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There is an urgent need to learn how to appropriately integrate technologies into dementia care. The aims of this Delphi study were to project which technologies will be most prevalent in dementia care in five years, articulate potential benefits and risks, and identify specific options to mitigate risks. Participants were also asked to identify technologies that are most likely to cause value tensions and thus most warrant a conversation with an older person with mild dementia when families are deciding about their use. Twenty-one interdisciplinary domain experts from academia and industry in aging and technology in the U.S. and Canada participated in a two-round online survey using the Delphi approach with an 84% response rate and no attrition between rounds. Rankings were analyzed using frequency counts and written-in responses were thematically analyzed. Twelve technology categories were identified along with a detailed list of risks and benefits for each. Suggestions to mitigate the most commonly raised risks are categorized as follows: intervene during design, make specific technical choices, build in choice and control, require data transparency, place restrictions on data use and ensure security, enable informed consent, and proactively educate users. This study provides information that is needed to navigate person-centered technology use in dementia care. The specific recommendations participants offered are relevant to designers, clinicians, researchers, ethicists, and policy makers and require proactive engagement from design through implementation.

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: Dementia is a progressive disease that decreases quality of life of persons with dementia and is associated with high societal costs. The burden of caring for persons with dementia also decreases the quality of life of family caregivers. The objective of this study was to assess the societal cost-effectiveness of Namaste Care Family program in comparison with usual care in nursing home residents with advanced dementia., Methods: Nursing homes were randomized to either Namaste Care Family program or usual care. Outcome measures of the cluster-randomized trial in 231 residents included Quality of Life in Late-Stage Dementia (QUALID) and the Gain in Alzheimer Care Instrument (GAIN) for family caregivers over 12 months of follow-up. Health states were measured using the EQ-5D-3L questionnaire which were translated into utilities. QALYs were calculated by multiplying the amount of time a participant spent in a specific health state with the utility score associated with that health state. Healthcare utilization costs were estimated using standard unit costs, while intervention costs were estimated using a bottom-up approach. Missing cost and effect data were imputed using multiple imputation. Bootstrapped multilevel models were used after multiple imputation. Cost-effectiveness acceptability curves were estimated., Results: The Namaste Care Family program was more effective than usual care in terms of QUALID (- 0.062, 95%CI: - 0.40 to 0.28), QALY (0.0017, 95%CI: - 0.059 to 0.063) and GAIN (0.075, 95%CI: - 0.20 to 0.35). Total societal costs were lower for the Namaste Care Family program as compared to usual care (- 552 €, 95%CI: - 2920 to 1903). However, these differences were not statistically significant. The probability of cost-effectiveness at a ceiling ratio of 0 €/unit of effect extra was 0.70 for the QUALID, QALY and GAIN., Conclusions: The Namaste Care Family program is dominant over usual care and, thus, cost-effective, although statistical uncertainty was considerable., Trial Registration: Netherlands Trial Register ( http://www.trialregister.nl/trialreg/index.asp , identifier: NL5570, date of registration: 2016/03/23).

Background: Adult Day care centres provide an important aspect of care provision through all phases of the dementia illness from diagnosis to the end of life (Dabelko HI 2008) supporting the well-being of both older people living with dementia and their care partners. Services within adult day care settings are designed to provide biopsychosocial health benefits to participants as well as care partner respite. Objective: To examine research studies, literature reviews and grey literature and identify and map the literature on psychosocial interventions used in day care services for older people living with dementia and chart their use, evaluation and outcomes. The research review question is "what are the psychosocial interventions used in day care service for older people living with dementia?" Psychosocial interventions are important non-pharmacological interventions which support people's wellbeing. Methods: Inclusion/Exclusion criteria were identified and guided the search strategy. Participants were people aged 60 years and over living with dementia attending day care services. The use of psychosocial interventions for this cohort was the focus of the review. Databases were searched (Cochrane Reviews, CINAHL, Embase, Medline EBSCO, Medline Ovid, Medline PubMed, PsycINFO, Scopus, Open Grey, Lenus and WHO Global Index Medicus databases) using keywords/terms with Boolean operators from 2011 to 2023. Rayyan was used to extract and manage the data. Results: The findings present a narrative and charting of the data from the 45 papers that met the review criteria, and this data is mapped onto the five objectives. Within this review, interventions were grouped into five broad types: nature (n = 6 papers), memory/cognitive (n = 11 papers), social (n = 17 papers), animal (n = 4 papers), or physical/sensory (n = 7 papers) based interventions. Conclusions: This review has illustrated the wide variety in the types, range and facilitation of psychosocial interventions within adult day care services. This review highlights the potential benefits of these interventions. However, findings must be considered in the context that many were provided as brief intervention studies with little evidence of continuation after the study and further research is required given the complex and diverse range of interventions. Results will be of interest to practitioners planning to implement or evaluate psychosocial interventions used in day care services for older people living with dementia. [ABSTRACT FROM AUTHOR]

Background: With the increase in the aging population, informal caregivers have become an essential pillar for the long-term care of older individuals. However, providing care can have a negative impact and increase the burden on caregivers, which is a cause for concern. Objective: This study aimed to comprehensively depict the concept of "informal caregiver burden" through bibliometric and content analyses. Methods: We searched the Web of Science (WoS) database to obtain bibliometric data and included only papers published between 2013 and 2022. We used content analysis to extract and identify the core concepts within the text systematically. Results: Altogether, 934 papers were included in the bibliometric analysis, from which we selected 19 highly impactful papers for content analysis. The results indicate that researchers have focused on exploring the factors that impact informal caregiver burden. Meanwhile, there has been a widespread discussion regarding the caregiver burden among those caring for recipients with specific illnesses, such as dementia, Alzheimer's disease, and cancer, as these illnesses can contribute to varying levels of burden on informal caregivers. In addition, questionnaires and interviews emerged as the predominant methods for data collection in the realm of informal caregiver research. Furthermore, we identified 26 distinct assessment tools specifically tailored for evaluating burden, such as caregiver strain index (CSI). Conclusion: For future studies, we suggest considering the intersectionality of factors contributing to the burden on informal caregivers. This approach could enhance the well-being of both caregivers and older care recipients. [ABSTRACT FROM AUTHOR]

Background: Driving cessation is one of the most challenging life transitions, associated with multiple negative consequences for individuals living with late-onset dementia. This paper extends the literature as to date there is no published review that details the experiences of people living with young onset dementia ("YOD"). Methods: A comprehensive search of the literature was conducted using the scoping review methodology. Results: Ten studies were included for full text review of 1634 initially identified through database searching. The results of the included articles indicated areas of concern for people living with YOD and their family members including, loss of independence; role change; threat to self-identify; feelings of isolation, grief; acceptance; predictors of driving cessation. Conclusion: There is a lack of robust evidence related to driving cessation and the experiences of people living with YOD. No published paper reported psychosocial interventions specifically targeted at supporting persons with YOD through driving cessation. [ABSTRACT FROM AUTHOR]

A recent paper concluded that cholesteryl ester transfer protein (CETP) inhibition may be a viable target to treat dementia, based on human genetic evidence of a protective effect of target inhibition on risk of Lewy body and Parkinson's dementia. Alzheimer's disease, which is by far the most prevalent cause of dementia (around 80% of all dementia cases) was not included as an outcome. Evidence shows CETP inhibition is unlikely to affect Alzheimer's risk and may even potentially modestly increase risk. There is also little evidence to support an effect of CETP inhibition on all-cause or vascular dementia. Thus, CETP inhibition is unlikely to be a viable target to treat the most prevalent causes of dementia. [ABSTRACT FROM AUTHOR]

Background: An application of artificial intelligence is machine learning, which allows computer programs to learn and create data. Methods: In this work, we aimed to evaluate the performance of the MySLR machine learning platform, which implements the Latent Dirichlet Allocation (LDA) algorithm in the identification and screening of papers present in the literature that focus on mutations of the apolipoprotein E (ApoE) gene in Italian Alzheimer's Disease patients. Results: MySLR excludes duplicates and creates topics. MySLR was applied to analyze a set of 164 scientific publications. After duplicate removal, the results allowed us to identify 92 papers divided into two relevant topics characterizing the investigated research area. Topic 1 contains 70 papers, and topic 2 contains the remaining 22. Despite the current limitations, the available evidence suggests that articles containing studies on Italian Alzheimer's Disease (AD) patients were 65.22% (n = 60). Furthermore, the presence of papers about mutations, including single nucleotide polymorphisms (SNPs) ApoE gene, the primary genetic risk factor of AD, for the Italian population was 5.4% (n = 5). Conclusion: The results show that the machine learning platform helped to identify case-control studies on ApoE gene mutations, including SNPs, but not only conducted in Italy. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether a positive association exists between waist circumference (WC) and dementia among older persons., Methods: The study population comprised 872,082 participants aged 65 years and older who participated in a Korean national health screening examination between January 1, 2009, and December 31, 2009. Adjusted hazard ratios and 95% CIs for dementia during follow-up from 2009 to 2015 were calculated according to baseline BMI and WC categories., Results: After a multivariate adjustment that included BMI, the hazard ratios for dementia showed a stepwise increase according to the increase in WC categories by 5 cm from 85 to 90 cm in men and from 80 to 85 cm in women until ≥ 110 cm (from 1.06 [95% CI: 1.03-1.09] to 1.64 [95% CI: 1.37-1.94] in men and from 1.04 [95% CI: 1.02-1.07] to 1.58 [95% CI: 1.36-1.84] in women). The influence of the current WC category for abdominal obesity on the risk of dementia was different according to BMI; especially, the normal weight men and women with abdominal obesity had a prominent increased risk of dementia compared with those without abdominal obesity., Conclusions: Abdominal obesity, as measured by WC, was associated with significantly increased risk of dementia after adjustment for general obesity., (© 2019 The Obesity Society.)

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]

Kinship caregivers (e.g., grandparents raising grandchildren) have been increasing over the last several decades. Approximately 3.5 million grandparents and other relatives are the primary caregivers for their related children, and African Americans are more likely to be kinship caregivers than persons from other groups. Kinship caregivers face unique challenges, such as parenting for uncertain periods of time and often with insufficient financial resources and support, placing them at significant risk of stress. Given the findings linking chronic stress to Alzheimer's disease (AD), there is a need for research to identify possible stressors and mitigate risks for outcomes such as AD among kin caregivers. Additionally, research indicates that African Americans (AAs) experience unusually high levels of stress due to factors often associated with structural racism, and they are disproportionately affected by cardiovascular disease (CVD), which is often a consequence of stress and another risk factor for AD. Regrettably, AA kin caregivers often incur a host of negative stress-related outcomes, including poor physical and mental health. Thus, there is an urgent need for research to identify modifiable risk factors for both stress and CVD to potentially mitigate the onset of AD in this population. The purpose of this paper is to provide a conceptual framework to examine the links between African Americans who commit to the unselfish act of providing kinship caregiving and their susceptibility to AD. Future research should investigate modifiable mechanisms to reduce the risks of AD in African American caregivers. [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]

Alzheimer's disease is the most common form of dementia and is a challenge for the modern world due to the due to aging populations. Researchers are trying their best to understand the mechanisms of onset and find effective ways to treat and prevent this disease. The purpose of the following paper is to present the impact of physical activity in the development of Alzheimer's disease. Numerous studies confirm that regular workouts have a positive reflection in the form of slowing the aging of the brain and alleviation of neuropsychiatric symptoms in affected individuals. During muscle work irisin is produced, which plays an important role in the formation of neurons and exhibits an anti-inflammatory effects. This review also looks at the aspect of maintaining proper composition of the gut microbiota, whose imbalance can promote the process of neuronal inflammation and cognitive dysfunction. Attention is also given to issues of training intensity and the effect of of exercise on blood flow in the brain. All of these elements play an important role in preventing and slowing down neurodegeneration. Purpose : The purpose of this scientific paper is to review the current knowledge of the effects of physical activity on the development of Alzheimer's disease. Review methods : We conducted our study as a literature review based on information gathered from PubMed, Embase, Google Scholar using combinations of the following keywords : Alzheimer's disease ; dementia ; physical activity ; cerebral blood flow ; gut-brain axis ; irisin. The state of knowledge : Alzheimer's disease is the most common type of dementia and one of the main neurodegenerative disorders affecting elderly people. Numerous studies confirm that regular exercise has a positive effect on slowing down brain aging and alleviating neuropsychiatric symptoms in patients. According to current knowledge, nerve cell degeneration can be exacerbated by peripheral inflammation that occurs in obesity. An imbalance of bacterial flora in the gastrointestinal tract causes systemic inflammation in the body. This in turn leads to excessive production of pro-inflammatory cytokines and activation of microglia so that the blood-brain barrier becomes leaky. Maintaining the appropriate composition of the gut microbiota plays an important role, as its imbalance can promote neuronal inflammation and cognitive impairment. During physical activity, irisin protein is produced in muscle tissue, which plays an important role in neuronal formation and exhibits anti-inflammatory effects. Currently, there is evidence that irisin can provide a number of beneficial effects, mainly through mechanisms that positively affect the gut microbiome. Attention is also given to issues of training intensity and the effect of exercise on cerebral blood flow. All these factors play an important role in preventing and slowing down neurodegeneration. Conclusion : Based on a review of the available literature, a significant effect of physical activity on the development of Alzheimer's disease can be demonstrated. The accumulated data suggest that physical activity is one of the main protective factors against the development and progression of Alzheimer's disease. Physical activity is associated with a reduction in cardiovascular risk factors and an increase in neuroprotective changes. The neuroprotective effect of physical exercise is dependent on its intensity. In addition, the role of the gut microbiota has been shown to be important for maintaining normal cognitive function. The protein irisin may also have significant neuroprotective potential in relation to the development and progression of cognitive disorders. Physical activity may be one of the strategies to prevent an increase in the incidence of Alzheimer's disease with positive health, economic and social implications in the future. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to verify the equivalence and effectiveness of the tablet-administered Korean Repeatable Battery for the Assessment of Neuropsychological Status (K-RBANS) for the prevention and early detection of dementia. Methods: Data from 88 psychiatry and neurology patient samples were examined to evaluate the equivalence between tablet and paper administrations of the K-RBANS using a non-randomly equivalent group design. We calculated the prediction scores of the tablet-administered K-RBANS based on demographics and covariate-test scores for focal tests using norm samples and tested format effects. In addition, we compared the receiver operating characteristic curves to confirm the effectiveness of the K-RBANS for preventing and detecting dementia. Results: In the analysis of raw scores, line orientation showed a significant difference (t=-2.94, p<0.001), and subtests showed small to large effect sizes (0.04-0.86) between paper- and tablet-administered K-RBANS. To investigate the format effect, we compared the predicted scaled scores of the tablet sample to the scaled scores of the norm sample. Consequently, a small effect size (d≤0.20) was observed in most of the subtests, except word list and story recall, which showed a medium effect size (d=0.21), while picture naming and subtests of delayed memory showed significant differences in the one-sample t-test. In addition, the area under the curve of the total scale index (TSI) (0.827; 95% confidence interval, 0.738-0.916) was higher than that of the five indices, ranging from 0.688 to 0.820. The sensitivity and specificity of TSI were 80% and 76%, respectively. Conclusion: The overall results of this study suggest that the tablet-administered K-RBANS showed significant equivalence to the norm sample, although some subtests showed format effects, and it may be used as a valid tool for the brief screening of patients with neuropsychological disorders in Korea. [ABSTRACT FROM AUTHOR]

Background: The number of older people in prison is growing. As a result, there will also be more prisoners suffering from dementia. The support and management of this population is likely to present multiple challenges to the prison system. Objectives: To examine the published literature on the care and supervision of people living in prison with dementia and on transitioning into the community; to identify good practice and recommendations that might inform the development of prison dementia care pathways. Methods: A scoping review methodology was adopted with reporting guided by the PRISMA extension for scoping reviews checklist and explanation. Results: Sixty-seven papers were included. Most of these were from high income countries, with the majority from the United Kingdom (n = 34), followed by the United States (n = 15), and Australia (n = 12). One further paper was from India. Discussion: The literature indicated that there were difficulties across the prison system for people with dementia along the pathway from reception to release and resettlement. These touched upon all aspects of prison life and its environment, including health and social care. A lack of resources and national and regional policies were identified as important barriers, although a number of solutions were also identified in the literature, including the development of locally tailored policies and increased collaboration with the voluntary sector. Conclusion: To our knowledge, this is the most comprehensive and inclusive review of the literature on dementia care pathways in prison to date. It has identified a number of important areas of concern and opportunities for future research across the prison system, and its operations. This will hopefully lead to the identification or adaptation of interventions to be implemented and evaluated, and facilitate the development of dementia care pathways in prisons. [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: Dementia has a major impact on individuals, their families and caregivers, and wider society. Some individuals experience a faster decline of their function and health compared to others. The objective of this systematic review was to determine prognostic factors, measurable in primary care, for poor outcome in people living with dementia. Methods: Cohort studies set in the community or primary care, and examining prognostic factors for care home admission, cognitive decline, or palliative care were included. Databases were searched from inception to 17th June 2022. Identified papers were screened, the risk of bias assessed using Quality in Prognostic Studies (QUIPS) tool, and data extracted by 2 reviewers, with disagreements resolved by consensus or a 3rd reviewer. A narrative synthesis was undertaken, informed by GRADE, taking into consideration strength of association, risk of bias and precision of evidence. Patient and Public Involvement and Engagement (PPIE) and stakeholder input was obtained to prioritise factors for further investigation. Results: Searches identified 24,283 potentially relevant titles. After screening, 46 papers were included, 21 examined care home admission investigating 94 factors, 26 investigated cognitive decline as an outcome examining 60 factors, and 1 researched palliative care assessing 13 factors. 11 prognostic factors (older age, less deprived, living alone, white race, urban residence, worse baseline cognition, taking dementia medication, depression, psychosis, wandering, and caregiver's desire for admission) were associated with an increased risk of care home admission and 4 prognostic factors (longer duration of dementia, agitation/aggression, psychosis, and hypercholesterolaemia) were associated with an increased risk of cognitive decline. PPIE and other stakeholders recommended further investigation of 22 additional potential prognostic factors. Conclusions: Identifying evidence for prognostic factors in dementia is challenging. Whilst several factors highlighted as of relevance by our stakeholder groups need further investigation, inequalities may exist in care home admission and there is evidence that several prognostic factors measurable in primary care could alert clinicians to risk of a faster progression. Registration: PROSPERO CRD42019111775. [ABSTRACT FROM AUTHOR]

Oral microorganisms have been found in the cerebral milieu, suggesting the involvement of oral microbiota in the onset and course of Alzheimer's Disease (AD) through mechanisms such as amyloid-beta accumulation, tau phosphorylation and neuroinflammation. It is still uncertain whether and which oral bacteria are associated with AD. Therefore, the aim of this systematic review was to assess the current evidence for associations between oral microbiota and AD. A database search in Pubmed and Embase resulted in 623 hits. After removing duplicates, 437 papers remained. Of these, 13 papers passed the inclusion criteria and were included for quality/risk of bias assessment and data extraction. Analysis of these 13 studies revealed high heterogeneity in terms of sample size, age, study design and microbiological methods. Quality assessment using the MINORS criteria indicated reasonable to good quality across studies. As a result of the omission of two of the criteria, the quality results may have been biased. There is no conclusive evidence as to if and which oral microbiota are associated with AD since many conflicting results were reported. Although the overall quality of the studies was acceptable, the studies differed in study design and protocol. Further research is needed to clarify this association. [ABSTRACT FROM AUTHOR]

Background: There are numerous communication barriers between family caregivers and providers of people living with dementia, which can pose challenges to caregiving and clinical decision-making. To address these barriers, a new web and mobile-enabled app, called CareHeroes, was developed, which promotes the collection and secured sharing of clinical information between caregivers and providers. It also provides caregiver support and education., Objective: The primary study objective was to examine whether dementia caregivers would use CareHeroes as an adjunct to care and gather psychosocial data from those who used the app., Methods: This paper presents the implementation process used to integrate CareHeroes into clinical care at 2 memory clinics and preliminary outcome evaluation. Family caregivers receiving services at clinics were asked to use the app for a 12-month period to collect, track, and share clinical information with the care recipient's provider. They also used it to assess their own mental health symptoms. Psychosocial outcomes were assessed through telephone interviews and user data were collected by the app., Results: A total of 21 caregivers enrolled in the pilot study across the 2 memory clinics. Usage data indicated that caregivers used many of the features in the CareHeroes app, though the chatbot was the most frequently used feature. Outcome data indicated that caregivers' depression was lower at 3-month follow-up (t11=2.03, P=.03)., Conclusions: Recruitment and retention of the pilot study were impacted by COVID-19 restrictions, and therefore more testing is needed with a larger sample to determine the potential impact of CareHeroes on caregivers' mental health. Despite this limitation, the pilot study demonstrated that integrating a new supportive app for caregivers as an adjunct to clinical dementia care is feasible. Implications for future technology intervention development, implementation planning, and testing for caregivers of people living with dementia are discussed., (© Nicole Ruggiano, Ellen Leslie Brown, Peter J Clarke, Vagelis Hristidis, Lisa Roberts, Carmen Victoria Framil Suarez, Sai Chaithra Allala, Shannon Hurley, Chrystine Kopcsik, Jane Daquin, Hamilton Chevez, Raymond Chang-Lau, Marc Agronin, David S Geldmacher. Originally published in JMIR Aging (https://aging.jmir.org).)

Background: Dementia management presents a significant challenge for individuals affected by dementia, as well as their families, caregivers, and health care providers. Digital applications may support those living with dementia; however only a few dementia-friendly applications exist., Objective: This paper emphasizes the necessity of considering multiple perspectives to ensure the high-quality development of supportive health care applications. The findings underscore the importance of incorporating input from stakeholders and the needs of affected families into application development., Methods: A qualitative approach was chosen, consisting of three interviews and an expert workshop. The interviews and the workshop were recorded and transcribed, and qualitative content analysis was carried out according to the methodology described by Kuckartz with the support of MAXQDA., Results: During the development phases of the application, team meetings and discussions took place. We found that general practitioners and family caregivers play pivotal roles in the treatment and care of people with dementia, often expressing specific preferences and suggestions regarding supportive and assistive technologies. Moreover, the successful development of a useful tablet application requires robust scientific and multidisciplinary discussions and teamwork within the health care community., Conclusions: This paper underscores the necessity of including multiple scientific, clinical, and technical perspectives to ensure the high-quality development of supportive health care applications. Furthermore, adopting a spiral development approach inclusive of feedback loops is imperative for iterative refinement and enhancement of the application., (© Juliana Supplieth, Sonia Lech, Julie Lorraine O’Sullivan, Robert Spang, Jan‐Niklas Voigt-Antons, Johanna Schuster. Originally published in JMIR Human Factors (https://humanfactors.jmir.org).)