Perceived Stress in Older Dementia Caregivers: Mediation by Loneliness and Depression

Coupled with aging, chronic stress experienced by dementia caregivers often leads to deteriorating health. Comparing caregivers and non-caregivers, we tested whether depression and loneliness mediate the relationship between caregiver status and a measure of chronic stress, the Perceived Stress Scale. Seventy-six cognitively normal older adults (mean age 72.7) were identified as caregivers or non-caregivers based on the functional independence of a paired family member. Caregivers reported more perceived stress, depression, and loneliness than non-caregivers. Using multiple mediation analyses, we found that loneliness and depression mediated the relationship of caregiver status with perceived stress. The loneliness effect on perceived stress was both direct and via its relationship with depressive symptoms. The findings suggest loneliness as a likely point of intervention to reduce caregiver stress. Initiatives to enable caregivers to maintain or develop social relationships apart from caregiver responsibilities may mitigate stress and its negative impact on mental and physical health.

The Auditory P50 Gating in Mild Cognitive Impairment: A Case-Control Study

Objective: Auditory P50 gating changed might be a neurophysiological biomarker of the diagnosis of Mild Cognitive Impairment (MCI). We aimed to determine the impact of MCI in auditory P50 gating. Methods: All recruited participants completed structured questionnaires and finished auditory P50 gating measure. Results: A total of 20 MCI patients and 17 controls had been recruited. MCI patients had a significant higher reduction of P50 gating at Fz site, when compared to controls (1.21 ± .68 vs .66 ± .37, P = .00). Zero point five was the best cut off point to distinguish MCI and control of auditory P50 gating S2/S1 at Fz site. The P50 average amplitude at Pz site in MCI patients was significantly higher than controls (2.62 ± 1.20 vs 1.70 ± .74, P = .01). Conclusion: MCI patients might have impaired the ability of inhibiting the repeated stimulus.

Gender Differences in Neuropsychiatric Symptoms Among Community-Dwelling Mexican Americans Aged 80 and Older

Background and Objectives To assess gender differences in prevalence of neuropsychiatric symptoms (NPS) among community-dwelling Mexican Americans ≥80 years. Research Design and Methods: Using data from Wave 7 (2010–2011) of the Hispanic Established Population for the Epidemiological Study of the Elderly, we analyzed the NPS of 914 participants as determined by the Neuropsychiatric Inventory (NPI) with assessments conducted by their caregivers. Multivariate logistic regression models were used to test the association of individual NPS with gender, adjusting for relevant characteristics. Results: The average age of our sample was 86.1 years, and 65.3% were women. Over 60% of participants had at least one informant/caregiver reported NPS. After adjustment, women had lower odds than men of agitation/aggression but higher odds of dysphoria/depression and anxiety. Discussion: Recognizing gender differences in NPS phenotype could help guide development of culturally appropriate NPS screening and treatment programs.

Trends in Mortality Rates for Alzheimer’s Disease and Other Dementias Over 30 Years in China

Objective: This study examines trends in the mortality of Alzheimer’s disease and other dementias in China from 1990 to 2019. Methods: The data were drawn from the Global Burden of Disease Study 2019 (GBD 2019), and an age–period–cohort model was used for analysis. Results: The net drift was .152% (95% confidence interval [CI]: .069%, .235%) per year for men ( P < .05) and .024% (95% CI: −.078%, .126%) per year for women. The local drift values were below 0 in both genders for people aged 45–54 years ( P < .05), and above 0 for males aged 60–94 years and females aged 60–79 years ( P < .05). In the same birth cohort, the risk of mortality of Alzheimer's disease and other dementias exponentially increases with age for both genders. Conclusion: More rapid and effective efforts are needed to mitigate the substantial impact of Alzheimer's and other dementias on the health of China’s elderly.

Clinical Markers May Identify Patients at Risk for Early Parkinson’s Disease Dementia: A Prospective Study

Background: The study aims at identifying features predictive of early onset of dementia in Parkinson’s disease (PD). Methods: 103 non-demented PD patients were evaluated on various scales at baseline and 89 patients at 3-year follow-up. Results: By the end of the study 43.8% of patients developed dementia. The development of dementia was linked to the baseline Mini Mental State Examination score (Pearson coefficient r = .404, p = 0.013), the presence of autonomic dysfunctions (r = −.621, p < 0.001) and insomnia (r = −.526, p = 0.001). A binary logistic regression analysis showed that the development of dementia was correlated strongly with the presence of autonomic dysfunctions (95% CI 2.60 to 52.83, p < 0.001), and insomnia (95% CI 0.60 to 0.95, p = 0.017). Conclusion: Patients with signs of autonomic dysfunction and insomnia are at higher risk for developing dementia and deserve closer monitoring of cognitive symptoms.

Oral Amylin Treatment Reduces the Pathological Cascade of Alzheimer’s Disease in a Mouse Model

Intraperitoneal injection of amylin or its analog reduces Alzheimer’s disease (AD) pathology in the brains. However, self-injecting amylin analogs is difficult for patients due to cognitive deficits. This work aims to study the effects of amylin on the brain could be achieved by oral delivery as some study reported that amylin receptor may be present in the gastrointestinal tract. A 6-week course of oral amylin treatment reduced components of AD pathology, including the levels of amyloid-β, phosphorylated tau, and ionized calcium binding adaptor molecule 1. The treatment reduced active forms of cyclin-dependent kinase 5. Oral amylin treatment led to improvements in social deficit in AD mouse. Using immunofluorescence, we observed the amylin receptor complexed with the calcitonin receptor and receptor activity-modifying proteins in the enteric neurons. The study suggests the potential of the oral delivery of amylin analogs for the treatment of AD and other neurodegenerative diseases through enteric neurons.

Herpes Zoster Does Not Increase the Risk of Neurodegenerative Dementia: A Case-Control Study

Objective: This study was conducted to evaluate the association between neurodegenerative dementia and herpes zoster infection (HZI) using a national sample cohort. Methods: From the national cohort study conducted by the Korean National Health Insurance Service, we extracted data for patients with neurodegenerative dementia and for 1:4 matched control participants and searched the patient histories for HZI. Results: The adjusted odds ratio (OR) for HZI was 0.90 (95% CI = 0.84-0.97) in the dementia group. According to the subgroup analysis, the adjusted OR for HZI was 0.91 (95% confidence interval [CI] = 0.83 -1.00) in the < 80 years old group, 0.88 (95% CI = 0.78 -1.00) in the ≥ 80 years old group, 0.77 (95% CI = 0.66-0.89) in men and 0.96 (95% CI = 0.88 -1.05) in women. Conclusions: We concluded that HZI does not increase the risk of neurodegenerative dementia in individuals of any age or of either sex.

Proton Pump Inhibitors and Risk of Dementia: A Hypothesis Generated but Not Adequately Tested

We reviewed the evidence on proton pump inhibitors (PPIs) and dementia. PPIs are among the most widely utilized drugs in the world. Dementia affects roughly 5% of the population of the United States (US) and world aged 60 years and older. With respect to PPIs and dementia, basic research has suggested plausible mechanisms but descriptive and analytic epidemiological studies are not inconsistent. In addition, a single large-scale randomized trial showed no association. When the evidence is incomplete, it is appropriate for clinicians and researchers to remain uncertain. Regulatory or public health authorities sometimes need to make real-world decisions based on real-world data. When the evidence is complete, then the most rational judgments for individual patients the health of the general public are possible At present, the evidence on PPIs and dementia suggests more reassurance than alarm. Further large-scale randomized evidence is necessary to do so.

Dementia Awareness Challenges in Sub-Saharan Africa: A Cross-Sectional Survey Conducted Among School Students in Ghana

The survey focuses on identifying dementia awareness challenges among Ghanaian school students. Data were generated in a cross-sectional survey (n = 1137). 9.3% of school students showed dementia awareness whilst the community respondents, representing both higher age and level of education, showed greater awareness (32.2%, P < .001). 45% of respondents believed in witchcraft and 57% were afraid of potentially being harmed by witchcraft. Age and education did not influence people’s belief in witchcraft. Moreover, dementia symptoms were often mistaken for witchcraft, especially by those who had encountered a person accused of witchcraft: “swearing at others” (24%), displaying “memory loss” and “confused speech” (22%), “forgetfulness” and who was seen “roaming around” (19%). Lack of dementia awareness was particularly evident among school students whereas belief in witchcraft was similar in both respondent groups. There was a correlation between low dementia awareness rates and misinterpretation of dementia symptoms with attribution to witchcraft.