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BACKGROUND: A number of studies document the benefits of face-to-face social interactions for cognitive functioning among middle-aged and older adults. Social activities in virtual worlds may confer similar if not enhanced cognitive benefits as face-to-face social activities, given that virtual interactions require the additional cognitive tasks of learning and navigating communicative tools and technology platforms. Yet, few studies have examined whether social activities in internet-based settings may have synergistic effects on cognitive functioning beyond those of face-to-face interactions. OBJECTIVE: This study examined whether internet-based social activity participation is associated with concurrent and later cognitive functioning, after adjusting for face-to-face social activity participation and sociodemographic covariates. METHODS: For cross-sectional analyses, we included 3650 adults aged 50 years and older who completed questions in the 2020 Health and Retirement Study about social activity participation, including specific internet-based social activities such as emailing or accessing social networks. Cognitive functioning was measured using the standardized cognitive tasks assessing working memory, episodic memory, and attention and processing speed. The longitudinal analyses included the 2034 participants who also completed follow-up cognitive assessments in 2022. RESULTS: Our results revealed that those with higher levels of internet-based social activity participation had higher levels of concurrent cognitive functioning than those with low levels of internet-based social activity participation, after adjusting for demographic and health-related factors and face-to-face social activity participation (b=0.44, SE 0.07; P

Background: Since older adults spend significant time in their neighborhood environment, environmental factors such as neighborhood socioeconomic disadvantage, high racial segregation, low healthy food availability, low access to recreation, and minimal social engagement may have adverse effects on cognitive function and increase susceptibility to dementia. DNA methylation, which is associated with neighborhood characteristics as well as cognitive function and white matter hyperintensity (WMH), may act as a mediator between neighborhood characteristics and neurocognitive outcomes. Methods: In this study, we examined whether DNA methylation in peripheral blood leukocytes mediates the relationship between neighborhood characteristics and cognitive function (N = 542) or WMH (N = 466) in older African American (AA) participants without preliminary evidence of dementia from the Genetic Epidemiology Network of Arteriopathy (GENOA). Results: For a 1-mile buffer around a participant's residence, each additional fast food destination or unfavorable food store with alcohol per square mile was nominally associated with a 0.05 (95%CI: 0.01, 0.09) and a 0.04 (0.00, 0.08) second improvement in visual conceptual tracking score, respectively. Also, each additional alcohol drinking place per square mile was nominally associated with a 0.62 (0.05, 1.19) word increase in delayed recall score, indicating better memory function (all p < 0.05). Neighborhood characteristics were not associated with WMH. We did not find evidence that DNA methylation mediates the observed associations between neighborhood characteristics and cognitive function. Conclusions: The presence of fast food destinations and unfavorable food stores with alcohol was associated cognitive measures, possibly due to greater social interaction provided in these venues. However, replication of these findings is necessary. Further examination of the potential pathways between the neighborhood environment and cognitive function/WMH may allow the development of potential behavioral, infrastructural, and pharmaceutical interventions to facilitate aging in place and healthy brain aging in older adults, especially in marginal populations that are most at risk. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To explore associations between the physical, cognitive, and mental post-intensive care syndrome (PICS) health domains with changes in health-related quality of life (HRQoL) following ICU admission. DESIGN: A longitudinal prospective multicenter cohort study. SETTING/PATIENTS: Patients (n = 4092) from seven Dutch ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: At ICU admission, 3 and 12 months post-ICU, patients completed validated questionnaires regarding physical health problems, cognitive health problems, mental health problems, and HRQoL. Composite scores were created for the physical health domain (physical problems and fatigue) and mental health domain (anxiety, depression, and post-traumatic stress disorder). Adjusted multivariable linear regression analyses were performed, including covariables (e.g., patient characteristics, disease severity, pre-ICU HRQoL, etc.) to explore associations between the physical, cognitive, and mental health domains of PICS and changes in HRQoL at 3 and 12 months post-ICU. At 3 months (n = 3368), physical health problems (β = –0.04 [95% CI, –0.06 to 0.02]; p < 0.001), cognitive health problems (β = –0.05 [95% CI, –0.09 to –0.02]; p < 0.001), and mental health problems (β = –0.08 [95% CI, –0.10 to –0.05]; p < 0.001) were negatively associated with changes in HRQoL. Also, at 12 months (n = 2950), physical health problems (β = –0.06 [95% CI, –0.08 to –0.03]; p < 0.001), cognitive health problems (β = –0.04 [95% CI, –0.08 to –0.01]; p < 0.015), and mental health problems (β = –0.06 [95% CI, –0.08 to –0.03]; p < 0.001) were negatively associated with changes in HRQoL. CONCLUSIONS: PICS symptoms in the physical, cognitive, and mental domains are all negatively associated with changes in HRQoL at 3 and 12 months post-ICU. At 3 months, PICS symptoms in the mental domain seem to have the largest negative associations. At 12 months, the associations of PICS in the mental and physical domains are the same. This implies that daily ICU care and follow-up care should focus on preventing and mitigating health problems across all three PICS domains to prevent a decrease in HRQoL. [ABSTRACT FROM AUTHOR]

This review article investigates the intricate relationship between nutrigenomics and neurological disorders, highlighting how genetic variations affect an individual’s response to nutrients. The study delves into the role of diet-related oxidative stress and the gut-brain axis in the progression and management of brain disorders such as Parkinson’s disease, Alzheimer’s disease, epilepsy, stroke, migraines, and depression. The review encompasses various clinical trials and introduces new trends and techniques, including omics and artificial intelligence, in identifying and managing neurological disorders. The main findings emphasize that personalized diet recommendations, tailored to an individual’s genetic makeup, can significantly improve cognitive health and manage neurological conditions. The study concludes that further research in the field of nutrigenomics is essential to advancing personalized nutrition strategies for better neurological functioning, ultimately linking diet, genes, and brain health. [ABSTRACT FROM AUTHOR]

As cities face escalating challenges related to urbanization, public health, and climate change, innovative solutions are needed to create resilient, sustainable urban environments. Blue-green infrastructure, which integrates green spaces and water management elements, offers significant cognitive, environmental, and social benefits. This paper explores how blue-green infrastructure, coupled with initiatives like the SECOVE project, can enhance urban resilience, promote community well-being, and reduce environmental impact. By fostering vocational training in green building skills, cities can support sustainable development, job creation, and improve quality of life for urban residents. The findings emphasize the importance of integrating ecological design with skilled labor to build urban environments that are healthier, more resilient, and aligned with sustainability goals. [ABSTRACT FROM AUTHOR]

Relationship satisfaction is associated consistently with better physical and mental health. Less is known about these associations in daily life, particularly the association between relationship satisfaction and cognitive health. This study examined the daily, within‐person association between relationship satisfaction and subjective health markers, including cognitive health. Participants from the United States (N = 303; Mage = 51.71, SD = 7.32) in the Couples Healthy Aging Project (CHAP) completed assessments of relationship satisfaction and health markers every night for eight days. Multilevel modeling was performed by accounting for personal (sex, age, race, education), relational (relationship duration), and contextual (day in the study, weekend day) factors. Within‐person, on days when participants were more satisfied with their relationship, they felt healthier, younger, more satisfied with their life, and more purposeful. They also reported a sharper mind, better memory, and clearer thinking; relationship satisfaction was unrelated to whether participants were bothered and disrupted by forgetting. Results indicated that a satisfying romantic relationship is closely associated with better physical, psychological, and cognitive health markers in daily life. [ABSTRACT FROM AUTHOR]

Background: The impact of social isolation on social cognition is not entirely clear. Objective: The aim of the study is to investigate the association between social isolation and social cognition. Methods: In a population-based sample of 83 individuals aged 50+ years without dementia, we assessed the relationship between social isolation (measured by the Lubben Social Network Scale - LSNS-6) and performance on emotional recognition (measured by the Emotion Recognition Task (ERT)) and on Theory of Mind (ToM) abilities (measured by the Reading the Mind in the Eyes Test (RMET)), two core aspects of social cognition. Results: No significant association was found between social isolation and ToM abilities for both the unadjusted and adjusted models. Similarly, no significant association was observed between social isolation and emotion recognition. Conclusions: Further research is needed to understand the complex correlation between social relationships and cognitive health, particularly in different cognitive domains, adopting a life course perspective. [ABSTRACT FROM AUTHOR]

Abstract Impaired cognitive health is the leading cause of various disabilities and disorders. Air pollution has been dramatically increasing over the last few decades and has been identified as a potential risk factor for impaired cognitive health. This study investigates the effect of air pollutants, particulate matter (PM2.5, PM10), sulfur dioxide (SO2), and ground-level ozone, on global cognitive health. The data on environmental pollutants and cognitive health were recorded from PubMed, Web of Science, Scopus, and Google Scholar. Initially, 790 articles were identified after screening for duplicates and applying the inclusion and exclusion criteria, 21 studies were included, and data was synthesized to get a pooled result. The overall results revealed that increased exposure to PM2.5 was positively and significantly associated with cognitive decline (OR 1.49; 95% CI 1.11, 1.99; p = 0.01). The risk of cognitive impairment due to PM10 (OR 1.30; 95% CI 1.00–1.70, p = 0.05), and SO2 (OR 1.39; 95% CI 1.27–1.51; p

ABSTRACT Introduction Methods Results Conclusions Multinational treatment guidelines support providing cognitive remediation to people recently diagnosed with schizophrenia, but the feasibility of implementing the treatment on a large scale is less well understood.This study took place between 2019 and 2023 at 14 clinics within a large network of programs providing early intervention services to people aged 16–30 experiencing nonaffective psychosis. Clinics were randomly assigned to deliver cognitive remediation as twice‐weekly clinician‐led groups (N = 5), cognitive remediation as once‐weekly clinician‐led groups with homework (N = 6), or treatment as usual (N = 3). All clinics screened for cognitive health need to guide treatment planning. Clinical teams (N = 11) received training to provide cognitive remediation. Program evaluation data were analysed for feasibility and acceptability.Screening for cognitive health needs was completed on 77% of the 1193 participants enrolled at the 11 clinics offering cognitive remediation. Clinicians identified cognitive difficulties in 53.9% (n = 496) of screened participants and referred 27% (n = 134) of these participants to cognitive remediation. Of referred participants, 77.6% (n = 104) initiated treatment, and n = 41 completed the treatment. The rate of referral was nearly double, and treatment initiation was significantly higher at programs delivering once‐weekly (84.3%) than twice‐weekly (64.4%) treatment but the difference in the rate of treatment completion was statistically nonsignificant. Satisfaction among treatment completers was high.Referrals to cognitive remediation required systemic support of a feasible cognitive health screening process. About a quarter of people with clinician‐identified cognitive health needs were referred to cognitive remediation. Feasibility data suggest a flexible model of treatment delivery may facilitate implementation in this service setting. [ABSTRACT FROM AUTHOR]

We tested the longitudinal associations between life space mobility (LSM) at baseline and cognitive performance in three domains (memory, reasoning, and speed of processing) over time. Our analytic sample includes 2,690 older adults (mean age = 73.0, 75.9% female) participating in the ACTIVE Study. We used multiple linear mixed-effects models to evaluate whether LSM, measured using the Life Space Questionnaire, at baseline was longitudinally associated with scores on eight cognitive tests and three composite scores across 10 years. In unadjusted models, there were significant main effects of baseline LSM on memory and reasoning domains, and one speed of processing test (beta: 0.019 to 0.055, p < 0.05). All effects were non-significant in adjusted models. Over time, baseline LSM was associated with one memory test score in adjusted models. Greater LSM at baseline is associated with marginally higher cognitive performance but does not appear to affect the rate of cognitive change at a clinically significant level. [ABSTRACT FROM AUTHOR]

Conjunctival melanoma, an uncommon form of ocular melanoma, shares some molecular characteristics with cutaneous melanoma and some with mucosal melanoma. Treatment of cases where it becomes advanced or metastatic raises unique treatment challenges. Nivolumab/relatlimab (Opdualag) recently received FDA approval for metastatic melanoma based on the phase 2/3 RELATIVITY-047 trial, which showed better median progression-free survival (PFS) in the first-line setting without new safety signals. The efficacy of this drug in conjunctival melanoma has not been reported yet. Case presentation: An 87-year-old woman with a history of mild dementia was admitted to the oncology department with a large, exophytic tumor protruding from her left eye, diagnosed as conjunctival melanoma two years previously. This tumor was secreting a whitish fluid and obstructing her vision. Immunotherapy with Opdualag was started, with a near clinical complete response after the 1st cycle. The patient was treated with only four cycles due to worsening of her dementia. Conclusion: Nivolumab/relatlimab (Opdualag) is a promising treatment alternative in conjunctival melanoma when surgery is not viable. [ABSTRACT FROM AUTHOR]

This study investigated the impact of social technology use on health outcomes through loneliness and relationship quality among older adults during the COVID-19 pandemic. Analyzing data from the 2020 Health and Retirement Study COVID-19 Project, we conducted a structural equation model analysis to assess the effects of social technology use on loneliness, relationship quality, and physical and cognitive health outcomes, with a validated index construct of social technology use. Our findings revealed that more frequent social technology use was significantly associated with younger age, being male, being of White race/ethnicity, and living with a spouse/partner. Higher levels of social technology use and positive relationship quality were related to lower feelings of loneliness, respectively. Loneliness mediated the impact of social technology use on physical and cognitive health outcomes. These results underscore the importance of adopting social technology to enhance the psychological well-being of vulnerable older adults, especially during health crises. [ABSTRACT FROM AUTHOR]

This study aims to investigate whether generational differences in intergenerational caregiving patterns (caring for parents only, caring for grandchildren only, and caring for parents and grandchildren simultaneously) are associated with cognitive health disparities among the sandwich generation within four-generation families, drawing upon the theories of intergenerational solidarity and intergenerational stake. Moreover, this study seeks to identify mediators that help explain these disparities. A nationally representative sample of 8,065 respondents was drawn from the 2011 and 2018 waves of the China Health and Retirement Longitudinal Study. The findings reveal that the sandwich generation caring for grandchildren only, as well as those caring for grandchildren and parents simultaneously, exhibit better cognitive health. However, caregiving for parents only is not significantly related to their cognitive health. This study identifies the inability to reduce depressive symptoms as a mediator explaining the insignificant association between caregiving for parents only and the cognitive health of the sandwich generation. The findings underscore the importance of offering support to the sandwich generation within four-generation families to enhance their cognitive health. Moreover, it is imperative to distinguish between different intergenerational caregiving patterns based on generational differences among the sandwich generation, with a specific emphasis on allocating public resources aimed at promoting cognitive health for those engaged in caring for parents. [ABSTRACT FROM AUTHOR]

Background: Social exposures are linked to an array of health outcomes, especially around aging. In this study, we examined the association of social capital, defined as social relationships and networks, with clinical and biological outcomes including cognitive health, oral inflammation, and epigenetic aging. Methods: We used data from the Canadian Longitudinal Study on Aging (CLSA) (n = 1,479; aged 45–85 years), categorizing social capital as structural and cognitive capital. Oral inflammation was determined as the presence of gum bleeding. Epigenetic aging was computed as the difference between chronological age and DNA methylation age. We constructed multivariable regression models adjusted for covariates to assess the relationships of interest. Results: Higher structural social capital was associated with decelerated epigenetic aging and better cognitive health outcomes, while higher cognitive social capital was associated with better cognitive outcomes and less oral inflammation. Conclusion: Enhanced social capital may contribute to better clinical and biological outcomes around aging. [ABSTRACT FROM AUTHOR]

Background: The global aging population underscores the critical importance of understanding factors that influence cognitive health and quality of life in the elderly. Physical activity and nutrition are pivotal in maintaining cognitive function and enhancing overall wellbeing among older adults. This review aims to synthesize the current literature on the impact of physical activity and nutrition on cognitive health and quality of life in the elderly. Methods: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar to identify peer-reviewed articles published from January 2000 to December 2023. The search terms included "physical activity," "exercise," "nutrition," "diet," "cognitive health," "cognitive function," "quality of life," "elderly," "older adults," and "aging." Studies were selected based on inclusion criteria focusing on participants aged 60 years and older, examining the effects of physical activity or nutritional interventions on cognitive health or quality of life, and being published in English. Data from selected studies were extracted and synthesized using a descriptive analysis approach. Results: The review found that physical activity improves cognitive health through increased cerebral blood flow, neurogenesis, and reduced inflammation. Aerobic exercises, resistance training, and balance exercises were all beneficial for cognitive function. Nutrition, including adequate intake of vitamins, minerals, antioxidants, and omega-3 fatty acids, supports cognitive health and reduces the risk of cognitive decline. Specific dietary patterns, such as the Mediterranean and DASH diets, were associated with better cognitive outcomes and quality of life. Combined physical activity and nutritional interventions provided synergistic benefits, enhancing cognitive function and overall well-being. Conclusion: Physical activity and nutrition are essential for maintaining cognitive health and quality of life among the elderly. Regular exercise and a balanced diet rich in essential nutrients contribute significantly to brain health and overall well-being. Policymakers, healthcare providers, and community organizations should promote these interventions to support healthy aging. Future research should focus on longitudinal and intervention studies to further explore the synergistic effects of physical activity and nutrition. [ABSTRACT FROM AUTHOR]

Age-related cerebromicrovascular changes, including blood-brain barrier (BBB) disruption and microvascular rarefaction, play a significant role in the development of vascular cognitive impairment (VCI) and neurodegenerative diseases. Utilizing the unique model of heterochronic parabiosis, which involves surgically joining young and old animals, we investigated the influence of systemic factors on these vascular changes. Our study employed heterochronic parabiosis to explore the effects of young and aged systemic environments on cerebromicrovascular aging in mice. We evaluated microvascular density and BBB integrity in parabiotic pairs equipped with chronic cranial windows, using intravital two-photon imaging techniques. Our results indicate that short-term exposure to young systemic factors leads to both functional and structural rejuvenation of cerebral microcirculation. Notably, we observed a marked decrease in capillary density and an increase in BBB permeability to fluorescent tracers in the cortices of aged mice undergoing isochronic parabiosis (20-month-old C57BL/6 mice [A-(A)]; 6 weeks of parabiosis), compared to young isochronic parabionts (6-month-old, [Y-(Y)]). However, aged heterochronic parabionts (A-(Y)) exposed to young blood exhibited a significant increase in cortical capillary density and restoration of BBB integrity. In contrast, young mice exposed to old blood from aged parabionts (Y-(A)) rapidly developed cerebromicrovascular aging traits, evidenced by reduced capillary density and increased BBB permeability. These findings underscore the profound impact of systemic factors in regulating cerebromicrovascular aging. The rejuvenation observed in the endothelium, following exposure to young blood, suggests the existence of anti-geronic elements that counteract microvascular aging. Conversely, pro-geronic factors in aged blood appear to accelerate cerebromicrovascular aging. Further research is needed to assess whether the rejuvenating effects of young blood factors could extend to other age-related cerebromicrovascular pathologies, such as microvascular amyloid deposition and increased microvascular fragility. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Neurofibrillary tangles (NFTs), a hallmark of tau pathology in Alzheimer's disease (AD), accumulate in the aging brain. However, some individuals remain cognitively intact despite high Braak (III–VI) stages, which characterize NFTs' accumulation. METHODS: We studied resistance and resilience to tau pathology by assessing Braak stages based on apolipoprotein E (APOE) alleles, sex, and age in a sample of 1932 cognitively intact individuals of European ancestry from the Alzheimer's Disease Sequencing Project (ADSP). RESULTS: Resistance, characterized by low (0–II) Braak stages, was observed in men and women younger than 85 years of age. Resilience, indicated by high (III–VI) Braak stages, increased significantly with age in both men and women for each APOE allele. It became more pronounced, with the proportion of high Braak stages exceeding 50% at 85 years and older in women, irrespective of the APOE allele. DISCUSSION: The identification of factors underlying resistance and resilience against AD‐related pathologies is essential for promoting cognitively healthy aging. Highlights: We investigated cognitive resistance and resilience to tau pathology in Alzheimer's disease (AD).This study included individuals who were not diagnosed with AD.Braak stages 0–II and III–VI were considered as a measure of resistance and resilience, respectively.Resistance was stronger at ages younger than 85 years in non‐carriers of the apolipoprotein E (APOE) ε4 allele.Resilience increased with age for each APOE allele independently of sex.At age 85 years and older, high resilience (>50%) was observed in women regardless of the APOE allele. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionsClinical ImplicationsEvidence for the association between purpose in life and cognitive health is primarily from North American and European samples. This study evaluates this association in a large sample from Malaysia, an upper-middle-income country in Southeast Asia.Participants (N = 5,579) from the Malaysian Ageing and Retirement Study reported on their purpose in life and subjective memory and were administered tasks that measured episodic memory, verbal fluency, and overall cognitive function.Purpose was associated with better subjective memory (β=.13), episodic memory (β=.06), verbal fluency (β=.12), and overall cognitive function (β=.07) (ps < .001). The associations were similar across sex and retirement status; purpose was more strongly related to subjective memory and overall cognitive function among older participants. Behavioral/social factors accounted for up to one-third of the associations, but all associations remained statistically significant.The positive association between purpose and cognition generalizes to a middle-income country in Southeast Asia. Similar to Western samples, behavioral and social factors accounted for part but not all the association. More research is needed in lower- and other middle-income countries to fully evaluate generalizability.Purpose may help support healthier cognitive aging across diverse populations and be a useful target to improve cognitive aging outcomes. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Cognitive health in schizophrenia spectrum psychosis has received substantial empirical attention in recent decades, coinciding with the development and implementation of interventions including cognitive remediation. Subjective experience in psychosis, including qualitative explorations of service user perspectives, has also proliferated; however, there is no available synthesis of service user representation in the psychosis cognitive health literature. This scoping review investigated prevalence and characteristics of qualitative research reporting service user perspectives across the extant research on cognitive health and related interventions in psychosis. Study Design We conducted a literature search on qualitative methods in cognitive health and/or related interventions across PubMed, Web of Science, and PsycInfo databases. The review followed the PRISMA-ScR guidelines for scoping reviews and identified 23 papers. Data extraction included study design and sample characteristics, qualitative methodology, and reporting. Study Results Of 23 articles, 18 reported on user experiences of interventions, most often in the context of feasibility/acceptability for otherwise quantitative trials. Five studies described service user experiences of cognitive health separately from interventions. Only 3 included any service user involvement or participatory methods. Twenty articles reported any demographic characteristics, and fewer than half (11) reported any racial or ethnic sample characteristics. There was substantial variability in qualitative methodology and reporting across studies. Conclusions Qualitative methodology is lacking in its representation and rigor across the cognitive health literature for schizophrenia spectrum psychosis. Additional inclusion of service user lived experience is critical for future research to better characterize cognitive health and inform interventions to promote recovery. [ABSTRACT FROM AUTHOR]

Impaired cognitive health is the leading cause of various disabilities and disorders. Air pollution has been dramatically increasing over the last few decades and has been identified as a potential risk factor for impaired cognitive health. This study investigates the effect of air pollutants, particulate matter (PM2.5, PM10), sulfur dioxide (SO2), and ground-level ozone, on global cognitive health. The data on environmental pollutants and cognitive health were recorded from PubMed, Web of Science, Scopus, and Google Scholar. Initially, 790 articles were identified after screening for duplicates and applying the inclusion and exclusion criteria, 21 studies were included, and data was synthesized to get a pooled result. The overall results revealed that increased exposure to PM2.5 was positively and significantly associated with cognitive decline (OR 1.49; 95% CI 1.11, 1.99; p = 0.01). The risk of cognitive impairment due to PM10 (OR 1.30; 95% CI 1.00–1.70, p = 0.05), and SO2 (OR 1.39; 95% CI 1.27–1.51; p < 0.01) exposure were also significantly heightened. The study findings show that overall exposure to particulate matter PM2.5, PM10, and SO2 was associated with an increased risk of a decrease in global cognitive functions. The findings suggest that reducing levels of air pollutants could be a strategic approach to mitigate cognitive health risks in populations worldwide. [ABSTRACT FROM AUTHOR]

Objective: The pandemic contributed to increased mental and cognitive health concerns as well as reduced utilization of preventive and treatment focused care. Deferred care can contribute to negative clinical outcomes, including increased acuity of mental and cognitive health concerns that benefit from early intervention. A new visit type was launched with the aim of reaching patients who may need care and supporting early identification of cognitive and mental health issues. Methods: We developed the Healthy Mind visit, a preventative visit administered by Primary Care Providers (PCPs) within outpatient clinics. The Healthy Mind visit included use of a pre-visit mental health screener as well as a brief computerized cognitive assessment. The clinical interaction focused on identifying mental and cognitive health concerns and developing a plan for wellness. Outcomes data collection occurred over nearly 2.5 years and focused on analyzing booking patterns, depression screening and follow-up, and clinical outcomes such as health confidence and post-visit motivation. Results: The visit was effective in supporting depression screening and follow-up with 29.6% of those participating in a Healthy Mind visit receiving a PHQ-9, and 82.5% of patients with elevated PHQ-9 scores attending a subsequent visit with their PCP. Improvements in health confidence and high patient reported motivation post-visit represent other notable clinical outcomes. The visit also promoted care utilization, with 73.5% of patients who attended a Healthy Mind visit being new to the practice or those who had not attended an appointment in the past 6 months. Conclusions: The Healthy Mind visit, with a focus on mental and cognitive health, was successful in reaching patients who may not have otherwise sought care and supported positive clinical outcomes including early identification and treatment of depression and increased health confidence. Recommendations: These findings reflect the importance of developing innovative programs to connect patients with care, especially those who may have deferred care due to a variety of factors. Focusing on mental and cognitive health with the use of innovative tools such as a computerized assessment, can drive patient interest in care offerings and support positive clinical outcomes. [ABSTRACT FROM AUTHOR]

BackgroundSocially isolated individuals tend to have less access to cognitively stimulating activities, which could adversely impact their cognitive health. The Internet-Based Conversational Engagement Clinical Trial (I-CONECT) intervention was designed to deliver online conversation sessions to socially isolated older old adults to prevent cognitive decline. The current study examined the intervention efficacy on participants’ weekly time spent out-of-home and their social interaction with family and friends.MethodsThe intervention group engaged in frequent conversations with trained interviewers via the Internet. Both intervention and control group participants received 10-min weekly phone check-in calls over 48 weeks, during which they were asked to self-report their time (in hours) spent out of home and whether they had contacted family or friends during this week (yes/no). Linear mixed-effect models for repeated measures were run for time spent out-of-home, and mixed-effect models with a logistic link for contact with family and friends. The intervention effect was modeled by including an interaction term of time (measured in weeks) and group assignments (intervention vs. control). We ran subgroup analyses for participants with normal cognition (NC) and mild cognitive impairment (MCI). All models controlled for age, sex, race, education, and the historical event of COVID-19.Results5,495 weekly records were included in the analysis. The main effect of time was statistically significant (p

Aim: The study aims to explore the relationship between periodontitis and Alzheimer's disease, focusing on the association and their potential impact on cognitive health. Methods: A retrospective study was conducted utilizing data obtained from the Brunei Health Information Management System (Bru-HIMS). The research study examined the correlation between periodontitis and Alzheimer's disease in individuals admitted to government healthcare settings between January 2014 and December 2023. Logistic regression and survival analysis were applied. Results: After diagnosis of periodontitis, 81.6 %, 59.2 % and 40.8 % developed Alzheimer's disease after 1–3- and 5-years, respectively. Women (34.3 %) had significantly lower proportion of developing Alzheimer's disease after 5 years compared to men (46.3 %). Furthermore, those with history of tooth extraction has a high risk of developing Alzheimer's disease (Adjusted Hazard Ratio = 5.00; 95 % CI: 2.04, 12.28; p < 0.001). Conclusion: The study highlights the importance of understanding periodontal health in Alzheimer's patients and suggests further research and targeted interventions to mitigate its impact on cognitive function.

BackgroundThe rapid growth of internet use among older adults in rural China offers a unique opportunity to examine its potential impact on their health. This study seeks to explore the relationship between internet use and the emotional, physical, and cognitive health of empty-nest older adults in rural China, while also considering the mediating role of social participation in this relationship.MethodsA total of 3,478 empty-nest older adults were selected from the China Health and Retirement Longitudinal Survey (CHARLS) in 2020. Among them, 820 individuals were included in the study using a propensity score matching (PSM) method to reduce the impact of selection bias. The participants' depression, physical health, and cognitive health were measured using the Center for Epidemiological Studies Depression Scale (CES-D), the Activities of Daily Living (ADL) scale, and a composite cognition score, respectively. Social participation was assessed based on engagement in various activities over the past month.ResultsAfter controlling for confounding factors through PSM, it was found that older adults who used the internet exhibited significantly lower level of depression and higher physical health compared to older adults who did not use the internet. However, there was no significant difference in cognitive health between the two groups. The mediating effect analysis revealed that social participation partially mediated the relationship between internet use and physical health, but not emotional health.ConclusionThe study suggests that internet use can improve emotional and physical health of older adults living in rural China without children at home, with social participation being a mediator in the relationship between internet use and physical health. Future research should explore the underlying mechanisms and develop targeted interventions to promote internet use and social engagement in this population.

Abstract Background With an increasing proportion of older adults and the associated risk of Alzheimer’s Disease and Related Dementias (ADRD) around the globe, there is an urgent need to engage in ADRD risk reduction efforts. African American (AA) older adults in the U.S. are disproportionally impacted by ADRD compared to other races and ethnicities. Mindful walking integrates two potentially protective factors of ADRD by elevating mindfulness and physical activity (i.e., walking), resulting in a synergistic behavioral strategy that is feasible and safe for older adults. However, the efficacy of applying this intervention for cognitive health outcomes has not been evaluated using experimental designs. Methods This paper documents the goal and protocol of a community-based, mindful walking randomized controlled trial to examine the short- and longer-term efficacy on cognitive and other health-related outcomes in ADRD at-risk AA older adults. The study outcomes include various brain health determinants, including cognitive function, quality of life, psychological well-being, physical activity, mindfulness, sleep, and overall health status. In addition, the estimated costs of program implementation are also collected throughout the study period. This study will recruit 114 older adults (ages 60+ years) with elevated ADRD risk from the Midlands region of South Carolina. Older adults are randomly assigned to participate in 24 sessions of outdoor mindful walking over three months or a delayed mindful walking group (n=57 in each group). Participants in both groups follow identical measurement protocols at baseline, after 12 weeks, after 18 weeks, and after 24 weeks from baseline. The outcome measures are administered in the lab and in everyday settings. Costs per participant are calculated using micro-costing methods. The eliciting participant costs for mindful walking engagement with expected results are reported using the payer and the societal perspectives. Discussion This study will generate evidence regarding the efficacy of mindful walking on sustaining cognitive health in vulnerable older adults. The results can inform future large-scale effectiveness trials to support our study findings. If successful, this mindful walking program can be scaled up as a low-cost and viable lifestyle strategy to promote healthy cognitive aging in diverse older adult populations, including those at greatest risk. Trial registration ClinicalTrials.gov number NCT06085196 (retrospectively registered on 10/08/2023).

Abstract The matter of raising and educating deaf children has been caught up in percepts of development that are persistently inaccurate and at odds with scientific research. These percepts have negatively impacted the health and quality of life of deaf children and deaf people in general. The all too prevalent advice is to raise the child strictly orally and wait to see what happens. Only when the child is seriously behind is a completely accessible language – a sign language – introduced, and that is far too late for protecting cognitive health. The medical profession, along with others, needs to offer parents better advice and better supports so that neither the children nor their parents wait and watch as the oral-only method fails. All must take responsible action to assure an approach that succeeds.

Abstract Background Concerns about mental and cognitive health are common among university students. Engaging in regular physical exercise has been shown to enhance both mental health and cognitive performance, yet most students are not participating in the level of exercise required to obtain these benefits. The Behaviour Change Wheel (BCW) provides a framework for developing behavioural interventions that are informed by theory, evidence, and stakeholder perspectives. The current study aimed to apply the BCW to develop the PEAK Mood, Mind, and Marks program (i.e., PEAK), a behaviour change intervention designed to increase university students’ exercise engagement for the benefit of their mental and cognitive health. Methods PEAK was developed across three stages of the BCW: (1) understand the target behaviour, (2) identify intervention options, and (3) identify intervention content and delivery mode. Development was informed by triangulated data from a systematic literature review, co-design consultations with key stakeholders, and knowledge of relevant experts. Consultations with stakeholders involved focus groups with 25 university students and individual interviews with 10 university leaders and staff to identify barriers and facilitators to students’ exercise engagement and the adoption and implementation of PEAK by universities. Template analysis was used to code transcripts to the capability, opportunity, and motivation (COM-B) model of behaviour. The BCW was applied to identify the most appropriate intervention types and behaviour change techniques (BCTs). Results Thirty-one barriers and facilitators were identified and mapped to seven intervention types (Education; Modelling; Persuasion; Environmental Restructuring; Incentivisation; Training; and Enablement) and 26 BCTs, which were delivered across digital channels and in-person. The final intervention consisted of multiple components targeting students’ capability (e.g., increasing knowledge about the mental and cognitive health benefits of exercise), opportunity (e.g., providing a flexible range of accessible exercise options and social support), and motivation (e.g., increasing the perceived importance of exercise) to exercise. Conclusions University students and staff describe a need and appetite for more empowering, scalable solutions to support students’ mental and cognitive health. Exercise-based approaches that are informed by behaviour change frameworks, evidence, and stakeholder perspectives, such as PEAK, have the potential to address this need. Current findings will inform a pilot of PEAK to evaluate its efficacy and implementation.

Background. Setting of norms for the parameters of P300 cognitive auditory evoked potentials (EP) in elderly people with intact cognitive functions considering their residence in certain climatic and geographical regions is an urgent problem.The aim of the study. To determine age-related parameters of P300 cognitive auditory evoked potentials in elderly people aged 60–69 and 70–74 years, living in the European North of Russia (using the example of Arkhangelsk).Methods. The parameters of P300 auditory EP were determined in randomly selected urban residents in the age groups of 60–69 years (n = 284) and 70–74 years (n = 115) with normal scores on the Montreal Cognitive Assessment Scale (MoCA), without depression (according to Beck Depression Inventory), with preserved ability to work and/or social functions. We calculated the 5th–95th percentile values (P5– P95) of the P300 EP parameters and assessed the relationships of these parameters with socio-demographic characteristics, lifestyle and the results on the MoCA scale and Beck Depression Inventory.Results. Statistically significant differences in latency indicators of P300 EP were determined between groups of 60–69 and 70–74 years (P25–P90) in all studied brain regions (frontal, central). In the group of 60–69 years, the range of P25–P75 values of P300 EP latencies was 342.5–401 ms, in the group of 70–74 years – 358.5–443 ms. Age differences in P300 EP amplitudes were minimal with an interquartile range of 4–13 μV in the total sample. Participants who smoked had higher latency scores and lower amplitude scores; former smokers had higher latency scores compared to never-smokers.Conclusion. Latency above 400 ms at the age of 60–65 years and above 443 ms at 70–74 years can be considered as a criterion for reduced cognitive reserve and an increased risk of developing cognitive disorders in elderly people living in the European North of Russia.

Background: With an increasing proportion of older adults and the associated risk of Alzheimer's Disease and Related Dementias (ADRD) around the globe, there is an urgent need to engage in ADRD risk reduction efforts. African American (AA) older adults in the U.S. are disproportionally impacted by ADRD compared to other races and ethnicities. Mindful walking integrates two potentially protective factors of ADRD by elevating mindfulness and physical activity (i.e., walking), resulting in a synergistic behavioral strategy that is feasible and safe for older adults. However, the efficacy of applying this intervention for cognitive health outcomes has not been evaluated using experimental designs. Methods: This paper documents the goal and protocol of a community-based, mindful walking randomized controlled trial to examine the short- and longer-term efficacy on cognitive and other health-related outcomes in ADRD at-risk AA older adults. The study outcomes include various brain health determinants, including cognitive function, quality of life, psychological well-being, physical activity, mindfulness, sleep, and overall health status. In addition, the estimated costs of program implementation are also collected throughout the study period. This study will recruit 114 older adults (ages 60+ years) with elevated ADRD risk from the Midlands region of South Carolina. Older adults are randomly assigned to participate in 24 sessions of outdoor mindful walking over three months or a delayed mindful walking group (n=57 in each group). Participants in both groups follow identical measurement protocols at baseline, after 12 weeks, after 18 weeks, and after 24 weeks from baseline. The outcome measures are administered in the lab and in everyday settings. Costs per participant are calculated using micro-costing methods. The eliciting participant costs for mindful walking engagement with expected results are reported using the payer and the societal perspectives. Discussion: This study will generate evidence regarding the efficacy of mindful walking on sustaining cognitive health in vulnerable older adults. The results can inform future large-scale effectiveness trials to support our study findings. If successful, this mindful walking program can be scaled up as a low-cost and viable lifestyle strategy to promote healthy cognitive aging in diverse older adult populations, including those at greatest risk. Trial registration: ClinicalTrials.gov number NCT06085196 (retrospectively registered on 10/08/2023). [ABSTRACT FROM AUTHOR]

As populations age, leveraging community resources to reduce dementia risk is increasingly vital for brain health. Using community-based participatory research methods, we co-developed and tested a pilot program with older adults in Metro Vancouver, Canada, to better understand and address brain health needs in community settings. Over 12 focus groups, older adults provided input which led to a place-based wellness model 'Connectedness, feeling At home, and joyful Play' (CAP). The CAP model was incorporated into an 8-week feasibility study, testing various components of a multi-domain realist controlled trial (n = 78). Older adults were recommended various existing activities in the community based on their CAP profiles. A 'Finding Meaning in Aging' mindful discussion program was added in response to older adults' feedback on current gaps. Path analysis of preliminary data suggests that total attendance (β =.196, p =.070) improved brain health at week 8 by increasing a sense of playfulness at week 4 (β =.284, p =.002). Mindfulness (β =.215, p =.046) improved brain health by increasing a sense of at-homeness (β =.227, p =.025). Both pre- and post-implementation feedback from older adults centred the importance of friendship in late life, specifically to address late-life losses. The community-generated CAP model shows promise for place-based cognitive health promotion. [ABSTRACT FROM AUTHOR]

The ability to learn new skills as an adult, cognitive stimulation in the ageing process, and a cognitively active lifestyle are of interest to experts in education, public health, and social studies. The game Scrabble, with its enjoyable nature, has gained recognition as an educational resource that facilitates the acquisition and preservation of vocabulary, thereby augmenting both practical and cognitive abilities. In this study, a descriptive quantitative research design was implemented to assess attentional capacity using the Bourdon Attention Test, specifically utilizing the BoPr (Prague Square Modification of the CSAT), within the cohort of Scrabble League e-players and the broader general population. With a focus on promoting cognitive brain health, this study presents a comparison of sustained attention levels between these groups. A sample of N = 60 participants (divided into Scrabble e-players who participate in a league [N = 30], and a comparison group of the general population [N = 30]) underwent a study comparing their levels of attention achieved in the Bourdon test. A significant difference (p = 0.050) was found in their attention span, favoring the league e-players. The results suggest that Scrabble e-games can potentially improve the cognitive well-being and attention of adults and older individuals. However, further investigation is necessary to understand their capabilities fully. Utilizing Scrabble in the realms of adult education, gerontology, and medical practice could be beneficial for enhancing cognitive brain health. [ABSTRACT FROM AUTHOR]

Introduction: Regular exercise has the potential to enhance university students' mental and cognitive health. The PEAK Mood, Mind and Marks program (i.e., PEAK) is a neuroscience-informed intervention developed using the Behaviour Change Wheel to support students to exercise three or more times per week to benefit their mental and cognitive health. This pilot study assessed the impact of PEAK on exercise, mental and cognitive health, and implementation outcomes. Methods: PEAK was delivered to 115 undergraduate university students throughout a 12-week university semester. The primary outcome was weekly exercise frequency. Secondary outcomes were: time spent engaged in moderate-vigorous exercise, sedentary behaviour and perceived mental health and cognitive health. All were measured via online self-report questionnaires. Qualitative interviews with 15 students investigated influences on engagement, the acceptability and appropriateness of PEAK, and its mechanisms of behaviour change. Paired t-tests, Wilcoxon Signed-Rank tests and template analysis were used to analyse quantitative and qualitative data, respectively. Results: On average, 48.4% of students engaged in the recommended frequency of three or more exercise sessions per week. This proportion decreased towards the end of PEAK. Sedentary behaviour significantly decreased from baseline to end-point, and moderate-vigorous exercise significantly increased among students' who were non-exercisers. Mental wellbeing, stress, loneliness, and sense of belonging to the university significantly improved. There were no significant changes in psychological distress. Concentration, memory, and productivity significantly improved. Sixty-eight percent of students remained engaged in one or more components of PEAK at end-point. Qualitative data indicated students found PEAK to be acceptable and appropriate, and that it improved aspects of their capability, opportunity, and motivation to exercise. Conclusions: Students are receptive to an exercise-based program to support their mental and cognitive health. Students exercise frequency decreased; however, these figures are likely a conservative estimate of students exercise engagement. Students valued the neuroscience-informed approach to motivational and educational content and that the program's goals aligned with their academic goals. Students identified numerous areas PEAK's content and implementation can be optimised, including use of a single digital delivery platform, more opportunities to connect with peers and to expand the content's cultural inclusivity. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodResultsConclusionLoneliness is associated with maladaptive cognitions, yet little is known about the association between loneliness and intrusive thinking during older adulthood. Links between loneliness and intrusive thoughts may be particularly strong among individuals with mild cognitive impairment (MCI), who may have greater difficulty regulating emotion and intrusive thoughts. In contrast, having close relationships (e.g. being married) may serve as a protective factor as marital status is associated with better overall well-being.Participants were 316 older adults (recruited from the Bronx, NY, as part of a larger study) without dementia at study intake (40% Black; 13% Hispanic, Mage = 77.45 years, 67% women) who completed ecological momentary assessments five times daily for 14 consecutive days (13,957 EMAs total). Multilevel modeling was used to examine the association between momentary loneliness and intrusive thoughts and whether MCI and marital status interacted to moderate this association.There was a significant three-way interaction (β = −0.17, p < 0.05), such that lagged momentary loneliness was positively associated with intrusive thoughts (3–4 h later) for those with MCI who were not married.Findings suggest that among older adults with MCI, being married may be a protective factor and being unmarried may be a risk factor for experiencing loneliness and subsequent intrusive thoughts. [ABSTRACT FROM AUTHOR]

Consumers often cite cognitive improvements as reasons for making dietary changes or using dietary supplements, a motivation that if leveraged could greatly enhance public health. However, rarely is it considered whether standardized cognitive tests that are used in nutrition research are aligned to outcomes of interest to the consumer. This knowledge gap presents a challenge to the scientific substantiation of nutrition-based cognitive health benefits. Here we combined focus group transcript review using reflexive thematic analysis and a multidisciplinary expert panel exercise to evaluate the applicability of cognitive performance tools/tasks for substantiating the specific cognitive benefits articulated by consumers with the objectives to (1) understand how consumers comprehend the potential benefits of nutrition for brain health, and (2) determine the alignment between consumers desired brain benefits and validated tests and tools. We derived a 'Consumer Taxonomy of Cognitive and Affective Health in Nutrition Research' which describes the cognitive and affective structure from the consumers perspective. Experts agreed that validated tests exist for some consumer benefits including focused attention, sustained attention, episodic memory, energy levels, and anxiety. Prospective memory, flow, and presence represented novel benefits that require the development and validation of new tests and tools. Closing the gap between science and consumers and fostering co-creative approaches to nutrition research are critical to the development of products and dietary recommendations that support realizable cognitive benefits that benefit public health. [ABSTRACT FROM AUTHOR]

Introduction: Although the growth of digital tools for cognitive health assessment, there’s a lack of known reference values and clinical implications for these digital methods. This study aims to establish reference values for digital neuropsychological measures obtained through the smartphone-based cognitive assessment application, Defense Automated Neurocognitive Assessment (DANA), and to identify clinical risk factors associated with these measures. Methods: The sample included 932 cognitively intact participants from the Framingham Heart Study, who completed at least one DANA task. Participants were stratified into subgroups based on sex and three age groups. Reference values were established for digital cognitive assessments within each age group, divided by sex, at the 2.5th, 25th, 50th, 75th, and 97.5th percentile thresholds. To validate these values, 57 cognitively intact participants from Boston University Alzheimer’s Disease Research Center were included. Associations between 19 clinical risk factors and these digital neuropsychological measures were examined by a backward elimination strategy. Results: Age- and sex-specific reference values were generated for three DANA tasks. Participants below 60 had median response times for the Go-No-Go task of 796 ms (men) and 823 ms (women), with age-related increases in both sexes. Validation cohort results mostly aligned with these references. Different tasks showed unique clinical correlations. For instance, response time in the Code Substitution task correlated positively with total cholesterol and diabetes, but negatively with high-density lipoprotein and low-density lipoprotein cholesterol levels, and triglycerides. Discussion: This study established and validated reference values for digital neuropsychological measures of DANA in cognitively intact white participants, potentially improving their use in future clinical studies and practice. [ABSTRACT FROM AUTHOR]

Objectives Recent studies have found that perceived discrimination as a chronic stressor predicts poorer cognitive health. However, little research has investigated how social relationships as potential intervening mechanisms may mitigate or exacerbate this association. Using a nationally representative sample of U.S. older adults, this study examined how the existence and quality of 4 types of relationships—with a partner, children, other family members, and friends—may modify the impact of perceived discrimination on incident dementia. Methods We analyzed data from the 2006 to 2016 Health and Retirement Study (N  = 12,236) using discrete-time event history models with competing risks. We used perceived discrimination, social relationships, and their interactions at the baseline to predict the risk of incident dementia in the follow-ups. Results Perceived discrimination predicted a higher risk of incident dementia in the follow-ups. Although having a partner or not did not modify this association, partnership support attenuated the negative effects of discrimination on incident dementia. Neither the existence nor quality of relationships with children, other family members, or friends modified the association. Discussion Our findings imply that intimate partnership plays a critical role in coping with discrimination and, consequently, influencing the cognitive health of older adults. Although perceived discrimination is a significant risk factor for the incidence of dementia, better partnership quality may attenuate this association. Policies that eliminate discrimination and interventions that strengthen intimate partnerships may facilitate better cognitive health in late life. [ABSTRACT FROM AUTHOR]

In most African societies with domestic activities having a feminine face, failure of households to access and utilize modern energy services could derail the socioeconomic efforts of contemporary women and affect their general well-being. Despite this, empirical studies that explore the avenues through which multidimensional energy poverty impacts women's well-being remain understudied, especially in sub-Saharan African countries where domestic activities are traditionally regarded as women's role. This study, therefore, used data from the recent Multiple Indicator Cluster Survey (MICS 6) for three West African countries to assess the impact of multidimensional energy poverty on women's subjective well-being and cognitive health. Results from structural equation modeling (SEM) and seemingly unrelated regression (SUR) models as well as other robustness checks revealed significant adverse effects of multidimensional energy poverty on women's subjective well-being and cognitive health. Further, we find that multidimensional energy poverty influences women's cognitive health through adverse impacts on women's subjective well-being. The revelations made in this study enforce the need to accelerate access to modern energy services to promote the efficiency of household domestic activities and, most importantly, improve the quality of life and the general well-being of women. [ABSTRACT FROM AUTHOR]

Dementia is a global public health priority. Physical activity has myriad health benefits, including for reducing dementia risk. To increase physical activity, detailed understanding of influencing factors is needed. Socioeconomic deprivation affects many aspects of health and wellbeing. Qualitative research with older people experiencing socioeconomic deprivation is needed to explore barriers and enablers to engaging in physical activity, with the view to co-designing interventions for implementation trials. A whole of society approach is pivotal to improving effectiveness of physical activity interventions for older adults with cognitive impairment, and target support for people experiencing socioeconomic deprivation, to improve their health outcomes. [ABSTRACT FROM AUTHOR]

Abstract INTRODUCTION Neurofibrillary tangles (NFTs), a hallmark of tau pathology in Alzheimer's disease (AD), accumulate in the aging brain. However, some individuals remain cognitively intact despite high Braak (III–VI) stages, which characterize NFTs’ accumulation. METHODS We studied resistance and resilience to tau pathology by assessing Braak stages based on apolipoprotein E (APOE) alleles, sex, and age in a sample of 1932 cognitively intact individuals of European ancestry from the Alzheimer's Disease Sequencing Project (ADSP). RESULTS Resistance, characterized by low (0–II) Braak stages, was observed in men and women younger than 85 years of age. Resilience, indicated by high (III–VI) Braak stages, increased significantly with age in both men and women for each APOE allele. It became more pronounced, with the proportion of high Braak stages exceeding 50% at 85 years and older in women, irrespective of the APOE allele. DISCUSSION The identification of factors underlying resistance and resilience against AD‐related pathologies is essential for promoting cognitively healthy aging. Highlights We investigated cognitive resistance and resilience to tau pathology in Alzheimer's disease (AD). This study included individuals who were not diagnosed with AD. Braak stages 0–II and III–VI were considered as a measure of resistance and resilience, respectively. Resistance was stronger at ages younger than 85 years in non‐carriers of the apolipoprotein E (APOE) ε4 allele. Resilience increased with age for each APOE allele independently of sex. At age 85 years and older, high resilience (>50%) was observed in women regardless of the APOE allele.

Conjunctival melanoma, an uncommon form of ocular melanoma, shares some molecular characteristics with cutaneous melanoma and some with mucosal melanoma. Treatment of cases where it becomes advanced or metastatic raises unique treatment challenges. Nivolumab/relatlimab (Opdualag) recently received FDA approval for metastatic melanoma based on the phase 2/3 RELATIVITY-047 trial, which showed better median progression-free survival (PFS) in the first-line setting without new safety signals. The efficacy of this drug in conjunctival melanoma has not been reported yet.Case presentationAn 87-year-old woman with a history of mild dementia was admitted to the oncology department with a large, exophytic tumor protruding from her left eye, diagnosed as conjunctival melanoma two years previously. This tumor was secreting a whitish fluid and obstructing her vision. Immunotherapy with Opdualag was started, with a near clinical complete response after the 1st cycle. The patient was treated with only four cycles due to worsening of her dementia.ConclusionNivolumab/relatlimab (Opdualag) is a promising treatment alternative in conjunctival melanoma when surgery is not viable.