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BackgroundAs a serious public health problem, dementia has placed a heavy burden on society and families. Evidence suggests that the use of music therapy as a non-pharmacological intervention has certain advantages with respect to reducing the behavioral and psychological symptoms of dementia (BPSD) and improving the cognition and mental status of dementia patients. However, research trends and hotspots regarding music therapy intervention for dementia analysis have not been systematically studied via bibliometric analysis.MethodsWe searched the Web of Science Core Collection (WoSCC) for texts published between January 1, 2010, and October 31, 2021, and visualized country, institution, journal, keyword co-occurrence, keyword emergence and keyword clustering.ResultsA total of 217 articles from the WoSCC database were analyzed. In this research field, the annual number of publications has generally shown a slowly increasing trend, and the United States has the most publications and the most frequent cooperation among countries. University College London (UCL) has the most extensive influence among research institutions. Among articles, those published in the JOURNAL OF ALZHEIMER'S DISEASE were the most numerous, with 20 such articles being published, accounting for 9.22% (20/217) of the total. Comprehensive analysis of five clusters via biclustering shows that the research hotspots in this field during the past 11 years have mainly focused on the autobiographical memory, cognitive function, mental state and BPSD of dementia patients.ConclusionThis study conducted a bibliometric and visual analysis of relevant studies concerning music therapy intervention for dementia patients. Psychological problems faced by dementia patients and the topics of quality of life, individualized music therapy, the mental state of caregivers and other related topics may be important research directions in the future. Therefore, the question of how to develop standardized research protocols and identify unified efficacy evaluation indicators should be a focus of and difficulty for future research.

Widespread access to emerging information and communication technologies (ICT) allows its use for the screening of diseases in the general population. At the initiative of the Spanish Confederation of Associations of Families of People with Alzheimer's disease and other dementias (CEAFA), a website (http://www.problemasmemoria.com) has been created that provides information about Alzheimer's disease and includes questionnaires to be completed by family or friends concerned about memory problems of a relative. A cross-sectional, randomized, multicenter study was performed to evaluate feasibility, validity, and user satisfaction with an electronic method of completion vs. the current method of paper-based questionnaires for clinically dementia screening completed by the informants: the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and the Alzheimer's disease-8 screening test (AD8). A total of 111 pairs were recruited by seven memory clinics. Informants completed IQCODE and AD8 questionnaires both in their paper and electronic versions. The correlation between paper and electronic versions was significantly positive for IQCODE (r = 0.98; p < 0.001) and AD8 (r = 0.96; p < 0.001). The execution time did not differ significantly, and participants considered their use equally easy. This study shows that an electronic version of the IQCODE and AD8 questionnaires is suitable for its online use via the internet and achieves the same results as the traditional paper versions. [ABSTRACT FROM AUTHOR]

Background: As a serious public health problem, dementia has placed a heavy burden on society and families. Evidence suggests that the use of music therapy as a non-pharmacological intervention has certain advantages with respect to reducing the behavioral and psychological symptoms of dementia (BPSD) and improving the cognition and mental status of dementia patients. However, research trends and hotspots regarding music therapy intervention for dementia analysis have not been systematically studied via bibliometric analysis. Methods: We searched the Web of Science Core Collection (WoSCC) for texts published between January 1, 2010, and October 31, 2021, and visualized country, institution, journal, keyword co-occurrence, keyword emergence and keyword clustering. Results: A total of 217 articles from the WoSCC database were analyzed. In this research field, the annual number of publications has generally shown a slowly increasing trend, and the United States has the most publications and the most frequent cooperation among countries. University College London (UCL) has the most extensive influence among research institutions. Among articles, those published in the JOURNAL OF ALZHEIMER'S DISEASE were the most numerous, with 20 such articles being published, accounting for 9.22% (20/217) of the total. Comprehensive analysis of five clusters via biclustering shows that the research hotspots in this field during the past 11 years have mainly focused on the autobiographical memory, cognitive function, mental state and BPSD of dementia patients. Conclusion: This study conducted a bibliometric and visual analysis of relevant studies concerning music therapy intervention for dementia patients. Psychological problems faced by dementia patients and the topics of quality of life, individualized music therapy, the mental state of caregivers and other related topics may be important research directions in the future. Therefore, the question of how to develop standardized research protocols and identify unified efficacy evaluation indicators should be a focus of and difficulty for future research. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is a complex neurodegenerative disease that leads to insidious deterioration of brain functions and is considered the sixth leading cause of death in the world. Multiple studies have shown that rehabilitation therapy is becoming an important field of AD research in recent years. Objective: We opted for bibliometric analysis to comprehensively summarize the advancements in the study of AD rehabilitation treatment, aiming to provide researchers with current trends and future research directions. Methods: All articles and reviews pertaining to rehabilitation treatment in Alzheimer's disease from 2000 to 2023 were downloaded through Web of Science Core Collection. The results were subjected to bibliometric analysis using Microsoft Excel (2019 version), CiteSpace (6.3 R1 Advanced) and VOSviewer 1.6.20. Results: Overall, 1,284 publications were included. The number of publications was increasing yearly. The United States has published the most publications. University of Toronto has published the most papers of all institutions. NEUROPSYCHOLOGICAL REHABILITATION and ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION were the journals with the most studies and the most commonly cited, respectively. Clare L is the author with the highest productivity and co-citation. After analysis, the most common keywords are mild cognitive impairment, cognitive, impairment memory and executive function indicates that cognitive impairment is the main focus of research. Transcranial magnetic stimulation, cognitive rehabilitation, and physical activity/exercise are the hotspots of research at the present stage and are likely to continue. Conclusion: Distinguishing non pharmacological treatments at different stages of development is a research hotspot in AD rehabilitation; Sports intervention, brain functional imaging techniques represented by brain functional connectivity, virtual reality, and quality of life are research directions that need attention. [ABSTRACT FROM AUTHOR]

Background: Existing literature on moral conflicts that healthcare professionals encounter in dementia care has explored, amongst others, issues related to autonomy, decision-making capacity, privacy, and more. Notably, conflicts related to healthcare professionals who support informal dementia caregiving and who are confronted with family members being overburdened with their care responsibly remains an underexplored topic in the current literature, particularly in the context of Low-and Middle-Income Countries. The present paper introduces such an encounter, presenting an ethical case analysis of a conflict that occurred during a larger research project conducted in North Macedonia. Case to be studied: Due to the absence of formal care services that could have relieved an overburdened family caregiver, healthcare professionals felt compelled to reach out to the uninvolved adult daughters, requesting them to participate in their parents' care. Wondering about whether their reaching out to the daughters might count as an attempt of pressure and undue interference, professionals conflicted over the appropriateness of their action. This paper follows up on their concern, ethically assessing the professionals' action. To answer the question on whether the healthcare professionals acted appropriately or not, and to what extent, theories of filial duties are applied, embedding their action in the larger context of dementia care in North Macedonia. Results and conclusion: It is argued that the lack of formal care services in North Macedonia is of utmost relevance to the conflict. Thus, the conclusion is that the ethical inappropriateness of the case is to be located not so much with the action of the healthcare professionals but with the state because of its failure to provide professional care services that allow healthcare professionals to take ethically sound actions to counteract overarching burdens that family members face when providing informal dementia care [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder. Clinically, the therapeutic strategy of PD could only alleviate the symptoms. Nursing plays a crucial role in providing patient education, symptom management, and psychosocial support. This study aims to analyze the current state and prospects of research in the field of Parkinson's disease (PD) and its associated nursing care through bibliometric methods to explore the trends that May guide its future development. Methods: Literature related to Parkinson's disease and nursing care was systematically searched by the Web of Science database from 1991 to 2023. Quantitative analysis of cooperative networks was conducted using bibliometric tools VOSviewer and CiteSpace. Results: The analysis covered 2,649 publications in the field of PD and nursing care, authored by 12,576 researchers from 3,869 institutions across 94 countries. The number of articles has steadily increased over the past 20 years. In this research field, the United States and the United Kingdom emerged as leading countries, and Radboud Universiteit Nijmegen was positioned as an international hub. Movement Disorders was identified as the journal with the highest output and with the most co-citation. Prof. Bastiaan R. Bloem published the most papers in the area, and Prof. Per Odin had the highest average citation. The major fields of these publications are clinical neurology, geriatrics & gerontology, multidisciplinary sciences, and health care sciences & services. Hot topics in the field predominantly revolve around Parkinson's disease, quality of life, and dementia. Conclusion: Research in Parkinson's disease and nursing care is experiencing a period of rapid growth, with continuous expansion in research scope and depth of investigation. One of the trends identified is the increasing focus on quality of life and the management of dementia in PD patients, reflecting the importance of these areas in research. The study further suggests that future advancements in the field May rely significantly on strengthening international collaborations and addressing global disparities in resource distribution, particularly by promoting research inclusivity and cooperation among low-resource countries. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder. Clinically, the therapeutic strategy of PD could only alleviate the symptoms. Nursing plays a crucial role in providing patient education, symptom management, and psychosocial support. This study aims to analyze the current state and prospects of research in the field of Parkinson's disease (PD) and its associated nursing care through bibliometric methods to explore the trends that May guide its future development. Methods: Literature related to Parkinson's disease and nursing care was systematically searched by the Web of Science database from 1991 to 2023. Quantitative analysis of cooperative networks was conducted using bibliometric tools VOSviewer and CiteSpace. Results: The analysis covered 2,649 publications in the field of PD and nursing care, authored by 12,576 researchers from 3,869 institutions across 94 countries. The number of articles has steadily increased over the past 20 years. In this research field, the United States and the United Kingdom emerged as leading countries, and Radboud Universiteit Nijmegen was positioned as an international hub. Movement Disorders was identified as the journal with the highest output and with the most co-citation. Prof. Bastiaan R. Bloem published the most papers in the area, and Prof. Per Odin had the highest average citation. The major fields of these publications are clinical neurology, geriatrics & gerontology, multidisciplinary sciences, and health care sciences & services. Hot topics in the field predominantly revolve around Parkinson's disease, quality of life, and dementia. Conclusion: Research in Parkinson's disease and nursing care is experiencing a period of rapid growth, with continuous expansion in research scope and depth of investigation. One of the trends identified is the increasing focus on quality of life and the management of dementia in PD patients, reflecting the importance of these areas in research. The study further suggests that future advancements in the field May rely significantly on strengthening international collaborations and addressing global disparities in resource distribution, particularly by promoting research inclusivity and cooperation among low-resource countries. [ABSTRACT FROM AUTHOR]

Introduction: The blood oxygen level-dependent (BOLD) signal derived from functional neuroimaging is commonly used in brain network analysis and dementia diagnosis. Missing the BOLD signal may lead to bad performance and misinterpretation of findings when analyzing neurological disease. Few studies have focused on the restoration of brain functional time-series data. Methods: In this paper, a novel U-shaped convolutional transformer GAN (UCT-GAN) model is proposed to restore the missing brain functional time-series data. The proposed model leverages the power of generative adversarial networks (GANs) while incorporating a U-shaped architecture to effectively capture hierarchical features in the restoration process. Besides, the multi-level temporal-correlated attention and the convolutional sampling in the transformer-based generator are devised to capture the global and local temporal features for the missing time series and associate their long-range relationship with the other brain regions. Furthermore, by introducing multi-resolution consistency loss, the proposed model can promote the learning of diverse temporal patterns and maintain consistency across different temporal resolutions, thus effectively restoring complex brain functional dynamics. Results: We theoretically tested our model on the public Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset, and our experiments demonstrate that the proposed model outperforms existing methods in terms of both quantitative metrics and qualitative assessments. The model's ability to preserve the underlying topological structure of the brain functional networks during restoration is a particularly notable achievement. Conclusion: Overall, the proposed model offers a promising solution for restoring brain functional time-series and contributes to the advancement of neuroscience research by providing enhanced tools for disease analysis and interpretation. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease psychosis (PDP) is one of the most severe and disabling non-motor symptoms in the progression of Parkinson's disease (PD), significantly impacting the prognosis of PD patients. In recent years, there has been an increase in literature on PDP. However, bibliometrics has rarely been applied to PDP research. This study provides an overview of the current state of PDP research and predicts future trends in this field. Methods: The literature search was conducted using the Web of Science Core Collection, with the search terms (Parkinson* AND (psychotic* OR hallucination* OR illusion* OR delusion* OR misperception* OR psychosis OR psychoses)). VOSviewer and CiteSpace software were employed to perform bibliometric analysis and visual representation of the search results. Results: A total of 603 articles were effectively included. Since 2017, there has been a significant upward trend in publications related to PDP. The United States, the United Kingdom, and Canada were the top three contributing countries in terms of publication volume, with France also having a strong influence in this field. Movement Disorders and King's College London included and published the most articles on PDP. The paper titled " Hallucinations in Parkinson's Disease: Prevalence, Phenomenology, and Risk Factors " received the highest number of citations and average citations. Cluster analysis results identified brain, prevalence, connectivity, and atypical antipsychotics as key hotspots in this field. High-frequency keywords were grouped into three themes: neurobiology, therapeutic strategies, and symptom research. Among them, pimavanserin, risk, and functional connectivity have been the most studied areas in the past 7 years and are likely to remain key topics in future research. Conclusion: Research on PDP has garnered increasing attention. This study visualizes PDP research over the past 25 years to analyze global hotspots and trends. It offers researchers a valuable perspective for identifying key topics and understanding research trajectories in this expanding field. [ABSTRACT FROM AUTHOR]

The aging of the world's population due to accelerating demographic shift on all continents is causing increasing pressure worldwide, giving rise to a "crisis of care" or "care wave." The increase in longevity is resulting in an increase in chronic diseases (such as dementia), an increase in care needs to perform the activities of daily living, and situations of isolation and profound loneliness among older adults. These circumstances are opening the debate on the need to use technology, such as robots, to improve the wellbeing of older adults and their caregivers. The aim of this paper is to address the ethical questions in using social and companion robots for people with dementia, such as concerning consent, the replacement of human care, the potential for increased dependency, and the burden on caregivers. Involving older adults and other stakeholders offers the potential to pursue robotics to support older people while also ensuring a strong ethical commitment. The study is a review of high-impact articles on the topic of the use of social and companion robots with older people with dementia. [ABSTRACT FROM AUTHOR]

A diagnosis of dementia often comes with difficulties in understanding a conversational context and expressing how one feels. So far, research on how to facilitate advance care planning (ACP) for people with dementia focused on defining relevant themes and topics for conversations, or on how to formalize decisions made by surrogate decision makers, e.g., family members. The aim of this review is to provide a better scope of the existing research on practical communication aspects related to dementia in ACP conversations. In November 2020, seven databases were searched to select papers for inclusion (Proquest, Medline, Embase, Scopus, Psycinfo, Amed, and Cinahl). This search was updated in December 2021. The search strategy consisted of three tiers (related terms to "dementia," "communication" and "ACP"), intersected by using the Boolean term "AND," and resulted in 787 studies. Two researchers followed explicit criteria for two sequential levels of screening, based on titles and abstracts and full papers. A total of 22 studies were included for data analysis. Seven topics (i.e., importance of having ACP conversations, knowledge gap, inclusion of people with dementia in ACP conversations, policy vs. practice, adapting to cognitive changes, adapting to psychosocial changes, and adapting to emotional changes) emerged clustered around two themes (i.e., communicating with people with dementia in ACP, and changes in communication due to dementia). This scoping review provides practical suggestions for healthcare professionals to improve ACP communication and uncovered gaps in research on communication aspects related to dementia in ACP conversations, such as non-verbal behavior, timing and implementation, and personal preferences. [ABSTRACT FROM AUTHOR]

Smart mobile phone use is increasing worldwide, as is the ability of mobile devices to monitor daily routines, behaviors, and even cognitive changes. There is a growing opportunity for users to share the data collected with their medical providers which may serve as an accessible cognitive impairment screening tool. Data logged or tracked in an app and analyzed with machine learning (ML) could identify subtle cognitive changes and lead to more timely diagnoses on an individual and population level. This review comments on existing evidence of mobile device applications designed to passively and/or actively collect data on cognition relevant for early detection and diagnosis of Alzheimer’s disease (AD). The PubMed database was searched to identify existing literature on apps related to dementia and cognitive health data collection. The initial search deadline was December 1, 2022. Additional literature published in 2023 was accounted for with a follow-up search prior to publication. Criteria for inclusion was limited to articles in English which referenced data collection via mobile app from adults 50+ concerned, at risk of, or diagnosed with AD dementia. We identified relevant literature (n = 25) which fit our criteria. Many publications were excluded because they focused on apps which fail to collect data and simply provide users with cognitive health information. We found that although data collecting cognition- related apps have existed for years, the use of these apps as screening tools remains underdeveloped; however, itmay serve as proof of concept and feasibility as there is much supporting evidence on their predictive utility. Concerns about the validity of mobile apps for cognitive screening and privacy issues remain prevalent. Mobile applications and use of ML is widely considered a financially and socially viable method of compiling symptomatic data but currently this large potential dataset, screening tool, and research resource is still largely untapped. [ABSTRACT FROM AUTHOR]

Introduction: Previous validation studies demonstrated that BrainCheck Assess (BC-Assess), a computerized cognitive test battery, can reliably and sensitively distinguish individuals with different levels of cognitive impairment (i.e., normal cognition (NC), mild cognitive impairment (MCI), and dementia). Compared with other traditional paper-based cognitive screening instruments commonly used in clinical practice, the Montreal Cognitive Assessment (MoCA) is generally accepted to be among the most comprehensive and robust screening tools, with high sensitivity/specificity in distinguishing MCI from NC and dementia. In this study, we examined: (1) the linear relationship between BC-Assess and MoCA and their equivalent cut-off scores, and (2) the extent to which they agree on their impressions of an individual's cognitive status. Methods: A subset of participants (N = 55; age range 54-94, mean/SD = 80/9.5) from two previous studies who took both the MoCA and BC-Assess were included in this analysis. Linear regression was used to calculate equivalent cut-off scores for BC-Assess based on those originally recommended for the MoCA to differentiate MCI from NC (cut-off = 26), and dementia from MCI (cutoff = 19). Impression agreement between the two instruments were measured through overall agreement (OA), positive percent agreement (PPA), and negative percent agreement (NPA). Results: A high Pearson correlation coefficient of 0.77 (CI = 0.63-0.86) was observed between the two scores. According to this relationship, MoCA cutoffs of 26 and 19 correspond to BC-Assess scores of 89.6 and 68.5, respectively. These scores are highly consistent with the currently recommended BCAssess cutoffs (i.e., 85 and 70). The two instruments also show a high degree of agreement in their impressions based on their recommended cut-offs: (i) OA = 70.9%, PPA = 70.4%, NPA = 71.4% for differentiating dementia from MCI/NC; (ii) OA = 83.6%, PPA = 84.1%, NPA = 81.8% for differentiating dementia/MCI from NC. Discussion: This study provides further validation of BC-Assess in a sample of older adults by showing its high correlation and agreement in impression with the widely used MoCA. [ABSTRACT FROM AUTHOR]

It is important to understand the relationship between cognitive abilities and language processing. Here, we explore a burgeoning area of research that harnesses semantic indices to predict cognitive impairment and track cognitive decline. One such index, propositional density, quantifies the information conveyed per language segment. Despite some variation stemming from methodological, sampling, and measurement differences, we suggest that propositional density has diagnostic and assessment value. This paper surveys existing studies that have used propositional density in the context of cognitive aging and impairment and offers some insights into the use of this index to highlight differences in cognition. We also suggest further explorations of basic research involving this concept, and some applications for assessing cognitive health. [ABSTRACT FROM AUTHOR]

Introduction: Alzheimer's disease and related dementias (ADRD) represent a substantial global public health challenge with multifaceted impacts on individuals, families, and healthcare systems. Brief cognitive screening tools such as the Mini-Cog© can help improve recognition of ADRD in clinical practice, but widespread adoption continues to lag. We compared the Digital Clock and Recall (DCR), a next-generation process-driven adaptation of the Mini-Cog, with the original paper-and-pencil version in a well-characterized clinical trial sample. Methods: DCR was administered to 828 participants in the Bio-Hermes-001 clinical trial (age median ± SD = 72 ± 6.7, IQR = 11; 58% female) independently classified as cognitively unimpaired (n = 364) or as having mild cognitive impairment (MCI, n = 274) or dementia likely due to AD (DLAD, n = 190). MCI and DLAD cohorts were combined into a single impaired group for analysis. Two experienced neuropsychologists rated verbal recall accuracy and digitally drawn clocks using the original Mini-Cog scoring rules. Inter-rater reliability of Mini- Cog scores was computed for a subset of the data (n = 508) and concordance between Mini-Cog rule-based and DCR scoring was calculated. Results: Inter-rater reliability of Mini-Cog scoring was good to excellent, but Rater 2's scores were significantly higher than Rater 1's due to variation in clock scores (p < 0.0001). Mini-Cog and DCR scores were significantly correlated (τB = 0.71, p < 0.0001). However, using a Mini-Cog cut score of 4, the DCR identified more cases of cognitive impairment (n = 47; χ² = 13.26, p < 0.0005) and Mini-Cog missed significantly more cases of cognitive impairment (n = 87). In addition, the DCR correctly classified significantly more cognitively impaired cases missed by the Mini-Cog (n = 44) than vice versa (n = 4; χ² = 21.69, p < 0.0001). Discussion: Our findings demonstrate higher sensitivity of the DCR, an automated, process-driven, and process-based digital adaptation of the Mini- Cog. Digital metrics capture clock drawing dynamics and increase detection of diagnosed cognitive impairment in a clinical trial cohort of older individuals. [ABSTRACT FROM AUTHOR]

Over the past decades, literature in dementia ethics has extensively looked at moral questions revolving around the care of older people living with dementia. Particularly prevalent are autonomy-related concerns regarding topics such as advance directives. In this paper, we argue that these discussions are crucially premised on how dementia is understood and represented. Despite the multiplicity of dementia presentations in people, the dominant discourse predominantly frames dementia as 'monstrous,' an 'enemy,' a destructive experience in need of eradication. We contend that such a monolithic approach, from a moral standpoint, is problematic in several respects. Indeed, framing heavily influences the way dementia is understood and experienced, leading to stigmatization, bias, and distress. Not only does it influence decisions and discussions on advance directives, but we argue that this flawed understanding of dementia is rooted in and contributes to epistemic harm. In the first section, we introduce the ethics of advance directives. More specifically, we introduce the view developed by Dworkin who has largely influenced the debate by making the case for advance directives by grounding them in the principles of autonomy and beneficence. In the second section, we show how dementia is still mostly framed monolithically as a 'destructive experience.' We then show that this framing is problematic because it oversteps the different pathologies dementia implies, which leads to an inaccurate representation of the condition. In the third section, we present possible alternative framings: dementia as normal aging, a person-centered care framework, and an embodied view. In the fourth section, drawing on recent developments in the epistemic injustice literature, we explore how maintaining and utilizing flawed understandings of dementia may lead to distinct moral-epistemic harms for those living with dementia and inform ongoing discussions on advance directives. Finally, in the concluding section, we return to the case of advance directives and what the implications of rethinking dementia are. [ABSTRACT FROM AUTHOR]

The cognitive screening test is a brief cognitive examination that could be easily performed in a clinical setting. However, one of the main drawbacks of this test was that only a paper-based version was available, which restricts the test to be manually administered and graded by medical personnel at the health centers. The main solution to these problems was to develop a potential remote assessment for screening individuals with cognitive impairment. Currently, multiple studies have been adopting artificial intelligence (AI) technology into these tests, evolving the conventional paper-based neurocognitive test into a digitized AI-assisted neurocognitive test. These studies provided credible evidence of the potential of AI-augmented cognitive screening tests to be better and provided the framework for future studies to further improve the implementation of AI technology in the cognitive screening test. The objective of this review article is to discuss different types of AI used in digitized cognitive screening tests and their advantages and disadvantages. [ABSTRACT FROM AUTHOR]

Introduction: Informal caregivers are the backbone of dementia care. iSupport is a World Health Organization digital support program for caregivers of people with dementia (PwD) that has been culturally adapted in several countries. iSupport was previously assessed for its feasibility in Portugal, and this countryspecific version is now being utilized as a remote measurement tool (RMT). It constitutes the first internationally developed iSupport platform that is technically and scientifically enhanced to collect data on sociodemographic, clinical, and psychosocial variables of dementia care dyads. This paper characterizes the early adopters of iSupport-Portugal and discusses its exploration as a RMT. Methods: Cross-sectional data were collected between February and July 2023 from users registering on isupport-portugal.pt. To characterize caregivers and PwD, eligibility was limited to unpaid caregivers assisting community dwelling PwD (n = 173). Data were collected through self-administered instruments in users' accounts. Caregivers completed psychosocial measures on burden, anxiety, depression, quality of life, desire to institutionalize and usage of community services. Textual data on caregivers' needs underwent content analysis. Results: Among the early adopters of iSupport-Portugal (n = 365), 52.3% were informal caregivers, while 44.7% were health/social care professionals or others. Most caregivers were female (82.7%), middle-aged (M 51.7 years), highly educated (M 15.3 years) and supporting a parent (70.5%). Caregivers cared for a median of 24 h/week and 60.8% lived with the PwD. Neuropsychiatric symptoms were reported for 94.1% of PwD, who scored as moderately dependent (Barthel Index: M 14.0). Significant burden was reported by 88.4% of caregivers (=21 on ZBI-22). Among caregivers scoring borderline or abnormal (=8 on HADS) for anxiety, depression, or both (75.5%), 30.8% sought mental health counseling. Caregivers supporting a PwD not using community services scored higher on anxiety (p = 0.003), and depression (p = 0.009). Text data revealed unmet practical, emotional, and informational needs. Discussion: iSupport-Portugal has garnered fair initial interest from caregivers, particularly from those who are children, highly educated, and employed. Early adopters exhibited significant psychological distress, and both practical and emotional needs, which contrast with limited use of support services for themselves and the PwD. iSupport-Portugal shows promise for descriptive research on care dyads, particularly among newer generations of caregivers. [ABSTRACT FROM AUTHOR]

Introduction: Social activities are important for health and act as a driver of cognitive reserve during aging. In this perspective paper, we describe challenges and outline future (research) endeavors to establish better operationalization of social activities in multidomain interventions to prevent dementia. Body: We first address the lack of conceptual clarity, which makes it difficult to measure engagement in social activities. Second, drawing from our experience with the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we discuss social activities in multidomain dementia prevention interventions. Using qualitative data from the Multimodal Preventive Trial for Alzheimer's Disease (MIND-ADmini), we reflect on participant experiences with social activities. Third, we address the potential and challenges of digital solutions in promoting social activities in interventions for dementia prevention. Finally, we share insights from a workshop on digital technology, where we consulted with individuals with andwithout cognitive impairment who have been involved in three European projects (i.e., EU-FINGERS, Multi-MeMo, and LETHE). Discussion: Based on these insights, we advocate for research that strengthens and accelerates the integration of social activities into multidomain interventions for dementia prevention. We propose several ways to achieve this: (a) by conducting mixed methods research to formulate a broadly accepted definition and instructions to measure social activities; (b) by focusing on promoting engagement in social activities beyond the intervention setting; and (c) by exploring the needs and preferences of older adults towards digitallysupported interventions and co-design of new technologies that enrich inperson social activities. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is a degenerative illness of the central nervous system that is irreversible and is characterized by gradual behavioral impairment and cognitive dysfunction. Researches on exosomes in AD have gradually gained the attention of scholars in recent years. However, the literatures in this research area do not yet have a comprehensive visualization analysis. The aim of this work is to use bibliometrics to identify the knowledge constructs and investigate the research frontiers and hotspots related to exosomes in AD. Methods: From January 2003 until June 2023, we searched the Web of Science Core Collection for literature on exosomes in AD. We found 585 papers total. The bibliometric study was completed using VOSviewer, the R package "bibliometrix," and CiteSpace. The analysis covered nations, institutions, authors, journals, and keywords. Results: Following 2019, the articles on exosomes in AD increased significantly year by year. The vast majority of publications came from China and the US. The University of California System, the National Institutes of Health, and the NIH National Institute on Aging in the US were the primary research institutions. Goetzl Edward J. was frequently co-cited, while Kapogiannis Dimitrios was the most prolific author in this discipline with the greatest number of articles. Lee Mijung et al. have been prominent in the last two years in exosomes in AD. The Journal of Alzheimer's Disease was the most widely read publication, and Alzheimers & Dementia had the highest impact factor. The Journal of Biological Chemistry, Proceedings of the National Academy of Sciences of the United States of America, and Journal of Alzheimer's Disease were the three journals with more than 1,000 citations. The primary emphasis of this field was Alzheimer's disease, exosomes, and extracellular vesicles; since 2017, the number of phrases pertaining to the role of exosomes in AD pathogenesis has increased annually. "Identification of preclinical Alzheimer's disease by a profile of pathogenic proteins in neurally derived blood exosomes: a case-control study" was the reference with the greatest citing power, indicating the future steered direction in this field. Conclusion: Using bibliometrics, we have compiled the research progress and tendencies on exosomes in Alzheimer's disease for the first time. This helps determine the objectives and paths for future study. [ABSTRACT FROM AUTHOR]

The worldwide incidence of cognitive impairment is escalating, yet no effective solutions for these afflictions have been discovered. Consequently, the importance of early identification and immediate intervention is heightened. Advanced eye movements--a form of voluntary eye movements that includes anti-saccades, memory-guided saccades, predictive saccades, pro-saccades and gap/overlap saccades, mediated by the cerebral cortex and subcortical pathways reflect cognitive levels and functions across different domains. In view of their objectivity, reproducibility, and non-invasive characteristics, advanced eye movement examination possesses significant prospective utility across a wide range of cognitive impairment. This paper extensively reviews various models associated with advanced eye movement examinations and their current applications in cognitive impairment such as Alzheimer's disease, Lewy body dementia and frontotemporal dementia. Advanced eye movement examination can serve as a biomarker for early screening diagnosis and research on cognitive impairment. In the future, combining advanced eye movement examination with neuropsychological scale assessment and other diagnostic methods may contribute to further early identification of these types of diseases. [ABSTRACT FROM AUTHOR]

Background: It is widely accepted that traumatic brain injury (TBI) increases the risk of developing long-term dementia, although some controversies surrounding this topic exist. Annually, approximately 69 million individuals suffer from TBI all around the world. Such a large population of TBI patients could lead to a future surge in the number of dementia patients. Due to the potentially severe consequences of TBI, various research projects on post-TBI dementia have emerged worldwide. Therefore, it is essential to comprehend the current status and development of post-TBI dementia for future research. Objective: The purpose of the study was to provide an overview of the field and identify hotspots, research frontiers, and future research trends for post-TBI dementia. Methods: Articles related to post-TBI dementia were retrieved from the Web of Science Core Collection for the period between 2007 and 2022, and analyzing them based on factors such as citations, authors, institutions, countries, journals, keywords, and references. Data analysis and visualization were conducted using VOSviewer, CiteSpace, and an online bibliometric platform (https://bibliometric. com). Results: From 2007 to 2022, we obtained a total of 727 articles from 3,780 authors and 1,126 institutions across 52 countries, published in 262 journals. These articles received a total of 29,353 citations, citing 25,713 references from 3,921 journals. Over the last 15 years, there has been a significant upward trend in both publications and citations. The most productive country was the United States, the most productive institution was Boston University, and the most productive author was McKee AC. Journal of Neurotrauma has been identified as the periodical with the greatest number of publications. Three clusters were identified through cluster analysis of keywords. A burst in the use of the term "outcome" in 2019 is indicative of a future research hotspot. The timeline view of references showed 14 clusters, of which the first 4 clusters collected the majority of papers. The first 4 clusters were "chronic traumatic encephalopathy," "age of onset," "tauopathy," and "cognitive decline," respectively, suggesting some areas of interest in the field. Conclusion: The subject of post-TBI dementia has raised much interest from scientists. Notably, America is at the forefront of research in this area. Further collaborative research between different countries is imperative. Two topical issues in this field are "The association between TBI and dementia-related alterations" and "chronic traumatic encephalopathy (CTE)." Studies on clinical manifestation, therapy, pathology, and pathogenic mechanisms are also popular in the field. [ABSTRACT FROM AUTHOR]

Objective: Alzheimer's disease (AD) is a major disease that affects the elderly worldwide. Several studies have revealed that vitamins may influence the risk of developing AD. However, information in this field remains ambiguous. Therefore, this study aimed to examine the relationship between AD and vitamins, identify journal publications and collaborators, and analyze keywords and research trends using a bibliometric method. Methods: We systematically searched the Web of Science (WOS) Core Collection for papers published on AD and vitamins. Retrieved data regarding institutions, journals, countries, authors, journal distribution, keywords, and so on. SPSS 25 software was used for the statistical analysis, and CiteSpace V.6.1.R6 was used to visualize the information through collaborative networks. Results: A total of 2,838 publications were ultimately included in accordance with the specified inclusion criteria. The number of publications gradually increased from 1996 to 2023, with papers published in 87 countries/regions and 329 institutions. China (centrality: 0.02) and the University of Kentucky (centrality: 0.09) were the major research countries and institutions, respectively. NEUROLOGY was cited most frequently, reaching 1,573, and had the greatest impact. The cited keywords show that "Alzheimer's disease," "oxidative stress," "vitamin E," and "dementia" have been research hotspots in recent years. Beta-carotene emerged in 2023 and was identified as a developmental trend in this field. Conclusion: This is the first bibliometric analysis of vitamins associated with AD. We identified 2,838 articles in the field of vitamins and AD, analyzed the information of major countries/regions, institutions, and core journals in this field, and summarized the research hotspots and frontiers. These findings provide useful information for researchers to explore the role of vitamins in AD further. [ABSTRACT FROM AUTHOR]

Dementias are responsible for the most frequent neurodegenerative diseases and the seventh leading cause of death worldwide. As a result, there is a growing effort by the neuroscientific community to understand the physiopathology of neurodegenerative diseases, including how to alleviate the effects of the cognitive decline by means of non-pharmacological therapies (e.g., physical exercise). Studies have shown that exercise can improve aspects of brain health related to cognition. However, there still needs to be more knowledge regarding the mechanisms controlling these relationships, and a newly discovered cleansing system in the brain, named the glymphatic system, can be the missing link in this mechanism. The objective of this paper is to review recent findings regarding the potential impacts of physical exercise on the glymphatic system and its implications for the onset of neurodegenerative diseases. Additionally, considering the close interplay between exercise and sleep quality, we aim to explore how sleep patterns may intersect with exercise-induced effects on glymphatic function, further elucidating the complex relationship between lifestyle factors and brain health. [ABSTRACT FROM AUTHOR]

Robot animals, designed to mimic living beings, pose ethical challenges in the context of caring for vulnerable patients, specifically concerning deception. This paper explores how emotions become a resource for dealing with the misinformative nature of robot animals in dementia care homes. Based on observations of encounters between residents, care workers, and robot animals, the study shows how persons with dementia approach the ambiguous robots as either living beings, material artifacts, or something in-between. Grounded in interactionist theory, the research demonstrates that emotions serve as tools in the sense-making process, occurring through interactions with the material object and in collaboration with care workers. The appreciation of social robots does not solely hinge on them being perceived as real or fake animals; persons with dementia may find amusement in "fake" animals and express fear of "real" ones. This observation leads us to argue that there is a gap between guidelines addressing misinformation and robots and the specific context in which the technology is in use. In situations where small talk and play are essential activities, care workers often prioritize responsiveness to residents rather than making sure that the robot's nature is transparent. In these situations, residents' emotional expressions serve not only as crucial resources for their own sensemaking but also as valuable indicators for care workers to comprehend how to navigate care situations. [ABSTRACT FROM AUTHOR]

Introduction: Dementia is one of the major global health issues among the aging population, characterized clinically by a progressive decline in higher cognitive functions. This paper aims to apply various artificial intelligence (AI) approaches to detect patients with mild cognitive impairment (MCI) or dementia accurately. Methods: Quantitative research was conducted to address the objective of this study using randomly selected 343 Saudi patients. The Chi-square test was conducted to determine the association of the patient's cognitive function with various features, including demographical and medical history. Two widely used AI algorithms, logistic regression and support vector machine (SVM), were used for detecting cognitive decline. This study also assessed patients' cognitive function based on gender and developed the predicting models for males and females separately. Results: Fifty four percent of patients have normal cognitive function, 34% have MCI, and 12% have dementia. The prediction accuracies for all the developed models are greater than 71%, indicating good prediction capability. However, the developed SVM models performed the best, with an accuracy of 93.3% for all patients, 94.4% for males only, and 95.5% for females only. The top 10 significant predictors based on the developed SVM model are education, bedtime, taking pills for chronic pain, diabetes, stroke, gender, chronic pains, coronary artery diseases, and wake-up time. Conclusion: The results of this study emphasize the higher accuracy and reliability of the proposed methods in cognitive decline prediction that health practitioners can use for the early detection of dementia. This research can also stipulate substantial direction and supportive intuitions for scholars to enhance their understanding of crucial research, emerging trends, and new developments in future cognitive decline studies. [ABSTRACT FROM AUTHOR]

Purpose: The SOUND method offers an innovative blended intervention based on music circle-activities and cognitive stimulation approaches which was codesigned by musicians, health professionals, older people with dementia, family caregivers and researchers, for its application in dementia settings. The purpose of the paper is to describe the detailed procedure of the quasi-experimental pilot study. Method: The experimental phase of SOUND uses a mixed-method design encompassing qualitative and quantitative observations, cognitive testing, selfreport and interviewer-assisted questionnaires to investigate the effectiveness of the intervention for 45 people with dementia and 45 professionals (15 in every study country: Italy, Portugal, Romania). Results: The pilot study will be the first implementation of the SOUND intervention aiming to investigate the feasibility and preliminary effects of the method. Conclusion: The novelty of SOUND is its multicomponent method, including the most evidenced features for improving the wellbeing of participants. [ABSTRACT FROM AUTHOR]

Neurofeedback training (NFT) is a non-invasive method and has been shown to be effective for attention deficit/hyperactivity disorder (ADHD) and various psychiatric disorders. The aim of this paper is to evaluate the effectiveness of NFT for patients with Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) or Vascular Diseases (VD), so that we searched research articles from four databases, using the keywords neurofeedback, elderly, MCI, AD, VD, and dementia. As a result, 13 articles were identified regarding the effectiveness of NFT in patients with MCI and AD. Although each study differed in study design, training protocol, electroencephalogram (EEG) electrode placement, and reward and inhibition frequency bands, all were shown to enhance memory, attention, and other cognitive abilities. Additional well-designed, randomized studies with sufficient power are needed to further confirm the effectiveness of NFT. [ABSTRACT FROM AUTHOR]

Personal narrative is a powerful way to include people in their care and to understand their values that drive their needs. In this paper, we describe a program designed to teach oral history to clinicians and trainees in the field of aging, dementia and caregiving. The training uses empathic listening, open-ended interviewing, and the discovery of individual values and experience to breakdown stigma and preconceptions of what it means to age with cognitive impairment. Sharing these stories of aging, dementia, and caregiving becomes an important tool to break down stereotypes, promote person-centered care, and advocate for the unheard. The profound impact of the oral history process is felt by the narrator, the interviewer and the listener. Human beings are wired for stories, and oral history taps into that power to connect us and provide better care through better understanding. [ABSTRACT FROM AUTHOR]

Many studies have documented cognitive deficits, especially spatial cognitive deficits, in patients with some form of vestibular loss. Almost 20 years ago, hippocampal (HPC) atrophy was reported to be correlated with spatial memory deficits in such patients and the idea has gradually emerged that HPC atrophy may be causally responsible for the cognitive deficits. However, the results of studies of HPC volume following vestibular loss have not always been consistent, and a number of studies have reported no evidence of HPC atrophy. This paper argues that HPC atrophy, if it does occur following vestibular loss, may not be directly, causally responsible for the cognitive deficits, and that it is more likely that rapid functional changes in the HPC are responsible, due to the interruption of the transmission of vestibular information to the HPC. The argument presented here rests on 3 tranches of evidence: (1) Cognitive deficits have been observed in humans even in the absence of HPC atrophy; (2) HPC atrophy has not been reported in animal studies following vestibular loss, despite cognitive deficits; and (3) Animal studies have shown that the interruption of the transmission of vestibular information to the HPC has immediate consequences for HPC place cells, far too quickly to be explained by HPC atrophy. It is possible that HPC atrophy, when it does occur, is related to the longer-term consquences of living with vestibular loss, which are likely to increase circulating cortisol. [ABSTRACT FROM AUTHOR]

This perspective paper discusses the concept of authenticity in relation to brain health and neurodegenerative diseases. We define authenticity as being true to oneself and consider it a social value of relevance to neuroscientists, clinicians, and caregivers. From a biological perspective, behaviors that can be interpreted as expressions of authenticity are produced by distributed brain networks. By understanding it as a dynamic process, we argue that harnessing authenticity across the lifespan can be protective by promoting resilience. We discuss the idea of authentic aging, which appreciates the complexity of human life within the world and can enhance positive views of later life. Authenticity is additionally applicable to caring for people with neurodegenerative diseases, both when understanding the behavior of people with dementia and the response of caregivers. Tailoring care to an individual's personality and strengths may improve their brain health. Finally, we describe an interdisciplinary learning event, themed around masks, designed to engage participants in identifying authenticity in their own work. For scientists, care professionals, and caregivers, reflecting upon authenticity can aid understanding of the person with dementia and therefore improve care. [ABSTRACT FROM AUTHOR]

Mild cognitive impairment (MCI), representing the ‘transitional zone’ between normal cognition and dementia, has become a novel topic in clinical research. Although early detection is crucial, it remains logistically challenging at the same time. While traditional pen-and-paper tests require in-depth training to ensure standardized administration and accurate interpretation of findings, significant technological advancements are leading to the development of procedures for the early detection of Alzheimer’s disease (AD) and facilitating the diagnostic process. Some of the diagnostic protocols, however, show significant limitations that hamper their widespread adoption. Concerns about the social and economic implications of the increasing incidence of AD underline the need for reliable, non-invasive, cost-effective, and timely cognitive scoring methodologies. For instance, modern clinical studies report significant oculomotor impairments among patients with MCI, who perform poorly in visual paired-comparison tasks by ascribing less attentional resources to novel stimuli. To accelerate the Global Action Plan on the Public Health Response to Dementia 2017–2025, this work provides an overview of research on saccadic and exploratory eye-movement deficits among older adults with MCI. The review protocol was drafted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases were systematically searched to identify peer-reviewed articles published between 2017 and 2022 that examined visual processing in older adults with MCI and reported gaze parameters as potential biomarkers. Moreover, following the contemporary trend for remote healthcare technologies, we reviewed studies that implemented non-commercial eye-tracking instrumentation in order to detect information processing impairments among the MCI population. Based on the gathered literature, eye-tracking-based paradigms may ameliorate the screening limitations of traditional cognitive assessments and contribute to early AD detection. However, in order to translate the findings pertaining to abnormal gaze behavior into clinical applications, it is imperative to conduct longitudinal investigations in both laboratory-based and ecologically valid settings. [ABSTRACT FROM AUTHOR]

Background: Coronavirus Disease 2019 (COVID-19) is a worldwide public health concern. It continues to spread rapidly throughout the world causing multiple physical and psychological consequences in the population. Especially, people affected by severe psychiatric or neurological diseases are highly susceptible to serious health complications not only due to the direct effect of the infection but also to the indirect effect of COVID-19 following social distancing during lockdowns and its general social consequences. Indeed, lockdown and difficulties in using the care services produced psychological consequences in caregivers such as depression, anxiety, and worsening of the quality of life which in turn affected the ability to manage patients. Our aim was to systematically review the psychological consequences of the COVID-19 lockdown in caregivers of patients with cognitive impairment and dementia and the impact on the health of their patients. Methods: A systematic literature search was conducted by searching in MEDLINE/PubMed, Scopus, and Web of Science by two independent researchers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Data extraction and quality assessment were also performed. Papers were screened for eligibility by abstract and then those which met inclusion criteria were included in this review. Results: The initial search returned 410 records. After the abstract screening and the inclusion/exclusion criteria were applied, 315 were excluded because they were irrelevant, 30 because they were reviews, meta-analyses, letters to editors, editorials, guidelines, or case reports, and 10 because they were duplicates. Then, 38 out of 55 abstracts/full-text articles were excluded because they did not simultaneously assess mental health of patients and caregivers. In the end, 17 papers were deemed eligible and included in the present review. Conclusion: Based on current literature, the COVID-19 pandemic and the ensuing lockdown caused severe psychological consequences for caregivers of patients with dementia, worsening their mental health, and increasing the psychological and physical burden, independently from the severity of the disease of their relatives, which resulted also independently globally worsened. [ABSTRACT FROM AUTHOR]

Introduction: Exercise is recognized as a modifiable lifestyle factor that can mitigate cognitive decline and dementia risk. While the benefits of exercise on cognitive aging have been reported on extensively, neuronal effects in adults experiencing cognitive decline have not been systematically synthesized. The aim of this systematic review was to assess the effects of exercise on cognition and brain function in people with cognitive decline associated with dementia risk. Method: A systematic search was conducted for randomized controlled trials of ≥ 4 weeks exercise (aerobic, resistance, or mind-body) that assessed cognition and brain function using neuroimaging and neurophysiological measures in people with subjective or objective cognitive decline. Study characteristics and brain function effects were narratively synthesized, while domain-specific cognitive performance was subjected to meta-analysis. Study quality was also assessed. Results: 5,204 records were identified and 12 unique trials met the eligibility criteria, representing 646 adults classified with cognitive frailty, mild or vascular cognitive impairment. Most interventions involved 40-minute sessions conducted 3 times/week. Exercise improved global cognition (g = -0.417, 95% CI, -0.694 to -0.140, p = 0.003, I² = 43.56%), executive function (g = -0.391, 95% CI, -0.651 to -0.131, p = 0.003, I² = 13.28%), but not processing speed or general short- term memory (both p >0.05). Across fMRI and ERP studies, significant neuronal adaptations were found with exercise cf. control throughout the brain and were linked with improved global cognition, memory, and executive function. Cerebral blood flow was also found to improve with 24 weeks of exercise, but was not linked with cognitive changes. Discussion: The cognitive improvements associated with exercise are likely driven by increased metabolic activity, cerebrovascular mechanisms, and neuroplasticity throughout the brain. Our paper shows the promise in, and need for, high-quality trials integrating cognitive and brain function measures to elucidate the functional relationship between exercise and brain health in populations with a high risk of dementia. Systematic review registration: PROSPERO, identifier: CRD42022291843. [ABSTRACT FROM AUTHOR]

Background: Dementia is a progressive neurodegenerative condition, while metabolic syndrome (MetS) is characterized by a combination of metabolic abnormalities such as hypertension, high blood sugar, and obesity. There exists a connection and overlap between the two conditions in certain aspects, and both are influenced to varying degrees by the process of aging. This study presents an overview of the current research landscape regarding dementia and MetS through bibliometric analysis. Methods: A systematic search was conducted to retrieve relevant literature on dementia and MetS published between 1 January 2000, and 30 November 2023, from the Web of Science Core Collection database. Various bibliometric tools, including VOSviewer, CiteSpace, and the R software package “bibliometrix,” were utilized for analysis. Results: A total of 717 articles were identified, showing an upward trend in annual publications. Leading contributors included the United States, Italy, and China, with institutions such as the University of California System at the forefront. The Journal of Alzheimer’s Disease emerged as the top publisher, while research published in Neurology garnered significant citations. Noteworthy authors encompassed Panza, Francesco; Frisardi, Vincenza; and Feldman, Eva L, with Kristine Yaffe being the most cited author (280 citations). Recent studies have focused on themes like “gut microbiota,” “neuroinflammation,” “fatty acids,” and “microglia.” Conclusion: This bibliometric analysis summarizes the foundational knowledge structure in the realm of dementia and MetS from 2000 to 2023. By highlighting current research frontiers and trending topics, this analysis serves as a valuable reference for researchers in the field. [ABSTRACT FROM AUTHOR]

Background: Social Frailty is a significant public health concern affecting the elderly, particularly with the global population aging rapidly. Older adults with social frailty are at significantly higher risk of adverse outcomes such as disability, cognitive impairment, depression, and even death. In recent years, there have been more and more studies on social frailty, but no bibliometrics has been used to analyze and understand the general situation in this field. Therefore, by using CiteSpace, VOSviewer, and Bilioshiny software programs, this study aims to analyze the general situation of the research on social frailties of the older adults and determine the research trends and hot spots. Methods: A bibliometric analysis was conducted by searching relevant literature on the social frailty of the older adults from 2003 to 2022 in the Web of Science core database, using visualization software to map publication volume, country and author cooperation networks, keyword co-occurrences, and word emergence. Results: We analyzed 415 articles from 2003 to 2022. Brazil has the highest number of articles in the field of social frailty of the older adults, and the United States has the highest number of cooperative publications. Andrew MK, from Canada, is the most published and co-cited author, with primary research interests in geriatric assessment, epidemiology, and public health. "Social Vulnerability," "Health," "Frailty," "Mortality," and "Older Adult" are among the research hotspots in this field. "Dementia," "Alzheimer's disease," "Population," and "Covid-19" are emerging research trends in social frailty among the older adults. Conclusion: This scientometric study maps the research hotspots and trends for the past 20 years in social frailty among the older adults. Our findings will enable researchers to better understand trends in this field and find suitable directions and partners for future research. [ABSTRACT FROM AUTHOR]

The global population is expected to have about 131.5 million people living with Alzheimer's disease (AD) and other dementias by 2050, posing a severe health crisis. Dementia is a progressive neurodegenerative condition that gradually impairs physical and cognitive functions. Dementia has a variety of causes, symptoms, and heterogeneity concerning the influence of sex on prevalence, risk factors, and outcomes. The proportion of male-to-female prevalence varies based on the type of dementia. Despite some types of dementia being more common in men, women have a greater lifetime risk of developing dementia. AD is the most common form of dementia in which approximately two-thirds of the affected persons are women. Profound sex and gender differences in physiology and pharmacokinetic and pharmacodynamic interactions have increasingly been identified. As a result, new approaches to dementia diagnosis, care, and patient journeys should be considered. In the heart of a rapidly aging worldwide population, the Women's Brain Project (WBP) was born from the necessity to address the sex and gender gap in AD. WBP is now a well-established international non-profit organization with a global multidisciplinary team of experts studying sex and gender determinants in the brain and mental health. WBP works with different stakeholders worldwide to help change perceptions and reduce sex biases in clinical and preclinical research and policy frameworks. With its strong female leadership, WBP is an example of the importance of female professionals' work in the field of dementia research. WBP-led peer-reviewed papers, articles, books, lectures, and various initiatives in the policy and advocacy space have profoundly impacted the community and driven global discussion. WBP is now in the initial phases of establishing the world's first Sex and Gender Precision Medicine Institute. This review highlights the contributions of the WBP team to the field of AD. This review aims to increase awareness of potentially important aspects of basic science, clinical outcomes, digital health, policy framework and provide the research community with potential challenges and research suggestions to leverage sex and gender differences. Finally, at the end of the review, we briefly touch upon our progress and contribution toward sex and gender inclusion beyond Alzheimer's disease. [ABSTRACT FROM AUTHOR]

BackgroundExisting literature on moral conflicts that healthcare professionals encounter in dementia care has explored, amongst others, issues related to autonomy, decision-making capacity, privacy, and more. Notably, conflicts related to healthcare professionals who support informal dementia caregiving and who are confronted with family members being overburdened with their care responsibly remains an underexplored topic in the current literature, particularly in the context of Low-and Middle-Income Countries. The present paper introduces such an encounter, presenting an ethical case analysis of a conflict that occurred during a larger research project conducted in North Macedonia.Case to be studiedDue to the absence of formal care services that could have relieved an overburdened family caregiver, healthcare professionals felt compelled to reach out to the uninvolved adult daughters, requesting them to participate in their parents’ care. Wondering about whether their reaching out to the daughters might count as an attempt of pressure and undue interference, professionals conflicted over the appropriateness of their action. This paper follows up on their concern, ethically assessing the professionals’ action. To answer the question on whether the healthcare professionals acted appropriately or not, and to what extent, theories of filial duties are applied, embedding their action in the larger context of dementia care in North Macedonia.Results and conclusionIt is argued that the lack of formal care services in North Macedonia is of utmost relevance to the conflict. Thus, the conclusion is that the ethical inappropriateness of the case is to be located not so much with the action of the healthcare professionals but with the state because of its failure to provide professional care services that allow healthcare professionals to take ethically sound actions to counteract overarching burdens that family members face when providing informal dementia care

This study examines implications of the expanded use of mobile platforms in testing cognitive function, and generates evidence on the impact utilizing mobile platforms for dementia screen. The Saint Louis University Mental State examination (SLUMS) was ported onto a computerized mobile application named the Cambridge University Pen to Digital Equivalence assessment (CUPDE). CUPDE was piloted and compared to the traditional pen and paper version, with a common comparator test for both groups. Sixty healthy participants (aged 50-79) completed both measurements. Differences were tested between overall outcomes, individual items, and relationship with the comparator. Significant differences in the overall scores between the two testing versions as well as within individual items were observed. Even when groups were matched by cognitive function and age, scores on SLUMS original version (M = 19.75, SD = 3) were significantly higher than those on CUPDE (M = 15.88, SD = 3.5), t(15) = 3.02, p < 0.01. Mobile platforms require the development of new normative standards, even when items can be directly translated. Furthermore, these must fit aging populations with significant variance in familiarity with mobile technology. Greater understanding of the interplay and related mechanisms between auditory and visual systems, which are not well understood yet in the context of mobile technologies, is mandatory. [ABSTRACT FROM AUTHOR]

The first wave of SARS-CoV-2 has deeply affected long term care facilities in the province of Quebec. In response, governmental officials took protective measures, such as suspending visits and activities and even requiring residents to self-isolate to their room. Consequently, residents with major cognitive impairments were cut from their routine as well as from significant social interactions, support, and stimulation essential to their well-being. This isolation negatively affected many residents. For some of them, the loss of bearings resulted in newly or deteriorated behavioral and psychological symptoms of dementia (BPSD). These residents were then more at risk of contracting the virus or contaminating others. To face this challenge, hotels in the Greater Montreal area were transformed into temporary care facilities. As members of a multidisciplinary team specialized in the management of BPSD, we were asked to support the redeployed staff who had little experience in this domain. In this paper, we present the innovative tools implemented in this uncommon work setting. We also discuss factors identified as facilitating the care and treatment of people with BPSD. This experience leads us to propose avenues toward better BPSD management. [ABSTRACT FROM AUTHOR]

The last years have evinced a remarkable growth in neuroimaging studies around the world. All these studies have contributed to a better understanding of the cerebral outcomes of dementia, even in the earliest phases. In low- and middle-income countries, studies involving structural and functional neuroimaging are challenging due to low investments and heterogeneous populations. Outstanding the importance of diagnosing mild cognitive impairment and dementia, the purpose of this paper is to offer an overview of neuroimaging dementia research in Brazil. The review includes a brief scientometric analysis of quantitative information about the development of this field over the past 10 years. Besides, discusses some peculiarities and challenges that have limited neuroimaging dementia research in this big and heterogeneous country of Latin America. We systematically reviewed existing neuroimaging literature with Brazilian authors that presented outcomes related to a dementia syndrome, published from 2010 to 2020. Briefly, the main neuroimaging methods used were morphometrics, followed by fMRI, and DTI. The major diseases analyzed were Alzheimer's disease, mild cognitive impairment, and vascular dementia, respectively. Moreover, research activity in Brazil has been restricted almost entirely to a few centers in the Southeast region, and funding could be the main driver for publications. There was relative stability concerning the number of publications per year, the citation impact has historically been below the world average, and the author's gender inequalities are not relevant in this specific field. Neuroimaging research in Brazil is far from being developed and widespread across the country. Fortunately, increasingly collaborations with foreign partnerships contribute to the impact of Brazil's domestic research. Although the challenges, neuroimaging researches performed in the native population regarding regional peculiarities and adversities are of pivotal importance. [ABSTRACT FROM AUTHOR]

Loneliness has been reframed from a 'social problem of old age' into a major public health problem. This transformation has been generated by findings from observational studies of a relationship between loneliness and a range of negative health outcomes including dementia. From a public health perspective, key to evaluating the relationship between loneliness and dementia is examining how studies define and measure loneliness, the exposure variable, and dementia the outcome. If we are not consistently measuring these then building a body of evidence for the negative health outcomes of loneliness is problematic. Three key criteria had to meet for studies to be included in our analysis. To test the proposition that loneliness is a cause of dementia we only included longitudinal studies. For inclusion studies had to measure loneliness at baseline, have samples free of dementia and assess dementia at follow up (specified as a minimum of 12 months). We identified 11 papers published between 2000 and 2018 that meet these criteria. These studies included seven different countries and only one was specifically focused upon dementia: all other studies were cohort studies focused upon ageing and health and wellbeing. There was extensive heterogeneity in how studies measured loneliness and dementia and in the use of co-variates. Loneliness was measured by either self-rating scales (n = 8) or scales (n = 3). Dementia was assessed by clinical tests (n = 5), diagnostic/screening tools (n = 3), cognitive function tests (n = 1), and self-reported doctor diagnosis (n = 2). Substantial variation in loneliness prevalence (range 5–20%) and dementia incidence (5–30 per 1000 person years at risk). Six studies did not report a statistically significant relationship between loneliness and dementia. Significant excess risk of dementia among those who were lonely ranged from 15% to 64%. None of these studies are directly comparable as four different loneliness and dementia measures were used. We suggest that the evidence to support a relationship between loneliness and dementia is inconclusive largely because of methodological limitations of existing studies. If we wish to develop this evidence base, then using a consistent set of loneliness and dementia outcome measures in major longitudinal studies would be of benefit. [ABSTRACT FROM AUTHOR]

Dementia, a prevalent disorder of the brain, has negative effects on individuals and society. This paper concerns using Spontaneous Speech (ADReSS) Challenge of Interspeech 2020 to classify Alzheimer's dementia. We used (1) VGGish, a deep, pretrained, Tensorflow model as an audio feature extractor, and Scikit-learn classifiers to detect signs of dementia in speech. Three classifiers (LinearSVM, Perceptron, 1NN) were 59.1% accurate, which was 3% above the best-performing baseline models trained on the acoustic features used in the challenge. We also proposed (2) DemCNN, a new PyTorch raw waveform-based convolutional neural network model that was 63.6% accurate, 7% more accurate then the best-performing baseline linear discriminant analysis model. We discovered that audio transfer learning with a pretrained VGGish feature extractor performs better than the baseline approach using automatically extracted acoustic features. Our DepCNN exhibits good generalization capabilities. Both methods presented in this paper offer progress toward new, innovative, and more effective computer-based screening of dementia through spontaneous speech. [ABSTRACT FROM AUTHOR]

Alzheimer’s Disease (AD) represents the most common type of dementia and is becoming a steadily increasing challenge for health systems globally. Inflammation is developing as the main focus of research into Alzheimer’s disease and has been demonstrated to be a major driver of the pathologies associated with AD. This evidence introduces an interesting research question, whether chronic inflammation due to pathologies such as inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) could lead to a higher risk of developing dementia. In both IBD and RA, increased levels of the inflammatory biomarker C-reactive protein (CRP) can be highlighted, the latter being directly implicated in neuroinflammation and AD. In this meta-analysis both the association between chronic inflammatory diseases and elevated levels of CRP during midlife were investigated to examine if they correlated with an augmented risk of dementia. Moreover, the association between increased CRP and modifications in the permeability of the Blood Brain Barrier (BBB) in the presence of CRP is explored. The results displayed that the odds ratio for IBD and dementia was 1.91 [1.15-3.15], for RA it was 1.90 [1.09-3.32] following sensitivity analysis and for CRP it was 1.62 [1.22-2.15]. These results demonstrate a higher risk of dementia in patients presenting chronic inflammation and that exists an independent association with high CRP in midlife. This paper builds on published research that suggest a critical role for CRP both in stroke and AD and provides an analysis on currently published research on multiple diseases (IBD and RA) in which CRP is raised as well as chronically elevated. CRP and the associated risk of dementia and further research indicated that the monomeric form of CRP can infiltrate the BBB/be released from damaged micro-vessels to access the brain. This meta-analysis provides first-time evidence that chronic elevation of CRP in autoimmune diseases is directly associated with an increased risk of later development of Alzheimer’s disease. Therefore, greater priority should be provided to the effective control of inflammation in patients with chronic inflammatory or autoimmune conditions and further long-term assessment of circulating CRP might inform of an individual’s relative risk of developing dementia. [ABSTRACT FROM AUTHOR]

Subjective cognitive decline (SCD) is a subclinical cognitive impairment that is complained by the individual without being objectively supported at clinical, diagnostic, and neuropsychological levels. It can negatively impact on patient’s frailty and quality of life, as well as on the caregiver’s burden. Moreover, it can be prodromal to Mild Cognitive Impairment or dementia. Although the clinical manifestations of SCD can differ along with several cognitive domains, to date there are only screening tools to investigate subjective memory complaints. Thus, the first aim of this paper is to propose a preliminary English and Italian version of a new screening tool called MASCoD (Multidimensional Assessment of Subjective Cognitive Decline); the second aim is to propose its preliminary adoption on a pilot sample. This schedule is a brief test derived from the review of the literature and the clinical experience provided by an experts panelist. From pilot tests, it seems promising as it can help the professional to make differential diagnosis and to predict the risk of developing severe cognitive impairment over time, developing a personalized care path. This screening tool is brief, easily embeddable in usual clinical assessment, and administrable by different professionals. Furthermore, following validation, it will allow to collect manifold cognitive manifestations of SCD, addressing the shortage of previous validated instruments globally assessing cognition affected by this condition. [ABSTRACT FROM AUTHOR]

Dementia is an incurable neurodegenerative disease primarily affecting the older population, for which the World Health Organisation has set to promoting early diagnosis and timely management as one of the primary goals for dementia care. While a range of popular machine learning algorithms and their variants have been applied for dementia diagnosis, fuzzy systems, which have been known effective in dealing with uncertainty and offer to explicitly reason how a diagnosis can be inferred, sporadically appear in recent literature. Given the advantages of a fuzzy rule-based model, which could potentially result in a clinical decision support system that offers understandable rules and a transparent inference process to support dementia diagnosis, this paper proposes a novel fuzzy inference system by adapting the concept of dominant sets that arise from the study of graph theory. A peeling-off strategy is used to iteratively extract from the constructed edge-weighted graph a collection of dominant sets. Each dominant set is further converted into a parameterized fuzzy rule, which is finally optimized in a supervised adaptive network- based fuzzy inference framework. An illustrative example is provided that demonstrates the interpretable rules and the transparent reasoning process of reaching a decision. Further systematic experiments conducted on data from the Open Access Series of Imaging Studies (OASIS) repository, also validate its superior performance over alternative methods. [ABSTRACT FROM AUTHOR]

Alzheimer’s disease is the most common type of dementia, producing a deterioration in the activities of daily living which can lead to the need for care provision. COVID-19 impacted their quality of life and in this care delivery. This study aimed to analyse most productive and prominent authors, the journals and countries with the highest number of publications, the most cited documents and the most used keywords. Publications were retrieved from journals indexed in the Main Collection of the Web of Science (WoS) and analysed using the traditional laws of bibliometrics. A total of 376 documents were found. The WoS categories with the highest number of publications accumulated were “Geriatric Gerontology” and “Gerontology.” Clarissa Giebel was the most productive (23 papers) and most cited (with 569 citations) co-author. The Journal of Alzheimer’s Disease (21 papers) published the most number of documents. The manuscript “2021 Alzheimer’s Disease Facts and Figures” was the most cited. Four thematic clusters related to mental health, telemedicine, care and well-being were found among the authors’ keywords. Research networks exist worldwide, with the United States of America and England leading the scientific output. These results may be of interest to researchers, publishers and professionals interested in this subject, as they provide current information on publications related to this topic.

Whilst Parkinson's disease (PD) is typically thought of as a motor disease, a significant number of individuals also experience cognitive impairment (CI), ranging from mild-CI to dementia. One technique that may prove effective in delaying the onset of CI in PD is cognitive training (CT); however, evidence to date is variable. This may be due to the implementation of CT in this population, with the motor impairments of PD potentially hampering the ability to use standard equipment, such as pen-and-paper or a computer mouse. This may, in turn, promote negative attitudes toward the CT paradigm, which may correlate with poorer outcomes. Consequently, optimizing a system for the delivery of CT in the PD population may improve the accessibility of and engagement with the CT paradigm, subsequently leading to better outcomes. To achieve this, the NeuroOrb Gaming System was designed, coupling a novel accessible controller, specifically developed for use with people with motor impairments, with a "Serious Games" software suite, custom-designed to target the cognitive domains typically affected in PD. The aim of the current study was to evaluate the usability of the NeuroOrb through a reiterative co-design process, in order to optimize the system for future use in clinical trials of CT in individuals with PD. Individuals with PD (n = 13; mean age = 68.15 years; mean disease duration = 8 years) were recruited from the community and participated in three co-design loops. After implementation of key stakeholder feedback to make significant modifications to the system, system usability was improved and participant attitudes toward the NeuroOrb were very positive. Taken together, this provides rationale for moving forward with a future clinical trial investigating the utility of the NeuroOrb as a tool to deliver CT in PD. [ABSTRACT FROM AUTHOR]