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Tau pathology accumulates in the perirhinal cortex (PRC) of the medial temporal lobe (MTL) during the earliest stages of the Alzheimer's disease (AD), appearing decades before clinical diagnosis. Here, we leveraged perceptual discrimination tasks that target PRC function to detect subtle cognitive impairment even in nominally healthy older adults. Older adults who did not have a clinical diagnosis or subjective memory complaints were categorized into "at‐risk" (score <26; n = 15) and "healthy" (score ≥26; n = 23) groups based on their performance on the Montreal Cognitive Assessment. The task included two conditions known to recruit the PRC: faces and complex objects (greebles). A scene condition, known to recruit the hippocampus, and a size control condition that does not rely on the MTL were also included. Individuals in the at‐risk group were less accurate than those in the healthy group for discriminating greebles. Performance on either the face or size control condition did not predict group status above and beyond that of the greeble condition. Visual discrimination tasks that are sensitive to PRC function may detect early cognitive decline associated with AD. [ABSTRACT FROM AUTHOR]

Background: Reversible lifestyle behaviors (modifiable risk factors) can reduce dementia risk by 40%, but their prevalence and association with cognition throughout the adult lifespan is less well understood. Methods: The associations between the number of modifiable risk factors for dementia (low education, hypertension, hearing loss, traumatic brain injury, alcohol or substance abuse, diabetes, smoking, and depression) and cognition were examined in an online sample (N = 22,117, ages 18–89). Findings: Older adults (ages 66–89) had more risk factors than middle‐aged (ages 45–65) and younger adults (ages 18–44). Polynomial regression revealed that each additional risk factor was associated with lower cognitive performance (equivalent to 3 years of aging), with a larger association as age increased. People with no risk factors in their forties to seventies showed similar cognitive performance to people 10 or 20 years younger with many risk factors. Interpretation: Modifiable dementia risk factors amplify lifespan age differences in cognitive performance. [ABSTRACT FROM AUTHOR]

Introduction: More women than men develop Alzheimer's disease, yet women perform better and show less decline on episodic memory measures, a contradiction that may be accounted for by modifiable risk factors for dementia. Methods: Associations among age, sex, modifiable dementia risk factors, and cognition were measured in a cross‐sectional online sample (n = 21,840, ages 18 to 89). Results: Across four tests of associative memory and executive functions, only a Face‐Name Association task revealed sex differences in associative memory that varied by age. Men had worse memory than women (the equivalent of performing similar to someone 4 years older) across ages. Men had larger age differences than women (ie, worse memory in older ages) among people with no to one risk factor, but not those with multiple risk factors. Discussion: Because the relationship between dementia risk factors and age‐related memory differences varies between men and women, sex‐specific dementia prevention approaches are warranted. [ABSTRACT FROM AUTHOR]

Background: The Intervention mapping framework was used to plan and develop Brain Health PRO (BHPro), a 45‐week, theory‐ and evidence‐based online educational program co‐created with users in English and French. The goal of the program is to improve dementia literacy, self‐efficacy, and attitude toward dementia and ultimately have a positive impact on the dementia risk profile. A pilot study evaluated usability and acceptability using a shorter version of the online program, which informed changes for a full efficacy trial. Method: A group of over 100 researchers contributed expert content targeting seven modifiable risk factors (physical activity, nutrition, cognitive engagement, sleep, social and psychological health, vascular health, vision and audition). 181, ten minute chapters were created in total. All chapters were reviewed and edited by the Citizen's Advisory group, consisting of older adults in the community. Information and recommendations for lifestyle improvement are delivered incrementally through weekly email interactions, and the platform is designed based on e‐learning principles. Participants complete online questionnaires to assess usability (eg: ease of use, ease of navigation, access, complexity), acceptability (eg: whether the program is interesting, whether they would use it again or recommend it) and level of risk at baseline for each of the seven modifiable risk factors. Result: A pilot study of Brain Health PRO was conducted, including 20 older adults, 13 women and 7 men. They had 16.75 years of education on average and their mean score on Logical Memory Scale II was 10.90. Two focus groups were conducted with a randomly selected group of participants to inform about the usability and acceptability of the program. The focus groups along with user experience questionnaires indicated excellent usability, with all dimensions rated in the positive range. Feedback from the end users were incorporated into the program prior to the main efficacy study. Conclusion: BHPro was designed out of necessity to pivot in the changing environment brought by COVID‐19. Early data indicate that the BHPro program meets the needs and abilities of older adults in a virtual setting. The platform is easy for older adults to learn and use and is considered relevant. [ABSTRACT FROM AUTHOR]

Background: The Brain Health Support Program (BHSP) of the CAN‐Thumbs Up Study is an online, interactive educational intervention designed to increase dementia literacy, self‐efficacy and address modifiable lifestyle risk factors. Recruiting for a virtual study presented both opportunities and challenges. This included the need to attract participants through means beyond referrals from medical clinics, as well as opportunities to reach geographically diverse Canadian population less feasible with in‐person evaluations. Methods: A comprehensive recruitment strategy for a virtual environment was implemented. A central website provided any interested candidate with study information, and a link to register and provide basic demographic information via a secure form. Potential participants were directed to the website via traditional recruitment through CCNA specialty clinics or existing cohorts, through geotargeting mailing to specific target populations throughout Canada, social medial advertising, partner organizations, and a coordinated National press release. Results: The study had an 8‐month open recruitment window. During this time 964 participants agreed to be contacted through our online portal. Of these, 18‐81 were consented to enroll in the study per month. A total of 7,569 geotargeted postcards were sent, with 153 individuals agreeing to be contacted for the study (2%). Social media advertising generated 974 clicks, with 6.8% subsequently agreeing to be contacted for more information. The majority of participants enrolled in the study came from existing clinical cohorts, CCNA clinical sites, and partner organizations. The recruitment cohort was from a diverse geographical location, 45% urban, 35% suburban, and 20% rural. Overall, the target cohort of 350 subjects was successfully enrolled by the end of the recruitment period. Conclusion: Recruitment for the BHSP intervention demonstrates the value of relatively underutilized clinical trials recruitment strategies, such as geotargeted mailing, and social media advertising. We also show the value of a centralized web site for initial screening of interested participants. While traditional recruitment methods still directed the majority of participants to the recruitment website, geotargeted mailing, social advertising, partner organizations, and earned media can all be scaled up, and will likely play a major role in future recruitments efforts in the broader CAN‐Thumbs Up Study. [ABSTRACT FROM AUTHOR]

Background: With the worldwide number of persons with dementia predicted to triple by 2050 and a current lack of curative treatment [1], reduction of modifiable risks is increasingly important. In 2020 the Lancet Commission on Dementia, Prevention, and Care reported on twelve health risk management factors that could potentially reduce the risk of dementia [2]. Peer support groups have a history in supporting self‐management of health risk behaviour [3,4]. We wanted to learn if older adults have successfully provided peer leadership in group interventions for older adult health management. Method: Using the Joanna Briggs Institute methodology for scoping reviews we searched three databases (Medline, Embase, and AgeLine) for articles describing older adult leadership for older adult health improvement in older adult health promotion or improvement groups. From the initial 16,000+ results, 19 studies met the criteria for full text screening and analysis. Result: Of the 19 studies, 12 used peer leaders and seven had a reciprocal support model. For those using peer leaders, training varied from none to 30 weeks. Older adult leadership or reciprocal support occurred in a range of settings. There were studies examining an older adult run seniors centre and a supportive community engagement program. Six studies focused on diabetes or hypertension, conditions linked with dementia risks. Interventions lasted from four weeks to 24 years. No quantifiable patterns of health management were observed. The only pattern that emerges is that positive physical and behaviour changes occurred more often when peer leaders or co‐facilitators were expected to motivate or encourage participant engagement or mutual support and where expectations included participant goal setting behaviour. Most of the studies of 12 weeks or less did not see lasting changes. Conclusions: When asked participants preferred and appreciated peer leadership; however, peer leadership itself was not sufficient for positive health changes. Research with a sharing and empowerment focus within groups often led to improved self‐efficacy and self‐management behaviours. Research with longer participant engagement may result in longer lasting health habits. [ABSTRACT FROM AUTHOR]

Objectives To determine how cardiovascular risk is associated with working memory task performance and task-related suppression of default-mode network ( DMN) activity in cognitively intact older adults. Design A cross-sectional functional magnetic resonance imaging study of older adults with cardiovascular risk factors. Setting Rotman Research Institute, Baycrest Health Sciences. Participants Thirty older adults with cardiovascular risk factors. Measurements Participants provided health information and a blood sample, and underwent functional magnetic resonance imaging during a working memory task and during a breath-hold task to assess cerebrovascular reactivity. Results Higher plasma low-density lipoprotein cholesterol ( LDL-C) was associated with poorer working memory task performance ( P = 0.008) and reduced task-related DMN suppression ( P = 0.005). A composite index of cardiovascular risk, the Framingham General Cardiovascular Risk Profile, showed no associations with task performance or task-related DMN suppression. These findings were independent of white matter burden and cerebrovascular reactivity and thus cannot be accounted for by individual differences in neurovascular health. Conclusion These findings suggest a deleterious effect of elevated LDL-C on working memory task performance and task-related DMN suppression in older adults with cardiovascular risk. The relations between the Framingham General Cardiovascular Risk Profile, cognitive task performance, and DMN function require further study. [ABSTRACT FROM AUTHOR]

Purpose: White matter hyperintensities (WMH) are prevalent among older adults and are often associated with cognitive decline and increased risk of stroke and dementia. Vascular risk factors (VRFs) are linked to WMH, yet the impact of multiple VRFs on gray matter function is still unclear. The goal of this study was to test for associations between the number of VRFs and cerebrovascular reactivity (CVR) and resting state (RS) coactivation among individuals with WMH.Materials and Methods: Twenty-nine participants with suspected WMH were grouped based on the number of VRFs (subgroups: 0, 1, or ≥2). CVR and RS coactivation were measured with blood oxygenation level-dependent (BOLD) imaging on a 3T magnetic resonance imaging (MRI) system during hypercapnia and rest, respectively. Default-mode (DMN), sensory-motor, and medial-visual networks, generated using independent component analysis of RS-BOLD, were selected as networks of interest (NOIs). CVR-BOLD was analyzed using two methods: 1) a model-based approach using CO2 traces, and 2) a dual-regression (DR) approach using NOIs as spatial inputs. Average CVR and RS coactivations within NOIs were compared between VRF subgroups. A secondary analysis investigated the correlation between CVR and RS coactivation.Results: VRF subgroup differences were detected using DR-based CVR in the DMN (F20,2  = 5.17, P = 0.015) but not the model-based CVR nor RS coactivation. DR-based CVR was correlated with RS coactivation in the DMN (r(2)  = 0.28, P = 0.006) but not the sensory-motor nor medial-visual NOIs.Conclusion: In individuals with WMH, CVR in the DMN was inversely associated with the number of VRFs and correlated with RS coactivation. [ABSTRACT FROM AUTHOR]

This study was designed to test the hypothesis that mindfulness involves sustained attention, attention switching, inhibition of elaborative processing and non-directed attention. Healthy adults were tested before and after random assignment to an 8-week Mindfulness-Based Stress Reduction (MBSR) course (n = 39) or a wait-list control (n = 33). Testing included measures of sustained attention, attention switching, Stroop interference (as a measure of inhibition of elaborative processing), detection of objects in consistent or inconsistent scenes (as a measure of non-directed attention), as well as self-report measures of emotional well-being and mindfulness. Participation in the MBSR course was associated with significantly greater improvements in emotional well-being and mindfulness, but no improvements in attentional control relative to the control group. However, improvements in mindfulness after MBSR were correlated with improvements in object detection. We discuss the implications of these results as they relate to the role of attention in mindfulness. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Prior studies have reported that older adults can benefit from formal educational programs about dementia. Participating in an online educational program focusing on risk and protective factors could potentially increase participants' dementia literacy, empowerment, and engagement in brain health promotion, which in turn could reduce their dementia risk. The goal is to develop a comprehensive, compelling, and evidence‐based online educational program on risk and protective factors for dementia. Method: The Brain Health Support Program is being developed as part of the Canadian Consortium on Neurodegeneration in Aging CAN‐Thumbs‐Up initiative. The program is designed to improve dementia literacy, promote lifestyle changes in at‐risk individuals who are cognitively intact or have mild cognitive impairment, and evaluate its effectiveness. Results: The content is based on the epidemiological literature on risk and protective factors for dementia. The format is determined from a review of web‐based educational programs for older adults and is co‐created with experts, stakeholders and citizen advisors. The program contains eight interactive modules with new content provided weekly over a 12‐month period. The modules contain general information and tips on modifiable risk factors including diet, physical activity, cognitively stimulating activity, sleep, vascular health, social and psychological factors, vision and hearing, as well as information on dementia, stigma, and stereotypes. Participants have access to an individualized risk profile to determine personal goals and are given feedback on lifestyle changes. Content is available in French and English. Changes in dementia literacy, self‐efficacy, attitudes toward dementia and modifiable risk factors will be collected from the platform. Conclusion: Providing access to scientifically validated education through an interactive web‐based platform is expected to have a positive effect on participants' attitude, engagement in brain health behaviours and dementia literacy. It might also increase readiness to change and maintain positive lifestyle changes. The content and format are co‐created with users and stakeholders, which should increase its relevance and facilitate future implementation. [ABSTRACT FROM AUTHOR]

In this study, the authors both developed and validated a self-report mindfulness measure, the Toronto Mindfulness Scale (TMS). In Study 1, participants were individuals with and without meditation experience. Results showed good internal consistency and two factors, Curiosity and Decentering. Most of the expected relationships with other constructs were as expected. The TMS scores increased with increasing mindfulness meditation experience. In Study 2, criterion and incremental validity of the TMS were investigated on a group of individuals participating in 8-week mindfulness-based stress reduction programs. Results showed that TMS scores increased following treatment, and Decentering scores predicted improvements in clinical outcome. Thus, the TMS is a promising measure of the mindfulness state with good psychometric properties and predictive of treatment outcome. © 2006 Wiley Periodicals, Inc. J Clin Psychol 62: 1445–1467, 2006. [ABSTRACT FROM AUTHOR]