Stages Of Dementia Research Articles

The effect of apathy on quality of life and caregiver burden in patients with dementia.

Apathy is one of the common neuropsychiatric symptoms in people with dementia (PwD). The aim of this study is to determine the impact of apathy on the patient's quality of life (QoL) and caregiver's burden among PwD. Sample of this cross-sectional descriptive study consisted of 88 PwD attending the outpatient clinic of a university hospital in Istanbul and their family caregivers. The evaluation battery included Apathy Evaluation Scale (AES), Caregiver Burden Inventory (CBI) and Quality of Life in Alzheimer's Disease Scale (QoL-AD). The mean age of the patients was 73.1 ± 11.7, and the time since diagnosis was 3.9 ± 3.1 years; 64.8% had Alzheimer's type dementia, and 53.4% (n = 47) had mild dementia. The mean AES-C score was 52.9 ± 10.2, QoL-AD score was 28.4 ± 5.6 and CBI score 32.6 ± 25.9. Apathy was associated with medical comorbidity, stage of dementia, neuropsychiatric symptoms, functional status and depression. Apathy was found to be predictor of the QoL-AD and also related with CBI. In dementia patients, apathy was associated with patients' functional status, quality of life, and caregiver burden. It is recommended that patients be evaluated for apathy and its impact on activities of daily living, quality of life and caregiver burden.

The value of privacy for people with dementia

IntroductionThe concept of privacy marks an astonishing gap in the discussion about care for people with dementia (PwD). In general, questions of privacy play an important role and attract much attention in the ethics of nursing care. Yet, when it comes to dementia care, there is hardly any systematic ethical debate on the topic at all. It almost seems as though PwD lost any plausible interest in privacy and no longer had a private sphere that needed to be considered or protected. However, this not only contradicts widespread moral intuitions but also ignores the views and needs of those affected.ArgumentsThis conceptual analysis sets out to explore the value of privacy for PwD. We first outline the origins and dimensions of the concept of privacy itself and point out problems and limitations in the context of dementia. Especially the prevalent liberal conceptions’ dependence on the idea of individual autonomy poses considerable challenges to an adequate understanding of the moral significance of privacy for PwD. Therefore, we subsequently examine alternative ways of conceptualizing the value of privacy in the context of dementia care.ConclusionWe argue that autonomy-based concepts of privacy may still apply in the early stages of dementia. In the further course of the syndrome, however, the relevance of other normative aspects comes to the fore, especially respect for remaining personal preferences as well as objective criteria of dignity and well-being. Thus, we outline in a differentiated way how and to what extent privacy can be of normative importance even beyond the purview of autonomy and should consequently be considered in dementia care.

Digital screening tool for the assessment of cognitive impairment in unsupervised setting—digiDEM-SCREEN: study protocol for a validation study

IntroductionDementia is one of the most relevant widespread diseases, with a prevalence of currently 55 million people with dementia worldwide. However, about 60–75% of people with dementia have not yet...

Expert opinion on Centiloid thresholds suitable for initiating anti-amyloid therapy. Summary of discussion at the 2024 spring Alzheimer's Association Research Roundtable.

A 24-30 Centiloid (CL) threshold was collectively considered by a group of global dementia experts as a practical and implementable cut-off for anti-amyloid therapy intervention, in Alzheimer's disease patients who have been diagnosed at the mild cognitive impairment or mild dementia stage of their disease. Though additional validation is needed, knowledge of this threshold would be valuable to those involved in diagnosing and treating patients in the new AD care pathways, as well as entry into clinical trials. Therapy monitoring to determine future treatment response and assess amyloid clearance can be accomplished with amyloid PET with some technical details still to be elucidated.

Two-Year Longitudinal Outcomes of Subjective Cognitive Decline in Hispanics Compared to Non-hispanic Whites.

Subjective cognitive decline (SCD), considered a preclinical dementia stage, is less understood in Hispanics, a high-risk group for dementia. We investigated SCD to mild cognitive impairment (MCI) progression risk, as well as baseline and longitudinal features of depressive symptoms, SCD complaints, and objective cognitive performance among Hispanics compared to non-Hispanic Whites (NHW). Hispanic (n = 23) and NHW (n = 165) SCD participants were evaluated at baseline and 2-year follow-up. Evaluations assessed function, depressive symptoms, SCD, and objective cognitive performance. Hispanics were at increased risk of progression to MCI (OR: 6.10, 95% CI 1.09-34.20, P = .040). Hispanic participants endorsed more depressive symptoms at baseline (P = .048) that worsened more longitudinally (OR: 3.16, 95% CI 1.18-8.51, P = .023). Hispanic participants had increased SCD complaints on the Brief Cognitive Rating Scale (BCRS) (β = .40 SE: .17, P = .023), and in specific BCRS domains: concentration (β = .13, SE: .07, P = .047), past memory (β = .13, SE: .06, P = .039) and functional abilities (β = .10, SE: .05, P = .037). In objective cognitive performance, Hispanic ethnicity associated with decline in MMSE (β = -.27, SE: .13, P = .039), MoCA (β = -.80 SE: .34, P = .032), Trails A (β = 2.75, SE: .89, P = .002), Trails B (β = 9.18, SE: 2.71, P = .001) and Guild Paragraph Recall Delayed (β = -.80 SE: .28, P = .005). Conclusions: Hispanic ethnicity associated with a significantly increased risk of 2-year progression of SCD to MCI compared to NHW. This increased risk associated with increased depressive symptoms, distinctive SCD features, and elevated amnestic and non-amnestic objective cognitive decline. This supports further research to refine the assessment of preclinical dementia in this high-risk group.

Loss of Insight in Syndromes Associated with Frontotemporal Lobar Degeneration: Clinical and Imaging Features.

The present study aims to assess the prevalence, associated clinical symptoms, longitudinal changes, and imaging correlates of Loss of Insight (LOI), which is still unexplored in syndromes associated with Frontotemporal Lobar Degeneration (FTLD). Retrospective longitudinal cohort study, from Oct 2009 to Feb 2023. Tertiary Frontotemporal Dementia research clinic. A sample of 712 FTLD patients, 331 of whom had follow-up evaluation. LOI was assessed by interview with the primary caregiver. Univariate and multiple logistic regression and linear mixed models were used to estimate predictors and longitudinal changes over time associated with LOI. Voxel-based morphometry and structural covariance analyses of brain structural MRI images were implemented in Statistical Parametric Mapping. LOI was reported in 45% of patients (321/712, 95%CI = 41-49), with progressively increased prevalence from prodromal to severe dementia stages. LOI was more prevalent in the behavioural variant FTD, in the semantic variant of Primary Progressive Aphasia (svPPA) and FTD with Amyotrophic Lateral Sclerosis than in other phenotypes (all p-values<0.001). LOI severity increased over time only in patients with svPPA (β = +0.59, p <0.001) and clustered with other behavioral symptoms (all p-values <0.05). Finally, LOI was significantly associated with greater atrophy in the right medial orbital gyrus (p <0.001 uncorrected). Structural covariance analysis demonstrated loss of negative correlation between right medial orbital gyrus and regions belonging to the Default Mode Network (DMN), such as the left precuneus and the left angular gyrus (p ≤0.05 family-wise error-corrected) in FTLD patients with LOI. A better comprehension of LOI mechanisms could lead to more effective interventions and healthcare policies.

Analytical and clinical performance of eight Simoa® and Lumipulse® assays for automated measurement of plasma p-tau181 and p-tau217

BackgroundAmong the Alzheimer’s disease (AD) biomarkers measured in blood, phosphorylated forms of tau (p-tau) have been shown to exhibit a particularly high diagnostic potential. Here, we performed a comprehensive method comparison study, followed by evaluation of the diagnostic performance of eight recent plasma p-tau immunoassays targeting different tau phosphorylation sites, different tau fragments, and that are measured by two distinct platforms.MethodsWe enrolled a cohort of 40 patients with AD at the stage of dementia (AD-dem) characterized by positive CSF A + T + profile, and a control group of 40 cognitively healthy participants (Control), to conduct a comprehensive method comparison for three plasma p-tau181 and five plasma p-tau217 assays run on the Simoa® HD-X™ or Lumipulse® G600II/G1200 platforms. Design of the compared assays differed in regard to: (1) tau phosphorylation site targeted by the capture antibody (T181 or T217), and (2) epitope of the pan-tau detector antibody (N-terminal or mid-region). For each of the assays we determined precision and analytical sensitivity parameters and used Passing-Bablok regression and Bland-Altman plots for pairwise comparison of p-tau181 or p-tau217 assays. Subsequently, we evaluated the diagnostic accuracy of all the assays for discrimination between AD-dem and Control groups.ResultsWe found a strong, positive correlation between all the measurements. Fixed and/or proportional bias was observed for each of compared p-tau181 assay pairs or p-tau217 assay pairs. While both plasma p-tau181 and p-tau217 levels were significantly increased in AD-dem vs. Control groups as measured by all assays, higher median concentration AD-dem/Control fold change and AUC values were observed for p-tau217 (assays range: fold change 3.72–6.74, AUC 0.916–0.956) compared with p-tau181 (assays range 1.81–2.94, AUC 0.829–0.909), independently of the platform used. No significant differences were observed between diagnostic performance of p-tau181 assays or p-tau217 assays targeting tau N-terminus or mid-region.ConclusionsAlthough all plasma p-tau measurements enabled discrimination between clinical groups, p-tau217 assays showed the highest robustness, independently of the pan-tau detector antibody targeting N-terminal or mid-region, and independently of the platform used. Considering the observed method disagreement in measured absolute concentrations, we stress the need for development of certified reference material, harmonizing measurements across different platforms.

Diagnostic accuracy of heart rate variability as a screening tool for mild neurocognitive disorder.

Mild neurocognitive disorder (mNCD) is recognized as an early stage of dementia and is gaining attention as a significant healthcare problem due to current demographic changes and increasing numbers of patients. Timely detection of mNCD provides an opportunity for early interventions that can potentially slow down or prevent cognitive decline. Heart rate variability (HRV) may be a promising measure, as it has been shown to be sensitive to cognitive impairment. However, there is currently no evidence regarding the diagnostic accuracy of HRV measurements in the context of the mNCD population. This study aimed to evaluate the diagnostic accuracy of vagally-mediated HRV (vm-HRV) as a screening tool for mNCD and to investigate the relationship between vm-HRV with executive functioning and depression in older adults who have mNCD. We retrospectively analyzed data from healthy older adults (HOA) and individuals with a clinical diagnosis of mNCD with a biomarker-supported characterization of the etiology of mNCD. Diagnostic accuracy was evaluated using receiver operating characteristic curve analysis based on the area under the curve. Sensitivity and specificity were calculated based on the optimal threshold provided by Youden's Index. Multiple linear regression analyses were conducted to investigate the relationship between vm-HRV and executive functioning and depression. This analysis included 42 HOA and 29 individuals with mNCD. The relative power of high frequency was found to be increased in individuals with mNCD. The greatest AUC calculated was 0.68 (with 95% CI: 0.56, 0.81) for the relative power of high frequency. AUCs for other vm-HRV parameters were between 0.53 and 0.61. No consistent correlations were found between vm-HRV and executive functioning or depression. It appears that vm-HRV parameters alone are insufficient to reliably distinguish between HOA and older adults with mNCD. Additionally, the relationship between vm-HRV and executive functioning remains unclear and requires further investigation. Prospective studies that encompass a broad range of neurocognitive disorders, HRV measurements, neuroimaging, and multimodal approaches that consider a variety of functional domains affected in mNCD are warranted to further investigate the potential of vm-HRV as part of a multimodal screening tool for mNCD. These multimodal measures have the potential to improve the early detection of mNCD in the future.

Assessment of cognition: dementia and delirium : In consideration of the AWMF guidelines 038-013 and 084-002LG

Cognitive disorders are multifaceted and the range of neuropsychological instruments is correspondingly extensive; however, most examiners have to limit themselves to asmall selection in order to master them safely. In geriatric patients the various forms and stages of dementia dominate. Delirium must be distinguished from these as an acute life-threatening event. The personal and external medical history as well as clinical observation are the first steps in the assessment of cognition; the selection of test procedures is graduated and bears the patient's benefit in mind. When compiling atoolbox for use in one's own field of work, in addition to instruments focusing on different degrees of severity, alternatives should also be considered for use in the presence of comorbidities that reduce the validity (visual, hearing and fine motor disorders) and the examination situation should be taken into account.

Effects of Mental Imagery on Quality of Life, Cognitive, and Emotional Status in Older Adults with Early-Stage Alzheimer's Disease Dementia: A Randomized Controlled Trial.

Dementia is a syndrome which involves cognitive and motor problems such as memory and motor control that impacts the individuals' quality of life. In mental imagery (MI) technique, motor acts are mentally rehearsed without any overt body movements. The aim of this study was to investigate the effectiveness of MI on the quality of life, cognitive, and emotional status of older adults with an early stage of dementia. The present randomized controlled trial consisted of 160 participants. The sample from an Athens Day Care Center of the Alzheimer Association was randomized to (a) the MI and exercise group (intervention group, n = 55), (b) the only exercise group (1st control group, n = 52), and (c) the neither MI nor exercise group (2nd control group, n = 53). Participants engaged in a total of 24 physiotherapy sessions, each lasting approximately 45 min, scheduled twice weekly over a 12-week period. They performed three assessments: (a) one week prior to the program, (b) one and a half months, and (c) after the program. The intervention group performed a 30 min MI with exercise program content immediately following every physiotherapy exercise session. Walking While Talking Test (WWITT), the Euro-Qol 5-Dimensions 5-Level of severity scale (Euro-Qol 5D-5L scale), the Short-Form of Geriatric Depression Scale (SF-GDS), and the Short Anxiety Screening Test (SAST) were used to assess cognitive status, emotional status, and quality of life. A total of 160 participants (43 men, 117 women, with MMSE M = 23.20 SD = 0.15) took part in this study in which most reported holding a university degree (n = 77), were married (n = 101), and had loss of memory as the 1st symptom of dementia (n= 117). The Friedman test revealed statistically significant differences across the three groups on (a) the WWITTmistakes (X2 = 14.95, df = 2, p = 0.001) and WWITTtime (X2 = 13.35, df = 2, p = 0.01), (b) the total Euro-Qol 5D-5L scale (X2 = 11.87.62, df = 2, p = 0.003) and quality of life on the measuring day (X2 = 25.59, df = 2, p = 0.00), (c) the SF-GDS (X2 = 6.54, df = 2, p = 0.038), and (d) the SAST (X2 = 39.907.62, df = 2, p = 0.00). The Friedman test with post hoc Wilcoxon analysis revealed that the mean scores for the intervention group and the 1st control were significantly better than the 2nd control group in many dependent variables. The results indicate that incorporating MI can positively influence cognitive status, emotional status, and the quality of life in older adults diagnosed with early-stage dementia.

Early diagnosis of Alzheimer’s disease: potential of &lt;sup&gt;18&lt;/sup&gt;F-FDG PET as a biomarker of neurodegeneration

BACKGROUND: Dementia is considered one of the most actual medical problems of our time, being one of the main causes of disability among the elderly, and its prevalence will only increase in the coming years. The first place among conditions leading to dementia is given to Alzheimer’s disease (up to 70%). The effectiveness of Alzheimer’s disease therapy largely depends on the timeliness of diagnosis, which leads to the need to search for diagnostic markers that allow to detect the disease at the earliest stages. AIM: To evaluate the possibilities of using 18F-FDG PET for the early diagnosis of Alzheimer’s disease. MATERIALS AND METHODS: Cerebral metabolism was assessed using positron emission tomography with 18F-FDG. A total of 183 patients were divided into groups depending on their diagnosis and the severity of cognitive impairment. RESULTS: A characteristic pattern of cerebral metabolic disorders has been established in patients with Alzheimer’s disease. It can be detected in the early pre-dementia stages and has developmental features as the disease progresses. The pattern was characterized by bilateral hypometabolism in the parietal and temporal cortex with a predominance in its mediobasal sections. An important marker of the development of the neurodegenerative process was a metabolic disorder of the cingulate gyrus, the posterior sections of which are affected already at the earliest stages of the disease, while the involvement of its anterior sections reflects the transition to the stage of severe dementia. Described metabolic disorders prevailed in the dominant (left) brain hemisphere at all stages of the disease. CONCLUSION: Currently 18F-FDG PET can be considered the most informative of the available methods for the early diagnosis of Alzheimer’s disease which have a fairly high degree of accuracy.

Effects of fully immersive virtual reality training on cognitive function in patients with mild cognitive impairment: a systematic review and meta-analysis.

Mild cognitive impairment (MCI) is a prodromal stage of dementia. There is no specific medication to slow the progression of MCI. Recent studies have confirmed the positive effects of virtual reality (VR). However, the results are inconsistent due to different types of VR interventions, small sample sizes, and the varying quality of the literature. This study aimed to assess the effects of fully immersive VR on cognitive function in MCI patients. A systematic review of published literature was conducted using PubMed, Cochrane Library, Embase, CINAHL, Web of Science, SinoMed, CNKI, Wanfang, and VIP Database. The search period was from inception through March 1, 2024. Eligible studies were randomized controlled trials evaluating the effects of fully immersive virtual reality training on cognitive function in MCI patients. Two investigators independently performed literature screening, data extraction, and quality assessment; a meta-analysis of the included literature was performed using RevMan 5.4. The Cochrane Risk of Bias tool was used to assess the methodological quality. A total of 11 randomized controlled trials with 525 patients were included. The meta-analysis showed that fully immersive virtual reality training had significant effects on global cognitive function (MD = 2.34, 95% CI [0.55, 4.12], p = 0.01); (MD = 0.93, 95% CI [0.30, 1.56], p < 0.01), executive function (SMD = -0.60, 95% CI [-0.84, -0.35], p < 0.01), and attention (MD = 0.69, 95% CI [0.15, 1.23], p = 0.01). Still, the difference in memory (SMD = 0.27, 95% CI [-0.24, 0.78], p = 0.30) was not statistically significant. Subgroup analyses showed that executive function could be improved only when the intervention duration was ≥40 h. In contrast, excessive training (≥30 times) was counterproductive. Fully immersive virtual reality training improved cognitive functioning, executive functioning, and attention in MCI patients but was less effective in improving memory. Subgroup analysis suggests that fully immersive VR training must ensure sufficient intervention duration while avoiding frequent interventions. https://www.crd.york.ac.uk/PROSPERO/, PROSPERO (CRD42024498629).

Amyloid beta biomarker for dementia detection by hyperspectral ophthalmoscope images.

The escalating prevalence and economic burden of dementia underscore the urgency for innovative detection methods. This study investigates the potential of hyperspectral imaging (HSI) to detect dementia by analyzing retinal changes associated with amyloid beta (Aβ) formations. Leveraging a dataset of 3,256 ophthalmoscopic images from 137 participants aged 60 to 85 years, categorized into dementia and non-dementia groups via the Mini-Mental State Examination (MMSE), we extracted features from five key regions of interest (ROIs) identified for their pronounced changes in Aβ biomarkers. The analysis revealed that gender does not significantly influence dementia levels, and no substantial spectral differences were observed within the 380 nm to 600 nm wavelength range. However, significant variations in spectral reflection intensity were noted between 600 nm and 780 nm across both genders, suggesting a potential avenue for distinguishing stages of dementia. Despite the impact of diabetes on the vascular system, its stages did not significantly influence dementia development. This research highlights the utility of HSI in identifying dementia-related retinal changes and calls for further exploration into its effectiveness as a diagnostic tool, potentially offering a non-invasive method for early detection of dementia.

Health System Readiness for Disease-Modifying Therapies for Alzheimer Disease

What Is the Issue? Alzheimer disease (AD) is a chronic neurological degenerative disease and one of the most common causes of dementia. It affected an estimated 368,200 people in Canada in 2020. Mild cognitive impairment (MCI) is a clinical condition involving memory loss that can progress to dementia and is often due to underlying AD. It was estimated to affect around 917,000 people in Canada aged 60 and older in 2020. Disease-modifying therapies (DMTs) are being developed that target underlying pathologic processes of AD to slow disease progression, unlike contemporary treatments that focus on managing symptoms. A prominent target of these therapies is amyloid-beta, a protein known to contribute to amyloid plaques. Many of the anti–amyloid-beta DMTs are intended for people with early-stage AD, which includes MCI and mild dementia due to AD. At least 7 countries have approved a therapy from this treatment class, and, at the time of writing, 2 therapies are undergoing regulatory review by Health Canada and reimbursement review by Canada's Drug Agency (CDA-AMC). DMTs demand more frequent health care visits and higher use of medical imaging for safe treatment and monitoring. This would greatly impact current care pathways for early-stage AD, necessitating an examination of health system readiness in Canada. What Did CDA-AMC Do? CDA-AMC sought to examine health system readiness in Canada and care pathways for early-stage patients with AD in preparation for the potential use of these anti–amyloid-beta DMTs in Canada. CDA-AMC reviewed publicly available data and literature about health systems and AD treatment pathways for improving dementia care to prepare for the possible introduction of DMTs in health systems in Canada. What Did CDA-AMC Find? CDA-AMC found that, if DMTs were approved by Health Canada and provincial and territorial drug plans, a new model of care for AD in Canada would be necessary. The new care pathway would require: earlier screening and diagnosis, at the MCI or mild dementia stages of AD guidance for optimal use of diagnostic imaging and biomarker-based tests, as well as an increase in equitable access to PET-CT units for amyloid PET exams or cerebrospinal fluid (CSF) testing to assess treatment eligibility increased capacity to administer IV infusions guidance for optimal use of MRI to avoid overuse and increase equitable access to MRI to monitor individuals through treatment a combination of reliable and validated methods and tools for evaluating cognitive decline in diverse populations, including Indigenous Peoples and racialized groups, presenting with cognitive symptoms or undergoing treatment clear criteria for discontinuing treatment. CDA-AMC found that assessment and diagnosis of early-stage AD and timely access to DMTs could be delayed due to: a lack of education and awareness of symptoms of early-stage AD among the general public and care providers, as well as cultural barriers, including a fear of stigma or cultural perceptions of the condition staffing shortages in care providers capable of assessing and treating dementia and other supporting staff, including primary care providers (PCPs), dementia specialists, nurses, imaging staff, and social care providers limited capacity of medical imaging (e.g., PET-CT and MRI) and laboratory services (i.e., CSF analysis) to confirm early-stage AD and treatment eligibility and to monitor drug response and disease progression. A variety of new technologies are in development, including new AD biomarker testing methods, that may alleviate some capacity concerns in dementia detection, treatment eligibility screening, treatment administration, and patient monitoring. Alternative DMTs that target other AD pathologic processes are also in development. What Does This Mean? There may be challenges in providing equitable and timely access to DMTs for AD, given the geographic distribution of the population (especially in rural and remote locations), cultural barriers, and lack of awareness of the condition in the population in Canada. Not all individuals with mild dementia due to early-stage AD or MCI who are eligible for treatment may have timely access to screening and diagnosis, which could prevent them from receiving DMTs. Additionally, an increased number of individuals — some of whom may not be eligible for DMTs — may be motivated to seek screening, leading to higher demand and potential delays in the screening process. Health system decision-makers may want to consider system-wide adaptations to enhance screening and care for individuals with suspected early-stage AD, given the projected rise in AD prevalence, which is expected to exceed 1.1 million people by 2050. This may include: adding more health and social care staff providing enhanced training to effectively assess and diagnose early-stage AD improving access to diagnostic imaging to screen and monitor patients using anti–amyloid-beta DMTs.

Designing sensory and cognitive stimulation activities with and for people living with moderate to late-stage dementia

This study addresses a participatory design project involving a researcher in the field of design and dementia, undergraduate design students, people living with moderate to late-stage dementia from a Day Centre run by Alzheimer Portugal and care workers. The project was held during four months as part of the research REMIND, and is grounded on the concept of personhood, emphasizing the importance of considering biographical features, values, interests, and culture of people with and for whom design projects are being developed. Considering the profile of the Centre’s users, the stage, and manifestations of dementia in each one, it was necessary to combine qualitative methods, which were systematically adapted according to each situation. Methods included: sensory ethnography, participatory observation, walking interviews, ethnographic field notes and interviewing. The strategies adopted in the participatory design process were designed according to the users’ aspirations and interests, prioritizing playfulness, enjoyment, and wellbeing in the moment. Sensory and cognitive stimulation games were designed with these people living with dementia and made available at the Centre for their use. The results of this project provide a basis for reflection on the ongoing research and inform future practices in this area.

Assessment of cognitive function in patients with metabolic dysfunction-associated steatotic liver disease

Background. Since the relationship between the initial stage of steatotic liver disease and dementia and cognitive function (CF) remains undetermined, there is a need to study such a combination. The aim is to evaluate CF in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Materials and methods. Thirty-nine outpatients with chronic forms of coronary heart disease were examined: 26 made up the main group with concomitant MASLD and 13 patients were included in the control group with an intact liver. In all of them, CF was evaluated using the Mini-Mental State Examination (MMSE). Results. The CF according to the MMSE was lower in patients with MASLD than among those with an intact liver (25.27 vs 28.22; p &lt; 0.01). Mild cognitive disorders were diagnosed in 7.69 %, moderate — in 65.38 %, and severe — in 26.93 % of patients with MASLD. In total, the frequency of deterioration of CF (MMSE ≤ 27) among patients with an intact liver was 33.33 %, while it was significantly higher (92.31 %) in patients with concomitant MASLD (p &lt; 0.05). Conclusions. CF can be an important criterion of the state of health and its changes, determines the course of the disease, allows assessing the activity of the endogenous intoxication syndrome and the state of the cardiovascular system. Impairment of cognitive functions occurs already at the stage of liver steatosis, which should be taken into account in the clinic.

Volumetric imaging analysis using deep learning classifier for various stages of dementia

Volumetric imaging analysis using deep learning classifier for various stages of dementia

Mild behavioral impairment in people with mild cognitive impairment: Are the two conditions related?

Mild cognitive impairment (MCI) and mild behavioral impairment (MBI) are both considered potential prodromal stages of dementia, especially Alzheimer's disease. Previous literature has lacked specific information about MBI in individuals with MCI and associations of several aspects of both, MBI and MCI. Our aim was to investigate whether associations exist between aspects of MBI and aspects of cognitive performance in certain dimensions of the Montreal Cognitive Assessment (MoCA). We used baseline data from the double-blind randomized controlled intervention MCI-CCT-study. Current cognitive performance of individuals with MCI was measured with the MoCA. MBI was assessed with the MBI Shortscale (MBI short), which was administered through a self-report interview. Associations were assessed with Pearson correlations. Sensitivity analyses were conducted for gender and cognition. Group differences were examined with independent samples t-tests or Welch test. Significant correlations were considered in binary logistic regressions under control of covariates. There was no significant correlation between the current MoCA and MBI short scores in the total sample or in the gender-related analysis. Using dichotomized cognitive performance, significant correlations between MCI and MBI were revealed for individuals with lower MoCA scores. On the task level, several significant associations were identified between MoCA dimensions and MBI dimensions in the total sample and in the sensitivity analyses, also under control of covariates. Our findings support the hypothesis that with increasing cognitive decline, the association between MCI and MBI becomes stronger. Furthermore, a certain cut-off on the MoCA must be reached to identify a correlation.

Assessing palliative care needs in patients with dementia: A cross-sectional analysis of an predominantly oldest-old population from a geriatric memory clinic.

In this cross-sectional study, we assessed palliative care (PC) needs in older adults with dementia. Using the NECPAL CCOMS-ICO© 3.1 tool and comprehensive geriatric assessment, 16.25% of the 554 evaluated patients required PC, which had clinical frailty and a moderate stage of dementia. Advanced frailty was associated with the poorest prognosis, according to the PC-based stratification. Our findings support the use of PC assessment in dementia care, which focuses on a person-centered approach while minimizing unnecessary or ineffective treatments and meeting the real-world patient's needs. PC care may fulfill the multidimensional nature of dementia, shifting towards personalized palliative approaches.

Positive Tau and Amyloid Burden as Potential Predictors for Financial Capacity in Pre‐ Dementia Stages of Alzheimer’s Disease

Positive Tau and Amyloid Burden as Potential Predictors for Financial Capacity in Pre‐ Dementia Stages of Alzheimer’s Disease