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Introduction and objectives: Brief cognitive tests (BCT) are used in primary care (PC) for the detection of cognitive impairment (CI). Still, there are little data on their diagnostic utility (DU) in a community setting. This work evaluates the DU at the population level of Fototest, T@M, AD8 questionnaire and MMSE. It provides new cut-off points (CoP) validated in a CI early detection program. Material and methods: In the population and validation samples, the evaluation was carried out in two phases, a first of screening and administration of BCT and a second of clinical diagnosis, blinded to the results of the BCT, applying the current NIA-AA criteria. The DU of BCT in the population sample was evaluated with the area under the ROC curve (aROC). Youden index and the CoP with the best specificity that ensured a sensitivity of 80% were used to decide on the most appropriate CoP. The sensitivity, specificity, and predictive values for these CoP were calculated in the validation sample. Results: 260 participants (23.1% with CI) from the population sample and 177 (42.4% with CI) from the validation sample were included. The Fototest has the best UD at the population level (aROC 0.851), which improves with the combination of Fototest and AD8 (aROC 0.875). The proposed CoP are AD8 ≥ 1, Fototest ≤ 35, T@M ≤ 40, and MMSE ≤ 26. Conclusion: BCT are helpful in detecting CI in PC. This work supports the use of more demanding PoC. Resumen: Introducción y objetivos: Los test cognitivos breves (TCB) se utilizan en atención primaria (AP) para la detección de deterioro cognitivo (DC) pero existen pocos datos sobre su utilidad diagnóstica (UD) en el ámbito comunitario.Este trabajo evalúa la UD de Fototest, T@M, cuestionario AD8 y MMSE en una muestra representativa de la población y aporta nuevos puntos de corte (PdC) que se han validado en un grupo de personas que consultan por quejas cognitivas. Material y métodos: Ambas muestras, la poblacional y la de validación, se realizó una evaluación en dos fases; una primera de cribado y administración de los TCB y una segunda de diagnóstico clínico, ciego a los resultados de los TCB, aplicando los criterios NIA-AA actuales.La UD de los TCB en la muestra poblacional se evaluó con el área bajo la curva ROC (aROC). Para elegir los PdC óptimos, se evaluaron dos métodos: el índice de Youden y el PdC con mejor especificidad que asegurase una sensibilidad del 80%. En la muestra de validación se calcularon los parámetros de sensibilidad, especificidad, y valores predictivos para estos PdC. Resultados: Se han incluido 260 participantes (23,1% con DC) de la muestra poblacional y 177 (42,4% con DC) de la de validación. El Fototest tiene la mejor UD a nivel poblacional (aROC 0,851), que mejora con la combinación de Fototest y AD8 (aROC 0,875; p

Resumen: Introducción y objetivos: Los test cognitivos breves (TCB) se utilizan en Atención Primaria (AP) para la detección de deterioro cognitivo (DC) pero existen pocos datos sobre su utilidad diagnóstica (UD) en el ámbito comunitario.Este trabajo evalúa la UD de Fototest, T@M, cuestionario AD8 y MMSE en una muestra representativa de la población y aporta nuevos puntos de corte (PdC) que se han validado en un grupo de personas que consultan por quejas cognitivas. Material y métodos: Ambas muestras, la poblacional y la de validación, se realizó una evaluación en 2 fases; una primera de cribado y administración de los TCB y una segunda de diagnóstico clínico, ciego a los resultados de los TCB, aplicando los criterios NIA-AA actuales.La UD de los TCB en la muestra poblacional se evaluó con el área bajo la curva ROC (aROC). Para elegir los PdC óptimos, se evaluaron 2 métodos: el índice de Youden y el PdC con mejor especificidad que asegurase una sensibilidad del 80%. En la muestra de validación se calcularon los parámetros de sensibilidad y especificidad, y los valores predictivos para estos PdC. Resultados: Se ha incluido a 260 participantes (23,1% con DC) de la muestra poblacional y 177 (42,4% con DC) de la de validación. El Fototest tiene la mejor UD a nivel poblacional (aROC 0,851), que mejora con la combinación de Fototest y AD8 (aROC 0,875; p

Abstract Background GOIZ ZAINDU (“caring early” in Basque) is a pilot study to adapt the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) methodology to the Basque population and evaluate the feasibility and adherence to a FINGER-like multidomain intervention program. Additional aims included the assessment of efficacy on cognition and data collection to design a large efficacy trial. Method GOIZ ZAINDU is a 1-year, randomized, controlled trial of a multidomain intervention in persons aged 60+ years, with Cardiovascular Risk Factors, Aging and Dementia (CAIDE) risk score ≥ 6, no diagnosis of dementia, and below-than-expected performance in at least one of three cognitive screening tests. Randomization to a multidomain intervention (MD-Int) or regular health advice (RHA) was stratified by sex, age (>/≤ 75), and cognitive status (mild cognitive impairment (MCI)/normal cognition). MD-Int included cardiovascular risk factor control, nutritional counseling, physical activity, and cognitive training. The primary outcomes were retention rate and adherence to the intervention program. Exploratory cognitive outcomes included changes in the Neuropsychological Test Battery z-scores. Analyses were performed according to the intention to treat. Results One hundred twenty-five participants were recruited (mean age: 75.64 (± 6.46); 58% women). The MD-Int (n = 61) and RHA (n = 64) groups were balanced in terms of their demographics and cognition. Fifty-two (85%) participants from the RHA group and 56 (88%) from the MD-Int group completed the study. More than 70% of the participants had high overall adherence to the intervention activities. The risk of cognitive decline was higher in the RHA group than in the MD-Int group in terms of executive function (p =.019) and processing speed scores (p =.026). Conclusions The GOIZ-ZAINDU study proved that the FINGER methodology is adaptable and feasible in a different socio-cultural environment. The exploratory efficacy results showed a lower risk of decline in executive function and processing speed in the intervention group. These results support the design of a large-scale efficacy trial. Trial registration GOIZ ZAINDU feasibility trial was approved and registered by the Euskadi Drug Research Ethics Committee (ID: PI2017134) on 23 January 2018. Retrospectively registered in ClinicalTrials.gov (NCT06163716) on 8 December 2023.

During the Spring semester of 2020, due to a global pandemic caused by the widespread of the novel COVID-19 pandemic, a sudden swift shift to remote instruction radically shook student experiences. Unplanned and disruptive, new struggles ("luchas") emerged. Inspired by Castillo-Montoya and Torres-Guzmán, who sought to reclaim the lived counter-narratives ("testimonio") as a tool for understanding the complexities of Latina identity, this study delves into what helped and hindered first-generation college Latina students' experience with rapid remote learning. The article shares discussions ("platicas de testimonio"). Grounded in critically compassionate intellectualism, this study evoked practical strategies for resilience and critical conscientization toward future learner-teacher solidarity.

Despite the expected co‐occurrence of effects from resident species, the environment, and disturbance on non‐natives, these factors have largely been treated as acting separately. Co‐occurring factors may, however, act in combination to result in a powerful, yet little explored, mechanism of invasion. Here, we addressed three hypotheses to explain the localized invasion of the non‐native Chenopodium album (Chenopodium) under the canopy of the dominant native tree Neltuma caldenia (Neltuma) in central Argentina. First, we evaluated that Neltuma favors Chenopodium by modifying environmental conditions, and specifically assessed the importance of soil versus that of the microclimate created by Neltuma shade. Second, we tested that Neltuma benefits Chenopodium by promoting under its canopy (calden microsite) the dominance of a grass species, Nassella tenuissima (Nassella), that exerts weaker competitive effects on Chenopodium than those exerted by the dominant grass, Piptochaetium napostaense (Piptochaetium), in adjacent communities free of the tree (open microsite). Lastly, we explored that the invasion of Chenopodium is mediated by disturbance. Chenopodium displayed increased biomass and fecundity (performance) in soil from calden relative to that from open microsites, whereas it exhibited no response to shade treatments. Also, Chenopodium performance in pots with Nassella was similar to that in pots with Piptochaetium. Finally, Chenopodium performance was much greater in pots with no initial plants than in those with grasses. Importantly, in pots without plants, Chenopodium performed much better in calden than open microsites, but in pots with grasses, Chenopodium performance exhibited no differences between microsites. These findings suggest that disturbance mediates Chenopodium invasion in calden microsites. Specifically, disturbance may weaken strong competitive effects from native grasses on Chenopodium, allowing this non‐native herb to benefit from favorable soil conditions under Neltuma. The combined action of natives enhancing resource levels and disturbance providing access to them could be a general mechanism of invasion. [ABSTRACT FROM AUTHOR]

Background: Practice effects are a well‐known cognitive phenomenon that is reduced in patients with Alzheimer's disease (AD). We aimed to investigate whether cognitively unimpaired (CU) individuals within the Alzheimer's continuum (i.e., positive amyloid‐β biomarker) display decreased practice effects on serial neuropsychological testing. Methods: We included 310 CU from four Spanish research centers, classified into controls (n = 250) or Aβ+ (n = 60). In the main cohort (Cohort A; n = 209), participants underwent neuropsychological assessment at baseline and annually during a 2‐year follow‐up (FU1 and FU2). A "long‐term cohort" (Cohort B; n = 101) was employed to assess practice effects over longer time periods (i.e., two follow‐up sessions at years 3 and 6 from baseline). Practice effects were defined as simple discrepancy scores (SDS) by subtracting Z‐scores at FU2 from Z‐scores at baseline for each neuropsychological variable, and linear mixed effects models (LME) were run to assess the temporal evolution of practice effects according to the two groups. Results: There were no cross‐sectional differences between the control and Aβ+ groups in none of the neuropsychological scores at baseline (Fig. 1). The Aβ+ group displayed lower practice effects than the controls in terms of SDS in several neuropsychological outcomes (Fig. 2). In Cohort A, LME showed negative slopes by the Aβ+ group in verbal memory measures such as the free learning score (β = ‐0.37, SD = 0.12, p = 0.0034), delayed free recall (β = ‐0.43, SD = 0.15, p = 0.0047) and delayed total recall (β = ‐0.46, SD = 0.17, p = 0.0069) from the Free and Cued Selective Reminding Test; as well as in language tasks (Boston Naming Test; β = ‐0.26, SD = 0.087, p = 0.0025) and executive function measures (Trail Making Test; β = ‐0.33, SD = 0.12, p = 0.0094) (Fig. 3A). In Cohort B, similar findings were observed in visual memory measures, such as the Rey‐Osterrieth Complex Figure immediate (β = ‐0.80, SD = 0.35, p = 0.024) and delayed (β = ‐1.25, SD = 0.34, p = 0.00038) recall (Fig. 3B). Conclusions: Individuals with normal cognition who are in the Alzheimer's continuum show decreased practice effects over serial neuropsychological testing. Our findings suggest the reduction of practice effects, particularly in memory measures, as an indicator of subtle cognitive decline in the earliest phase of the Alzheimer's continuum and could be particularly relevant for the design and interpretation of primary prevention trials on disease‐modifying therapies. [ABSTRACT FROM AUTHOR]

Abstract Accelerated long‐term forgetting (ALF) refers to a rapid loss of information over days or weeks despite normal acquisition/encoding. Notwithstanding its potential relevance as a presymptomatic marker of cognitive dysfunction, no study has addressed the relationship between ALF and Alzheimer’s disease (AD) biomarkers. We examined ALF in APOE ɛ4 carriers versus noncarriers, and its relationships with AD cerebrospinal fluid (CSF) biomarkers. We found ALF over three months in APOE ɛ4 carriers (F(1,19) = 5.60; P

Background: Neuropsychological performance guides diagnostic and therapeutic decision‐making on Alzheimer's disease (AD) and related disorders. Despite broad recognition that amyloid‐beta (Aβ) impacts cognition during preclinical AD, the added value of Aβ‐negative norms remains uncertain. Furthermore, normative modeling is constrained by limitations inherent to traditional methods. Here, we derived next‐generation norms (NGN) for a comprehensive neuropsychological battery and compared their utility with that of traditional norms (TN). Methods: This multicenter study included 2405 non‐demented participants conventionally identified as cognitively normal (CN, n = 987) or with mild cognitive impairment (MCI, n = 1418) (Table 1). All participants had extensive neuropsychological data and CSF AD biomarkers at baseline. Based on the performance of 774 Aβ‐negative CN individuals, we derived NGN using generalized additive models for location, scale, and shape (GAMLSS). First, we compared the accuracy of NGN and TN to discriminate Aβ‐positive from Aβ‐negative MCI participants. Next, we actuarially reclassified all participants as CN or MCI according to both TN and NGN, and we examined the concordance of these classifications with AD biomarkers. For a subset of participants with clinical follow‐up (n = 1318), linear mixed‐effects modeling was used to capture the longitudinal change in Clinical Dementia Rating Scale‐Sum of Boxes. The Akaike Information Criteria (AIC) was employed to select the best model. Results: Age‐, education‐, and sex‐adjusted percentiles were obtained for 14 neuropsychological measures across main cognitive domains (memory, language, attention, executive functioning, and visuospatial skills) (Table 2). NGN outperformed TN at detecting prodromal AD for verbal memory measures, with all but one of the differences reaching statistical significance (p<0.05). Most participants were actuarially reclassified as either CN (43%) or MCI (52%) based on both TN and NGN. Among conflicting diagnoses (5%), the MCI/CN group (3%) ‐individuals diagnosed with MCI according to TN but considered CN as per NGN‐ was analogous to the CN/CN group, while the CN/MCI (2%) paralleled the MCI/MCI group in their rates of Aβ‐positivity (Figure 1). Cognitive status based on NGN better predicted clinical progression than TN (AIC = 5195.5 vs 5206.1, respectively). Conclusion: NGN incorporating Aβ status and GAMLSS yield stronger associations with biomarkers and disease progression than TN. This has direct implications for clinical practice and research. [ABSTRACT FROM AUTHOR]

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Alzheimer's disease is a progressive neurodegenerative disorder, the early detection of which is crucial for timely intervention and enrollment in clinical trials. However, the preclinical diagnosis of Alzheimer's encounters difficulties with gold-standard methods. The current definitive diagnosis of Alzheimer's still relies on expensive instrumentation and post-mortem histological examinations. Here, we explore label-free Raman spectroscopy with machine learning as an alternative to preclinical Alzheimer's diagnosis. A special feature of this study is the inclusion of patient samples from different cohorts, sampled and measured in different years. To develop reliable classification models, partial least squares discriminant analysis in combination with variable selection methods identified discriminative molecules, including nucleic acids, amino acids, proteins, and carbohydrates such as taurine/hypotaurine and guanine, when applied to Raman spectra taken from dried samples of cerebrospinal fluid. The robustness of the model is remarkable, as the discriminative molecules could be identified in different cohorts and years. A unified model notably classifies preclinical Alzheimer's, which is particularly surprising because of Raman spectroscopy's high sensitivity regarding different measurement conditions. The presented results demonstrate the capability of Raman spectroscopy to detect preclinical Alzheimer's disease for the first time and offer invaluable opportunities for future clinical applications and diagnostic methods. [ABSTRACT FROM AUTHOR]

Background: Down syndrome (DS) is the most common genetically determined intellectual disability. In recent decades, it has experienced an exponential increase in life expectancy, leading to a rise in age-related diseases, including Alzheimer's disease (AD). Specific health plans for the comprehensive care of the DS community are an unmet need, which is crucial for the early and accurate diagnosis of main medical comorbidities. We present the protocol of a newly created clinical and research cohort and its feasibility in real life. Methods: The Down Syndrome—Basque Alzheimer Initiative (DS-BAI) is a population-based, inclusive, multidisciplinary initiative for the clinical-assistance and clinical-biological research approach to aging in DS led by the CITA-Alzheimer Foundation (Donostia, Basque Country). It aims to achieve the following: (1) provide comprehensive care for adults with DS, (2) optimize access to rigorous and quality training for socio-family and healthcare references, and (3) create a valuable multimodal clinical-biological research platform. Results: During the first year, 114 adults with DS joined the initiative, with 36% of them showing symptoms indicative of AD. Furthermore, adherence to training programs for healthcare professionals and families has been high, and the willingness to collaborate in basic and translational research has been encouraging. Conclusion: Specific health plans for DS and conducting clinical and translational research on the challenges of aging, including AD, are necessary and feasible. [ABSTRACT FROM AUTHOR]