Drug Development.

Background: The autophagy lysosomal pathway (ALP) and the ubiquitin-proteasome system (UPS) are key proteostasis mechanisms in cells, which are dysfunctional in AD and linked to protein aggregation and neuronal death. Autophagy is over activated in Alzheimer's disease brain whereas UPS is severely impaired. Activating autophagy has received most attention, however recent evidence suggests that UPS can clear aggregate proteins and a potential therapeutic target for AD and protein misfolding diseases.

Drug Development.

Background: Selecting the optimal dose for clinical development is especially problematic for drugs directed at CNS-specific targets. For drugs with a novel mechanism of action, these problems are often greater. We describe Xanamem's clinical pharmacology, including the approach to dose selection and proof-of-concept studies.

Drug Development.

Background: Accumulation of amyloid beta 42 (Aβ42) senile plaques is the most critical event leading to Alzheimer's disease (AD). Currently approved drugs for AD have not been able to effectively modify the disease. This has caused increasing research interests in health beneficial nutritious plant foods as viable alternative therapy to prevent or manage AD.

Drug Development.

Background: Alzheimer's Disease (AD) poses a substantial global health burden, necessitating innovative therapeutic strategies. This study investigates the neuroprotective potential of a chrysin-loaded Nanostructured Lipid Carrier (NLC) drug delivery system in AD management. Employing the high-pressure homogenization method, chrysin-loaded NLCs were meticulously formulated to optimize drug delivery efficiency.

Drug Development.

Background: Iron is vital for metabolism but can act as a catalyst for oxidative damage. Elevated brain iron, determined from biomarkers of iron (CSF ferritin and quantitative susceptibility mapping MRI) and from post-mortem measurement of brain iron, has been associated with accelerated cognitive decline in multiple Alzheimer's disease (AD) clinical, cohorts. These findings supported the hypothesis that treatment with the brain-permeable iron chelator deferiprone may be associated clinical benefit in AD.

Drug Development.

Background: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by the impairment of cognitive development and disruption of neurocognitive function. This neuropathological condition is marked by neurodegeneration, loss of neural tissue, and the formation of neurofibrillary tangles and Aβ plaques. Various studies reported the utilization of phytoconstituents like fisetin, quercetin, berberine, and xanthohumol for the treatment of AD.

Drug Development.

Background: Recent growth in the functionality and use of technology has prompted an increased interest in the potential for remote or decentralised clinical trials in dementia. There are many potential benefits associated with decentralised medication trials, but the field is currently lacking specific recommendations for their delivery in the dementia field.

Method: A modified Delphi method engaged a panel with substantial expertise in dementia trial design and delivery and backgrounds that included neurology, psychiatry, pharmacology and psychology, to develop recommendations for the conduct of decentralised medication trials in dementia prevention.

Drug Development.

Numerous drugs (including disease-modifying therapies, cognitive enhancers and neuropsychiatric treatments) are being developed for Alzheimer's and related dementias (ADRD). Emerging neuroimaging modalities, and genetic and other biomarkers potentially enhance diagnostic and prognostic accuracy. These advances need to be assessed in real-world studies (RWS).

Drug Development.

Real-world data on the uptake, effectiveness and safety of new diagnostics and disease-modifying (DMT) treatments for Alzheimer's Disease (AD) are imperative. This can be achieved through patient registries. A major challenge is how to embed registry data capture into routine clinical practice.

Drug Development.

Background: Progranulin (PGRN), a glycoprotein secreted by microglia and neurons, regulates lysosomal function, neuroinflammation, and has neurotrophic effects. Variants in the granulin gene (GRN) that cause a reduction of PGRN in plasma and cerebrospinal fluid (CSF) are associated with an increased risk of Alzheimer's disease (AD). The sortilin receptor (SORT1) on neurons and microglia regulates PGRN degradation.

Drug Development.

Background: Reliable treatment approaches for addressing early cognitive impairment and Alzheimer's disease (AD) are currently lacking. Given the multifactorial nature of AD, therapeutic strategies need to focus on disease-specific biochemical pathways. Given the significance of metabolic pathways in cognitive impairment, it is essential to investigate alternative disease modifiers capable of targeting multiple metabolic pathways, such as phytochemicals.

Dementia Care Research and Psychosocial Factors.

Background: Alzheimer's disease (AD) is a type of degenerative disorder that affects the brain. There are various herbal drugs that have been tested for their effectiveness in treating AD, and chrysin is one of them. Chrysin is a polyphenolic flavonoid that has several neuroprotective effects, including reducing the levels of AChE enzyme, accumulated amyloid β, oxidative stress, and neuroinflammation.

Dementia Care Research and Psychosocial Factors.

Background: There is a need to understand the benefits and limitations of innovative models of dementia care to ensure models meet the needs of people living with dementia, their families and staff. The aim of this scoping review was to explore and synthesise the barriers and facilitators to the widespread implementation of small-scale residential dementia care.

Method: A scoping review was conducted in 2023 in MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, and CENTRAL to identify empirical, peer-reviewed studies, published in English from database inception to October 2023.

Dementia Care Research and Psychosocial Factors.

Background: The progressive nature of dementia and the complex needs means that people living with dementia require tailored approaches to address their changing care needs over time. These include physical multimorbidity, psychological, behavioural, and cognitive symptoms and possible risks arising from these and helping family caregivers. However, provision of these interventions is highly variable between and within countries, partly due to uncertainty about their efficacy and scarce resources.

Dementia Care Research and Psychosocial Factors.

Background: People with dementia and their care givers are provided limited guidance in medication management, potentially contributing to medication-related harm. Importantly, there are no resources that provide comprehensive medication management guidance across care settings. To ensure that resources are co-designed, genuine involvement of people with dementia, their care givers and the community in identifying the priorities for medication management guidance resources is needed.

Dementia Care Research and Psychosocial Factors.

Background: We have co-produced with carers of people with dementia (hereafter carers) a culturally tailored iSupport Virtual Assistant (VA), namely e-DiVA, to support English-, Bahasa- and Vietnamese-speaking carers in Australia, Indonesia, New Zealand and Vietnam. The presented research reports qualitative findings from the e-DiVA user-testing study.

Method: Family carers and healthcare professionals working in the field of dementia care were given the e-DiVA to use on their smartphone or handheld device for 1-2 weeks.

Dementia Care Research and Psychosocial Factors.

Background: People with dementia of all ages have a human right to equal access to quality health care. Despite evidence regarding its effectiveness, many people living with dementia lack access to evidence-based rehabilitation for promoting function and quality of life. The aims of this study were to 1) explore barriers to access to dementia rehabilitation; and 2) identify solutions which improve access to rehabilitation.

Dementia Care Research and Psychosocial Factors.

Background: Data from high-income countries (HICs) suggest a decline in age-specific incidence rates of dementia. However, this has happened primarily in HICs, with low- and middle- income countries (LMICs) facing two main challenges: a higher burden of risk factors and, in general, a faster ageing population. Most people with dementia live in LMICs, and this is set to increase, thus requiring urgent and robust action to prevent, treat and support people with dementia and their families.

Dementia Care Research and Psychosocial Factors.

Background: Dementia, including its younger-onset variant, increasingly challenges diverse workplaces, affecting both employees living with dementia and their employers. With a growing global trend of individuals extending their working years, it becomes crucial to understand the specific challenges and implications for those with dementia within various employment contexts. This review delves into the cognitive, interpersonal, and organizational challenges faced by employees living with dementia across a broad range of workplaces, reflecting the evolving dynamics of today's work environment.

Dementia Care Research and Psychosocial Factors.

Background: MATCH (Music Attuned Technology - Care via eHealth) is a music and health application that supports caregivers of people living with dementia to use music strategically to better manage care through virtual training and intuitive music technology. This study trialled a prototype version of the MATCH app with family caregivers and people with dementia residing in the community.

Method: 16 Dyads trialled the prototype MATCH app.

Dementia Care Research and Psychosocial Factors.

Background: Our authors from around the world met to summarise the available knowledge, decide which potentially modifiable risk factors for dementia have compelling evidence and create the most comprehensive analysis to date for potentially modifiable risk factors to inform policy, give individuals the opportunity to control their risks and generate research.

Method: We incorporated all risk factors for which we judged there was strong enough evidence. We used the largest recent worldwide meta-analyses for risk factor prevalence and relative risk and if not available the best data.

Dementia Care Research and Psychosocial Factors.

Background: The Promoting Independence Through quality Care at Home (PITCH) project aimed to improve outcomes for people with dementia and their carers via a co-designed training intervention for home care workers (HCWs). The results of the primary efficacy analysis of the successful stepped-wedge cluster RCT (n = 172 HCWs in 18 clusters in 7 Australian service providers) were presented at AAIC 2023.

Method: This presentation goes beyond efficacy and discusses the implementation science (process evaluation and behavioural change) and health economic analysis of the intervention.

Dementia Care Research and Psychosocial Factors.

Background: The 2020 Lancet Commission on dementia prevention, intervention and care estimated that up to 40% of dementia cases could be prevented by tackling 12 potentially modifiable risk factors, namely less education, hearing loss, hypertension, physical inactivity, diabetes, social isolation, excessive alcohol consumption, air pollution, smoking, obesity, traumatic brain injury, depression. As more evidence on risk factors emerges, the Lancet standing commission on dementia met to update evidence on established dementia risk factors and to consider the evidence for other risk factors.

Method: We used a lifecourse approach to understand how to reduce risk or prevent dementia, as many risks operate at different timepoints in the lifespan.

Dementia Care Research and Psychosocial Factors.

Background: Behaviour support plans (BSPs) for people in residential aged care (RAC) were mandated nationally in 2019 for those who require, or may require, restrictive practices as part of their care. The legislation aims to reduce and potentially eliminate restrictive practices: long-standing problems of their inappropriate use were highlighted by the Royal Commission into Aged Care Quality and Safety (2018). Many people living with dementia will be impacted: up to 90% experience changed behaviours; 54% of people in RACs have dementia; and approximately 20% experience cognitive decline without a diagnosis.

Dementia Care Research and Psychosocial Factors.

Background: Proxy ratings primarily provided by informal caregivers are usually administered if patients living with dementia (PlwD) are cognitively unable to rate health independently. The literature is limited by the use of typically agreement statistics, reporting that proxies generally underestimate PlwD health. Additional analyses of self- and proxy-rated discrepancies in individual responses that focus on HRQoL dimensions are lacking.