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Aim: The association between visual impairment and mild cognitive impairment (MCI) has not been investigated to date. Thus, we assessed this association among older adults from six low- and middle-income countries (LMICs) (China, India, Ghana, Mexico, Russia, and South Africa) using nationally representative datasets. Methods: Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment (at distance and near) was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better-seeing eye. The definition of MCI was based on the National Institute on Aging-Alzheimer’s Association criteria. Multivariable logistic regression was conducted. Results: Data on 32,715 individuals aged ≥ 50years [mean (SD) age 62.1 (15.6) years; 51.2% females] were analyzed. Compared to those without far or near vision impairment, those with near vision impairment but not far vision impairment (OR = 1.33; 95% CI = 1.16–1.52), and those with both far and near vision impairment (OR = 1.70; 95% CI = 1.27–2.29) had significantly higher odds for MCI. Only having far vision impairment was not significantly associated with MCI. Conclusions: Visual impairment is associated with increased odds for MCI among older adults in LMICs with the exception of far vision impairment only. Future longitudinal and intervention studies should examine causality and whether improvements in visual acuity, or early intervention, can reduce risk for MCI and ultimately, dementia. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.

Background: Loneliness may be a risk factor for mild cognitive impairment but studies on this topic are scarce, particularly from low- and middle-income countries (LMICs). Therefore, the aim of the present study was to investigate the association between loneliness and mild cognitive impairment (MCI) in six LMICs (China, Ghana, India, Mexico, Russia and South Africa). Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. Results: The final analytical sample consisted of 19,092 and 13,623 individuals aged 50–64 years (middle-aged adults) and ≥65 years (older adults), respectively. Among the middle-aged, overall, loneliness was associated with a non-significant 1.43 (95% confidence interval [CI]=0.93–2.21) times higher odds for MCI although significant associations were observed in China (OR=1.51; 95%CI=1.08–2.09) and South Africa (OR=3.87; 95%CI=1.72–8.71). As for older adults, overall, there was a significant association between loneliness and MCI (OR=1.52; 95%CI=1.12–2.07). Conclusion: In this large representative sample of middle-aged and older adults from multiple LMICs, findings suggest that loneliness is associated with MCI. It may be prudent to consider reducing loneliness in low-economic settings to aid in the prevention of MCI and ultimately dementia.

Background-\ud \ud The limited available literature suggests that sleep problems are linked to an increased risk of mild cognitive impairment (MCI). However, this association has been little studied to date in low-income settings.\ud \ud Objective-\ud \ud To investigate the association between sleep problems and MCI in a large sample of adults from six low-and middle-income countries (LMICs).\ud \ud Design-\ud \ud Cross-sectional.\ud \ud Setting-\ud \ud Study on Global Ageing and Adult Health (SAGE).\ud \ud Subjects-\ud \ud 32,715 individuals aged ≥50 years with preservation in functional abilities [age range 50–114 years; 51.7% females].\ud \ud Methods-\ud \ud MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Sleep problems were assessed by the question “Overall in the last 30 days, how much of a problem did you have with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?” and categorized as “None”, “Mild”, “Moderate”, “Severe/Extreme”. Multivariable logistic regression analysis and meta-analysis were conducted.\ud \ud Results-\ud \ud Compared to no sleep problems, mild, moderate, and severe/extreme sleep problems were associated with significant 1.40, 1.83, and 2.69 times higher odds for MCI with similar associations being observed between age groups and sex. Severe/extreme sleep problems were positively associated with MCI (i.e., OR > 1) in the six countries studied with the overall estimate being OR = 1.80 (95% CI = 1.50–2.16), and a low level of between-country heterogeneity was observed (I2 = 28.2%).\ud \ud Conclusions-\ud \ud Sleep problems were associated with higher odds for MCI. Interventions to improve sleep quality among middle-aged and older adults in LMICs may be an effective strategy in reducing risk of MCI and dementia.

International audience; The cerebrospinal fluid (CSF) biochemical markers (biomarkers) Amyloidβ 42 (Aβ42), total Tau (T-tau) and Tau phosphorylated at threonine 181 (P-tau181) have proven diagnostic accuracy for mild cognitive impairment and dementia due to Alzheimer's Disease (AD). In an effort to improve the accuracy of an AD diagnosis, it is important to be able to distinguish between AD and other types of dementia (non-AD). The concentration ratio of Aβ42 to Aβ40 (Aβ42/40 Ratio) has been suggested to be superior to the concentration of Aβ42 alone when identifying patients with AD. This article reviews the available evidence on the use of the CSF Aβ42/40 ratio in the diagnosis of AD. Based on the body of evidence presented herein, it is the conclusion of the current working group that the CSF Aβ42/40 ratio, rather than the absolute value of CSF Aβ42, should be used when analysing CSF AD biomarkers to improve the percentage of appropriately diagnosed patients.

本研究の目的は，認知症対応型共同生活介護（以下，グループホーム）での実習における，看護学生の学びの実態を明らかにすることである。 研究参加者は，平成Ⅹ年に老年看護実習を行った看護学科３年次生のうち，研究承諾を得られた40名である。老年看護実習終了後に自記式による質問紙調査を行った。調査内容は項目毎に分析し，自由記述については質的帰納的に分析を行った。 分析の結果，グループホーム実習における学びとして，＜その人らしく生きることを支える個別性の看護の重要性の理解＞＜認知症の方との接し方の理解＞＜認知症の症状の理解＞＜医療機関との連携についての理解＞という4つが見出された。 生活を重視したグループホームでの実習では，生活を通して個別性が見えやすく，＜その人らしく生きることを支える個別性の看護の重要性の理解＞が得られやすい可能性が示唆された。また，4日間と限られた実習日数ではあっても，受持ち利用者を決め看護過程の展開を行うこと，さらに看護過程の展開にあたってセンター方式を活用することで＜その人らしく生きることを支える個別性の看護の重要性の理解＞につながりやすいことが示唆された。, The purpose of this study is to clarify what the nursing students actually learned during their practical training at a facility where patients with dementia live together (hereafter group home). Study participants are 40 junior students of the nursing department who gave consent for cooperating the study from among those who completed practical training of geriatric nursing in 20XX. After the practical training on geriatric nursing, we asked them to answer a written questionnaire. The answers were analyzed item by item, while free comments were analyzed qualitatively and inductively. Our analysis found that the learning acquired by the students during the training at the group home included understanding on: 1) importance of individuality in caring so as to support each patient to live his/her own life, 2) how to deal with patients with dementia, 3) dementia symptoms, and 4) cooperation with medical facilities. Practical training at a group home that provides a family-like environment facilitates observing each patient’s individuality through their everyday living. It was suggested that such training may prove to be an opportunity “to understand the importance of individuality in caring so as to support each patient to live his/her own life.” It was also suggested that even during the limited time of four days, dealing with a designated patient to lay out nursing process as well as utilizing the Center Method to Support Persons with Dementia for laying out nursing process help them acquire “understanding of the importance of individuality in caring so as to support each patient to live his/her own life.”