Treatment Of Dementia Research Articles

Osteoporosis as a Potential Modifiable Risk Factor for Dementia in Thailand: A Cross-Sectional Analysis.

This study aims to explore the potential of osteoporosis as a modifiable risk factor for dementia and investigatewhether treatments like estrogen supplementation and bisphosphonates can reduce the risk of dementia in the Thai population. This study aimed to evaluate the risk of dementia in patients with osteoporosis. A cross-sectional analysis was conducted. Participants aged <50 years and those with a history of dementia at baseline were excluded. Clinical variables were analyzed using the chi-squared test. Logistic regression analysis was conducted to determine independent factors of dementia after adjusting for potential confounders. The cohort was conducted on 54,399 participants, of whom 9763 (17.9%) had osteoporosis. The results indicated that individuals with osteoporosis had an odds ratio (OR) of 1.62-fold higher risk of developing dementia compared to those without osteoporosis (95% confidence interval (CI) 1.37-1.92, p-value < 0.001). Furthermore, compared to patients with osteoporosis not undergoing any treatment, those receiving estrogen supplementation and bisphosphonate treatment showed reduced associations with dementia, with an OR of 0.84 (95% CI 0.73-0.98, p-value = 0.023) and 0.66 (95% CI 0.60-0.73, p-value < 0.001), respectively. The study findings suggest an elevated risk of dementia in patients with osteoporosis and contribute substantially to our understanding of the link between osteoporosis and dementia in the Thai population.

A Pilot Trial of CRESCENT in a Large Academic Healthcare System: A CaReEcoSystem Primary Care Embedded DemeNtia Treatment

ObjectiveThe prevalence of Alzheimer's Disease (AD) and related dementias is escalating, with substantial societal and economic impact. Existing dementia care is often inadequate due to underdiagnosis, delayed diagnosis, and insufficient resources, especially for caregivers. Behavioral symptoms of dementia further complicate care, contributing to negative outcomes. Collaborative care programs show promise, yet resource-intensive models can be challenging to scale. This study aimed to assess the feasibility of CRESCENT (CaReEcoSystem primary Care Embedded dementia Treatment), an adaptation of the CareEcosystem intervention, providing dementia care training to nurse care managers in a primary care setting. DesignEmbedded pilot cluster randomized controlled study. ParticipantsThe thirty nurse care managers enrolled in the trial had 393 patients with an ICD-10 diagnosis code consistent with dementia on their panels, 206 patients corresponding to the 15 intervention nurses and 187 patients corresponding to the 15 control nurses. MeasurementsPrimary outcome: Feasibility of capturing ED utilization using Medicare claims data and of implementing the intervention in a care management program. Secondary outcomes: ED use and change in caregiver distress (via survey) between baseline and 6-month follow-up using the Neuropsychiatric Inventory Questionnaire (NPI-Q) Distress scale. ResultsWe demonstrated the feasibility of collecting ED visit data through Medicare claims and of implementing the intervention in a busy care management program. In the 6-month follow-up, there were no changes in ED visits postintervention. A nonsignificant 2.7-point greater reduction in caregiver distress among caregivers of PWD in the intervention cohort was observed. ConclusionA dementia care coordination program can be integrated into a care management program. Future trials will explore the effectiveness of CRESCENT in a fully powered clinical trial, aiming to address the rising dementia epidemic and improve dementia-informed care in healthcare systems.

초기 치매 노인의 의사소통 파트너 참여형 가정 기반 인지-의사소통 중재 효과: 인지보존 능력과의 상관성을 중심으로

초기 치매 노인의 의사소통 파트너 참여형 가정 기반 인지-의사소통 중재 효과: 인지보존 능력과의 상관성을 중심으로

Relationship Between Physical Exercise and Cognitive Function Among Older Adults in China: Cross-Sectional Population-Based Study.

The existing literature reveals several significant knowledge gaps that hinder health care providers in formulating exercise prescriptions for cognitive health. This study endeavors to elucidate the relationship between the level of physical activity and cognitive function in older adults in China. Moreover, it seeks to explore the associations between distinct exercise behaviors-such as exercise types, the purpose motivating engagement in exercise, the accessibility of exercise fields, and the inclination toward exercise-and cognitive function. Using data from the China Longitudinal Aging Social Survey (CLASS conducted in 2016, cognitive function was meticulously assessed through the modified Chinese version of the Mini-Mental State Examination, encompassing measures of orientation, memory, and calculation. Using self-report structured questionnaires, a myriad of information about physical activity during leisure time, exercise engagement, exercise intensity, primary exercise types, reasons for exercise participation, availability of sports facilities, and exercise willingness was diligently gathered. Robust ordinary least squares regression models were then used to compute coefficients along with 95% CIs. A discernible inverted U-shaped trend in cognitive scores emerged as the level of physical activity surpassed the threshold of 500 metabolic equivalents of task (MET) minutes per week. Notably, individuals with a physical activity level between 500 and 999 MET minutes per week exhibited a coefficient of 0.31 (95% CI 0.09 to 0.54), those with a physical activity level between 1000 and 1499 MET minutes per week displayed a coefficient of 0.75 (95% CI 0.52 to 0.97), and those with a physical activity level above 1500 MET minutes per week demonstrated a coefficient of 0.45 (95% CI 0.23 to 0.68). Older individuals engaging in exercise at specific MET levels showcased superior cognitive function compared to their inactive counterparts. Furthermore, individuals driven by exercise motivations aimed at enhancing physical fitness and health, as well as those using sports facilities or public spaces for exercise, exhibited notably higher cognitive function scores. The findings underscore the potential of exercise as a targeted intervention for the prevention and treatment of dementia or cognitive decline associated with aging in older individuals. Leveraging these insights to formulate informed exercise recommendations holds promise in addressing a significant public health challenge linked to aging populations.

Alzheimer's Disease and Related Dementias in Muslim Women: Recommendations for Culturally Sensitive Care.

Alzheimer's disease and related dementias (ADRD) present significant challenges including cognitive and functional loss, behavioral disruption, emotional distress, and significant financial burden. These stressors are amplified in minority groups, who experience higher rates of ADRD but less frequent and later diagnosis. There is therefore a critical need to identify tangible approaches to culturally informed dementia assessment and care for patients from diverse communities. Muslim patients and particularly Muslim women are among the populations most understudied in the ADRD space. Muslim patients may hold unique religious, spiritual, and cultural beliefs and practices that can impact care-seeking for dementia symptoms, diagnostic accuracy, and treatment uptake. This paper outlines culturally informed approaches to assessing and treating Muslim women and families at each stage of ADRD care, though many recommendations extend to the broader Muslim community and others of diverse racial-ethnic backgrounds. We provide concrete suggestions for building rapport within and leveraging common family structures, respecting principles of modesty and privacy for all women including those who observe hijab or niqab, and communicating dementia diagnosis and care in the context of spiritual and ethical beliefs. While not intended as a comprehensive and prescriptive guide, this review provides important points of consideration and discussion with patients of Muslim backgrounds.

Antidepressant Effect of Vincamine, Melatonin and their Combination in Experimental Rat Models of Depression

Background: Depression, a form of mood illness, is characterized by a lack of or diminished social life, melancholy, and symptoms linked to an uplifted or depressed mood. Vincamine and Melatonin combination may prove beneficial for treating depression because vincamine and melatonin have already been reported in the treatment of dementia. Dementia is a CNS disorder which is connected to the level of neurotransmitters at the synaptic cleft, which is similar to depression that is why it might be effective in the treatment of depression. Aim: The aim of this research is to conduct an experimental study on the antidepressant activity of Vincamine alone and along with Melatonin and comparison with standard antidepressant drugs. Method: In this study, all animals are trained for the experiment, and then animals are divided into groups according to the treatment protocol. Animals were placed for the rest for 1 week. Vincamine and melatonin were administered to the treated groups on days 8 and 21 for the behavioral analysis using different kinds of models like elevated plus maze, forced swim test, open field test and sucrose preference test. Animals were sacrificed at day 22 for the estimation of biochemical (SOD) and neurotransmitters (Serotonin, Norepinephrine and Dopamine). Results: After extensive investigation, it has been established that Vincamine, alone and in combination with Melatonin, is beneficial in treating depression. Positive results are obtained. The group treated with Vincamine taken per oral route ((10 mg/kg), Melatonin (10 mg/kg), Vincamine + Melatonin (10 mg/kg + 10 mg/kg) and std (10 mg/kg) treatment showed significant result which are followed as for all groups (a) p &lt; 0.0001 vs NC; (b) p &lt; 0.0001 vs disease control; (c) p &lt; 0.05 vs Std (10 mg/kg); (d) p &lt; 0.001V vs M (10 mg/kg); (e) p &lt; 0.0090 vs V+M (10 mg/kg+10 mg/kg). It was demonstrated by a number of behavioral (elevated plus maze, forced swim test, open field test, and sucrose preference test) and biochemical parameters (estimation of neurotransmitters such as serotonin, epinephrine, and dopamine). Vincamine alone and in combination with Melatonin demonstrated positive results (p &lt; 0.0001) in the evaluation of the SOD antioxidant defence system. Also, it significantly attenuated the alteration in locomotor activity, oxidative stress and neurotransmitters in rat brain. result: After extensive investigation, it has been established that Vincamine, alone and in combination with Melatonin, is beneficial in treating depression. Positive results are obtained. The group treated with Vincamine taken per oral route ((10mg/kg), Melatonin (10mg/kg), Vincamine + Melatonin (10mg/kg + 10mg/kg) and std (10mg/kg) treatment showed significant result which are followed as for all groups (a) p &amp;amp;lt; 0.0001 vs NC; (b) p &lt; 0.0001 vs disease control; (c) p &lt; 0.05 vs Std (10 mg/kg); (d) p &lt; 0.001V vs M (10 mg/kg); (e) p &lt; 0.0090 vs V+M (10mg/kg+10mg/kg). It was demonstrated by a number of behavioral (elevated plus maze, forced swim test, open field test, and sucrose preference test) and biochemical parameters (estimation of neurotransmitters such as serotonin, epinephrine, and dopamine). Vincamine alone and in combination with Melatonin demonstrated positive results (p&lt;0.0001) in the evaluation of the SOD antioxidant defence system. Also, significantly attenuated the alteration in locomotor activity, oxidative stress and neurotransmitters in rat brain. Conclusion: It has been concluded that vincamine alone and along with melatonin is effective for the treatment of depression on the basis of behavioural and biochemical parameters. That’s why it might be useful for the future prospect.

Advancements in dementia research, diagnostics, and care in Latin America: Highlights from the 2023 Alzheimer's Association International conference satellite symposium in Mexico City.

While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. In 2023, the Alzheimer's Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. Significant initiatives in the region, including intracountry support, showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; researchers conducting emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care, and use affordable biomarkers in the region was highlighted. The myriad of topics discussed at the 2023 AAIC satellite symposium highlighted the growing research efforts in LatAm, providing valuable insights into dementia biology, genetics, epidemiology, treatment, and care.

Cardiovascular Disease and Dementia: Exploring Intersections, Risks, and Therapeutic Challenges.

This review examines the complex bidirectional relationship between cardiovascular disease and various dementia subtypes, including Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia. Traditional cardiovascular risk factors such as hypertension, coronary artery disease, arrhythmia, and diabetes mellitus are strongly linked to the development of dementia. Emerging evidence indicates that cognitive decline can exacerbate cardiovascular risks through heightened inflammatory responses and compromised autonomic regulation. Additionally, this review explores trials that investigate the impact of cardiovascular medications, such as antihypertensive and statin therapies, on cognitive outcomes, as well as studies examining how dementia treatments like anticholinesterases affect cardiovascular health. This review emphasizes the importance of early identification of at-risk individuals, integrated care approaches, and lifestyle interventions aimed at reducing both cardiovascular disease and dementia risk, ultimately aiming to enhance patient outcomes and quality of life.

Pretrained models for classification of dementia degree and treatment of Alzheimer’s disease

Pretrained models for classification of dementia degree and treatment of Alzheimer’s disease

Nonpharmacological intervention therapies for dementia: potential break-even intervention price and savings for selected risk factors in the European healthcare system

BackgroundNew effective treatments for dementia are lacking, and early prevention focusing on risk factors of dementia is important. Non-pharmacological intervention therapies aimed at these factors may provide a valuable tool for reducing the incidence of dementia. This study focused on the development of a mathematical model to predict the number of individuals with neurodegenerative diseases, specifically Alzheimer’s disease, Parkinson’s disease, vascular dementia, and amyotrophic lateral sclerosis. Scenarios for non-pharmacological intervention therapies based on risk factor reduction were also assessed. The estimated total costs and potential cost savings from societal were included.MethodsBased on demographic and financial data from the EU, a mathematical model was developed to predict the prevalence and resulting care costs of neurodegenerative diseases in the population. Each disease (Alzheimer’s disease, Parkinson’s disease, vascular dementia, and amyotrophic lateral sclerosis) used parameters that included prevalence, incidence, and death risk ratio, and the simulation is related to the age of the cohort and the disease stage.ResultsA replicable simulation for predicting the prevalence and resulting cost of care for neurodegenerative diseases in the population exhibited an increase in treatment costs from 267 billion EUR in 2021 to 528 billion EUR by 2050 in the EU alone. Scenarios related to the reduction of the prevalence of dementia by up to 20% per decade led to total discounted treatment cost savings of up to 558 billion EUR.ConclusionThe model indicates the magnitude of the financial burden placed on EU healthcare systems due to the growth in the population prevalence of neurodegenerative diseases in the coming decades. Lifestyle interventions based on reducing the most common risk factors could serve as a prevention strategy to reduce the incidence of dementia with substantial cost-savings potential. These findings could support the implementation of public health approaches throughout life to ultimately prevent premature mortality and promote a healthier and more active lifestyle in older individuals.

Exploring the Potential of Bioactive Compounds as Interventions for Dementia: Current Insights and Future Directions

Temp

Results from the open-label, single-center, clinical study assessing the efficacy and safety of a group cognitive stimulation therapy in Russian-speaking patients with the moderate dementia stage of Alzheimer's disease

Introduction. Cognitive stimulation therapy (CST) used worldwide to treat cognitive impairment has recently attracted interest of Russian medical and scientific minds. However, when applied to Russian-speaking patients with dementia, CST requires adaptation. Aim. To evaluate the effectiveness and safety of the Russian-language version of CST for Russian-speaking patients with Alzheimer’s disease at the stage of moderate dementia.Materials and мethods. 8 participants involved into the trial were residents of social care center ZILANT diagnosed as dementia patients with Alzheimer’s, aged 76 ± 10.8 years, with the median MMSE score identified 17 ± 5.0. Before implementing the main course of CST developed by E. Spector et al we translated and localized it for Russian patients. The patients undergoing CST were assessed for the state of cognitive functions, everyday activity, mental symptoms, as well as enjoyment and involvement. One of the recruited patients was excluded due to restlessness and anxiety.Results. Seven patients had significantly improved on ADAS-Cog scale (p = 0.002), Lowton&amp;Brody and ADCS-ADL. The NPI scale indicated a reduction in symptoms of delirium and apathy which contributed to a reduction in antipsychotic dosages and a corresponding decrease in caregiver’s distress. The most striking indicator of CST effectiveness was improvements in the patient’s mood and satisfaction, which we view significant in everyday life and as an indicator of CST safety.Conclusion. The Russian-language version of CST proved effective and safe for moderate dementia patients with Alzheimer’s and can be recommended for implementing in clinical practice. This opens up prospects for studying CST as part of various drug strategies in treatment of dementia of various origins.

Trends of use and characterisation of anti-dementia drugs users: a large multinational-network population-based study.

An updated time-trend analysis of anti-dementia drugs (ADDs) is lacking. The aim of this study is to assess the incident rate (IR) of ADD in individuals with dementia using real-world data. Primary care data (country/database) from the UK/CPRD-GOLD (2007-20), Spain/SIDIAP (2010-20) and the Netherlands/IPCI (2008-20), standardised to a common data model. Cohort study. Participants: dementia patients ≥40years old with ≥1year of previous data. Follow-up: until the end of the study period, transfer out of the catchment area, death or incident prescription of rivastigmine, galantamine, donepezil or memantine. Other variables: age/sex, type of dementia, comorbidities. Statistics: overall and yearly age/sex IR, with 95% confidence interval, per 100,000 person-years (IR per 105 PY (95%CI)). We identified a total of (incident anti-dementia users/dementia patients) 41,024/110,642 in UK/CPRD-GOLD, 51,667/134,927 in Spain/SIDIAP and 2,088/17,559 in the Netherlands/IPCI.In the UK, IR (per 105 PY (95%CI)) of ADD decreased from 2007 (30,829 (28,891-32,862)) to 2010 (17,793 (17,083-18,524)), then increased up to 2019 (31,601 (30,483 to 32,749)) and decrease in 2020 (24,067 (23,021-25,148)). In Spain, IR (per 105 PY (95%CI)) of ADD decreased by 72% from 2010 (51,003 (49,199-52,855)) to 2020 (14,571 (14,109-15,043)). In the Netherlands, IR (per 105 PY (95%CI)) of ADD decreased by 77% from 2009 (21,151 (14,967-29,031)) to 2020 (4763 (4176-5409)). Subjects aged ≥65-79years and men (in the UK and the Netherlands) initiated more frequently an ADD. Treatment of dementia remains highly heterogeneous. Further consensus in the pharmacological management of patients living with dementia is urgently needed.

Association of Dietary and Supplement Intake of Antioxidants with Risk of Dementia: A Meta-Analysis of Cohort Studies.

Dementia is a neuropsychiatric disorder with cognitive decline due to multiple factors. With the arrival of the aging population, the incidence of dementia has gradually increased. There is still no effective treatment for dementia, and therefore, the prevention of dementia has become crucial. Oxidative stress is considered to be one of the pathogenesis of dementia; therefore, antioxidant therapy and prevention of dementia have been gradually proposed. Our meta-analysis aimed to investigate the association of antioxidants with risk of dementia. We searched PubMed, Embase, and Web of Science databases for articles on antioxidants associated with dementia risk, and those containing cohort studies with high-dose versus low-dose controls were included in our meta-analysis. The resulting risk ratios (RR) and hazard ratios (HR) and 95% confidence intervals were statistically analyzed using Stata12.0 free software. A total of 17 articles were included in this meta-analysis. Of 98,264 participants, 7,425 had dementia after 3-23 years of follow-up. The results of the meta-analysis showed a trend towards a lower incidence of dementia with high intake of antioxidants (RR = 0.84, 95% CI 0.77-1.19 I2 = 54.6%), but this was not statistically significant. High antioxidant intake significantly reduced the incidence of Alzheimer 's disease (RR = 0.85, 95% CI 0.79-0.92 I2 = 45.5%), and we additionally carried out subgroup analyses by nutrient type, diet or supplement, region, and study quality score. Dietary intake of antioxidants or supplements reduces both the risk of dementia and the risk of Alzheimer's disease.

Selection and Progress of drugs for treating Dementia

Dementia is a major health problem among the elderly around the world; the number of dementia patients, as well as antidementia drugs, has been increasing in recent years. In this paper, we searched the dementia treatment guidelines, domestic and foreign literature reports in the past five years, summarized the classification of dementia, the selection of current pharmacotherapies in dementia, evidence-based evaluation of guidelines and some drugs with clinical treatment prospects to provide a reference for the decision-making of dementia drug therapy.

γ-Oryzanol from Rice Bran Antagonizes Glutamate-Induced Excitotoxicity in an In Vitro Model of Differentiated HT-22 Cells.

The excessive activation of glutamate in the brain is a factor in the development of vascular dementia. γ-Oryzanol is a natural compound that has been shown to enhance brain function, but more research is needed to determine its potential as a treatment for vascular dementia. This study investigated if γ-oryzanol can delay or improve glutamate neurotoxicity in an in vitro model of differentiated HT-22 cells and explored its neuroprotective mechanisms. The differentiated HT-22 cells were treated with 0.1 mmol/L glutamate for 24 h then given γ-oryzanol at appropriate concentrations or memantine (10 µmol/L) for another 24 h. Glutamate produced reactive oxygen species and depleted glutathione in the cells, which reduced their viability. Mitochondrial dysfunction was also observed, including the inhibition of mitochondrial respiratory chain complex I activity, the collapse of mitochondrial transmembrane potential, and the reduction of intracellular ATP levels in the HT-22 cells. Calcium influx triggered by glutamate subsequently activated type II calcium/calmodulin-dependent protein kinase (CaMKII) in the HT-22 cells. The activation of CaMKII-ASK1-JNK MAP kinase cascade, decreased Bcl-2/Bax ratio, and increased Apaf-1-dependent caspase-9 activation were also observed due to glutamate induction, which were associated with increased DNA fragmentation. These events were attenuated when the cells were treated with γ-oryzanol (0.4 mmol/L) or the N-methyl-D-aspartate receptor antagonist memantine. The results suggest that γ-oryzanol has potent neuroprotective properties against glutamate excitotoxicity in differentiated HT-22 cells. Therefore, γ-oryzanol could be a promising candidate for the development of therapies for glutamate excitotoxicity-associated neurodegenerative diseases, including vascular dementia.

A dynamic computational model of the parallel circuit on the basal ganglia-cortex associated with Parkinson's disease dementia.

The cognitive impairment will gradually appear over time in Parkinson's patients, which is closely related to the basal ganglia-cortex network. This network contains two parallel circuits mediated by putamen and caudate nucleus, respectively. Based on the biophysical mean-field model, we construct a dynamic computational model of the parallel circuit in the basal ganglia-cortex network associated with Parkinson's disease dementia. The simulated results show that the decrease of power ratio in the prefrontal cortex is mainly caused by dopamine depletion in the caudate nucleus and is less related to that in the putamen, which indicates Parkinson's disease dementia may be caused by a lesion of the caudate nucleus rather than putamen. Furthermore, the underlying dynamic mechanism behind the decrease of power ratio is investigated by bifurcation analysis, which demonstrates that the decrease of power ratio is due to the change of brain discharge pattern from the limit cycle mode to the point attractor mode. More importantly, the spatiotemporal course of dopamine depletion in Parkinson's disease patients is well simulated, which states that with the loss of dopaminergic neurons projecting to the striatum, motor dysfunction of Parkinson's disease is first observed, whereas cognitive impairment occurs after a period of onset of motor dysfunction. These results are helpful to understand the pathogenesis of cognitive impairment and provide insights into the treatment of Parkinson's disease dementia.

Rethinking interventions for dementia through a nonpharmaceutical lens: An analysis of five interventions

ABSTRACT The future welfare of older adults is a worldwide concern. By 2034, it is estimated that individuals 65 and older in the U.S. will be 77 million. Consequently, this reality will impact healthcare facilities and increase Medicare and Medicaid costs, resulting in higher incidents of homeless older adults, children caring for parents, the need for more caregivers, and an increased number of older individuals experiencing various forms of dementia. To address these concerns, the current trend for treating the onset of dementia and Alzheimer’s disease has been moving toward nonpharmaceutical interventions. Even though researchers have tapped into the benefits of several nonpharmaceutical treatments, there appears to be a constant debate on establishing which method is most effective. Deciding on best practices and methods to slow down and/or halt the progression of dementia is the gap this research needs to fill. To provide clarity on the topic, an analysis of alternative interventions to treat the onset of dementia is what this paper strived to achieve. The analysis involved comparing and contrasting the benefits of each intervention as well as illustrating the implications of the findings. In this regard, a systematic review was conducted examining the benefits of five nonpharmaceutical strategies; mental training, music therapy, technology usage, physical activity, and social interaction. Although findings revealed some form of improvement in each of the nonpharmacological interventions examined, the overarching theme appeared to lean toward providing mental stimulation. It was also not conclusive that physical activity prevented cognitive decline. More research is recommended.

Effectiveness of Non-Pharmacological Interventions for Dementia among the Elderly: A Randomized Controlled Trial.

(1) Background: Up until now, there is still no medicine that can cure dementia, but there are some that can only help slow down the progression of the disease and reduce some symptoms. Pharmacological interventions for dementia have many side effects and are expensive, so non-pharmacological treatments for dementia become more urgent. This study aimed to evaluate the effectiveness of multifactorial non-pharmacological interventions in dementia patients; (2) Methods: This is a randomized controlled trial conducted in Hai Duong from July 2021 to December 2022. Selected subjects included 88 patients diagnosed with very mild, mild, and moderate dementia, of whom 44 patients were assigned to the intervention group and 44 patients to the control group; (3) Results: For the effectiveness of the non-pharmacological multifactorial intervention on depression severity: in the intervention group, the GDS 15 depression score decreased from 4.8 to 2.9, while, in the control group, the GDS 15 depression score increased by 1.3 points after six months of no intervention. For the effect of the non-pharmacological multifactorial intervention on the level of sleep disturbance, in the intervention group, the PSQI sleep disturbance score decreased by nearly half (from 10.2 to 5.6), while, in the control group, this trend was not clear. For the effect of the non-pharmacological multifactorial intervention on daily functioning: in the intervention group, the ADL and IADL scores improved (1.02 ± 1.32 and 1.23 ± 1.75), while, in the control group, the ADL and IADL scores decreased (0.93 ± 1.2 and 0.98 ± 2.19). For the effect of the non-pharmacological multifactorial intervention on quality of life: in the intervention group, the EQ-5D-5L scores improved (0.17 ± 0.19), while, in the control group, the EQ-5D-5L scores decreased (0.20 ± 0.30); (4) Conclusions: Non-pharmacological multifactorial interventions, including physical activity, cognitive training, listening to educational lectures, and organizing miniature social models, have been shown to improve mental health, self-control, and quality of life.

Association of Tumor Necrosis Factor-α Inhibitors with Incident Dementia: Analysis Based on Population-Based Cohort Studies.

Preliminary evidence suggests a possible preventive effect of tumor necrosis factor-α inhibitors (TNFi) on incident dementia. The objective of the analysis was to investigate the association between TNFi and the risk of incident dementia in a population undergoing treatment for rheumatological disorders. We followed patients aged ≥ 65years with dementia and rheumatological conditions in two cohort studies, DANBIO (N = 21,538), a Danish clinical database, and AOK PLUS (N = 7112), a German health insurance database. We defined incident dementia using diagnostic codes and/or medication use and used Cox regression to compare the associations of TNFi with other rheumatological therapies on the risk of dementia. To ensure that the patients were receiving long-term medication, we included patients with rheumatic diseases and systemic therapies. We observed similar trends towards a lower risk of dementia associated with TNFi versus other anti-inflammatory agents in both cohorts (hazard ratios were 0.92 [95% confidence interval 0.76, 1.10] in DANBIO and 0.89 [95% confidence interval 0.63, 1.24] in AOK PLUS, respectively). Tumor necrosis factor-α inhibitors may decrease the risk of incident dementia although the association did not reach statistical significance in this analysis. Further research, ideally with randomization, is needed to gauge the potential of repurposing TNFi for dementia prevention and/or treatment.