Journal of Alzheimer's Disease - Volume 77, issue 2

Authors: Pedrini, Steve | Hone, Eugene | Gupta, Veer B. | James, Ian | Teimouri, Elham | Bush, Ashley I. | Rowe, Christopher C. | Villemagne, Victor L. | Ames, David | Masters, Colin L. | Rainey-Smith, Stephanie | Verdile, Giuseppe | Sohrabi, Hamid R. | Raida, Manfred R. | Wenk, Markus R. | Taddei, Kevin | Chatterjee, Pratishtha | Martins, Ian | Laws, Simon M. | Martins, Ralph N. | the AIBL Research Group

Article Type: Research Article

Abstract: Background: The link between cholesterol and Alzheimer’s disease (AD) has received much attention, as evidence suggests high levels of cholesterol might be an AD risk factor. The carriage of cholesterol and lipids through the body is mediated via lipoproteins, some of which, particularly apolipoprotein E (ApoE), are intimately linked with AD. In humans, high density lipoprotein (HDL) is regarded as a “good” lipid complex due to its ability to enable clearance of excess cholesterol via ‘cholesterol reverse transport’, although its activities in the pathogenesis of AD are poorly understood. There are several subclasses of HDL; these range from the newly …formed small HDL, to much larger HDL. Objective: We examined the major subclasses of HDL in healthy controls, mild cognitively impaired, and AD patients who were not taking statins to determine whether there were HDL profile differences between the groups, and whether HDL subclass levels correlated with plasma amyloid-β (Aβ) levels or brain Aβ deposition. Methods: Samples from AIBL cohort were used in this study. HDL subclass levels were assessed by Lipoprint while Aβ1–42 levels were assessed by ELISA. Brain Aβ deposition was assessed by PET scan. Statistical analysis was performed using parametric and non-parametric tests. Results: We found that small HDL subclass is reduced in AD patients and it correlates with cognitive performance while plasma Aβ concentrations do not correlate with lipid profile or HDL subfraction levels. Conclusion: Our data indicate that AD patients exhibit altered plasma HDL profile and that HDL subclasses correlate with cognitive performances. Show more

Keywords: Amyloid-β, apolipoprotein, blood, cholesterol, lipid transport

DOI: 10.3233/JAD-200291

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 733-744, 2020

Authors: Keleman, Audrey | Wisch, Julie K. | Bollinger, Rebecca M. | Grant, Elizabeth A. | Benzinger, Tammie L. | Morris, John C. | Ances, Beau M. | Stark, Susan L.

Article Type: Research Article

Abstract: Background: Behavioral markers for Alzheimer’s disease (AD) are not included within the widely used amyloid-tau-neurodegeneration framework. Objective: To determine when falls occur among cognitively normal (CN) individuals with and without preclinical AD. Methods: This cross-sectional study recorded falls among CN participants (n  = 83) over a 1-year period. Tailored calendar journals recorded falls. Biomarkers including amyloid positron emission tomography (PET) and structural and functional magnetic resonance imaging were acquired within 2 years of fall evaluations. CN participants were dichotomized by amyloid PET (using standard cutoffs). Differences in amyloid accumulation, global resting state functional connectivity (rs-fc) intra-network signature, …and hippocampal volume were compared between individuals who did and did not fall using Wilcoxon rank sum tests. Among preclinical AD participants (amyloid-positive), the partial correlation between amyloid accumulation and global rs-fc intra-network signature was compared for those who did and did not fall. Results: Participants who fell had smaller hippocampal volumes (p  = 0.04). Among preclinical AD participants, those who fell had a negative correlation between amyloid uptake and global rs-fc intra-network signature (R = –0.75, p  = 0.012). A trend level positive correlation was observed between amyloid uptake and global rs-fc intra-network signature (R = 0.70, p  = 0.081) for preclinical AD participants who did not fall. Conclusion: Falls in CN older adults correlate with neurodegeneration biomarkers. Participants without falls had lower amyloid deposition and preserved global rs-fc intra-network signature. Falls most strongly correlated with presence of amyloid and loss of brain connectivity and occurred in later stages of preclinical AD. Show more

Keywords: Alzheimer’s disease, biomarkers, falls, resting state functional connectivity, volumetrics

DOI: 10.3233/JAD-200192

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 745-752, 2020

Authors: Rao, Shalini S. | Portbury, Stuart. D. | Lago, Larissa | Bush, Ashley I. | Adlard, Paul A.

Article Type: Research Article

Abstract: This article has been retracted, and the online PDF has been watermarked “RETRACTED”. A retraction notice is available at DOI: https://dx.doi.org/10.3233/JAD-239009 .

DOI: 10.3233/JAD-200551

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 753-771, 2020

Authors: Hasegawa, Tohru | Kosoku, Yoshinori | Sano, Yuka | Yoshida, Hiroshi | Kudoh, Chiaki | Tabira, Takeshi

Article Type: Research Article

Abstract: Background: In the treatment of Alzheimer’s disease (AD), it is thought to be most effective to intervene at the earliest and mildest stages. For diagnosis at the earliest and mildest stages, it is desirable to use a biomarker that can be detected by a minimally invasive, cost-effective technique. Recent research indicates the potential clinical usefulness of plasma amyloid-β (Aβ ) biomarkers in predicting brain Aβ burden at an individual level. However, it is as yet unproven that accumulation of Aβ necessarily leads to the development of AD. Objective: Homocysteic acid (HCA) is useful as an …early diagnostic marker for mild cognitive impairment (MCI), a pre-stage of AD. Methods: We measured the concentration of HCA, tumor necrosis factor alpha, cortisol, tau, and phosphorylated tau (p-tau) in patients’ plasma of 22 AD, 23 MCI, and 9 negative control (NC) cases. Results: Plasma HCA was shown to be very high in areas under the receiver operating characteristic curves (AUC), distinguished between MCI and NC; when 0.116μ M was chosen as the analyte concentration cut-off, the sensitivity was 95.7% and the specificity was 70%. Conclusion: Our results suggest that plasma HCA may be a useful indicator as an early diagnostic marker for MCI. HCA seems to be upstream from neurodegeneration in the AD pathology because it is known that an overactive NMDA receptor promotes amyloid polymerization and tau phosphorylation in AD. Show more

Keywords: Alzheimer disease, homocysteic acid, mild cognitive impairment, plasma

DOI: 10.3233/JAD-200234

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 773-780, 2020

Authors: Zhang, Chenbo | Luo, Jianfeng | Yuan, Changzheng | Ding, Ding

Article Type: Research Article

Abstract: Background: Previous studies have indicated that B vitamin deficiencies are an essential cause of neurological pathology. There is a need to provide evidence of the benefit of B vitamins for the prevention of cognitive decline in community-dwelling older adults. Objective: To examine the association between intake and plasma levels of vitamins B12, B6, and folate and cognitive function in older populations through a systematic review and meta-analysis. Methods: Medline (PubMed), EMBASE, and Cochrane databases were used to search the literature though August 8, 2019. We included observational population-based studies evaluating the association between concentrations or intake …levels of vitamins B6, B12, or folate and cognition in older adults aged ≥45 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale. Odds ratios (ORs) and hazard ratios (HRs) were analyzed by the random-effects model. Sensitivity analyses were conducted by excluding the studies with significant heterogeneity. Results: Twenty-one observational studies with sample sizes ranging from 155–7030 were included in the meta-analysis. Higher levels of vitamin B12 (OR = 0.77, 95% CI = 0.61–0.97) and folate concentration (OR = 0.68, 95% CI = 0.51–0.90) were associated with better cognition in cross-sectional studies, but not in sensitivity analyses or prospective studies. High vitamin B6 concentrations showed no significant benefit on cognition and dementia risk. Prospective studies did not provide substantial evidence for the relationship. Conclusion: The results from our meta-analysis suggest that vitamins B12, B6, and folate may not be modifiable risk factors for slowing cognitive decline among community-dwelling older individuals. Show more

Keywords: Alzheimer’s disease, cognitive decline, dementia, folate, nutrition, vitamin B6, vitamin B12

DOI: 10.3233/JAD-200534

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 781-794, 2020

Authors: Furtado, André | Astaburuaga, Rosario | Costa, Ana | Duarte, Ana C. | Gonçalves, Isabel | Cipolla-Neto, José | Lemos, Manuel C. | Carro, Eva | Relógio, Angela | Santos, Cecília R.A. | Quintela, Telma

Article Type: Research Article

Abstract: Background: The choroid plexus (CP), which constitutes the blood-cerebrospinal fluid barrier, was recently identified as an important component of the circadian clock system. Objective: The fact that circadian rhythm disruption is closely associated to Alzheimer’s disease (AD) led us to investigate whether AD pathology can contribute to disturbances of the circadian clock in the CP. Methods: For this purpose, we evaluated the expression of core-clock genes at different time points, in 6- and 12-month-old female and male APP/PS1 mouse models of AD. In addition, we also assessed the effect of melatonin pre-treatment in vitro before …amyloid-β stimulus in the daily pattern of brain and muscle Arnt-like protein 1 (Bmal1) expression. Results: Our results showed a dysregulation of circadian rhythmicity of Bmal1 expression in female and male APP/PS1 transgenic 12-month-old mice and of Period 2 (Per2 ) expression in male mice. In addition, a significant circadian pattern of Bmal1 was measured the intermittent melatonin pre-treatment group, showing that melatonin can reset the CP circadian clock. Conclusion: These results demonstrated a connection between AD and the disruption of circadian rhythm in the CP, representing an attractive target for disease prevention and/or treatment. Show more

Keywords: Alzheimer’s disease, amyloid-β, blood-cerebrospinal fluid barrier, choroid plexus, circadian clock, melatonin

DOI: 10.3233/JAD-200331

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 795-806, 2020

Authors: Wang, Yan-Juan | Gong, Wei-Gang | Ren, Qing-Guo | Zhang, Zhi-Jun

Article Type: Research Article

Abstract: Background: The inhibition of tau hyperphosphorylation is one of the most promising therapeutic targets for the development of Alzheimer’s disease (AD) modifying drugs. Escitalopram, a kind of selective serotonin reuptake inhibitor antidepressant, has been previously reported to ameliorate tau hyperphosphorylation in vitro . Objective: In this study, we determined whether escitalopram alleviates tau pathologies in the aged P301L mouse. Methods: Mice were intraperitoneal injected with either escitalopram or saline for 4 weeks, and a battery of behavioral tests were conducted before tissue collection and biochemical analyses of brain tissue with western blot and immunohistochemistry. …Results: Wild-type (Wt) mice statistically outperformed the aged pR5 mice in the Morris water maze, while escitalopram treatment did not significantly rescue learning and memory deficits of aged pR5 mice. Tau phosphorylation at different phosphorylation sites were enhanced in the hippocampus of aged pR5 mice, while escitalopram treatment significantly decreased tau phosphorylation. The levels of phosphorylated GSK-3β and phosphorylated Akt were significantly decreased in the hippocampus of aged pR5 mice, while escitalopram administration markedly increased the expression level. The aged pR5 mice showed significant decreases in PSD95 and PSD93, while the administration of escitalopram significantly increased PSD95 and PSD93 to levels comparable with the Wt mice. Conclusion: The protective effects of escitalopram exposure during advanced AD are mainly associated with significant decrease in tau hyperphosphorylation, increased numbers of neurons, and increased synaptic protein levels, which may via activation of the Akt/GSK-3β signaling pathway. Show more

Keywords: Alzheimer’s disease, selective serotonin reuptake inhibitor, synapse, tau hyperphosphorylation, transgenic mice

DOI: 10.3233/JAD-200401

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 807-819, 2020

Authors: Silverman, Hannah E. | Gazes, Yunglin | Barker, Megan S. | Manoochehri, Masood | Goldman, Jill S. | Wassermann, Eric M. | Tierney, Michael C. | Cosentino, Stephanie | Grafman, Jordan | Huey, Edward D.

Article Type: Research Article

Abstract: Background: Changes in sexual behaviors in frontotemporal dementia (FTD) are common and multifaceted, but not well characterized. Objective: To characterize changes in sexual behaviors and intimacy in FTD compared to corticobasal syndrome (CBS) and normal controls (NC), and to evaluate the neuroanatomical associations of these changes. Methods: Spouses of 30 FTD patients, 20 CBS patients, and 35 NC completed the Sexual Symptoms in Neurological Illness and Injury Questionnaire (SNIQ), which captures changes in sexual interest, inappropriate sexual behaviors, and prosocial sexual behaviors. 25 patients with FTD and 14 patients with CBS also received 18-flouorodeoxyglucose positron-emission topography …(18 FDG-PET) scans to determine the metabolic changes associated with these symptoms. Results: FTD patients showed a greater increase in inappropriate sexual behaviors than CBS patients [p  = 0.009] and NC [p  < 0.001] and a greater decrease in prosocial sexual behaviors than CBS patients [p  = 0.026] and NC [p  < 0.001]. Groups did not differ in change in sexual interest. Among both patient groups, the most common change was decreased prosocial sexual behaviors p  < 0.01. Hypometabolism in Brodmann’s Area 10 (BA10), within the right frontal pole, correlated with decreased prosocial sexual behaviors [p (FWE-corr) <0.05, k  = 44]. No anatomical associations were found with other sexual changes. Conclusion: Decreased prosocial sexual behavior was associated with hypometabolism in BA 10, an area tied to social knowledge and theory of mind, supporting the idea that changes reflect social-cognitive deficits due to frontal dysfunction. Show more

Keywords: Frontal lobe, frontotemporal dementia, neurodegenerative disorders, prefrontal cortex, sexual behavior

DOI: 10.3233/JAD-200346

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 821-830, 2020

Authors: Aksnes, Mari | Müller, Ebba Glersen | Tiiman, Ann | Edwin, Trine Holt | Terenius, Lars | Revheim, Mona-Elisabeth | Vukojević, Vladana | Bogdanović, Nenad | Knapskog, Anne-Brita

Article Type: Research Article

Abstract: Background: Aggregation of amyloid-β (Aβ) is an early pathological event in Alzheimer’s disease (AD). Consequently, measures of pathogenic aggregated Aβ are attractive biomarkers for AD. Here, we use a recently developed Thioflavin-T-Fluorescence Correlation Spectroscopy (ThT-FCS) assay to quantify structured ThT-responsive protein aggregates, so-called nanoplaques, in the cerebrospinal fluid (CSF). Objective: The overall aim of this work was to assess whether ThT-FCS determined CSF nanoplaque levels could predict amyloid brain uptake as determined by 18 F-Flutemetamol PET analysis. Further, we assess whether nanoplaque levels could predict clinical AD. Methods: Nanoplaque levels in the CSF from 54 memory …clinic patients were compared between sub-groups classified by 18 F-Flutemetamol PET as amyloid-positive or amyloid-negative, and by clinical assessment as AD or non-AD. Results: Nanoplaque levels did not differ between amyloid groups and could not predict brain amyloid uptake. However, nanoplaque levels were significantly increased in patients with clinical AD, and were significant predictors for AD when adjusting for age, sex, cognitive function, and apolipoprotein E (APOE) genotype. Conclusion: The concentration of nanoplaques in the CSF differentiates patients with clinical AD from non-AD patients. Show more

Keywords: Alzheimer’s disease, amyloid, amyloid-β peptides, amyloidogenic proteins, biomarkers, cerebrospinal fluid, fluorescence spectrometry, positron-emission tomography, Thioflavin T

DOI: 10.3233/JAD-200237

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 831-842, 2020

Authors: Trammell, Antoine R. | McDaniel, Darius J. | Obideen, Malik | Okafor, Maureen | Thomas, Tiffany L. | Goldstein, Felicia C. | Shaw, Leslie M. | Hajjar, Ihab M.

Article Type: Research Article

Abstract: Background: African Americans (AA) have a higher Alzheimer’s disease (AD) prevalence and report more perceived stress than White Americans. The biological basis of the stress-AD link is unclear. This study investigates the connection between stress and AD biomarkers in a biracial cohort. Objective: Establish biomarker evidence for the observed association between stress and AD, especially in AA. Methods: A cross-sectional study (n  = 364, 41.8% AA) administering cognitive tests and the perceived stress scale (PSS) questionnaire. A subset (n  = 309) provided cerebrospinal fluid for measurement of Aβ42 , Tau, Ptau, Tau/Aβ42 (TAR), and Ptau/Aβ42 (PTAR). …Multivariate linear regression, including factors that confound racial differences in AD, was performed. Results: Higher PSS scores were associated with higher Ptau (β= 0.43, p  = 0.01) and PTAR (β= 0.005, p  = 0.03) in AA with impaired cognition (mild cognitive impairment). Conclusion: Higher PSS scores were associated with Tau-related AD biomarker indices in AA/MCI, suggesting a potential biological connection for stress with AD and its racial disparity. Show more

Keywords: African Americans, Alzheimer’s disease, tauopathy, amyloid-β peptides, cognitive function, mild cognitive impairment, neurocognitive tests, psychological stress

DOI: 10.3233/JAD-200089

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 843-853, 2020

Authors: Mar, Javier | Gorostiza, Ania | Ibarrondo, Oliver | Cernuda, Carlos | Arrospide, Arantzazu | Iruin, Álvaro | Larrañaga, Igor | Tainta, Mikel | Ezpeleta, Enaitz | Alberdi, Ane

Article Type: Research Article

Abstract: Background: Neuropsychiatric symptoms (NPS) are the leading cause of the social burden of dementia but their role is underestimated. Objective: The objective of the study was to validate predictive models to separately identify psychotic and depressive symptoms in patients diagnosed with dementia using clinical databases representing the whole population to inform decision-makers. Methods: First, we searched the electronic health records of 4,003 patients with dementia to identify NPS. Second, machine learning (random forest) algorithms were applied to build separate predictive models for psychotic and depressive symptom clusters in the training set (N = 3,003). Third, calibration and discrimination …were assessed in the test set (N = 1,000) to assess the performance of the models. Results: Neuropsychiatric symptoms were noted in the electronic health record of 58% of patients. The area under the receiver operating curve reached 0.80 for the psychotic cluster model and 0.74 for the depressive cluster model. The Kappa index and accuracy also showed better discrimination in the psychotic model. Calibration plots indicated that both types of model had less predictive accuracy when the probability of neuropsychiatric symptoms was <25%. The most important variables in the psychotic cluster model were use of risperidone, level of sedation, use of quetiapine and haloperidol and the number of antipsychotics prescribed. In the depressive cluster model, the most important variables were number of antidepressants prescribed, escitalopram use, level of sedation, and age. Conclusion: Given their relatively good performance, the predictive models can be used to estimate prevalence of NPS in population databases. Show more

Keywords: Dementia, depressive symptoms, machine learning, neuropsychiatric symptoms, predictive model\sep prevalence, psychotic symptoms, real-world data

DOI: 10.3233/JAD-200345

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 855-864, 2020

Authors: Monsees, Jessica | Schmachtenberg, Tim | Hoffmann, Wolfgang | Kind, Amy | Gilmore-Bykovskyi, Andrea | Kim, Alice J. | Thyrian, Jochen René

Article Type: Research Article

Abstract: Background: As the proportion of older people with migration background (PwM) increases, the proportion of older PwM with dementia might also increase. Dementia is underdiagnosed in this group and a large proportion of PwM with dementia and family caregivers are not properly supported. Healthcare utilization is lower among older migrant populations. Thus, a better understanding of how PwM and family caregivers perceive their situation and how they experience healthcare services is needed to improve utilization of the healthcare system. Objective: Analyze how family caregivers of PwM with dementia experience their situation, why healthcare services are utilized less often, …and what can be done to reverse this. Methods: Eight semi-structured interviews were conducted with people with Turkish migration background caring for PwM with dementia. Qualitative content analysis was used for data analysis. Results: Daily care was performed by one family member with the support of others. Healthcare services were used by most participants. Participants identified a need for better access to relevant information and incorporation of Turkish culture into healthcare services. Conclusion: PwM face similar challenges in taking care of persons with dementia as those without migration background. There is a willingness to use services, and services embracing Turkish culture would help to reduce hesitance and make affected people feel more comfortable, thereby increasing utilization and satisfaction. A limitation of this study is that participants were already connected to health services, which may not reflect the help-seeking behavior of those in the Turkish community who are not involved in healthcare. Show more

Keywords: Dementia, healthcare, healthcare services, migration, Turkish migration background, utilization

DOI: 10.3233/JAD-200184

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 865-875, 2020

Authors: González, Andrea | Guzmán-Martínez, Leonardo | Maccioni, Ricardo B.

Article Type: Research Article

Abstract: Background: A major drawback in Alzheimer’s disease (AD) is the lack of validated biomarkers for routine clinical diagnostic. We have reported earlier a novel blood biomarker, named Alz-tau® , based on variants of platelet tau. This marker evaluates the ratio of high molecular weight tau (HMWtau) and the low molecular weight (LMWtau) tau. Objective: To analyze a potential novel source of antigen for Alz-tau® , plasma tau, detected by immunoreactivity with the novel monoclonal antibody, tau51. Methods: We evaluated tau variants in plasma precipitated with ammonium sulfate from 36 AD patients and 15 control subjects by …western blot with this novel monoclonal antibody. Results: The HMW/LMWtau ratio was statistically different between AD patients and controls. Conclusions: Plasma tau variants are suitable to be considered as a novel antigen source for the Alz-tau® biomarker for AD. Show more

Keywords: Alz-tau®, Alzheimer’s disease, HMW/LMWtau ratio, monoclonal antibodies, peripheral biomarkers, tau protein in the human plasma

DOI: 10.3233/JAD-200386

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 877-883, 2020

Authors: Lepper, Simon | Rädke, Anika | Wehrmann, Hannah | Michalowsky, Bernhard | Hoffmann, Wolfgang

Article Type: Research Article

Abstract: Background: Treatment decisions based on guidelines rather than patients’ preferences determine adherence to and compliance with treatment, which, in turn, could improve health-related outcomes. Objectives: To summarize the stated treatment and care preferences of people with dementia (PwD). Methods: A systematic review was conducted to assess the stated preferences of PwD. The inclusion criterion was the use of quantitative methods to elicit stated preferences, enabling a ranking of preferences. Results: Eleven studies revealed preferences for diagnostics, treatment decisions, patient-related outcomes, care services, end-of-life care, leisure activities, and digital life story work. PwDs prefer accurate, …pain-free, and comfortable diagnostic procedures without radioactive markers as well as being accompanied by a caregiver. PwD’s quality of life (QoL), self-efficacy, and depression were equally most important for PwD and caregivers. However, PwD memory was only important for caregivers but not for PwD, and caregiver QoL was moderately important for PwD but least important for caregivers. Additionally, comfort and family involvement were most important for patients’ end-of-life care, whereas caregivers most preferred good communication and pain management. Also, preferences depend on the living situation: Patients living not alone prefer a regular care provider most, whereas those living alone only want to live nearby the caregiver. Preferences for leisure activities did not differ between past and present ratings, indicating that PwD prefer activities that have always been carried out. Conclusion: Only a few studies have applied quantitative methods to elicit the preferences of PwD. More research is needed to capture the stated preferences for the treatment, care, and support of PwD to improve health-related outcomes and the allocation of healthcare resources. Show more

Keywords: Dementia, decision making, patient outcome assessment, patient preference

DOI: 10.3233/JAD-191299

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 885-901, 2020

Authors: Sheng, Can | Yang, Kun | Wang, Xiaoni | Li, Hongyan | Li, Taoran | Lin, Li | Liu, Yi | Yang, Qin | Wang, Xiaoqi | Wang, Xue | Sun, Yu | Han, Ying

Article Type: Research Article

Abstract: Background: Subjective cognitive decline (SCD) is considered the earliest symptomatic manifestation of preclinical Alzheimer’s disease (AD). Currently, given the lack of effective and curable pharmacological treatments for AD, non-pharmacological interventions (NPIs) for individuals with SCD may provide a valuable opportunity for the secondary prevention of AD. Objective: This systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, aimed to investigate the benefits of current NPIs in the population with SCD. Methods: The online electronic databases, including MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, PsycInfo, and CINAHL, were searched to identify randomized controlled trials …of NPIs for SCD. Intervention strategies were psychological and health-related education interventions, mind-body therapy, lifestyle modification, cognitive training, and multidomain interventions. Outcomes included subjective memory, objective memory, global cognitive function, psychological well-being, and mood. Study quality was determined using the criteria of the Cochrane collaboration’s tool. The Hedges’ g of change was analyzed. Results: Eighteen studies were included in this review and meta-analysis. Overall, psychological and health-related education interventions exhibited a medium effect on objective memory function (Hedges’ g  = 0.53, p  = 0.01). Cognitive training led to a small effect on objective memory, which was marginal statistically (Hedges’ g  = 0.19, p  = 0.05). In addition, cognitive training also significantly improved subjective memory performance (Hedges’ g  = 0.49, p  = 0.0003) and psychological well-being (Hedges’ g  = 0.27, p  = 0.03). Conclusion: Overall, the psychological intervention and cognitive training may be beneficial to cognitive function and psychological well-being. NPIs may be effectively implemented in older adults with SCD. Show more

Keywords: Alzheimer’s disease, cognitive training, intervention, lifestyle, non-pharmacological, psychological, subjective cognitive decline

DOI: 10.3233/JAD-191295

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 903-920, 2020

Article Type: Book Review

DOI: 10.3233/JAD-201012

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 921-921, 2020