Introduction: Stable religious participation may have beneficial contributions to cognitive and mental health; however, less is known about how changes in religious participation, such as disengagement or increased engagement in church activities, affect these health outcomes and whether there are differences between racial groups. This study aimed to examine the association between changes in church activity and cognitive, functional, and mental health in older adults, and explore differences by race. Methods: Using data from the University of Pennsylvania Alzheimer’s Disease Research Center Aging Brain Cohort in 2021–2022, we examined associations between self-reported change in church activity with cognitive and functional health (Global Clinical Dementia Score [CDR] and Total CDR) and neuropsychiatric symptoms (Neuropsychiatric Inventory) in cognitively normal older adults (n = 158). We used multivariable regression analysis, controlling for self-reported age, sex, education, and social interaction, to examine differences between individuals who identified as either Black or White. Results: Controlling for covariates, Black participants who reported substantially more or less church activity in the last year had lower cognition and function (Global CDR, β = 0.19, 95% CI: [0.04, 0.34], p < 0.05) and Total CDR (β = 0.30, 95% CI: [0.01, 0.58], p = 0.042), and more neuropsychiatric symptoms (β = 0.63, 95% CI: [0.02, 1.24], p < 0.045). No significance was found in White older adults. Black older adults reporting major changes in church activity experienced lower cognitive, functional, and mental health. Conclusion: To explore if church activity changes could be an early sign of cognitive, functional, and mental health decline, longitudinal studies are needed.

Introduction: Although sensor technologies hold potential for addressing challenges for the detection and management of behavioural and psychological symptoms of dementia (BPSD), their application in this context remains in its early stages. This review evaluated the accuracy of sensor technologies to detect and/or monitor neuropsychiatric symptoms in individuals with dementia, particularly in real-world home settings. Methods: Systematic searches were conducted in five databases on February 20, 2025. Two independent reviewers performed data extraction, with a third reviewer resolving any disagreements. Results: Of 109 records meeting the inclusion criteria for full-text review, 17 studies were included. Sensor-based detection of agitation (number of studies, n = 6) and other common BPSD, specifically sleep (n = 5) and Activities of Daily Living (ADLs) (n = 3), shows early promise, particularly when multimodal data and machine learning techniques are employed. However, the current evidence base is limited by small, predominantly observational studies and inconsistent accuracy across studies. Predictive capabilities remain underdeveloped (n = 3), and the generalizability of findings across different settings is unproven. Conclusions: This review highlights that the application of sensor technology for detecting and monitoring BPSD remains at an early stage, with existing evidence largely confined to a small subset of symptoms and providing limited clinimetric validation. Additionally, it emphasizes the need for consensus on standard definitions, outcome measures, and validation methodologies to guide and inform future research, which can then leverage these technologies to improve the care and quality of life of persons with dementia and their caregivers.

Plain Language SummaryMild cognitive impairment with Lewy bodies (MCI-LB) is an early stage of Lewy body disease, a brain disorder that can cause problems with thinking, attention, movement, and alertness. People with MCI-LB often experience faster decline in memory and thinking abilities than those with mild cognitive impairment due to Alzheimer’s disease (MCI-AD). Although medicines for dementia exist, there are few nondrug programs specifically tested for people with MCI-LB. This study followed 74 older adults who joined a hospital-based day-care program called the Cognitive Improvement Day-Care (CIDC) at the University of Tsukuba Hospital. Among them, 14 had MCI-LB and 60 had MCI-AD. The CIDC is a structured, nondrug program that combines physical exercise, cognitive (brain) training, music therapy, and art activities in two-hour sessions, usually held once a week. Participants were observed for up to 3 years. Their thinking abilities were measured each year using the Mini-Mental State Examination (MMSE), a common test of global cognitive function. Overall, thinking abilities declined only slightly over time, and there was no meaningful difference between people with MCI-LB and those with MCI-AD. These findings suggest that people with MCI-LB may exhibit a similar pattern of cognitive change to people with MCI-AD when participating in structured, nondrug multimodal programs such as CIDC. Further research with larger groups of participants is needed to confirm these results and to better understand how such programs may support brain health in different types of mild cognitive impairment.

Karger Publishers and the editors of Dementia and Geriatric Cognitive Disorders Extra would like to thank the reviewers for their ongoing support in reviewing manuscripts for our Journal in 2025. This year we have chosen not to disclose the names of our reviewers to preserve the principle of anonymity inherent to the single-blind peer-review we follow. Even so, this should not be in our way to sincerely thank all contributing reviewers who have volunteered their time, effort, and expertise in benefit of the quality of the manuscripts we received and published in 2025. Individual reviewers can still claim their personal “Certificate of Review” via the Journal’s manuscript submission system.

Introduction: Caregiver burden significantly impacts patient and caregiver outcomes and is an important treatment consideration in dementia. Previous research has demonstrated that like behavioral variant frontotemporal dementia, prion disease has higher levels of caregiver burden than other forms of dementia; however, limited prospective research has investigated this specifically. Here, we aimed to describe caregiver well-being and caregiver burden in prion disease and determine whether demographic features, support group attendance, or features of the disease process predicted higher caregiver burden. Methods: Thirty patients with prion disease and their caregivers were assessed longitudinally through the Teleneurology Assessment Program for Creutzfeldt-Jakob Disease. Caregivers were administered the Neuropsychiatric Inventory Questionnaire (NPI-Q), MRC Prion Disease Rating Scale, Outcome Evaluation of the National Family Caregiver Support Program, and other assessment instruments. We performed descriptive and inferential statistics to examine the progression of caregiver burden and to identify features that impacted caregiver burden severity. Results: Thirty caregiver-patient dyads were followed longitudinally. Prion disease duration averaged 7.88 months. Mean initial NPI-Q distress score was 15. Qualitatively, distress increased from the time of study enrollment until peaking on average half-way through study participation and then declined. Higher burden (4-item Zarit Burden Interview) was associated with younger age at disease onset. Burden was not predicted by disease type, duration, caregiver demographics, relationship to the patient, MRC Prion Rating Scale scores, NPI-Q, or support group attendance. Conclusion: These findings confirm significant caregiver distress in prion disease and help better describe the course of caregiver burden throughout the disease. Statistical analyses were limited by small sample size and phenotypic heterogeneity, and future research would benefit from larger sample sizes.

Introduction: The aim of the study was to provide a comprehensive overview of the current application of tools used for assessing neuropsychiatric symptoms (NPSs) in patients with Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), and multiple system atrophy (MSA) through bibliometric analysis. Methods: Publications published between 2014 and 2023 were searched using the Web of Science Core Collection database (WoSCC). Only articles and reviews published in the English language were included. CiteSpace was used to analyze the countries, keyword patterns, and reference co-citations. A detailed full-text analysis was further conducted across all studies to assess the usage of NPS assessment tools. Results: Our analysis included 530 publications demonstrating consistent annual growth, reflecting rising global interest in NPSs within neurodegenerative and neuroinflammatory diseases. However, these studies reveal research deficiency in current assessment methodologies that demands more attention. Research output remains predominantly concentrated in developed nations with aging populations, particularly the USA, which leads in both publication volume and quality. The primary focus of current research involves evaluating the validity of existing assessment tools, while emerging investigations explore next-generation assessment tools designed to enhance diagnostic precision and enable personalized treatment strategies. Despite these advances, widespread clinical adoption remains limited, and further validation studies are required to establish their reliability across diverse populations and disease stages. Conclusion: This study highlights the growing importance of NPSs in neurodegenerative diseases, particularly in HD, ALS, and MSA. We identify hotspots and deficiencies in the research field of validating NPS assessment tools, integrating NPSs into the diagnostic framework and elucidating neurobiological mechanisms. These findings will contribute to enhanced diagnostic and therapeutic approaches for neurodegenerative diseases.

Introduction: Cutoff values for cerebrospinal fluid biomarkers vary by analytic technique and population, which complicates the differentiation of Alzheimer’s disease (AD) from non-AD dementias. We aimed to establish local cerebrospinal fluid biomarker cutoffs within a Thai cohort. Materials and Methods: We recruited 68 patients with various forms of dementia from the Memory Clinic at Siriraj Hospital, Thailand. Each patient underwent clinical subtyping for dementia, and their cerebrospinal fluid levels of Aβ42, p-tau181, and t-tau were quantified using the Fujirebio INNOTEST ELISA. We then employed a data-driven approach, specifically a Z-score-based Gaussian Mixture Model, to define intersection cutoffs for Aβ42, p-tau181, t-tau, and the p-tau181/Aβ42 ratio. These established biomarker cutoffs were subsequently incorporated with clinical manifestations to refine the clinicobiological diagnoses. Results: Our study included 67 patients (mean age 65.5 ± 7.4 years, 61.2% female). Using a data-driven approach, we established the following CSF biomarker cutoffs for identifying AD in this Thai cohort: Aβ42 at 492.67 pg/mL, p-tau181 at 44.00 pg/mL, t-tau at 545.97 pg/mL, and the p-tau181/Aβ42 ratio at 0.057. After incorporating these CSF biomarker results with clinical profiles, the diagnoses changed in 17.9% of the patients. Conclusions: In this study, CSF cutoffs for differentiating AD from non-AD dementia were established through a data-driven approach, which has been demonstrated as a valid alternative methodology. The integration of clinical and biological profiles is paramount in achieving accurate dementia diagnoses.

Introduction: Frontotemporal symptoms are usually associated with frontotemporal dementia (FTD), but people with all forms of dementia may develop these symptoms as the dementia disease progresses. Knowledge about psychosocial interventions that meet the needs of people with FTD symptoms, and literature on the subject, is hard to find. The aim of the study was to describe current practice as it is experienced by healthcare experts in the clinical field in Norway. Method: Three focus groups were conducted. Healthcare personnel with clinical experience in care and treatment to people with FTD and other dementia diseases with frontotemporal symptoms were eligible for inclusion. Qualitative directed content analysis with open coding focusing on both manifest and latent content was applied. Results: Four categories were described: (1) Dilemmas of anosognosia, (2) establishment of a diagnosis, (3) establishment of post-diagnostic support at home, and (4) establishment of care in the nursing home. Conclusion: People with FTD and other dementias with frontotemporal symptoms need rigid, easy-to-understand, predictable surroundings and healthcare personnel that are clear, friendly, and respectful in their communication. Post-diagnostic support provided in flexible systems ensuring smooth transitions between services and levels of care is required. To ensure quality of care, frontline healthcare staff should be able to recognize FTD symptoms. To achieve this, supervision and training are needed. More research about clinical care interventions and how to derive good nursing practice should be prioritized.

Introduction: The ε4 allele of the apolipoprotein E (APOE4) gene is a well-known risk factor for the onset and development of late-onset Alzheimer’s disease (AD). Lipid metabolism also plays a key role in AD. However, data on the association between APOE4, cognitive function, and blood lipid metabolism, particularly fatty acid metabolism, in the healthy elderly Japanese population are lacking. Methods: We analyzed the baseline data of 506 healthy elderly Japanese individuals (mean age: 73 ± 0.4 years) from Shimane Prefecture, Japan, who participated in six intervention trials conducted between 2008 and 2020. Among them, participants with mild cognitive impairment (MCI) were divided into the following two groups: APOE4 carriers (n = 104) and noncarriers (n = 321). Results: Compared with the noncarriers, the APOE4 carriers had significantly lower scores in the “recalling five objects” sub-item of Hasegawa’s Dementia Scale-Revised and longer total times in the Cognitive Assessment for Dementia, iPad version. The ratio of docosahexaenoic acid (DHA)-to-arachidonic acid was significantly decreased, and the erythrocyte eicosapentaenoic acid (EPA) and DHA levels tended to be reduced in APOE4 carriers. Conclusion: These findings suggest a possible association between the APOE4 allele and reduced erythrocyte EPA and DHA levels, even in healthy elderly Japanese individuals with high ω-3 fatty acid intake. Such alterations in lipid metabolism may be linked to cognitive vulnerability in older adults and individuals with MCI.