Public Health.

Background: This study addresses the impact of neighborhood-level socioeconomic disadvantage, as measured by the Area Deprivation Index (ADI), on individuals with mild cognitive impairment and dementia. Our primary outcome aimed to explore associations between ADI and hippocampal volume in cognitively impaired individuals from a comprehensive memory center.

Methods: We conducted a retrospective, cross-sectional analysis of patients over 50 from Virginia and North Carolina, with visits between January 1st, 2014, and July 1st, 2022.

Developing Topics.

Background: The rapid development of blood-based biomarkers (BBMs) has improved Alzheimer's disease (AD) diagnostics with some tests now potentially suitable for clinical use. This aligns with the clinical availability of anti-Aβ immunotherapies for early symptomatic AD, where BBMs can help address the increasing need for more rapid and early diagnosis. Clinical practice guidelines (CPG) can help guide healthcare professionals in incorporating BBMs into their clinical practice.

Drug Development.

Background: Agitation is a common and disabling symptom of Alzheimer's dementia (AD). Pharmacological treatments are recommended if agitation is not responsive to psychosocial intervention. Citalopram was effective in treating agitation in AD but was associated with cognitive and cardiac risks linked to its R- but not S-enantiomer.

Dementia Care Research and Psychosocial Factors.

Background: Previous studies attest to a lack of awareness about Alzheimer's Disease (AD) and limited participation of Black Americans in AD clinical trials. The AHEAD Study is a multicenter trial focused on preventing AD by evaluating the effectiveness and safety of Lecanemab in individuals with preclinical AD. The study aims to recruit at least 15% from underrepresented populations, including Black Americans.

Benefits and risks of FDA-approved amyloid-targeting antibodies for treatment of early Alzheimer's disease: Navigating clinician-patient engagement.

The emergence of the United States Food and Drug Administration (FDA)-approved amyloid-targeting therapies for Alzheimer's disease challenges clinicians and healthcare providers with a transformative landscape. Effectively communicating the risks, benefits, burdens, costs, and available support associated with these novel disease-modifying treatments to patients, families, and other healthcare providers is essential but complex. In response, the Alzheimer's Association's Clinical Meaningfulness Workgroup has proposed language surrounding treatment eligibility, benefits, amyloid-related imaging abnormalities (ARIA), apolipoprotein E (APOE) genotyping, and treatment costs, serving as a resource to healthcare professionals in navigating discussions with patients and their families.

Functionally distinct pericyte subsets differently regulate amyloid-β deposition in patients with Alzheimer's disease.

Although the concept that the blood-brain barrier (BBB) plays an important role in the etiology and pathogenesis of Alzheimer's disease (AD) has become increasingly accepted, little is known yet about how it actually contributes. We and others have recently identified a novel functionally distinct subset of BBB pericytes (PCs). In the present study, we sought to determine whether these PC subsets differentially contribute to AD-associated pathologies by immunohistochemistry and amyloid beta (Aβ) peptidomics.

Downstream Biomarker Effects of Gantenerumab or Solanezumab in Dominantly Inherited Alzheimer Disease: The DIAN-TU-001 Randomized Clinical Trial.

Importance: Effects of antiamyloid agents, targeting either fibrillar or soluble monomeric amyloid peptides, on downstream biomarkers in cerebrospinal fluid (CSF) and plasma are largely unknown in dominantly inherited Alzheimer disease (DIAD).

Objective: To investigate longitudinal biomarker changes of synaptic dysfunction, neuroinflammation, and neurodegeneration in individuals with DIAD who are receiving antiamyloid treatment.

Design, Setting, And Participants: From 2012 to 2019, the Dominantly Inherited Alzheimer Network Trial Unit (DIAN-TU-001) study, a double-blind, placebo-controlled, randomized clinical trial, investigated gantenerumab and solanezumab in DIAD.

Utility of amyloid PET Imaging in a Memory Clinic.

There is greater interest in amyloid biomarker for the diagnosis of Alzheimer disease (AD) with the recent Food and Drug Administration approval of amyloid-targeted therapy. The goal of this study was to assess the clinical utility of amyloid positron emission tomography (PET) in clinically ambiguous cases of cognitive impairment by examining outcomes of patients enrolled in the Imaging Dementia-Evidence of Amyloid Scanning study at 2 academic institutions. Of the 112 patients in the study, 66.

Atypical Case of VV1 Creutzfeldt-Jakob Disease Subtype: Case Report.

Creutzfeldt-Jakob disease (CJD) is a rare form of rapidly progressive, neurodegenerative disease that results from the misfolding and accumulation of an aberrant, disease-associated prion protein (PrPD). CJD affects 1-1.5 cases per million per year with the sporadic-type accounting for an estimated 85% of these cases.

Sleep in Alzheimer's disease: a systematic review and meta-analysis of polysomnographic findings.

Polysomnography (PSG) studies of sleep changes in Alzheimer's disease (AD) have reported but not fully established the relationship between sleep disturbances and AD. To better detail this relationship, we conducted a systematic review and meta-analysis of reported PSG differences between AD patients and healthy controls. An electronic literature search was conducted in EMBASE, MEDLINE, All EBM databases, CINAHL, and PsycINFO inception to Mar 2021.

Discordance Between Cerebrospinal Fluid Biomarkers and Amyloid Positron Emission Tomography in Alzheimer's Sheds Light on Clinical Trial Exclusion Criteria.

Alzheimer's disease (AD) is the most common type of dementia and affects millions of adults over the age of 60 years. Accurate diagnosis relies on multiple modalities, including neuropsychological testing, cerebrospinal fluid (CSF) biomarkers, and amyloid positron emission tomography (PET) imaging. Discordant results between CSF biomarkers and amyloid PET can be seen in up to 15% of cases and can lead to exclusion from clinical trials along with anxiety and confusion for the patient and family.

Low-Frequency Transcranial Magnetic Stimulation (LF-TMS) in Treating Depression in Patients With Impaired Cognitive Functioning.

Objective: Common methodologies for treating depressive symptoms have demonstrated decreased efficacy among individuals with impaired cognitive functioning. While transcranial magnetic stimulation (TMS) has been approved to treat major depressive disorder, few studies have analyzed the ability of TMS to treat depressive symptoms among individuals with cognitive impairments. The present study had two objectives: to determine whether low-frequency TMS (LF-TMS) might demonstrate efficacy in treating depressive symptoms among individuals with impaired cognitive functioning; and to determine whether LF-TMS might improve neurocognitive functioning above and beyond depressive symptom improvements.

A subtype of cerebrovascular pericytes is associated with blood-brain barrier disruption that develops during normal aging and simian immunodeficiency virus infection.

Lax phenotypic characterization of these morphologically distinct pericytes has delayed our understanding of their role in neurological disorders. We herein establish markers which uniquely distinguish different subpopulations of human brain microvascular pericytes and characterize them independently from cerebrovascular smooth muscle cells. Furthermore, we begin to elucidate the roles of these subsets in blood-brain barrier (BBB) breakdown by studying natural aging and simian immunodeficiency virus (SIV) infection in rhesus macaques.

Perivascular macrophages in the neonatal macaque brain undergo massive necroptosis after simian immunodeficiency virus infection.

We previously showed that rhesus macaques neonatally infected with simian immunodeficiency virus (SIV) do not develop SIV encephalitis (SIVE) and maintain low brain viral loads despite having similar plasma viral loads compared to SIV-infected adults. We hypothesize that differences in myeloid cell populations that are the known target of SIV and HIV in the brain contribute to the lack of neonatal susceptibility to lentivirus-induced encephalitis. Using immunohistochemistry and immunofluorescence microscopy, we examined the frontal cortices from uninfected and SIV-infected infant and adult macaques (n = 8/ea) as well as adults with SIVE (n = 4) to determine differences in myeloid cell populations.

TOWARDS MUSCULOSKELETAL SIMULATION-AWARE FALL INJURY MITIGATION: TRANSFER LEARNING WITH DEEP CNN FOR FALL DETECTION.

This paper presents early work on a fall detection method using transfer learning method, in conjunction with a long-term effort to combine efficient machine learning and prior personalized musculoskeletal modeling to deploy fall injury mitigation in geriatric subjects. Inspired by the tremendous progress in image-based object recognition with deep convolutional neural networks (DCNNs), we opt for a pre-trained kinematics-based machine learning approach through existing large-scale annotated accelerometry datasets. The accelerometry datasets are converted to images using time-frequency analysis, based on scalograms, by computing the continuous wavelet transform filter bank.

Evaluation of a clinically practical, ERP-based neurometric battery: Application to age-related changes in brain function.

Objective: Event-related potentials (ERPs) show promise as markers of neurocognitive dysfunction, but conventional recording procedures render measurement of many ERP-based neurometrics clinically impractical. The purpose of this work was (a) to develop a brief neurometric battery capable of eliciting a broad profile of ERPs in a single, clinically practical recording session, and (b) to evaluate the sensitivity of this neurometric profile to age-related changes in brain function.

Methods: Nested auditory stimuli were interleaved with visual stimuli to create a 20-min battery designed to elicit at least eight ERP components representing multiple sensory, perceptual, and cognitive processes (Frequency & Gap MMN, P50, P3, vMMN, C1, N2pc, and ERN).

Preventive health care in the elderly population: a guide for practicing physicians.

Preventive medicine provides important benefits to all persons, including older adults; however, these benefits may be seen more clearly in younger adults than in older persons. Smoking cessation, proper nutrition, exercise, and immunizations are important regardless of age. The prevalence of illness increases as we age; at the same time, life expectancy decreases.