Impact Of Alzheimer Research Articles

Different meanings of a three-point decline in MMSE score in Alzheimer's disease and depressive disorder.

The Mini-Mental State Examination (MMSE) is a composite scale that is included in diagnostic algorithms and in procedures to assess severity of cognitive impairment and efficacy of therapeutic interventions. It is unclear, however, whether the MMSE provides information about the same deficits in different diseases. To assess patterns of MMSE scores in patients with confirmed diagnosis of Alzheimer's disease or depressive disorder. We used data from a previously published cross-sectional retrospective observational clinical cohort study. The final analysis included only patients in whom biomarker analysis showed results characteristic of Alzheimer's disease (n = 167) and patients with depressive disorder in whom Alzheimer's disease had been ruled out by analysis of biomarkers (n = 69). A three-point decline in MMSE score from 30 to 27 reflected impairment of memory recall in patients with Alzheimer's disease, whereas it reflected impairments in calculation and memory recall in patients with depressive disorder. A further three-point decline in MMSE score from 27 to 24 predominantly reflected additional calculation impairment in patients with Alzheimer's disease. Our results indicate that memory performance is the most important measure of disease severity and the main contributor to the decline in MMSE score at onset of clinical manifestation of Alzheimer's disease. In general, this suggests that memory should be the primary measure used in routine clinical care and the primary endpoint in clinical trials involving patients with Alzheimer's disease at onset of clinical manifestation. Changes in other measures of cognition should prompt consideration of possible comorbidities as a cause, rather than the impact of Alzheimer's disease itself.

Potential Impact of Slowing Disease Progression in Early Symptomatic Alzheimer's Disease on Patient Quality of Life, Caregiver Time, and Total Societal Costs: Estimates Based on Findings from GERAS-US Study.

Impact of Alzheimer's disease (AD) progression on patient health-related quality of life (HRQoL), caregiver time, and societal costs is not well characterized in early AD. To assess the association of change in cognition with HRQoL, caregiver time, and societal costs over 36 months, and estimate the impact of slowing disease progression on these outcomes. This post-hoc analysis included patients with amyloid-positive mild cognitive impairment (MCI) and mild AD dementia (MILD AD) from the 36-month GERAS-US study. Disease progression was assessed using the Mini-Mental State Examination score. Change in outcomes associated with slowing AD progression was estimated using coefficients from generalized linear models. At baseline, 300 patients had MCI and 317 had MILD AD. Observed natural progression over 36 months was associated with: 5.1 point decline in the Bath Assessment of Subjective Quality of Life in Dementia (BASQID) score (for HRQoL), increase in 1,050 hours of total caregiver time, and $8,504 total societal costs for MCI; 6.6 point decline in the BASQID score, increase in 1,929 hours of total caregiver time, and $12,795 total societal costs for MILD AD per person. Slowing AD progression by 30% could result in per person savings in HRQoL decline, total caregiver time, and total societal costs: for MCI: 1.5 points, 315 hours, and $2,638; for MILD AD: 2.0 points, 579 hours, and $3,974. Slowing AD progression over 36 months could slow decline in HRQoL and save caregiver time and societal cost in patients with MCI and MILD AD.

“Don’t you recognize me…?”: Insights From Social Media Posts On The Impact of Alzheimer’s Disease On Care Partners

AbstractBackgroundCaring for someone with Alzheimer’s disease (AD) can have a profound impact on care partners’ wellbeing and daily life. We conducted a social media (SM) review to gain insights into how the impact of AD on care partners is described by persons‐living‐with‐AD (PwADs)/care partners/family members.MethodWeb‐based searches identified SM data from 4 sources: YouTube, Alzheimer’s Association, Alzheimer Society of Canada, and Dementia UK. English‐language SM posts uploaded between May 2011‐May 2021 shared by PwADs/care partners/family members were included in the review if posts discussed the impact of AD on care partners. SM data were analyzed thematically.ResultOf 279 SM posts identified, 55 met the review criteria (21 blog posts, 21 videos, 13 comments). The 55 posts were shared by 70 contributors (4 PwADs and 66 PwAD care partners/family members) who discussed self‐reported/observed impacts of AD on care partners and family members. Notable areas affected included psychological and emotional well‐being (n = 53, 75.7%); a profound theme raised was the emotional distress and sadness (n = 24; 34.3%) associated with the care partners’ experience of ‘living bereavement’; i.e., the gradual psychological receding of a loved one prior to their passing. Care partner emotional distress was also exacerbated by the PwAD’s AD‐related symptoms such as altered behaviour and memory loss. Contributors also reported impacts on care partner, overall health‐related‐quality‐of‐life (n = 27, 38.6%), daily life (n = 9, 12.9%), work and employment (n = 8, 11.4%) and physical health (n = 5, 7.1%). Prioritisation of patient care had long‐term consequences for care partners such as diminished personal wellbeing, family and personal sacrifices including loss of employment and unanticipated financial burden.ConclusionSM research provides a unique approach to explore the experiences and challenges associated with caring for someone with AD potentially not captured through traditional research methods. Insights from SM data emphasized the burden of ‘living bereavement’ for care partners and the subsequent need for improved coping strategies/interventions to enable care partners to better manage this phenomenon. The care partners’ candid posts provided valuable insights on the psychological, social, and financial impairments associated with becoming a care partner, which require further investigation.

The impact of Alzheimer's disease risk factors on the pupillary light response.

Alzheimer's disease (AD) is the leading cause of dementia, and its prevalence is increasing and is expected to continue to increase over the next few decades. Because of this, there is an urgent requirement to determine a way to diagnose the disease, and to target interventions to delay and ideally stop the onset of symptoms, specifically those impacting cognition and daily livelihood. The pupillary light response (PLR) is controlled by the sympathetic and parasympathetic branches of the autonomic nervous system, and impairments to the pupillary light response (PLR) have been related to AD. However, most of these studies that assess the PLR occur in patients who have already been diagnosed with AD, rather than those who are at a higher risk for the disease but without a diagnosis. Determining whether the PLR is similarly impaired in subjects before an AD diagnosis is made and before cognitive symptoms of the disease begin, is an important step before using the PLR as a diagnostic tool. Specifically, identifying whether the PLR is impaired in specific at-risk groups, considering both genetic and non-genetic risk factors, is imperative. It is possible that the PLR may be impaired in association with some risk factors but not others, potentially indicating different pathways to neurodegeneration that could be distinguished using PLR. In this work, we review the most common genetic and lifestyle-based risk factors for AD and identify established relationships between these risk factors and the PLR. The evidence here shows that many AD risk factors, including traumatic brain injury, ocular and intracranial hypertension, alcohol consumption, depression, and diabetes, are directly related to changes in the PLR. Other risk factors currently lack sufficient literature to make any conclusions relating directly to the PLR but have shown links to impairments in the parasympathetic nervous system; further research should be conducted in these risk factors and their relation to the PLR.

Expression of INPP5D Isoforms in Human Brain: Impact of Alzheimer's Disease Neuropathology and Genetics.

The single nucleotide polymorphisms rs35349669 and rs10933431 within Inositol Polyphosphate-5-Phosphatase D (INPP5D) are strongly associated with Alzheimer's Disease risk. To better understand INPP5D expression in the brain, we investigated INPP5D isoform expression as a function of rs35349669 and rs10933431, as well as Alzheimer's disease neuropathology, by qPCR and isoform-specific primers. In addition, INPP5D allelic expression imbalance was evaluated relative to rs1141328 within exon 1. Expression of INPP5D isoforms associated with transcription start sites in exon 1 and intron 14 was increased in individuals with high Alzheimer's disease neuropathology. In addition, a novel variant with 47bp lacking from exon 12 increased expression in Alzheimer's Disease brains, accounting for 13% of total INPP5D expression, and was found to undergo nonsense-mediated decay. Although inter-individual variation obscured a possible polymorphism effect on INPP5D isoform expression as measured by qPCR, rs35349669 was associated with rs1141328 allelic expression imbalance, suggesting that rs35349669 is significantly associated with full-length INPP5D isoform expression. In summary, expression of INPP5D isoforms with start sites in exon 1 and intron 14 are increased in brains with high Alzheimer's Disease neuropathology, a novel isoform lacking the phosphatase domain was significantly increased with the disease, and the polymorphism rs35349669 correlates with allele-specific full-length INPP5D expression.

Impact of Alzheimer's association support and engagement in the AD/ADRD research community through the COVID-19 pandemic and beyond.

The WHO estimates that 55 million people worldwide have dementia and this number is expected to increase to 139 million by 2050. Founded in 1980, the Alzheimer's Association is the world's leading voluntary health organization in AD/ADRD care, support and research. Alzheimer's Association-led funding opportunities and awards, conferences and other activities beginning with the COVID-19 pandemic were reviewed. The Association remains committed to funding, convening, leading and implementing research studies that accelerate the global effort to eliminate Alzheimer's and all other dementia. This manuscript describes funding, convening and other global initiatives, influenced in part by the COVID-19 pandemic, to strengthen and drive research forward.

Impact of Alzheimer's disease and related dementias (ADRD) on the quality of room cleaning in nursing homes.

Persons with Alzheimer's disease and related dementias (ADRD) are prone to receiving reduced quality of care. We compared the quality of room cleaning of rooms with ADRD residents and rooms with non-ADRD residents in nursing homes using an ultraviolet (UV) marker. ADRD status was associated with greater failure of UV marker removal (odds ratio, 1.68; 95% confidence interval, 1.04-2.71; P = .03).

The impact of Alzheimer’s Disease on care partners

AbstractBackgroundThe burden of informal caregiving of people with Alzheimer’s Disease (AD) is often overlooked. We wanted to provide an overview of the burden of AD for care partners and to explore how the burden increases with disease progression through a systematic literature review.MethodA protocol was developed before searches in PubMed, Embase, PsycINFO, and Cochrane Library were run October 2021 via the Silvi.ai‐platform. Eligible studies were published in English and provided data from 2010 or later. Two reviewers screened titles and abstracts independently. A single reviewer conducted full‐text analysis and data extraction, and a PRISMA overview was generated. Studies were quality ranked in accordance with Oxford quality grading scale.Result911 hits were identified of which 61 studies were relevant for data extraction. Most care partners were women. The majority of studies reported moderate‐to‐severe levels of impact on care partners life (using the Zarit Burden Interview (ZBI) and the Maslach burnout inventory) and on care partners’ overall quality of life (using the WHO Quality of Life questionnaire);1,2 care partners exhibited higher levels of stress, depression, and anxiety compared to control groups.3,4,5,6 Females had significantly higher score on care partner burden than males (measured by the Caregiver Burden Inventory (CBI)).7 The higher the number, frequency and severity of symptoms affecting patients, the more intense care partner distress as measured by the Neuropsychiatric Inventory Distress Scale.8 The care partners of people with severe dementia due to AD reported the greatest care partner burden measured by the short version of the ZBI and the CBI.9,10 There was a clear correlation between hours of care giving and score of the ‘Activities of Daily Living’ questionnaire. The higher the score, the more hours of care giving.11,12,13,14 ConclusionBeing a care partner to a person with AD is often associated with emotional stress, depression, anxiety, low overall QoL as well as impact on physical health. Female care partners are disproportionally affected compared to males. The more severe the AD, the larger the burden. More research within the field is required to illuminate the true health consequences for care partners of people with AD.

Impact of Alzheimer's disease and related dementias on colorectal cancer screening utilization, knowledge, and associated health disparities.

Background: Colorectal cancer screening can detect colorectal cancer at an early stage and reduce mortality. None of the existing clinical practice guidelines provide specific recommendations for colorectal cancer screening in patients with Alzheimer’s disease and related dementias (ADRD). Limited studies have assessed the impacts of ADRD on colorectal cancer screening use and knowledge, and no studies have focused on the associated health disparities. Objectives: To examine the utilization, knowledge, and associated health disparities of colorectal cancer screening in older adults with ADRD. Methods: This study used the Medicare Current Beneficiary Survey from 2015 to 2018. Two types of colorectal cancer screening, including fecal occult blood test (FOBT) and colonoscopy/sigmoidoscopy, were measured. The colorectal cancer screening knowledge was evaluated by asking if the participants have heard of two screening methods and whether they knew Medicare pays for colorectal cancer screenings. Logistic regression models were used to examine the impact of ADRD diagnosis on the utilization and knowledge of colorectal cancer screening. Results: The overall colorectal cancer screening rate in older adults increased from 86.4% to 88.96% from 2015 to 2018. Patients with AD were 39% (OR: 0.61; 95% CI: 0.50–0.76) less likely and those with RD were 25% (OR: 0.75; 95% CI: 0.62–0.91) less likely to use any colorectal cancer screening when compared to older adults without ADRD. The rate of knowledge of colonoscopy/sigmoidoscopy remained high between 84.23% and 84.57% while the knowledge of FOBT increased from 64.32% to 78.69% during the study period. Compared to older adults without ADRD, those with AD were 77% (OR: 1.77; 95% CI: 1.12–2.81) more likely to hear of colonoscopy/sigmoidoscopy. The rate of knowledge of Medicare pay for colorectal cancer screening increased from 42.19% to 45.27% during the study period. Compared to older adults without ADRD, those with AD were 19% (OR: 0.81; 95% CI: 0.70–0.94) less likely to know that Medicare pays for colorectal cancer screening. Conclusion: ADRD was significantly associated with colorectal cancer screening utilization and knowledge. In addition, this study identified health disparities in race/ethnicity, gender, and urban/rural residence in colorectal cancer screening use and knowledge.

Drug Distribution in Brain and Cerebrospinal Fluids in Relation to IC50 Values in Aging and Alzheimer’s Disease, Using the Physiologically Based LeiCNS-PK3.0 Model

BackgroundVery little knowledge exists on the impact of Alzheimer’s disease on the CNS target site pharmacokinetics (PK).AimTo predict the CNS PK of cognitively healthy young and elderly and of Alzheimer’s patients using the physiologically based LeiCNS-PK3.0 model.MethodsLeiCNS-PK3.0 was used to predict the PK profiles in brain extracellular (brainECF) and intracellular (brainICF) fluids and cerebrospinal fluid of the subarachnoid space (CSFSAS) of donepezil, galantamine, memantine, rivastigmine, and semagacestat in young, elderly, and Alzheimer’s patients. The physiological parameters of LeiCNS-PK3.0 were adapted for aging and Alzheimer’s based on an extensive literature search. The CNS PK profiles at plateau for clinical dose regimens were related to in vitro IC50 values of acetylcholinesterase, butyrylcholinesterase, N-methyl-D-aspartate, or gamma-secretase.ResultsThe PK profiles of all drugs differed between the CNS compartments regarding plateau levels and fluctuation. BrainECF, brainICF and CSFSAS PK profile relationships were different between the drugs. Aging and Alzheimer’s had little to no impact on CNS PK. Rivastigmine acetylcholinesterase IC50 values were not reached. Semagacestat brain PK plateau levels were below the IC50 of gamma-secretase for half of the interdose interval, unlike CSFSAS PK profiles that were consistently above IC50.ConclusionThis study provides insights into the relations between CNS compartments PK profiles, including target sites. CSFSAS PK appears to be an unreliable predictor of brain PK. Also, despite extensive changes in blood-brain barrier and brain properties in Alzheimer’s, this study shows that the impact of aging and Alzheimer’s pathology on CNS distribution of the five drugs is insignificant.

CITED PAPERS ON ALZHEIMER DISEASE: A SCIENTOMETRIC ANALYSIS USING SCOPUS DATABASE

The impact of Alzheimer's disease on the population is signicant. Alzheimer's disease rose from the 25th most burdensome disease in the world. In order to identify depth and importance of the disease a scientometric study has been carried out. The study was carried out with the objective to examine the cited publications in Alzheimer's disease research and to examine the chronological growth of cited publications. The literature on Alzheimer's disease research data has been downloaded from 'Scopus', multidisciplinary online database, which is an international indexing and abstracting database, using the search term “Alzheimer's”. A total of 1,79,722 records have been identied during the period of 1970-2017 (48 years). The study was carried out with the objective to examine the cited publications in Alzheimer's disease research and to examine the chronological growth of cited publications. Further study identies the authorship pattern of cited publications. The data were analysed based on trend of Cited publications; Citation and type of access; Yearwise growth; Block yearwise; Authorship pattern and Document type of cited publications. Nearly 85.3% of publications were cited and only 14.7% of publications were uncited. The study reveals that the citation of articles gets study increase every year during the study period and seems to be in linear trend. Nine papers out of 10 papers get cited irrespective of document type except short survey.

The impact of Alzheimer's disease susceptibility loci on lateral ventricular surface morphology in older adults.

The enlargement of ventricular volume is a general trend in the elderly, especially in patients with Alzheimer's disease (AD). Multiple susceptibility loci have been reported to have an increased risk for AD and the morphology of brain structures are affected by the variations in the risk loci. Therefore, we hypothesized that genes contributed significantly to the ventricular surface, and the changes of ventricular surface were associated with the impairment of cognitive functions. After the quality controls (QC) and genotyping, a lateral ventricular segmentation method was employed to obtain the surface features of lateral ventricle. We evaluated the influence of 18 selected AD susceptibility loci on both volume and surface morphology across 410 subjects from Alzheimer's Disease Neuroimaging Initiative (ADNI). Correlations were conducted between radial distance (RD) and Montreal Cognitive Assessment (MoCA) subscales. Only the C allele at the rs744373 loci in BIN1 gene significantly accelerated the atrophy of lateral ventricle, including the anterior horn, body, and temporal horn of left lateral ventricle. No significant effect on lateral ventricle was found at other loci. Our results revealed that most regions of the bilateral ventricular surface were significantly negatively correlated with cognitive scores, particularly in delayed recall. Besides, small areas of surface were negatively correlated with language, orientation, and visuospatial scores. Together, our results indicated that the genetic variation affected the localized areas of lateral ventricular surface, and supported that lateral ventricle was an important brain structure associated with cognition in the elderly.

Amyloid Beta Dynamics in Biological Fluids-Therapeutic Impact.

Despite the significant impact of Alzheimer’s disease (AD) at individual and socioeconomic levels and the numerous research studies carried out on this topic over the last decades, the treatments available in daily clinical practice remain less than satisfactory. Among the accepted etiopathogenic hypotheses, the amyloidogenic pathway theory, although intensively studied and even sometimes controversial, is still providing relevant theoretical elements for understanding the etiology of AD and for the further development of possible therapeutic tools. In this sense, this review aims to offer new insights related to beta amyloid (Aβ), an essential biomarker in AD. First the structure and function of Aβ in normal and pathological conditions are presented in detail, followed by a discussion on the dynamics of Aβ at the level of different biological compartments. There is focus on Aβ elimination modalities at central nervous system (CNS) level, and clearance via the blood–brain barrier seems to play a crucial/dominant role. Finally, different theoretical and already-applied therapeutic approaches for CNS Aβ elimination are presented, including the recent “peripheral sink therapeutic strategy” and “cerebrospinal fluid sinks therapeutic strategy”. These data outline the need for a multidisciplinary approach designed to deliver a solution to stimulate Aβ clearance in more direct ways, including from the cerebrospinal fluid level.

A 10-Year Behavioral and Social Sciences Research Agenda for ADRD: Reflection on a New National Academies Report

The National Academies of Sciences, Engineering, and Medicine (NASEM) was charged with developing a ten-year agenda for research in the behavioral and social sciences that would substantially contribute to reducing the impact of Alzheimer’s disease and related dementias (AD/ADRD). The report, expected to be publicly released in June 2021, has been developed by a committee of individuals with expertise across a range of disciplines and fields, including dementia research. The committee was charged with assessing the role of the social and behavioral sciences in reducing the impact of dementia. The committee held several evidence-gathering sessions, reviewed published literature, commissioned several papers, and engaged individuals living with dementia and caregivers as a part of an Advisory Panel to the committee. This presentation will engage attendees in a discussion about the ten-year behavioral and social science research agenda related to dementia produced by this NASEM committee.

Impact of Alzheimer’s disease and related disorders neuropathology on neuropsychiatric symptoms during life

AbstractBackgroundThere is limited information on the impact of specific neuropathologies on neuropsychiatric symptoms (NPS). We evaluated the impact of neuropathologically defined subtypes of Alzheimer’s Disease and Related Dementias (ADRD) on neuropsychiatric symptoms (NPS) during life.MethodThe study design used a direct and unbiased approach that did not consider clinical diagnoses and included all brains with neuropathological diagnoses in the V.10 collection of the National Alzheimer’s Coordinating Center (NACC) database that also had Neuropsychiatric Interview‐Questionnaire (NPI‐Q) data collected during life. Data from 1,808 patients from 39 sites were examined. We utilized pairwise, ordinal and multiple logistic regression analyses to assess the effects of 8 neuropathological diagnoses on 12 domains in the Neuropsychiatric Inventory Questionnaire (NPI‐Q), correcting for multiple statistical comparisons. For NPS, average NPI‐Q domain scores during annual follow‐ups was the primary measure and NPI‐Q domain ever present/always absent was the secondary measure.ResultThe neuropathological diagnosis of Alzheimer’s disease (AD) using ABC criteria showed moderate associations with increased delusions, agitation/aggression and hallucinations. Cerebral amyloid angiopathy showed associations with NPS that were similar to AD. Lewy Body Disease (LBD) showed increased hallucinations. Infarcts/lacunes and microinfarcts showed weak associations with mood and motivational symptoms. Frontotemporal Dementia (FTD) was associated with marked increase in apathy and significantly decreased psychotic features and agitation. Hippocampal sclerosis was associated with less depression and increased apathy and disinhibition; these associations persisted after controlling for vascular neuropathology and FTD. In multiple regression analyses that controlled for other neuropathologies, the main findings were not altered.ConclusionThe associations of ADRD neuropathologies with specific NPS support current diagnostic criteria for behavioral symptoms in specific disorders. The findings on apathy and disinhibition in hippocampal sclerosis are novel and unique, and may explain inconsistent findings for depression treatment in dementia. Further investigation is needed to clarify the impact of hippocampal sclerosis on medial temporal lobe function and NPS, which may help eventually with diagnosis and clinical management.

Differential effects of risk factors on the cognitive trajectory of early- and late-onset Alzheimer\u2019s disease

BackgroundAlthough few studies have shown that risk factors for Alzheimer’s disease (AD) are associated with cognitive decline in AD, not much is known whether the impact of risk factors differs between early-onset AD (EOAD, symptom onset < 65 years of age) versus late-onset AD (LOAD). Therefore, we evaluated whether the impact of Alzheimer’s disease (AD) risk factors on cognitive trajectories differ in EOAD and LOAD.MethodsWe followed-up 193 EOAD and 476 LOAD patients without known autosomal dominant AD mutation for 32.3 ± 23.2 months. Mixed-effects model analyses were performed to evaluate the effects of APOE ε4, low education, hypertension, diabetes, dyslipidemia, and obesity on cognitive trajectories.ResultsAPOE ε4 carriers showed slower cognitive decline in general cognitive function, language, and memory domains than APOE ε4 carriers in EOAD but not in LOAD. Although patients with low education showed slower cognitive decline than patients with high education in both EOAD and LOAD, the effect was stronger in EOAD, specifically in frontal-executive function. Patients with hypertension showed faster cognitive decline than did patients without hypertension in frontal-executive and general cognitive function in LOAD but not in EOAD. Patients with obesity showed slower decline in general cognitive function than non-obese patients in EOAD but not in LOAD.ConclusionsKnown risk factors for AD were associated with slower cognitive decline in EOAD but rapid cognitive decline in LOAD.

Impact of Alzheimer's Dementia on Caregivers and Quality Improvement through Art and Music Therapy.

Dementia is a general term for a series of medical conditions that affect the brain and evolve progressively. According to the literature, there are over 200 subtypes and causes of dementia, with Alzheimer’s disease (AD) being the most common in elderly people. AD is an irreversible progressive neurodegenerative condition that leads to a decline in mental function, enough to disrupt daily life. Thinking skills slowly deteriorate, which, in advanced stages, makes it impossible to perform simple tasks. Besides the change in the quality of life of AD patients and their families, there is a considerable alteration in the quality of life of their caregivers, whose health can be negatively affected by the development of mental and somatic disorders. This article reviews the literature in order to reveal the benefits of applying non-pharmacological interventions such as music and art therapy to improve quality of life. This article also aims to shed light on the impact of this disease on the caregiver’s life. Music and art therapy have produced reliable results in the treatment of patients with AD, and the best effects are related to increased socialization and the maintenance of social status.

Exercise interventions for older adults with Alzheimer\u2019s disease: a systematic review and meta-analysis protocol

BackgroundThe growing societal and economic impact of Alzheimer’s disease (AD) is further compounded by the present lack of disease-modifying interventions. Non-pharmacological intervention approaches, such as exercise, have the potential to be powerful approaches to improve or mitigate the symptoms of AD without added side effects or financial burden associated with drug therapies. Various forms and regiments of exercise (i.e., strength, aerobic, multicomponent) have been reported in the literature; however, conflicting evidence obscures clear interpretation of the value and impact of exercise as an intervention for older adults with AD. The primary objective of this review will be to evaluate the effects of exercise interventions for older adults with AD. In addition, this review will evaluate the evidence quality and synthesize the exercise training prescriptions for proper clinical practice guidelines and recommendations.MethodsThis systematic review and meta-analysis will be carried out by an interdisciplinary collective representing clinical and research stakeholders with diverse expertise related to neurodegenerative diseases and rehabilitation medicine. Literature sources will include the following: Embase, PsychINFO, OVID Medline, and Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily. Inclusion criteria are participants with late onset AD and structured exercise interventions with prescribed duration, frequency, and intensity. The primary outcome of this study will center on improved or sustained cognitive functioning. Secondary outcomes will include institutionalization-related outcomes, ability in activities of daily living, mood and emotional well-being, quality of life, morbidity, and mortality. Analysis procedures to include measurement of bias, data synthesis, sensitivity analysis, and assessment of heterogeneity are described in this protocol.DiscussionThis review is anticipated to yield clinically meaningful insight on the specific value of exercise for older adults with AD. Improved understanding of diverse exercise intervention approaches and their specific impact on various health- and function-related outcomes is expected to guide clinicians to more frequently and accurately prescribe meaningful interventions for those affected by AD.Systematic review registrationPROSPERO CRD42020175016.

The Impact of Alzheimer’s Disease and Related Dementias on Dental Care Utilization and Costs in Older Adults

There is limited information on the impact of cognition function on dental care utilization and costs. This study used the Medicare current beneficiaries survey in 2016 and included 4,268 participants 65+. Dental care utilization and costs were measured by self-report and included preventive and treatment events. Negative binomial regression and generalized linear regression were used to examine the impact of Alzheimer’s disease (AD) and related dementia (RD) on dental care utilization and costs. We found that AD was not associated with dental care utilization, but RD was associated with a lower number of total treatment dental care visits (IRR: 0.60; 95% CI: 0.37~0.98). RD was not associated with dental care costs, but AD was associated with higher total dental care costs (estimate: 1.08; 95% CI: 0.14~2.01) and higher out-of-pocket costs (estimate: 1.25; 95% CI: 0.17~2.32). AD and RD had different impacts on different types of dental care utilization and costs. Part of a symposium sponsored by the Oral Health Interest Group.

Impact of Alzheimer's Disease and Related Dementia Diagnosis after Treatment for Bladder Cancer

Impact of Alzheimer's Disease and Related Dementia Diagnosis after Treatment for Bladder Cancer