Public Health.

Background: Weakened white matter (WM) integrity is highly associated with dementia risk. Still, not everyone with WM changes develops dementia, suggesting the important role modifiable lifestyle factors may have in reducing dementia risk. We investigated how social relationships in mid-life may modify the association between WM integrity and incident dementia risk within race and sex subgroups.

Public Health.

Background: Midlife vascular risk factors are associated with an increased risk of dementia. However, the overall contribution of modifiable vascular risk factors in midlife and late-life to dementia remains unclear. In this study, we quantified population attributable fractions, which account for risk factor prevalence and strength of relative risks, of incident dementia from vascular risk factors measured in midlife and early late-life.

Public Health.

Background: Socioeconomic disadvantage at different life-course stages has been associated with later life cognitive impairment. However, its association with changes in cognitive function needs to be further elucidated. We assessed the association between socioeconomic position (SEP) throughout the life-course and cognitive function change in middle-aged and older Hispanic/Latino adults.

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.

Public Health.

Background: People living with dementia (PWD) often have inactivity-induced muscle atrophy, increased sedentary behavior, and circadian rhythm disorders. Exercise may improve physical activity, sedentary behavior, and sleep in PWD, but further research is needed. The purpose of this pilot randomized controlled trial (RCT) was to examine whether a structured exercise program improves physical activity, sedentary behavior, and sleep in PWD.

Public Health.

Background: Environmental pollutants, called perfluoroalkyl substances (PFAS) have been linked to adverse cardiometabolic outcomes, immune dysfunction and cancer risk, but their associations with adult cognition are unknown. Nearly everyone in the United States has detectable levels of PFAS in their blood, but our prior work found that Asian Americans have the highest exposure burden. As Asian Americans fastest growing segment of older adults, examination of relationships between serum PFAS concentrations and cognition in Asian Americans urgently needed.

Public Health.

Background: Pesticide exposure may contribute to cognitive decline, but empirical evidence is limited. We examined high pesticide exposure events (HPEE) in relation to subjective cognitive decline among farmers in the Pesticide and Sense of Smell Study (PASS), a sub-cohort of the Agricultural Health Study (AHS).

Method: This analysis included 2365 predominantly white male farmers from Iowa and North Carolina (aged 70±10 years) who enrolled in AHS from 1993-1997 and participated in PASS in 2020-2021.

Public Health.

Background: Geographical differences in the burden of Alzheimer's disease and related dementias (ADRD) exist in the US. Rural and Appalachian areas are characterized by limited access to primary and specialty health care in comparison to their urban and non-Appalachian counterparts. Better access to telehealth can improve detection of ADRD in remote regions but it highly relies on availability of broadband services.

Public Health.

Background: Individuals with higher educational attainment have a lower risk for dementia, but it is less clear how educational attainment of an individual's parents may influence dementia risk, particularly in diverse populations. The study goal was to investigate the association between intergenerational educational attainment for two adjacent generations (individuals and their parents) and the risk of incident dementia, in a community-based study.

Method: Participants from the Atherosclerosis Risk in Communities (ARIC) study, a prospective community-based cohort, were asked their own educational level (at study baseline; 1987-1989; ages 44-66 years) and that of each of their parents several years later.

Public Health.

Background: The Aging and Cognitive Health Evaluation in Elders (ACHIEVE, Clinicaltrials.gov Identifier: NCT03243422) randomized trial investigated the effect of hearing intervention versus health education control on 3-year cognitive change among dementia-free older adults with untreated hearing loss. Participants were recruited from the Atherosclerosis Risk in Communities (ARIC) study (n = 238) or de novo from the community (n = 739).

Public Health.

Background: Cardiometabolic diseases and mental health disorders, which are high-risk factors for dementia and cognitive decline, are associated with higher mortality and morbidity with age. Interventions before age 60 may lessen the burden of cognitive and physical function in later life. Telehealth offers early intervention and solutions for their complex demands in continuous behavior monitoring and medication refilling.

Public Health.

Background: Shared genetic risk between Alzheimer's disease (AD) and concussion may help explain the association between concussion and elevated risk for dementia. However, there has been little investigation into whether AD risk genes also associate with concussion severity/recovery, and the limited findings are mixed. We used AD polygenic risk scores (PRS) and APOE genotypes to investigate associations between AD genetic risk and concussion severity/recovery in the NCAA-DoD Grand Alliance CARE Consortium (CARE) dataset.

Biomarkers.

Background: Synuclein Aggregate Assays (SAA) in cerebrospinal fluid (CSF) and in skin biopsy have been shown to successfully identify underlying synuclein (Lewy body) pathology in patients with Parkinson's disease. Data in Lewy Body Dementia (LBD) is limited, particularly with pathologic confirmation and staging of underlying Lewy body pathology, and other co-pathologies.

Method: Utilizing data and biofluids from participants in the U.

Biomarkers.

Background: Olfactory impairment appears early in the course of Alzheimer's Disease (AD) and may serve as a non-invasive early marker of AD. Few studies have examined the association between olfaction and blood biomarkers of AD neuropathology in large, diverse, community-based populations. Blood levels of amyloid-beta (Aβ and Aβ), phosphorylated-tau (p-tau) forms, glial fibrillary acidic protein (GFAP), and neurofilament-light chain (NfL) appear to reliably reflect corresponding brain neuropathologies and neurodegeneration.

Biomarkers.

Background: Studies suggest that approximately 60 to 70 percent of the variability observed in cognitive abilities during aging can be attributed to genetic factors. Therefore, investigating the longitudinal multiomics changes associated with alterations in cognitive measures, such as the Mini-Mental State Examination (MMSE) score, is of utmost importance.

Method: Longitudinal changes in gene and protein expression related to MMSE scores were examined in the Cameron County Hispanic Cohort (CCHC), an extensively phenotyped, randomly-recruited, cohort of Mexican Americans residing at the US-Mexico border.

Biomarkers.

Background: Older adults with dual cognitive and mobility impairments have higher financial costs and poorer quality of life than adults with either impairment alone. Blood biomarkers of Alzheimer Disease (AD) pathology (Aβ42, Aβ40 and p-tau181) and neurodegeneration (neurofilament light (NFL) and glial fibrillary acidic protein (GFAP)) may identify individuals at risk for both mobility and cognitive impairment and provide novel insights into mechanistic underpinnings.

Method: Blood biomarkers (SiMoA Quanterix N4PE, p-tau181 single-plex) were available in a subsample of 1751 ARIC study participants at Visit 5 (V5, 2011-13, mean age 76.

Biomarkers.

Background: While we do not yet have the means to detect early Alzheimer's disease (AD), studying subjects at risk conferred by the presence of the APOE4 allele, can provide useful information before clinical onset. We show that using symmetric bilinear regression with L1 penalty (SBL) of individual (DTI, fMRI) and fused connectomes, we can identify vulnerable regions changing in association with hallmark AD biomarkers measured in cerebrospinal fluid: amyloid beta Aβ42/40, phosphorylated tau (PTAU), and neurofibrillary light (NfL) as a proxy for neurodegeneration.

Methods: We use structural connectomes derived from diffusion-weighted MRI (DTI) and functional connectomes (fMRI) from 57 subjects, 45 normal controls and 12 cognitively impaired to predict CSF Aβ42/40, PTAU, and NfL to reflect neurodegeneration.

Biomarkers.

Background: Residence in a disadvantaged neighborhood (e.g., high poverty rate, poor housing, etc.

Biomarkers.

Background: Blood-based biomarkers show promise as a noninvasive, inexpensive method for measuring Alzheimer's disease pathology throughout the lifecourse. However, the predictive and classification accuracy of these biomarkers at different stages of the lifecourse and among diverse, community-dwelling populations requires further investigation.

Method: Between 2014 and 2015, 329 dementia-free participants from the Atherosclerosis Risk in Communities Study underwent brain magnetic resonance imaging (MRI) and florbetapir positron emission tomography (PET).

Biomarkers.

Background: Few large microbiome studies on Alzheimer's Disease and Related Dementia (AD/ADRD) have been conducted, especially among US Latinos. We conducted a study within the Study of Latinos- Investigation of Neurocognitive Aging (SOL-INCA) cohort to examine the role of the gut microbiota in cognitive function.

Methods: We analyzed the fecal metagenomes of 2,470 SOL-INCA participants to, cross-sectionally, identify microbial taxonomic and functional features associated with cognitive function.

Biomarkers.

Background: The Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) study demonstrated that amyloid PET changes patient management in >60% of Medicare beneficiaries with MCI/atypical dementia. IDEAS had limited racial/ethnic diversity and excluded patients with "typical" amnestic clinical presentations. Here we present preliminary results from the New IDEAS study, which evaluates the clinical impact of amyloid PET in a more racially, ethnically and clinically diverse cohort.

Nurses' Journey Towards Recovery: Describing Suffering During the COVID-19 Pandemic to Present Day.

The nursing profession has been significantly affected by the COVID-19 pandemic, and nurses continue to suffer emotionally and psychologically. The purpose of this study was to describe the experiences of chronic and ongoing occupational psychological trauma nurses have endured during the COVID-19 pandemic to present day. Eight nurses were interviewed between November 2022 and April 2023.

Development of 3D-printed conducting microneedle-based electrochemical point-of-care device for transdermal sensing of chlorpromazine.

Despite the various benefits of chlorpromazine, its misuse and overdose may lead to severe side effects, therefore, creating a user-friendly point-of-care device for monitoring the levels of chlorpromazine drug to manage the potential side effects and ensure the effective and safe use of the medication is highly desired. In this report, we have demonstrated a simple and scalable manufacturing process for the development of a 3D-printed conducting microneedle array-based electrochemical point-of-care device for the minimally invasive sensing of chlorpromazine. We used an inkjet printer to print the carbon and silver ink onto a customized 3D-printed ultrasharp microneedle array for the preparation of counter, working, and reference electrodes.

Cost-effectiveness of finerenone therapy for patients with chronic kidney disease and type 2 diabetes in England & Wales: results of the FINE-CKD model.

Objective: Chronic kidney disease (CKD) is the leading cause of kidney failure, end-stage kidney disease (ESKD), and cardiovascular (CV) events in patients with type 2 diabetes (T2D). The FIDELIO-DKD trial demonstrated that finerenone lowered the risk of renal and CV events in patients with CKD and T2D, regardless of cardiovascular disease history. This study evaluated the cost-effectiveness of finerenone added to background treatment (finerenone + BT) versus background treatment (BT) alone in patients with CKD and T2D from the perspective of the National Health Service in England and Wales.

Developing Topics.

Background: Apathy in Alzheimer's disease improves with methylphenidate (MPH) but treatment response was found to vary depending on clinical factors. Here, we explored whether underlying biological factors assessed by blood-based biomarkers of neurodegeneration, inflammation and oxidative stress affect apathy treatment response.

Method: A subset of participants from the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) were included in this study whose blood samples were available at baseline and at the 6-month treatment completion.