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Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.

IntroductionClinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown.MethodsWe included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier.ResultsBoth semantic variant (sv) PPA and logopenic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices.DiscussionThis study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers.HighlightsNoun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and logopenic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices. In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA. Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages.

The current study examined cognitive effects of two pathways of second language (L2) acquisition longitudinally in Chinese speakers learning English in an L2-dominant environment. Thirty-nine participants who attended an intensive 10-week English course (L2-instruction group) were compared to 38 participants who attended regular university courses taught in English (L2-immersion group). Four repeated assessments were conducted over 10 weeks: precourse (baseline) and postcourse assessments, and two interim assessments every 3 weeks. Both groups matched on background variables (e.g., intelligence) and showed comparable cognitive performance in all measures at the baseline. The longitudinal results showed a similar improvement in both groups for most cognitive measures, such as visual and auditory inhibition. The only significant group difference was observed in the auditory inhibition test, where the L2-instruction group outperformed the L2-immersion group. Taken together, our results suggest a specific effect of language experience and an overall effect of linguistic context on cognitive functions.

Studies examining the potential effects of bilingualism on interference suppression show inconsistent results. Our study approaches this topic by distinguishing two potential subcomponents within interference suppression (i.e., Stimulus-Stimulus and Stimulus-Response conflict). We investigated the two subcomponents through their operationalisation in different tasks and examined the role of language proficiency in modulating it. A sample of 111 young adult participants performed four non-linguistic cognitive tasks measuring both visual and auditory domains of cognitive control. Bilinguals outperformed monolinguals in tasks involving Stimulus-Stimulus conflict, but showed comparable performance in tasks involving Stimulus-Response conflict. Specific effects of language proficiency on cognitive control were observed: group differences in auditory inhibition and visual orienting were only observed between high-proficient bilinguals and monolinguals. Taken together, types of conflicts involved in interference tasks and language proficiency could differentially affect performance in monolinguals and bilinguals. [ABSTRACT FROM AUTHOR]

Work-related musculoskeletal disorders (MSDs) are among the most commonly reported issue in Europe. Using robotic exoskeletons to support users in performing heavy industrial tasks can effectively mitigate the work-related MSDs. In this paper, a dynamic model of a hybrid exoskeleton is presented to analyze the assistive effect. The exoskeleton in this study is able to passively support the human shoulder joint and actively support the human forearm movements by providing different levels of assistive torque. With the model, two different tasks are simulated, i.e., an overhead lifting task and a static load transferring task. The results show that the assistive torque provided by the passive spring-loaded mechanism reduces the maximum human upper arm effort by 22.65%. Moreover, the exoskeleton elbow joint's assistive torque reduces the peak torque of human forearm from 10.12 Nm to 5.1 Nm. All these results demonstrate the efficacy of the model developed in the simulation and analysis of human-exoskeleton systems. [ABSTRACT FROM AUTHOR]

This study investigated the effect of the specific L2 learning experience (i.e., usage, proficiency, and exposure) on cognitive performance in 121 Chinese learners of English.The participants were divided into three groups: beginning, intermediate, and advanced learners. They are homogeneous in background variables (e.g., cultural and educational environment) but heterogeneous in the L2 language experience. They performed three non-linguistic cognitive tasks, tapping into multiple dimensions of cognitive functions in visual and auditory domains.Linear mixed-effect models were applied to RT-based analysis (i.e., analysis based on Reaction Time), and linear regression models were used for accuracy-based analysis. In addition, further multiple stepwise regression analyses were conducted to explore the relationships between individuals’ demographics, language experience, and their performance on the attentional tasks.Three groups were comparable in background measures (e.g., socioeconomic status [SES]) and fundamental cognitive abilities (e.g., working memory and IQ), but differed in specific subcomponents of cognitive functions. Specifically, compared with beginning learners, advanced learners who had a longer length of L2 usage and higher proficiency showed better inhibitory control; intermediate learners who received intensive L2 exposure and had higher proficiency showed better-switching ability and attentional disengagement. Intermediate and advanced learners were comparable in cognitive performance. The results suggest that early adulthood L2 learners experience similar cognitive effects of bilingualism, which are modulated by specific language experience.This is one of the first bilingual studies to incorporate both visual and auditory cognitive functions, while providing additional analyses to investigate the other components of cognitive control.The results contribute to the understanding of the key aspects of the L2 learning experience that contribute to the emergence of the cognitive effects of young adult learners. [ABSTRACT FROM AUTHOR]

This study describes an interdisciplinary approach to develop a 5 degrees of freedom assistive upper limb exoskeleton (ULE) for users with severe to complete functional tetraplegia. Four different application levels were identified for the ULE ranging from basic technical application to interaction with users, interaction with caregivers and interaction with the society, each level posing requirements for the design and functionality of the ULE. These requirements were addressed through an interdisciplinary collaboration involving users, clinicians and researchers within social sciences and humanities, mechanical engineering, control engineering media technology and biomedical engineering. The results showed that the developed ULE, the EXOTIC, had a high level of usability, safety and adoptability. Further, the results showed that several topics are important to explicitly address in relation to the facilitation of interdisciplinary collaboration including, defining a common language, a joint visualization of the end goal and a physical frame for the collaboration, such as a shared laboratory. The study underlined the importance of interdisciplinarity and we believe that future collaboration amongst interdisciplinary researchers and centres, also at an international level, can strongly facilitate the usefulness and adoption of assistive exoskeletons and similar technologies.