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Background: In addition to measures of cognition, global Alzheimer's disease (AD) clinical trials commonly include measures to assess functional status (activities of daily living; ADLs) and quality of life (QoL) reported by participants and study partners. Most common assessments were validated with North American, White, English‐speaking populations and research suggests that these are not free from cultural and linguistic influence. ADLs and QoL may exhibit regional differences due to socioeconomic and cultural factors. It is important to understand how geo‐cultural factors influence these measures, which are often used as trial efficacy endpoints. In this study, we examined the impact of geo‐cultural region on ADCS‐MCI‐ADL and QoL‐AD when considering baseline cognitive status. Method: This study included electronic ADCS‐MCI‐ADL, QoL‐AD, and ADAS‐Cog data from two multi‐national AD clinical trials of participants with prodromal to mild AD. Data were collected from three geo‐cultural regions: Asia (n = 688); Western Europe (WE; n = 589); and North America (NA; n = 1925). Participants were stratified into five cohorts based on ADAS‐Cog13 scores. Result: QoL‐AD Study Partner and AD Participant scores varied significantly across geo‐cultural regions (Kruskal‐Wallis test; p<0.0001). Both study partner‐reported and participant reported QoL‐AD scores in Asia were lower than scores in NA and WE for all ADAS‐Cog13 cohorts (Dunn's test; p<0.0001). QoL‐AD AD Participant scores in NA and WE did not differ. For participants with lower cognitive performance (ADAS‐Cog > 40th percentile), study partner‐reported QoL‐AD scores in NA were significantly higher than those in WE (Dunn's test; p<0.05), but there was not significant difference on the participant‐reported QoL‐AD scores between these regions. ADCS‐MCI‐ADL scores were not significantly different across groups. Conclusion: Our study found that QoL‐AD, but not ADCS‐MCI‐ADL scores differed significantly across geo‐cultural regions when considering baseline cognitive performance. Both participant and study‐partner reported QoL was lower in Asia than in WE and NA. Cross‐regional differences in QoL may also be moderated by baseline cognitive performance. Different social norms and aging expectation, healthcare resources, and trial participation may have contributed to the regional variance observed. Future studies should examine if specific constructs are more contextually dependent on the local culture. [ABSTRACT FROM AUTHOR]

Objective: To investigate the feasibility, safety, and utility of tablet devices as novel nonpharmacologic tools in managing older psychiatric inpatients with agitation and dementia.Methods: Thirty-six patients at a geriatric psychiatry inpatient unit were provided with tablets when agitated and used various apps on the tablet related to communication, games, music, web browser, and photography during their stay. Study staff documented the frequency, duration, and app usage history and rated the extent to which agitation improved after tablet use.Results: All participants, regardless of dementia severity, were able to use apps and were rated by staff to have clinical benefit. Dementia severity was negatively associated with app complexity. Age was negatively associated with frequency and duration of tablet use.Conclusion: Tablet use as a nonpharmacologic intervention for agitation in older adults, including those with severe dementia, appears to be feasible, safe, and of potential utility. [ABSTRACT FROM AUTHOR]

There is growing evidence to suggest that aging is accompanied by enhancement in psychosocial well-being, despite age-related declines in physical and cognitive functioning. A small but growing body of research has reported on positive trajectories of well-being, and its determinants, among community-dwelling seniors as well as in people with specific diseases such as stroke. Current strategies for promoting successful aging include physical, cognitive and social activities, healthy lifestyle, social support, and positive traits such as resilience and optimism. These strategies have typically been employed in samples without serious illnesses, but an emerging body of evidence suggests that they are as relevant in cohorts with neurologic and other diseases. Future strategies will include those that work at the community level and not just at individual level, and will focus on use of technology as well as group interventions to enhance resilience and building age-friendly communities. [ABSTRACT FROM PUBLISHER]

Background: Alzheimer's disease (AD) clinical trials are increasingly global. Most measures used were validated and standardized with North American, White, English‐speaking populations with limited consideration of cultural nuance. Prior research suggests that both the Clinical Dementia Rating (CDR) and Mini Mental State Examination (MMSE) are not free from cultural and linguistic influence. It is important to understand how geo‐cultural factors influence longitudinal change in scores on these measures, which is often used as the primary endpoint for study efficacy. In this study, we examined whether change in CDR and MMSE scores over one‐year follow‐up varied across geo‐cultural regions. Method: This study included electronic CDR (eCDR) and electronic MMSE (eMMSE) data from four multi‐national AD clinical trials of subjects with prodromal to mild AD. Data were collected at screening and one‐year follow‐up from seven geo‐cultural regions: East Asia (n = 138); Eastern Europe (n = 170); Western Europe (n = 484); North America (n = 496); South America (n = 55); Middle East/Africa (n = 26); and Oceania (n = 26). Result: The Kruskal–Wallis test found statistically significant variance in CDR‐Sum of Box (CDR‐SB) scores across geo‐cultural regions (p <0.0001). Results of the Dunn's test indicated mean change in CDR‐SB scores for South America was significantly lower than those for North America, Eastern Europe, Western Europe, and Mideast/Africa. Additionally, mean change in CDR‐SB scores for East Asia was significantly lower than those for Western and Eastern Europe. Change in MMSE total scores did not vary across geo‐cultural regions. Conclusion: Our study found average change in CDR‐SB but not MMSE total scores differed significantly across geo‐cultural regions. CDR‐SB scores were relatively more stable in South America compared to most other regions, and in East Asia compared to Western/Eastern Europe. The CDR may be more susceptible to cultural factors due to its reliance on subjective information from caregivers, in contrast with the MMSE, a standardized, objective measure. Different social norms and expectations for aging, functional independence, and trial participation in these regions may have contributed to the variance. Future studies should examine if specific CDR or MMSE items are more contextually dependent on the local culture. [ABSTRACT FROM AUTHOR]

Background: The increasingly global scope of clinical trials in Alzheimer's disease (AD) has led to the recruitment of subjects from various geo‐cultural regions. Recent studies suggest that commonly used objective measures of cognition such as the MMSE as well as subjective, clinician‐rated global measures such as the CDR might be impacted by cultural and/or linguistic differences. This raises the question regarding the impact of cultural differences on the convergent validity of the CDR and MMSE. In this analysis, we examined the extent to which the correspondence between the CDR and MMSE varied across seven geo‐cultural regions in multinational AD clinical trials. Method: This study included electronic CDR (eCDR) and electronic MMSE (eMMSE) data from four multinational AD clinical trials of subjects with Prodromal to Mild AD. Data were collected at screening from seven geo‐cultural regions: East Asia (n = 1916), Eastern Europe (n = 1882), South America (n = 1601), Middle East/Africa (n = 188), North America (n = 9311), Oceania (n = 363), and Western Europe (n = 5174). Result: Pearson correlations between eCDR Sum of Boxes (SOB) and eMMSE across the 7 geo‐cultural regions ranged from r = ‐.31 (East Asia, Western Europe) to r = ‐.48 (Mideast/Africa). A linear regression model with geo‐cultural regions entered as covariates further demonstrated that the relationship between eMMSE and eCDR SoB scores differed by region (Adjusted R2 = 0.14, p<0.001). Conclusion: Findings indicate the strength of the correlation between the CDR SOB and MMSE total score varied by geo‐cultural region. These results build on prior findings indicating that CDR SOB and MMSE scores vary across regions independent of each other. A growing body of literature suggests these differences might be due to cultural and/or linguistic factors. [ABSTRACT FROM AUTHOR]

Patients with obstructive sleep apnea (OSA) commonly have cognitive complaints. There are few randomized studies that have examined neuropsychological effects of continuous positive airway pressure (CPAP) treatment in patients with OSA. In this double-blind trial, we examined if a three-week CPAP treatment compared with placebo CPAP treatment has specific therapeutic effects on cognitive impairments in patients with OSA and if there are specific domains of cognitive impairments sensitive to three-week CPAP treatment. Thirty-eight newly diagnosed patients with untreated OSA underwent neuropsychological testing before and after three-week CPAP or placebo-CPAP treatment. The two treatment groups (therapeutic CPAP and placebo-CPAP) were compared using repeated measures analysis of variance (ANOVA). Impairments in neuropsychological functioning ranged from 2.6% to 47.1% before treatment. In response to three weeks of treatment, there was no significant time by treatment interaction for a global deficit score of neuropsychological functioning. Only the Stroop Color (number correct) test showed significant improvement specific to CPAP treatment. The study demonstrates the importance of further randomized placebo-controlled studies in this area. [ABSTRACT FROM AUTHOR]

The article talks about research carried out that states older adults with cognitive impairment such as dementia could possibly show behavioral control when tablet devices (iPads) are used as an intervention.