Clinical Manifestations.

Background: Predicting decline over the course of Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD), especially on relatively short time frames, is vital for appropriate treatment planning and to tailor patient and support systems' expectations. The current study tested if a functional upper limb motor learning task could predict one-year change in cognition and daily function.

Method: Cognitively unimpaired (n = 61), MCI (n = 35), and AD (32) older subjects (age: 74.

Clinical Manifestations.

Background: Agitation is one of the most challenging behaviors exhibited by people with cognitive decline, causing distress in caregivers, earlier placement into long-term care and faster disease progression. In order to better manage agitated behaviors in people with cognitive decline, it is important to identify associated factors. The MODERATE (Monitoring Dementia-Related Agitation Using Technology Evaluation) study aims to characterize agitation using technology and identify precipitants (behavioral or environmental) of agitation.

Clinical Manifestations.

Background: Neuropsychological assessments are often affected by demographic factors, such as age, education, and sex. These demographic variables frequently lead to differences in test scores between minorities and non-minorities, lowering diagnostic accuracy of Alzheimer's disease (AD) among minoritized groups. A new test (quick Behavioral Exam to Advance Neuropsychological Screening, or qBEANS) has been developed to assess early signs of AD.

Life-Space Mobility Is Related to Loneliness Among Living-Alone Older Adults: Longitudinal Analysis With Motion Sensor Data.

Background: Life-space mobility can be a behavioral indicator of loneliness. This study examined the association between life-space mobility measured with motion sensors and weekly vs. annually reported loneliness.

I-CONECT intervention effects on weekly time spent outside of home and social contacts among socially isolated older adults.

Background: Socially isolated individuals tend to have less access to cognitively stimulating activities, which could adversely impact their cognitive health. The Internet-Based Conversational Engagement Clinical Trial (I-CONECT) intervention was designed to deliver online conversation sessions to socially isolated older old adults to prevent cognitive decline. The current study examined the intervention efficacy on participants' weekly time spent out-of-home and their social interaction with family and friends.

ω-3 PUFA for Secondary Prevention of White Matter Lesions and Neuronal Integrity Breakdown in Older Adults: A Randomized Clinical Trial.

Importance: Older adults with lower intake and tissue levels of long-chain ω-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA; 20:5) and docosahexaenoic acid (DHA; 22:6) have more brain white matter lesions (WMLs), an association suggesting that small-vessel ischemic disease, a major contributor to the development of dementia, including Alzheimer disease, may be preventable through ω-3 treatment.

Objective: To determine whether ω-3 treatment reduces WML accumulation in older adults without dementia harboring WMLs and with suboptimal ω-3 status.

Design, Setting, And Participants: This quadruple-blinded, placebo-controlled, randomized clinical trial with treatment stratification by apolipoprotein E ε4 allele (APOE*E4) carrier status used linear mixed-effects models to estimate mean annual change between groups.

Chinese Immigrant Caregivers: Understanding Their Unmet Needs and the Co-Design of an mHealth App.

Background: Immigrant caregivers support the aging population, yet their own needs are often neglected. Mobile technology-facilitated interventions can promote caregiver health by providing easy access to self-care materials.

Objective: This study employed a design thinking framework to examine Chinese immigrant caregivers' (CICs) unmet self-care needs and co-design an app for promoting self-care with CICs.

Enlarged perivascular spaces are associated with white matter injury, cognition and inflammation in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.

Enlarged perivascular spaces have been previously reported in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, but their significance and pathophysiology remains unclear. We investigated associations of white matter enlarged perivascular spaces with classical imaging measures, cognitive measures and plasma proteins to better understand what enlarged perivascular spaces represent in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and whether radiographic measures of enlarged perivascular spaces would be of value in future therapeutic discovery studies for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Twenty-four individuals with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and 24 age- and sex-matched controls were included.

"Do Your Best to Avoid it": Appraisals and Coping with Discrimination-Related Stress Among Older Chinese Immigrants in Affordable Senior Housings During the COVID-19 Pandemic.

This study investigated how older Chinese immigrants in affordable senior housing facilities (ASHs) appraise and cope with anti-Asian discrimination and related stress during the COVID-19 pandemic. Qualitative interviews were conducted with 26 participants aged over 65, analyzing verbatim transcripts and field notes using thematic analysis. Four major domains were identified: (1) discriminatory experience, (2) appraisals of discrimination stress, (3) coping strategies, and (4) rationales behind coping.

Social network and mental health of Chinese immigrants in affordable senior housing during the COVID-19 pandemic: a mixed-methods study.

Objective: Chinese immigrant older adults who live in affordable housing are at high risk of experiencing social isolation during the COVID-19 pandemic, which can affect their mental health. Using a triangulation mixed-methods approach, this study describes Chinese immigrant older adults' social network, mental health status, and their associations during the pandemic.

Methods: Semi-structured in-depth interviews were conducted with 26 Chinese immigrant older adults from June to August 2021.

Associations of Enlarged Perivascular Spaces With Brain Lesions, Brain Age, and Clinical Outcomes in Chronic Traumatic Brain Injury.

Background And Objectives: Enlarged perivascular spaces (ePVS) have been identified as a key signature of glymphatic system dysfunction in neurologic conditions. The incidence and clinical implications of ePVS after traumatic brain injury (TBI) are not yet understood. We investigated whether individuals with chronic moderate-to-severe TBI had an increased burden of ePVS and whether ePVS burden is modulated by the presence of focal lesions, older brain age, and poorer sleep quality.

Ability and Willingness to Participate in Dementia Clinical Research: A Qualitative Study.

Background And Objective: Dementia clinical research studies have difficulty recruiting and enrolling participants and their study partners. Through convening and working with a community advisory board and the incorporation of the perspectives of people living with dementia and caregivers, this study utilized a community-engaged approach to identify factors affecting dementia clinical research participation.

Methods: In this qualitative study, 24 participants (12 people living with dementia and 12 caregivers), half of whom participated in dementia clinical research, were interviewed.

Preferences of NIA Alzheimer's Disease Research Center participants regarding remote assessment during the COVID-19 pandemic.

Introduction: During the COVID-19 pandemic, in-person research study visits were moved to an online format using a variety of communication platforms (e.g., Webex and Zoom).

Emotional characteristics of socially isolated older adults with MCI using tablet administered NIH toolbox: I-CONECT study.

Introduction: Examining the emotional functioning of individuals with mild cognitive impairment (MCI) could help describe their cognitive status and inform the development of interventions. This study compared the emotional characteristics of socially isolated older adults with and without MCI.

Methods: We used baseline data from the Internet-based Conversational Engagement Clinical Trial.

Perivascular spaces as a marker of disease severity and neurodegeneration in patients with behavioral variant frontotemporal dementia.

Background: Behavioural Variant Frontotemporal Dementia (bvFTD) is a rapidly progressing neurodegenerative proteinopathy. Perivascular spaces (PVS) form a part of the brain's glymphatic clearance system. When enlarged due to poor glymphatic clearance of toxic proteins, PVS become larger and more conspicuous on MRI.

Mood and activity changes during the COVID-19 pandemic in rural and urban Veterans and their cohabitants.

Objectives: We aimed to examine the impact of COVID-19 pandemic-related stay-at-home orders on weekly reports of mood and activity before and during COVID-19 in a sample of older Veterans and their cohabitants.

Methods: Urban and rural Veterans and their cohabitants living in the Pacific Northwest ≥62 years old were enrolled as part of the Collaborative Aging Research Using Technology initiative (n = 100, age = 71.2 ± 6.

Investigating Biological Pathways Underpinning the Longitudinal Association Between Loneliness and Cognitive Impairment.

Background: Loneliness precedes the onset of cognitive impairment (CI) in older adults. Although the mechanisms through which loneliness "gets under the skin" to influence the risk of developing CI have been conceptually proposed, they are rarely empirically examined. The Evolutionary Theory of Loneliness posits that loneliness as a stressor could cause dysregulations in multiple physiological systems.

Depressive symptoms in older adult couples: Associations with dyadic physical health, social engagement, and close friends.

Objective: The objective of this study was to examine associations between level of depressive symptoms in older adult spouse/partner couples and their physical health and social factors (social activity and number of close friends).

Methods: Using data from 116 community-dwelling couples (age 76.2 ± 8.

Venous Collagenosis as Pathogenesis of White Matter Hyperintensity.

Objective: Periventricular white matter hyperintensities (pvWMHs) are commonly observed on MRI in older individuals and are associated with cognitive and motor decline. The etiology of pvWMH remains unknown. Venous collagenosis has been implicated, which may also interfere with perivascular fluid flow leading to dilation of perivascular spaces (PVS).

Nutrition state of science and dementia prevention: recommendations of the Nutrition for Dementia Prevention Working Group.

Observational studies suggest that nutritional factors have a potential cognitive benefit. However, systematic reviews of randomised trials of dietary and nutritional supplements have reported largely null effects on cognitive outcomes and have highlighted study inconsistencies and other limitations. In this Personal View, the Nutrition for Dementia Prevention Working Group presents what we consider to be limitations in the existing nutrition clinical trials for dementia prevention.

Systemic and central nervous system neuroinflammatory signatures of neuropsychiatric symptoms and related cognitive decline in older people.

Background: Neuroinflammation may contribute to psychiatric symptoms in older people, in particular in the context of Alzheimer's disease (AD). We sought to identify systemic and central nervous system (CNS) inflammatory alterations associated with neuropsychiatric symptoms (NPS); and to investigate their relationships with AD pathology and clinical disease progression.

Methods: We quantified a panel of 38 neuroinflammation and vascular injury markers in paired serum and cerebrospinal fluid (CSF) samples in a cohort of cognitively normal and impaired older subjects.

The Remote Assessment and Dynamic Response Program: Development of an In-Home Dementia-Related Care Needs Assessment to Improve Well-Being.

Background And Objectives: The Remote Assessment and Dynamic Response (READyR) Program was developed in order to address the current lack of early-stage dementia care planning programs that assess the care needs of persons with dementia. The goal was to create a program informed by care values and ongoing ecologically valid data. The objectives of this study are to describe the development and design process of the READyR Program, and to evaluate the utility of the READyR Program for identifying dementia-related care needs.

Cerebrospinal Fluid Proteome Alterations Associated with Neuropsychiatric Symptoms in Cognitive Decline and Alzheimer's Disease.

Although neuropsychiatric symptoms (NPS) are common and severely affect older people with cognitive decline, little is known about their underlying molecular mechanisms and relationships with Alzheimer’s disease (AD). The aim of this study was to identify and characterize cerebrospinal fluid (CSF) proteome alterations related to NPS. In a longitudinally followed-up cohort of subjects with normal cognition and patients with cognitive impairment (MCI and mild dementia) from a memory clinic setting, we quantified a panel of 790 proteins in CSF using an untargeted shotgun proteomic workflow.

Association Between Mild Cognitive Impairment and Seasonal Rest-Activity Patterns of Older Adults.

Seasonal variation in rest-activity patterns has been observed in healthy adult populations. This study examined seasonal variation in total time spent overnight in the bedroom by cognitively intact older adults and older adults with mild cognitive impairment (MCI). We hypothesize that seasonal variation in rest-activity patterns is observed in the cognitively intact group and that this variation is disturbed in those with MCI.