPSIIIC mice using an Adeno-Associated Vector (AAV) delivering HGSNAT via intraparenchymal brain injections using an AAV2 derived AAV-truetype (AAV-TT) serotype with improved distribution over AAV9.

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Background: In addition to the clear cardiovascular benefit, there has been renewed interest in the potential of statins in the prevention of cognitive impairment and dementia in older adults. However, whether ongoing statin use can delay cognitive decline or dementia progression in those with established Alzheimer dementia, is unclear.

Methods: Using data from NILVAD, we analysed the association between ongoing statin use and cognitive decline (Alzheimer Disease Assessment Scale-Cognitive Subsection [ADAS-Cog])/dementia progression (Clinical Dementia Rating Scale [CDR-Sb]/Disability Assessment for Dementia [DAD]) over 18 months in older adults with mild-moderate AD.

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Clinical outcomes from infection with SARS-CoV-2, the cause of the COVID-19 pandemic, are remarkably variable ranging from asymptomatic infection to severe pneumonia and death. One of the key drivers of this variability is differing trajectories in the immune response to SARS-CoV-2 infection. Many studies have noted markedly elevated cytokine levels in severe COVID-19, although results vary by cohort, cytokine studied and sensitivity of assay used.

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The appearance of new dominant variants of concern (VOC) of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) threatens the global response to the coronavirus disease 2019 (COVID-19) pandemic. Of these, the alpha variant (also known as B.1.

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Midlife Type 2 Diabetes Mellitus (T2DM) is associated with an increased risk of Alzheimer Disease (AD) in later life, with altered inflammatory responses postulated as key pathological drivers. Previous studies have demonstrated increased responsiveness to NLR family pyrin domain containing 3 (NLRP3) inflammasome agonists, both in individuals with untreated T2DM in addition to those with established AD. We hypothesised that peripheral NLRP3 inflammasome responses may be altered during the early stages of T2DM-related cognitive dysfunction.

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The role of low-frequency (terahertz) vibrational motions on charge carrier dynamics in organic semiconductors (OSCs) is becoming well-known, and efforts are underway to rationally design new materials to mitigate these detrimental effects. However, most efforts have focused on stabilizing the fused-ring semiconducting 'core', often by functionalizing with various side-groups, yet questions regarding the role of such modifications on electron-phonon couplings are still outstanding. In this work, the influence of thiophene rings σ-bonded directly to the π-conjugated cores is explored.

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Type 2 Diabetes Mellitus (T2DM) in midlife is associated with a greater risk of dementia in later life. Both gait speed and spatiotemporal gait characteristics have been associated with later cognitive decline in community-dwelling older adults. Thus, the assessment of gait characteristics in uncomplicated midlife T2DM may be important in selecting-out those with T2DM at greatest risk of later cognitive decline.

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Older adults in nursing homes are at greatest risk of morbidity and mortality from SARS-CoV-2 infection. Nursing home residents constituted one-third to more than half of all deaths during the early waves of the COVID-19 pandemic. Following this, widespread adaptation of infection prevention and control measures and the supply and use of personal protective equipment resulted in a significant decrease in nursing home infections and deaths.

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