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01/2022 journal articles

DEMENTIA PREVENTION: A GLOBAL CHALLENGE IN URGENT NEED OF SOLUTIONS

G. Price, C. Udeh-Momoh, M. Kivipelto, L.T. Middleton

J Prev Alz Dis 2022;1(9):1-2

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CITATION:
G. Price ; C. Udeh-Momoh ; M. Kivipelto ; L.T. Middleton ; (2022): Dementia Prevention: A Global Challenge in Urgent Need of Solutions. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.10

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MECHANISMS UNDERLYING NON-PHARMACOLOGICAL DEMENTIA PREVENTION STRATEGIES: A TRANSLATIONAL PERSPECTIVE

V. Alanko, C. Udeh-Momoh, M. Kivipelto, A. Sandebring-Matton

J Prev Alz Dis 2022;1(9):3-11

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Since developing an effective treatment for Alzheimer’s disease (AD) has been encountered as a challenging task, attempts to prevent cognitive decline by lifestyle modifications have become increasingly appealing. Physical exercise, healthy diet, and cognitive training are all modifiable, non-pharmacological lifestyle factors considered to influence cognitive health. Implementing lifestyle modifications on animal models of AD and cognitive impairment may reveal underlying mechanisms of action by which healthy lifestyle contribute to brain health. In mice, different types of lifestyle interventions have been shown to improve cognitive abilities, alleviate AD-related pathology and neuroinflammation, restore mitochondrial function, and have a positive impact on neurogenesis and cell survival. Different proteins and pathways have been identified to mediate some of the responses, amongst them BDNF, Akt–GSK3β, JNK, and ROCK pathway. Although some important pathways have been identified as mediating improvements in brain health, more research is needed to confirm these mechanisms of action and to improve the understanding of their interplay. Moreover, multidomain lifestyle interventions targeting multiple risk factors simultaneously may be a promising avenue in future dementia prevention strategies. Therefore, future work is needed to better understand the synergistic impact of combinatory lifestyle strategies on cellular mechanisms and brain health.

CITATION:
V. Alanko ; C. Udeh-Momoh ; M. Kivipelto ; A. Sandebring-Matton ; (2022): Mechanisms Underlying Non-Pharmacological Dementia Prevention Strategies: A Translational Perspective. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.9

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BLOOD DERIVED AMYLOID BIOMARKERS FOR ALZHEIMER’S DISEASE PREVENTION

C. Udeh-Momoh, B. Zheng, A. Sandebring-Matton, G. Novak, M. Kivipelto, L. Jönsson, L. Middleton

J Prev Alz Dis 2022;1(9):12-21

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Background: Reliable, widely accessible and affordable biomarkers for predicting Alzheimer’s disease (AD) brain pathology status are a necessity to aid development of prevention strategies in cognitively healthy at-risk older adults, at the right timepoint. Measurements of the key neuropathological hallmark beta-amyloid (Aβ) by PET neuroimaging or cerebrospinal fluid measures reflect its accumulation in the brain, yet recent methodological advancements now enable blood-based measures reflecting cerebral amyloid burden. Objectives: The current study validated the capacity of plasma Aβ42/Aβ40 measured using six different assays to predict amyloid positivity in a subgroup of cognitively unimpaired (CU) participants in the ADNI study and assessed its ability to discriminate CU from AD cases. We also explored economic viability of using two different plasma amyloid assays for pre-screening in AD prevention trials and as routine clinical diagnostic tool, versus amyloid PET alone. Design: A cross-sectional analysis of plasma and brain amyloid data, including comparative cost analysis of the plasma biomarkers in relation to brain amyloid PET. Setting: Alzheimer’s Disease Neuroimaging Initiative (ADNI). Participants: ADNI participants consisting of 115 CU, mild cognitive impairment and AD cases who had plasma Aβ42/Aβ40 measured with six platforms. Measurements: Plasma Aβ42/Aβ40 was measured via six different platforms: three immunoassays (Roche, Quanterix and ADx Neurosciences) and three mass spectrometry (MS) based assays (WashU, Shimadzu and Gothenburg). Aβ-PET imaging was conducted within three months of plasma sampling using [18F]florbetapir. Results: There was a weak to moderate correlation of plasma Aβ42/Aβ40 ratio between platforms. The MS-based WashU test had the highest capacity to discriminate between CU and AD (area under the curve, AUC = 0.734, 95% CI: 0.613-0.854; P = 0.008). Within the CU group, the WashU plasma amyloid test had the best discriminative capacity to distinguish Aβ+ from Aβ– (AUC = 0.753, 95% CI: 0.601-0.905; P = 0.003) closely followed by the immunoassay from Roche (AUC = 0.737, 95% CI: 0.597-0.877; P = 0.006). The exploratory economic analyses showed that the use of Roche or WashU plasma amyloid assay as a pre-screening tool prior to Aβ-PET scans for clinical trial recruitment significantly reduced total screening cost (saving up to $5882 per recruited patient) expected in an AD prevention trial. Conclusions: With few available treatment strategies, dementia prevention is a global priority. CU individuals at risk for AD are the target population for dementia prevention but have been poorly studied. Our findings confirming diagnostic value of ultrasensitive immunoassays and high-performance immunoprecipitation coupled with MS for measurement of plasma Aβ42/Aβ40 to detect PET amyloid positivity in CU participants allude to potential clinical utility of this biomarker. Plasma Aβ42/Aβ40 could be optimal for pre-selecting at-risk candidates for more invasive and expensive investigations across AD prevention clinical trials and clinical care for a rapidly ageing population.

CITATION:
C. Udeh-Momoh ; B. Zheng ; A. Sandebring-Matton ; G. Novak ; M. Kivipelto ; L. Jönsson ; L. Middleton ; for the Alzheimer’s Disease Neuroimaging Initiative ; (2021): Blood Derived Amyloid Biomarkers for Alzheimer’s Disease Prevention. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.70

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SENOLYTIC THERAPY TO MODULATE THE PROGRESSION OF ALZHEIMER’S DISEASE (STOMP-AD): A PILOT CLINICAL TRIAL

M.M. Gonzale, V.R. Garbarino, E. Marques Zilli, R.C. Petersen2, J.L. Kirkland, T. Tchkonia, N. Musi, S. Seshadri, S. Craft, M.E. Orr

J Prev Alz Dis 2022;1(9):22-29

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Preclinical studies indicate an age-associated accumulation of senescent cells across multiple organ systems. Emerging evidence suggests that tau protein accumulation, which closely correlates with cognitive decline in Alzheimer’s disease and other tauopathies, drives cellular senescence in the brain. Pharmacologically clearing senescent cells in mouse models of tauopathy reduced brain pathogenesis. Compared to vehicle treated mice, intermittent senolytic administration reduced tau accumulation and neuroinflammation, preserved neuronal and synaptic density, restored aberrant cerebral blood flow, and reduced ventricular enlargement. Intermittent dosing of the senolytics, dasatinib plus quercetin, has shown an acceptable safety profile in clinical studies for other senescence-associated conditions. With these data, we proposed and herein describe the objectives and methods for a clinical vanguard study. This initial open-label clinical trial pilots an intermittent senolytic combination therapy of dasatinib plus quercetin in five older adults with early-stage Alzheimer’s disease. The primary objective is to evaluate the central nervous system penetration of dasatinib and quercetin through analysis of cerebrospinal fluid collected at baseline and after 12 weeks of treatment. Further, through a series of secondary outcome measures to assess target engagement of the senolytic compounds and Alzheimer’s disease-relevant cognitive, functional, and physical outcomes, we will collect preliminary data on safety, feasibility, and efficacy. The results of this study will be used to inform the development of a randomized, double-blind, placebo-controlled multicenter phase II trial to further explore of the safety, feasibility, and efficacy of senolytics for modulating the progression of Alzheimer’s disease. Clinicaltrials.gov registration number and date: NCT04063124 (08/21/2019)

CITATION:
M.M. Gonzales ; V.R. Garbarino ; E. Marques Zilli ; R.C. Petersen ; J.L. Kirkland ; T. Tchkonia ; N. Musi ; S. Seshadri ; S. Craft ; M.E. Orr ; (2021): Senolytic Therapy to Modulate the Progression of Alzheimer’s Disease (SToMP-AD): A Pilot Clinical Trial. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.62

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MULTIMODAL PREVENTIVE TRIAL FOR ALZHEIMER’S DISEASE: MIND-ADMINI PILOT TRIAL STUDY DESIGN AND PROGRESS

S. Sindi, C. Thunborg, A. Rosenberg, P. Andersen, S. Andrieu, L.M. Broersen, N. Coley, C. Couderc, C.Z. Duval, G. Faxen-Irving, G. Hagman, M. Hallikainen, K. Håkansson, J. Lehtisalo, N. Levak, F. Mangialasche, J. Pantel, E. Kekkonen, A. Rydström, A. Stigsdotter-Neely, A. Wimo, T. Ngandu, H. Soininen, T. Hartmann, A. Solomon, M. Kivipelto

J Prev Alz Dis 2022;1(9):30-39

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Background: Interventions simultaneously targeting multiple risk factors and mechanisms are most likely to be effective in preventing cognitive impairment. This was indicated in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) testing a multidomain lifestyle intervention among at-risk individuals. The importance of medical food at the early symptomatic disease stage, prodromal Alzheimer’s disease (AD), was emphasized in the LipiDiDiet trial. The feasibility and effects of multimodal interventions in prodromal AD are unclear. Objectives: To evaluate the feasibility of an adapted FINGER-based multimodal lifestyle intervention, with or without medical food, among individuals with prodromal AD. Methods: MIND-ADmini is a multinational proof-of-concept 6-month randomized controlled trial (RCT), with four trial sites (Sweden, Finland, Germany, France). The trial targeted individuals with prodromal AD defined using the International Working Group-1 criteria, and with vascular or lifestyle-related risk factors. The parallel-group RCT includes three arms: 1) multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management and social stimulation); 2) multimodal lifestyle intervention+medical food (Fortasyn Connect); and 3) regular health advice/care (control group). Primary outcomes are feasibility and adherence. Secondary outcomes are adherence to the individual intervention domains and healthy lifestyle changes. Results: Screening began on 28 September 2017 and was completed on 21 May 2019. Altogether 93 participants were randomized and enrolled. The intervention proceeded as planned. Conclusions: For the first time, this pilot trial tests the feasibility and adherence to a multimodal lifestyle intervention, alone or combined with medical food, among individuals with prodromal AD. It can serve as a model for combination therapy trials (non-pharma, nutrition-based and/or pharmacological interventions).

CITATION:
S. Sindi ; C. Thunborg ; A. Rosenberg ; P. Andersen ; S. Andrieu ; L.M. Broersen ; N. Coley ; C. Couderc ; C.Z. Duval ; G. Faxen-Irving ; G. Hagman ; M. Hallikainen ; K. Håkansson ; J. Lehtisalo ; N. Levak ; F. Mangialasche ; J. Pantel ; E. Kekkonen ; A. Rydström ; A. Stigsdotter-Neely ; A. Wimo ; T. Ngandu ; H. Soininen ; T. Hartmann ; A. Solomon ; M. Kivipelto ; ; (2022): Multimodal Preventive Trial for Alzheimer’s Disease: MIND-ADmini Pilot Trial Study Design and Progress. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.4

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THE SINGAPORE GERIATRIC INTERVENTION STUDY TO REDUCE COGNITIVE DECLINE AND PHYSICAL FRAILTY (SINGER): STUDY DESIGN AND PROTOCOL

X. Xu, K.A. Chew, Z.X. Wong, A.K.S. Phua, E.J.Y. Chong, C.K.L. Teo, N. Sathe, Y.C. Chooi, W.P.F. Chia, C.J. Henry, E. Chew, M. Wang, A.B. Maier, N. Kandiah, C.L.-H. Chen

J Prev Alz Dis 2022;1(9):40-48

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Background: The SINgapore GERiatric intervention study to reduce cognitive decline and physical frailty (SINGER) randomised controlled trial (RCT) uses a multidomain lifestyle interventions approach, shown to be effective by the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial, to delay cognitive decline. Objective: To investigate the efficacy and safety of the SINGER multidomain lifestyle interventions in older adults at risk for dementia to delay cognitive decline. Participants: 1200 participants between 60-77 years old, with Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score ≥6, fulfilling at least one of the following LIBRA index for diet, cognitive activity, physical activity and a Montreal Cognitive Assessment (MoCA) score ≥18, ≤27 points, will be recruited across Singapore. Methods: SINGER is a 2-year multi-site RCT consisting of multidomain interventions: dietary advice, exercise, cognitive training, and vascular risk factors management. Participants will be randomised into either the Self-Guided Intervention (SGI; general lifestyle and health information and resources) or Structured Lifestyle Intervention (SLI) group. The SLI comprises diet training (6 group and 3 individual sessions over 12 months); exercise (supervised: 1-hour twice weekly for 6 months, unsupervised: 2-3/week for the rest of the study duration); cognitive sessions (15-30 minutes/session, 3/week for 6 months, together with 10 workshops in 24 months). Vascular management takes place every 3-6 months or otherwise as specified by study physicians. The primary outcome is global cognition measured using the modified Neuropsychological Battery assessing performance in various domains, such as episodic memory, executive function and processing speed. Secondary outcome measures include: domain-specific cognition and function, imaging evidence of brain and retinal changes, incidence and progression of chronic diseases, blood biomarkers, quality of life, mental health and cost-benefit analysis. Conclusions: SINGER is part of the Worldwide-FINGERS international network, which is at the forefront of harmonizing approaches to effective non-pharmacological interventions in delaying cognitive decline in older adults at risk of dementia. By establishing the efficacy of multidomain interventions in preventing cognitive decline, SINGER aims to implement the findings into public health and clinical practices by informing policy makers, and guiding the design of community- and individual-level health promotion initiatives.

CITATION:
X. Xu ; K.A. Chew ; Z.X. Wong ; A.K.S. Phua ; E.J.Y. Chong ; C.K.L. Teo ; N. Sathe ; Y.C. Chooi ; W.P.F. Chia ; C.J. Henry ; E. Chew ; M. Wang ; A.B. Maier ; N. Kandiah ; C.L.-H. Chen ; (2022): The SINgapore GERiatric Intervention Study to Reduce Cognitive Decline and Physical Frailty (SINGER): Study Design and Protocol. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.5

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EVIDENCE-BASED TOOLS FOR DIETARY ASSESSMENTS IN NUTRITION EPIDEMIOLOGY STUDIES FOR DEMENTIA PREVENTION

K.A. Abbott, J.M. Posma, I. Garcia-Perez, C. Udeh-Momoh, S. Ahmadi-Abhari, L. Middleton, G. Frost

J Prev Alz Dis 2022;1(9):49-53

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Increasing evidence proposes diet as a notable modifiable factor and viable target for the reduction of Alzheimer’s Disease risk and age-related cognitive decline. However, assessment of dietary exposures is challenged by dietary capture methods that are prone to misreporting and measurement errors. The utility of -omics technologies for the evaluation of dietary exposures has the potential to improve reliability and offer new insights to pre-disease indicators and preventive targets in cognitive aging and dementia. In this review, we present a focused overview of metabolomics as a validation tool and framework for investigating the immediate or cumulative effects of diet on cognitive health.

CITATION:
K.A. Abbott ; J.M. Posma ; I. Garcia-Perez ; C. Udeh-Momoh ; S. Ahmadi-Abhari ; L. Middleton ; G. Frost ; (2022): Evidence-Based Tools for Dietary Assessments in Nutrition Epidemiology Studies for Dementia Prevention. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.6

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KETONE ESTER EFFECTS ON BIOMARKERS OF BRAIN METABOLISM AND COGNITIVE PERFORMANCE IN COGNITIVELY INTACT ADULTS ≥ 55 YEARS OLD. A STUDY PROTOCOL FOR A DOUBLEBLINDED RANDOMIZED CONTROLLED CLINICAL TRIAL

K.I. Avgerinos, R.J. Mullins, J.M. Egan, D. Kapogiannis

J Prev Alz Dis 2022;1(9):54-66

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BACKGROUND: Ketone bodies have been proposed as an “energy rescue” for the Alzheimer’s disease (AD) brain, which underutilizes glucose. Prior research has shown that oral ketone monoester (KME) safely induces robust ketosis in humans and has demonstrated cognitive-enhancing and pathology-reducing properties in animal models of AD. However, human evidence that KME may enhance brain ketone metabolism, improve cognitive performance and engage AD pathogenic cascades is scarce. Objectives: To investigate the effects of ketone monoester (KME) on brain metabolism, cognitive performance and AD pathogenic cascades in cognitively normal older adults with metabolic syndrome and therefore at higher risk for AD. Design: Double-blinded randomized placebo-controlled clinical trial. Setting: Clinical Unit of the National Institute on Aging, Baltimore, US. Participants: Fifty cognitively intact adults ≥ 55 years old, with metabolic syndrome. Intervention: Drinks containing 25 g of KME or isocaloric placebo consumed three times daily for 28 days. Outcomes: Primary: concentration of beta-hydroxybutyrate (BHB) in precuneus measured with Magnetic Resonance Spectroscopy (MRS). Exploratory: plasma and urine BHB, multiple brain and muscle metabolites detected with MRS, cognition assessed with the PACC and NIH toolbox, biomarkers of AD and metabolic mediators in plasma extracellular vesicles, and stool microbiome. Discussion: This is the first study to investigate the AD-biomarker and cognitive effects of KME in humans. Ketone monoester is safe, tolerable, induces robust ketosis, and animal studies indicate that it can modify AD pathology. By conducting a study of KME in a population at risk for AD, we hope to bridge the existing gap between pre-clinical evidence and the potential for brain-metabolic, pro-cognitive, and anti-Alzheimer’s effects in humans.

CITATION:
K.I. Avgerinos ; R.J. Mullins ; J.M. Egan ; D. Kapogiannis ; (2022): Ketone Ester Effects on Biomarkers of Brain Metabolism and Cognitive Performance in Cognitively Intact Adults ≥ 55 Years Old. A Study Protocol for a Double-Blinded Randomized Controlled Clinical Trial. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.3

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AT A GLANCE: AN UPDATE ON NEUROIMAGING AND RETINAL IMAGING IN ALZHEIMER’S DISEASE AND RELATED RESEARCH

J. Ford, D. Kafetsouli, H. Wilson, C. Udeh-Momoh, M. Politis, S. AhmadiAbhari, I. Rabiner, L.T. Middleton

J Prev Alz Dis 2022;1(9):67-76

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Neuroimaging serves a variety of purposes in Alzheimer’s disease (AD) and related dementias (ADRD) research - from measuring microscale neural activity at the subcellular level, to broad topological patterns seen across macroscale-brain networks, and everything in between. In vivo imaging provides insight into the brain’s structure, function, and molecular architecture across numerous scales of resolution; allowing examination of the morphological, functional, and pathological changes that occurs in patients across different AD stages (1). AD is a complex and potentially heterogenous disease, with no proven cure and no single risk factor to isolate and measure, whilst known risk factors do not fully account for the risk of developing this disease (2). Since the 1990’s, technological advancements in neuroimaging have allowed us to visualise the wide organisational structure of the brain (3) and later developments led to capturing information of brain ‘functionality’, as well as the visualisation and measurement of the aggregation and accumulation of AD-related pathology. Thus, in vivo brain imaging has and will continue to be an instrumental tool in clinical research, mainly in the pre-clinical disease stages, aimed at elucidating the biological complex processes and interactions underpinning the onset and progression of cognitive decline and dementia. The growing societal burden of AD/ADRD means that there has never been a greater need, nor a better time, to use such powerful and sensitive tools to aid our understanding of this undoubtedly complex disease. It is by consolidating and reflecting on these imaging advancements and developing long-term strategies across different disciplines, that we can move closer to our goal of dementia prevention. This short commentary will outline recent developments in neuroimaging in the field of AD and dementia by first describing the historical context of AD classification and the introduction of AD imaging biomarkers, followed by some examples of significant recent developments in neuroimaging methods and technologies.

CITATION:
J. Ford ; D. Kafetsouli ; H. Wilson ; C. Udeh-Momoh ; M. Politis ; S. AhmadiAbhari ; I. Rabiner ; L.T. Middleton ; (2022): At a Glance: An Update on Neuroimaging and Retinal Imaging in Alzheimer’s Disease and Related Research. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.7

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ASSOCIATION BETWEEN 9P21-23 LOCUS AND FRAILTY IN A COMMUNITY-DWELLING GREEK POPULATION: RESULTS FROM THE HELLENIC LONGITUDINAL INVESTIGATION OF AGEING AND DIET

N. Mourtzi, A. Hatzimanolis, G. Xiromerisiou, E. Ntanasi, M.K. Georgakis, A. Ramirez, S. Heilmann-Heimbach, B. Grenier-Boley, J.C. Lambert, M. Yannakoulia, M. Kosmidis, E. Dardiotis, G. Hadjigeorgiou, P. Sakka, N. Scarmeas

J Prev Alz Dis 2022;1(9):77-85

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Background: Frailty is a complex geriatric syndrome arising from a combination of genetic and environmental factors and is associated with adverse health outcomes and mortality. A recent study reported an association between variants of the 9p21-23 locus, associated with a number of age-related disorders, including Alzheimer’s disease (AD), and frailty. Frailty has been associated with increased risk of developing AD and it has been proposed that frailty burden may modify AD clinical presentation. In view of the overlapping genetic architecture between the two disorders, it is noteworthy to conduct studies to uncover risk variants that contribute to both AD and frailty. The purpose of this study is to test the reproducibility of the association of 9p21-23 locus with frailty in a population that is ethnically different from previous work and in the context of multidimensional definitions of frailty that will allow us to examine the potential impact to domains pertaining to AD pathology. Methods: We operationalized frailty according two definitions and the corresponding instruments, the Frailty Index (FI) and the Tilburg Frailty Indicator (TFI) and we determined genotypes of eight alleles previously identified as risk increasing for frailty in 1172 community-dwelling older participants (57% females) from the HELIAD study with a mean age of 74 years old. We cross-sectionally investigated the association between risk alleles and frailty, as well as with specific components of each definition using linear regression analyses adjusted for age, sex and years of education. Results: Compared to non-carriers, carriers of rs7038172 C risk allele, were associated with a higher FI Score (β=0.089, p=0.002). Similarly, we found a positive association between the presence of at least one rs7038172 C variant and TFI score (β=0.053, p=0.04). Moreover, the rs7038172 variant was associated, irrespectively of dementia status, with the memory and psychological domain of FI and TFI, respectively. Conclusion: Our study confirms the association of the rs7038172 C allele with the frailty syndrome in a Greek population and in the context of multidimensional definitions of frailty. Furthermore, we report novel associations between this allele and the memory domain of FI and the psychological domain of TFI, that includes memory problems on its components. Given that frailty burden has been shown to modify the AD clinical presentation, it is likely that rs7038172 C allele may accelerate the transition of AD or frailty to dementia Overall, our study corroborates the role of the 9p21-23 region in frailty development and draw potential links with AD pathology.

CITATION:
N. Mourtzi ; A. Hatzimanolis ; G. Xiromerisiou ; E. Ntanasi ; M.K. Georgakis ; A. Ramirez ; S. Heilmann-Heimbach ; B. Grenier-Boley ; J.C. Lambert ; M. Yannakoulia ; M. Kosmidis ; E. Dardiotis ; G. Hadjigeorgiou ; P. Sakka ; N. Scarmeas ; (2022): Association between 9p21-23 Locus and Frailty in a Community-Dwelling Greek Population: Results from the Hellenic Longitudinal Investigation of Ageing and Diet. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.2

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ASSOCIATIONS OF CARDIOVASCULAR AND NONCARDIOVASCULAR COMORBIDITIES WITH DEMENTIA RISK IN PATIENTS WITH DIABETES: RESULTS FROM A LARGE UK COHORT STUDY

B. Zheng, B. Su, C. Udeh-Momoh, G. Price, I. Tzoulaki, E.P Vamos, A. Majeed, E. Riboli, S. Ahmadi-Abhari, L.T. Middleton

J Prev Alz Dis 2022;1(9):86-91

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Background: Type 2 diabetes (T2D) is an established risk factor for dementia. However, it remains unclear whether the presence of comorbidities could further increase dementia risk in diabetes patients. Objectives: To examine the associations between cardiovascular and non-cardiovascular comorbidities and dementia risk in T2D patients. Design: Population-based cohort study. Setting: The UK Clinical Practice Research Datalink (CPRD). Participants: 489,205 T2D patients aged over 50 years in the UK CPRD. Measurements: Major cardiovascular and non-cardiovascular comorbidities were extracted as time-varying exposure variables. The outcome event was dementia incidence based on dementia diagnosis or dementia-specific drug prescription. Results: During a median of six years follow-up, 33,773 (6.9%) incident dementia cases were observed. Time-varying Cox regressions showed T2D patients with stroke, peripheral vascular disease, atrial fibrillation, heart failure or hypertension were at higher risk of dementia compared to those without such comorbidities (HR [95% CI] = 1.64 [1.59-1.68], 1.37 [1.34-1.41], 1.26 [1.22-1.30], 1.15 [1.11-1.20] or 1.10 [1.03-1.18], respectively). Presence of chronic obstructive pulmonary disease or chronic kidney disease was also associated with increased dementia risk (HR [95% CI] = 1.05 [1.01-1.10] or 1.11 [1.07-1.14]). Conclusions: A range of cardiovascular and non-cardiovascular comorbidities were associated with further increases of dementia risk in T2D patients. Prevention and effective management of these comorbidities may play a significant role in maintaining cognitive health in T2D patients.

CITATION:
B. Zheng ; B. Su ; C. Udeh-Momoh ; G. Price ; I. Tzoulaki ; E.P Vamos ; A. Majeed ; E. Riboli ; S. Ahmadi-Abhari ; L.T. Middleton (2022): Associations of Cardiovascular and Non-Cardiovascular Comorbidities with Dementia Risk in Patients with Diabetes: Results from a Large UK Cohort Study. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.8

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THE UPS AND DOWNS OF AMYLOID IN ALZHEIMER’S

E. Siemers, P.S. Aisen, M.C. Carrillo

J Prev Alz Dis 2022;1(9):92-95

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CITATION:
E. Siemers ; P.S. Aisen ; M.C. Carrillo (2021): The Ups and Downs of Amyloid in Alzheimer’s. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.54

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THE EFFECT OF MULTIDOMAIN INTERVENTIONS ON GLOBAL COGNITION, SYMPTOMS OF DEPRESSION AND APATHY – A POOLED ANALYSIS OF TWO RANDOMIZED CONTROLLED TRIALS

M.G.H.E. den Brok, M.P. Hoevenaar-Blom, N. Coley, S. Andrieu, J. van Dalen, Y. Meiller, J. Guillemont, C. Brayne, W.A. van Gool, E.P. Moll van Charante, E. Richard

J Prev Alz Dis 2022;1(9):96-103

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BACKGROUND: Cardiovascular risk factors and lifestyle factors are associated with an increased risk of cognitive decline and dementia in observational studies, and have been targeted by multidomain interventions. Objectives: We pooled individual participant data from two multi-domain intervention trials on cognitive function and symptoms of depression to increase power and facilitate subgroup analyses. Design: Pooled analysis of individual participant data. Setting: Prevention of Dementia by Intensive Vascular Care trial (preDIVA) and Multidomain Alzheimer Preventive Trial (MAPT). Participants: Community-dwelling individuals, free from dementia at baseline. Intervention: Multidomain interventions focused on cardiovascular and lifestyle related risk factors. Measurements: Data on cognitive functioning, depressive symptoms and apathy were collected at baseline, 2 years and 3-4 years of follow-up as available per study. We analyzed crude scores with linear mixed models for overall cognitive function (Mini Mental State Examination [MMSE]), and symptoms of depression and apathy (15-item Geriatric Depression Scale). Prespecified subgroup analyses were performed for sex, educational level, baseline MMSE <26, history of hypertension, and history of stroke, myocardial infarction and/or diabetes mellitus. Results: We included 4162 individuals (median age 74 years, IQR 72, 76) with a median follow-up duration of 3.7 years (IQR 3.0 to 4.1 years). No differences between intervention and control groups were observed on change in cognitive functioning scores and symptoms of depression and apathy scores in the pooled study population. The MMSE declined less in the intervention groups in those with MMSE <26 at baseline (N=250; MD: 0.84; 95%CI: 0.15 to 1.54; p<0.001). Conclusions: We found no conclusive evidence that multidomain interventions reduce the risk of global cognitive decline, symptoms of depression or apathy in a mixed older population. Our results suggest that these interventions may be more effective in those with lower baseline cognitive functioning. Extended follow-up for dementia occurrence is important to inform on the potential long-term effects of multidomain interventions.

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EFFECTS OF MINDFULNESS-BASED TAI CHI CHUAN ON PHYSICAL PERFORMANCE AND COGNITIVE FUNCTION AMONG COGNITIVE FRAILTY OLDER ADULTS: A SIX-MONTH FOLLOW-UP OF A RANDOMIZED CONTROLLED TRIAL

Z. Jiayuan, J. Xiang-Zi, M. Li-Na, Y. Jin-Wei, Y. Xue

J Prev Alz Dis 2022;1(9):104-112

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Background: The Objective: To assess the effectiveness of a mindfulness-based Tai Chi Chuan on physical performance and cognitive function among cognitive frailty older adults. Design: A single-blind,three-arm randomized controlled trial. Setting: Three communities in Daqing, China. Participants: The study sample comprised 93 men and women aged 65 years or older who were able to walk more than 10 m without helping tools, scored 0.5 on Clinical Dementia Rating (CDR) and absence of concurrent dementia, identified pre-frailty (scored 1-2 on Fried Frailty Criteria) and frailty older adults (scored 3-5 on Fried Frailty Criteria). Intervention: Subjects were randomly allocated to three groups: Group1, which received mindfulness intervention (formal and informal mindfulness practices); Group 2, which received Tai-Chi Chuan intervention; Group 3, which received MTCC intervention. Measurements: The primary outcomes was cognitive frailty rate(measured by Fried Frailty Criteria and Clinical Dementia Rating-CDR) , the secondary outcome were cognitive function (measured by Min-Mental State Examination-MMES) and physical level (measured by Short physical performance battery- SPPB, Timed up and Go test-TUG and the 30-second Chair test). They were all assessed at Time 1-baseline, Time 2-after the end of 6-month intervention and the follow up (Time 3-half year after the end of 6-month intervention). Results: The baseline characteristics did not differ among the groups.Improvements in the cognitive function (MMES), physical performance (SPPB, TUG, 30-second Chair test) were significantly difference between time-group interaction (p<.05). The rate of CF was significantly different among groups at 6-month follow-up period (χ2=6.37, p<.05). A lower prevalence of frailty and better cognitive function and physical performance were found in the Group 3 compared with other two groups at the follow-up period (p<.05). Conclusions: MTCC seems to be effectively reverse CF, improving the cognitive and physical function among older adults, suggesting that MTCC is a preferably intervention option in community older adults with cognitive frailty.

CITATION:
Z. Jiayuan ; J. Xiang-Zi ; M. Li-Na ; Y. Jin-Wei ; Y. Xue ; (2021): Effects of Mindfulness-Based Tai Chi Chuan on Physical Performance and Cognitive Function among Cognitive Frailty Older Adults: A Six-Month Follow-Up of a Randomized Controlled Trial. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.40

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REPRESENTATION OF RACIAL AND ETHNIC MINORITY POPULATIONS IN DEMENTIA PREVENTION TRIALS: A SYSTEMATIC REVIEW

A.R. Shaw, J. Perales-Puchalt, E. Johnson, P. Espinoza-Kissell, M. Acosta-Rullan, S. Frederick, A. Lewis, H. Chang, J. Mahnken, E.D. Vidoni

J Prev Alz Dis 2022;1(9):113-118

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Despite older racial and ethnic minorities (REMs) being more likely to develop dementia they are underrepresented in clinical trials focused on neurological disorders. Inclusion of REMs in dementia prevention studies is vital to reducing the impact of disparities in dementia risk. We conducted a systematic review to characterize the number of REM enrolled in brain health and prevention randomized controlled trials (RCTs). RTCs published from January 1, 2004 to April 21, 2020 were included. Participants were normal cognitive adults aged 45 years and older who participated in a Phase II or Phase III U.S. based preventative trial. Analyses were performed to examine differences in trial characteristics between RCTs that did and those that did not report race/ethnicity and to calculate the pooled proportion of each racial/ethnic group in randomized brain healthy prevention trials. A total of 42 studies consisting of 100,748 participants were included in the final analyses. A total of 26 (62%) reported some racial/ethnic identity data. The pooled proportion of REM participants was 0.256 (95% CI, 0.191, 0.326). There is a lack of racial/ethnic reporting of participants and REMs remain underrepresented in brain health prevention RCTs.

CITATION:
A.R. Shaw ; J. Perales-Puchalt ; E. Johnson ; P. Espinoza-Kissell ; M. Acosta-Rullan ; S. Frederick ; A. Lewis ; H. Chang ; J. Mahnken ; E.D. Vidoni ; (2021): Representation of Racial and Ethnic Minority Populations in Dementia Prevention Trials: A Systematic Review. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.49

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DIVERSIFYING RECRUITMENT REGISTRIES: CONSIDERING NEIGHBORHOOD HEALTH METRICS

J.D. Grill, A. Kind, D. Hoang, D.L. Gillen

J Prev Alz Dis 2022;1(9):119-125

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BACKGROUND: Disparities in clinical research participation perpetuate broader health disparities. Recruitment registries are novel tools to address known challenges in accrual to clinical research. Registries may accelerate accrual, but the utility of these tools to improve generalizability is unclear. Objective: To examine the diversity of a local on-line recruitment registry using the Area Deprivation Index (ADI), a publicly available metric of neighborhood disadvantage. Design: Retrospective analysis. Setting: Data were collected in the University of California Irvine Consent-to-Contact Registry. Participants: We categorized N=2,837 registry participants based on the ADI decile (collapsed into quintiles) using a state-based rankings. Measurements: We examined the proportion of enrollees per ADI quintile and quantified the demographics of these groups. We assessed willingness to participate in studies involving unique research procedures among the ADI groups. Results: Although registry enrollees represented the full spectrum of the ADI, they disproportionately represented less disadvantaged neighborhoods (lowest to highest quintiles: 42%, 30%, 15%, 6%, 7%). Compared to participants from less disadvantaged neighborhoods, participants from more disadvantaged neighborhoods were more often female, of non-white race, and Hispanic ethnicity. Despite demographic differences, ADI groups were observed to have similar willingness to participate in research studies. Conclusions: People from more disadvantaged neighborhoods may be underrepresented in recruitment registries, increasing the risk that they will be underrepresented when using these tools to facilitate prospective recruitment to clinical research. Once enrolled in registries, participants from more disadvantaged neighborhoods may be equally willing to participate in research. Efforts to increase representation of participants from disadvantaged neighborhoods in registries could be an important first step toward increasing the generalizability of clinical research.

CITATION:
J.D. Grill ; A. Kind ; D. Hoang ; D.L. Gillen ; (2021): Diversifying Recruitment Registries: Considering Neighborhood Health Metrics. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.50

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LIVING ENVIRONMENT, BUILT ENVIRONMENT AND COGNITIVE FUNCTION AMONG OLDER CHINESE ADULTS: RESULTS FROM A CROSS-SECTIONAL STUDY

H. Fangfang, H. Xiao, Z. Shuai, W. Qiong, Z. Jingya, S. Guodong

J Prev Alz Dis 2022;1(9):126-135

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Background: Many studies have addressed the relationship between environmental factors and cognitive function; however, evidence from China is very rare. Objectives: To discuss the relationship between the living and built environment and cognitive function among older Chinese adults. Design: The Anhui Healthy Longevity Survey (AHLS) was used to investigate the ability to control major non-communicable diseases through behavioural techniques among adults aged 60 or older dwelling in Anhui Province. A multistage sampling strategy was used to obtain a representative sample. Cross-sectional data were collected for the analyses. Setting: The included participants were recruited from four selected cities in Anhui Province, China. Participants: The participants were adults aged 60 or older and resided in the selected urban or rural communities. Measurements: The Mini Mental State Examination was used to measure the cognitive status of the participants. Mild cognitive impairment (MCI) was defined as illiteracy with MMSE scores lower than 18, MMSE scores lower than 21 among those educated for 0–6 years, or MMSE scores lower than 25 among those with 6 or more years of education. The living environment was assessed by asking the participants about their daily living conditions. The distances between the participants’ dwellings and the nearest facilities and the proportions of green/blue spaces within 800 m buffers were calculated based on the textural address to indicate the built environment. Results: The male participants who lived in a non-dusty environment had higher MMSE scores (β=0.828, 95% CI: 0.240, 1.416, p=0.006) and lower risks of mild cognitive impairment (MCI) (OR=0.651, 95% CI: 0.488, 0.868, p=0.003), and the male participants with no access to recreation spaces had lower MMSE scores (β=-1.107, 95% CI: -1.531, -0.684, p<0.001) and higher risks of MCI (OR=1.403, 95% CI: 1.134, 1.737, p=0.002). The female participants who lived far from a supermarket had significantly lower MMSE scores (Q3:β=-0.750, 95% CI: -1.266, -0.233, p adjusted=0.036; Q4: β=-1.184, 95% CI: -1.745, -0.624, p adjusted<0.001) than those who lived near a supermarket (Q1). Conclusions: The living environment and built environment might have sex-specific associations with cognitive function among older adults.

CITATION:
H. Fangfang ; H. Xiao ; Z. Shuai ; W. Qiong ; Z. Jingya ; S. Guodong ; Z. Yan (2021): Living Environment, Built Environment and Cognitive Function among Older Chinese Adults: Results from a Cross-Sectional Study. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.59

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TAU PATHOLOGIES MEDIATE THE ASSOCIATIONS OF VASCULAR RISK BURDEN WITH COGNITIVE IMPAIRMENTS IN NONDEMENTED ELDERS: THE CABLE STUDY

G.-X. Yu, Y.-N. Ou, Y.-L. Bi, Y.-H. Ma, H. Hu, Z.-T. Wang, X.-H. Hou, W. Xu, L. Tan, J.-T. Yu

J Prev Alz Dis 2022;1(9):136-143

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BACKGROUND: Studies suggested that vascular dysfunction might increase the risk of developing Alzheimer’s disease (AD), but the underlying mechanisms still remain obscure. Objective: To evaluate the associations of vascular risk burden with AD core pathologies and investigate the effects of AD core pathologies on relationships between vascular risk burden and cognitive impairments. Design: The Chinese Alzheimer’s Biomarker and LifestyLE (CABLE) study was principally focusing on aging, as well as the risk factors and biomarkers of AD initiated in 2017. Setting: The CABLE study was a large cohort study established in Qingdao, China. Participants: A total of 618 non-demented elders were obtained from CABLE study. Measurements: The general vascular risk burden was assessed by the Framingham General Cardiovascular Risk Score (FGCRS). Multivariate linear regression analyses were performed to evaluate the associations of FGCRS with cerebrospinal fluid (CSF) AD biomarkers and cognition. Casual mediation analyses were performed to investigate the mediating effects of AD biomarkers on cognition. Results: Increased FGCRS was related to higher levels of CSF total tau (t-tau, p < 0.001), phosphorylated tau (p-tau, p < 0.001) as well as the ratio of t-tau and amyloid-β 42 (t-tau/Aβ42, p = 0.010), and lower Chinese-Modified Mini-Mental State Examination (CM-MMSE, p = 0.010) score. Stratified analysis indicated that age modified the associations, with FGCRS being significantly associated with tau pathology (p < 0.001 for t-tau and p-tau) in middle-aged group (<65 years old), instead of older group. The influences of FGCRS on cognitive impairments were partially mediated by tau pathologies (a maximum proportion of 20.9%). Conclusions: Tau pathology might be a pivotal mediator for effects of vascular risk on cognitive decline. Early and comprehensive intervention for vascular risk factors might be a potential approach to delaying or preventing cognitive impairment and AD.

CITATION:
G.-X. Yu ; Y.-N. Ou ; Y.-L. Bi ; Y.-H. Ma ; H. Hu ; Z.-T. Wang ; X.-H. Hou ; W. Xu ; L. Tan ; J.-T. Yu (2021): Tau Pathologies Mediate the Associations of Vascular Risk Burden with Cognitive Impairments in Non-demented Elders: The CABLE Study. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.55

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COMMUNICATING PERSONAL RISK PROFILES OF ALZHEIMER’S DISEASE TO OLDER ADULTS: A PILOT TRIAL

I. Choi, H. La Monica, S.L. Naismith, A. Rahmanovic, L. Mowszowski, N. Glozier

J Prev Alz Dis 2022;1(9):144-150

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Communicating personal Alzheimer’s disease risk profiles based on validated risk algorithms may improve public knowledge about risk reduction, and initiate action. This proof of concept pilot trial aimed to test whether this is feasible and potentially effective and/or harmful. Older at-risk adults (N=24) were provided with their personal Alzheimer’s disease risk profile online, which contained information on their personal risk level, scores and tailored recommendations to manage modifiable risk factors. After receiving the risk profile, participants were significantly more accurate in identifying risk and protective factors, and revised their perceived risk to be lower than their initial estimate. There was no apparent harm seen in psychological distress or dementia-related worry. This shows preliminary support for the feasibility of delivering personal dementia risk profiles to low risk, help-seeking older adults in an online format. A definitive trial examining behavioural outcomes and testing in groups with higher risk profiles is now warranted.

CITATION:
I. Choi ; H. La Monica ; S.L. Naismith ; A. Rahmanovic ; L. Mowszowski ; N. Glozier (2021): Communicating Personal Risk Profiles of Alzheimer’s Disease to Older Adults: A Pilot Trial . The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.34

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LOW AMINO ACID SCORE OF BREAKFAST IS ASSOCIATED WITH THE INCIDENCE OF COGNITIVE IMPAIRMENT IN OLDER JAPANESE ADULTS: A COMMUNITY-BASED LONGITUDINAL STUDY

K. Kinoshita, R. Otsuka, M. Takada, M. Tsukamoto-Yasui, Y. Nishita, C. Tange, M. Tomida, H. Jinzu, H. Shimokata, M. Kuzuya, A. Imaizumi, H. Arai

J Prev Alz Dis 2022;1(9):151-157

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Background: The protein digestibility-corrected amino acid score (PDCAAS) represents the degree of utilizable dietary protein, namely the protein quality. The PDCAAS of a diet is required to be evaluated on a meal-by-meal basis, as food digestion and absorption occur with each meal intake. Although a positive association between protein intake and cognitive function has been reported, no study has investigated the association between PDCAAS of a diet and cognitive function. Objectives: To investigate the relationship between PDCAAS of a diet and cognitive impairment in older adults. Design: Longitudinal epidemiological study Setting: Community-based setting Participants: We analyzed 541 community-dwellers who participated in both baseline and follow-up survey. They were 60–83 years of age without cognitive impairment at baseline. Measurements: Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score ≤27. Individual PDCAASs were calculated for each of three regular meals from the 3-day dietary records at baseline. Participants were classified into two groups according to the sex-specific tertiles (T1–T3) of the PDCAAS for each meal (i.e., T1 as the low score group and T2–T3 as the medium and high score group). The dependent variable was cognitive impairment observed after 4 years, and the explanatory variables were the PDCAAS groups for each meal (the medium and high group as the reference) and covariates (sex, age, body mass index, education, depressive symptoms, medical history, protein intake at each meal, and the MMSE score at baseline). Multivariable logistic regression analysis was performed to evaluate the low PDCAAS group for cognitive impairment after 4 years. Results: A significant association was observed only between a low PDCAAS of breakfast and the incidence of cognitive impairment (the adjusted odds ratios [95% confidence intervals] of low PDCAAS for cognitive impairment for breakfast, lunch, and dinner were 1.58 [1.00–2.50], 0.85 [0.54–1.34], and 1.08 [0.71–1.65], respectively). Conclusion: A lower PDCAAS of breakfast, i.e., a diet with poor quality of protein, was associated with the incidence of cognitive impairment in older adults of the community.

CITATION:
K. Kinoshita ; R. Otsuka ; M. Takada ; M. Tsukamoto-Yasui ; Y. Nishita ; C. Tange ; M. Tomida ; H. Jinzu ; H. Shimokata ; M. Kuzuya ; A. Imaizumi ; H. Arai (2021): Low Amino Acid Score of Breakfast is Associated with the Incidence of Cognitive Impairment in Older Japanese Adults: A Community-Based Longitudinal Study. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.25

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GENIPOSIDIC ACID CONFERS NEUROPROTECTIVE EFFECTS IN A MOUSE MODEL OF ALZHEIMER’S DISEASE THROUGH ACTIVATION OF A PI3K/AKT/GAP43 REGULATORY AXIS

Q.Y. Chen, Y. Yin, L. Li, Y.J. Zhang, W. He, Y. Shi

J Prev Alz Dis 2022;1(9):158-171

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BACKGROUND: Alzheimer’s disease (AD) is a major cause of dementia, which is a growing global health problem and has a huge impact on individuals and society. As the modifying role of geniposidic acid (GPA) has been suggested in AD, this study sets out to determine if and how GPA treatment affects AD progression in mice. METHODS: Potential downstream target genes of GPA during AD were identified by bioinformatics analysis, revealing GAP43 as a primary candidate protein. Then, mPrP-APPswe/PS1De9 AD transgenic mice were treated with GPA via intragastric administration. This allowed for gain- and loss-of-function assays of candidate proteins being carried out with or without GPA treatment, after which behavioral tests could be conducted for mice. Cortical neuron apoptosis was measured by TUNEL staining, Amyloid β-protein (Aβ) expression in cerebral cortex by Thioflavin-s staining, and Aβ, IL-1β, IL-6, IL-4 and TNF-α levels in cerebral cortex by ELISA. GAP43 expression in cerebral cortex of mice was detected by immunohistochemistry. Primary cortical neurons of embryonic mice were isolated and induced by Aβ1-42 to construct AD cell model. Cell viability was assessed by CCK-8, and axon growth by immunofluorescence. RESULTS: GPA administration significantly improved the cognitive impairment, reducing Aβ accumulation and neuronal apoptosis in AD mice, and alleviated inflammation and axonal injury of Aβ1-42-induced neurons. GAP43 was shown experimentally to be the target of GPA in AD. Silencing of GAP43 repressed the neuroprotective effect of GPA treatment on AD mice. GPA elevated GAP43 expression via PI3K/AKT pathway activation and ultimately improved nerve injury in AD mice. CONCLUSION: GPA activates a PI3K/AKT/GAP43 regulatory axis to alleviate AD progression in mice.

CITATION:
Q.Y. Chen ; Y. Yin ; L. Li ; Y.J. Zhang ; W. He ; Y. Shi ; (2021): Geniposidic Acid Confers Neuroprotective Effects in a Mouse Model of Alzheimer’s Disease through Activation of a PI3K/AKT/GAP43 Regulatory Axis. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.60

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CLUSTERS OF DEMENTIA LITERACY: IMPLICATIONS FROM A SURVEY OF OLDER ADULTS

Y. Barak, C. Rapsey, K.M. Scott

J Prev Alz Dis 2022;1(9):172-177

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Clinicians and scientists suggest that up to 40% of dementia cases are potentially preventable. Data on awareness of dementia risk and protective factor among older adults can inform and facilitate designing educational interventions to prevent dementia. We aimed to quantify awareness of dementia risk and protective factors using a telephone survey. The modified Lifestyle for Brain Health scale was used to assess dementia risk and prevention knowledge. A representative sample of 1,005 older adults, mean age 64.02 (standard deviation + 1.4; range: 50-74 years) completed the survey (77% response rate). Under representation of non-European ethnicities was noted. Participants Respondents were all New Zealanders, more women (n=518, 51.5%), mostly European (n=921, 91.6%) and well educated (n=347, 34.5%, university or post-graduate degree). Only 6/14 modifiable risk or protective factors for dementia were adequately identified. Three clusters of dementia literacy were identified: psychosocial, medical and activities. These findings support personalizing dementia prevention efforts via targeted educational packages.

CITATION:
Y. Barak ; C. Rapsey ; K.M. Scott ; (2021): Clusters of Dementia Literacy: Implications from a Survey of Older Adults. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.66

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LONGITUDINAL COGNITIVE DECLINE IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT OR DEMENTIA DUE TO ALZHEIMER’S DISEASE

Y.Y. Lim, J. Kong, P. Maruff, J. Jaeger, E. Huang, E. Ratti

J Prev Alz Dis 2022;1(9):178-183

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Sensitive cognitive assessments accurately detect and track cognitive decline in Alzheimer’s disease. The Cogstate battery was used to measure cognitive change in cognitively normal participants and in individuals with mild cognitive impairment and mild Alzheimer’s disease enrolled in the Australian Imaging, Biomarker and Lifestyle Rate of Change Substudy. Over 18 months, verbal episodic memory performance declined for mild cognitive impairment and mild Alzeheimer’s disease groups when compared to cognitively normal participants. Frequent assessments of episodic memory may facilitate early detection of cognitive decline due to Alzheimer’s disease.

CITATION:
Y.Y. Lim ; J. Kong ; P. Maruff ; J. Jaeger ; E. Huang ; E. Ratti ; (2021): Longitudinal Cognitive Decline in Patients With Mild Cognitive Impairment or Dementia Due to Alzheimer’s Disease. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.64

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IS “PRE-PRECLINICAL AD” HELPFUL TO THE EU/US CTAD TASK FORCE?

T. Daly

J Prev Alz Dis 2022;1(9):184

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CITATION:
T. Daly ; (2021): Is “Pre-Preclinical AD” Helpful to the EU/US CTAD Task Force? . The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2021.65

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HOW LARGER SOCIETY CAN GIVE A HELPING HAND TO WORLDWIDE FINGERS

T. Daly

J Prev Alz Dis 2022;1(9):185

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CITATION:
T. Daly (2022): How Larger Society Can Give a Helping Hand to Worldwide FINGERS. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2022.11

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