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Background: : Preventing or reducing the risk of cognitive decline and dementia is of great public health interest. Longitudinal data from diverse samples are needed to properly inform clinicians, researchers, and policy makers. CAN-PROTECT is a recently launched online observational cohort study that assesses factors contributing to both risk for incident cognitive decline and dementia and resilience against brain aging, in participants across the lifespan. Methods: : Measures of cognition, behaviour, and quality of life administered to both participants and study partners were compared using partial Spearman correlations adjusted for participant and study partner age, sex, and education. In participants, relationships between cognition, behaviour, function, and quality of life were examined using adjusted multivariable linear and negative binomial regression models. Results: : In the first three-month window, 2150 participants spanning all Canadian provinces enrolled; 637 nominated study partners had already completed assessments. Engagement with the study was excellent, with many optional assessments completed. Initial analyses demonstrated relationships between cognition, behaviour, function, and quality of life. Discussion: : These preliminary results speak to the utility and feasibility of CAN-PROTECT to obtain data relevant to brain health, highlighting the public interest in participating in studies on cognition. The online portal facilitated participation of a geographically diverse sample. This group is ideal to study brain aging, dementia prevention, and early detection of neurodegenerative disease. Longitudinal data will provide additional insights. Several features of CAN-PROTECT are important to consider in terms of assessing risk and resilience in Canadians, and for further development and recruitment of a research-ready cohort.

Abstract Introduction Anxiety is a common symptom for those experiencing dementia and is associated with worse outcomes. The aim of the study was to examine which anxiety tools have been validated compared with a gold standard diagnostic criterion in persons with dementia. Methods We completed a systematic review of the literature, which was registered a priori with PROSPERO (CRD42016042123). Three databases were searched, MEDLINE, EMBASE, and PsycINFO, as well as the gray literature. Abstracts and full text were searched in duplicate for inclusion. Risk of bias was assessed in duplicate. Results We identified 9626 citations from all sources after duplicates were removed. Many excluded studies used tools for anxiety, for which no diagnostic accuracy study was identified. Four articles were included in the final synthesis. Included articles had between 32 to 101 participants with mild to moderate dementia. The gold standard criteria focused on either generalized anxiety or all anxiety subtypes. The prevalence of anxiety was between 27.7% and 63.4%. Three tools were examined, the Geriatric Anxiety Inventory, Penn State Worry Questionnaire, and the Rating Anxiety in Dementia (RAID) scale. Sensitivity varied but was the highest in the RAID at 90% and lowest in the self‐rated version of the Geriatric Anxiety Inventory (58%). Discussion Given how burdensome the symptoms of anxiety are to persons with dementia, valid tools are needed to help identify symptoms. We identified three validated tools, but further validation of these and other tools are needed. Practitioners should consider the use of tools with high sensitivity such as the RAID in persons with dementia.

Background Cerebral amyloid angiopathy (CAA) causes cognitive decline, but it is not known whether it is associated with neuropsychiatric symptoms (NPS). Methods and Results Participants with CAA, mild cognitive impairment, mild dementia due to Alzheimer's disease, and normal cognition were recruited from stroke and dementia clinics and community advertising. NPS were captured using the Neuropsychiatric Inventory Questionnaire short form. The number and total severity (number multiplied by severity of each symptom [mild, moderate, or severe]) of NPS were analyzed using generalized linear regression with a negative binomial link and multiple linear regression, adjusting for age, sex, and education. A total of 109 participants (43 with CAA, 15 with Alzheimer's disease, 28 with mild cognitive impairment, and 23 with normal cognition) (mean age 71.1 [SD=7.6]; 53.2% male) were included. The most frequent NPS in CAA were depression/dysphoria (48.8%), irritability/lability (37.2%), agitation/aggression (37.2%), apathy/indifference (34.9%), and anxiety (32.6%). In adjusted models, patients with CAA had 3.2 times (95% CI, 1.7–6.0) more NPS symptoms and 3.1 units (95% CI, 1.0–5.1) higher expected severity score. The number of NPS was similar to patients with mild cognitive impairment (3.2 times higher than controls) but less than in patients with Alzheimer's disease dementia (4.1 times higher than controls). Within patients with CAA, there were 1.20 times (95% CI, 1.01–1.32) more NPS per 1% increase in white matter hyperintensity as a percentage of intracranial volume. Conclusions NPS are common in CAA, with a similar prevalence as in mild cognitive impairment. The association of the total number of NPS with higher white matter hyperintensity volume suggests that white matter damage may underlie some of these symptoms.