Risk, protective, and biomarkers of dementia in Indigenous peoples: A systematic review

Nguyen, Huong X. T.; Bradley, Kate; McNamara, Bridgette J.; Watson, Rosie; Malay, Roslyn; LoGiudice, Dina

doi:10.1002/alz.13458

Cited by 8 publications

(4 citation statements)

References 68 publications

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“…Higher education levels correlate with better cognitive performance. Nguyen et al ’s systematic review indicated that education has the potential to act as a preventive factor against dementia ( 43 ). A study in China involving 1,286 older adult individuals supports the key role of education in maintaining cognitive health in disadvantageous settings ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

A nomogram based on neuron-specific enolase and substantia nigra hyperechogenicity for identifying cognitive impairment in Parkinson’s disease

Hou,

Yang,

et al. 2024

Quant Imaging Med Surg

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Background One in four individuals with Parkinson’s disease (PD) experience cognitive impairment (CI). However, few practical models integrating clinical and neuroimaging biomarkers have been developed to address CI in PD. This study aimed to evaluate the correlation between circulating neuron-specific enolase (NSE) levels, substantia nigra hyperechogenicity (SNH), and cognitive function in PD and to develop a nomogram based on clinical and neuroimaging biomarkers for predicting CI in patients with PD. Methods A total of 385 patients with PD who underwent transcranial sonography (TCS) from January 2021 to December 2022 at Beijing Tiantan Hospital, Capital Medical University, were recruited as the training cohort. For validation, 165 patients with PD treated from January 2023 to December 2023 were enrolled. Data for SNH, plasma NSE, and other clinical measures were collected, and cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Logistic regression analysis was employed to select potential risk factors and establish a nomogram. The receiver operating characteristic curve and calibration curve were generated to evaluate the performance of the nomogram. Results Patients with PD exhibiting CI displayed advanced age, elevated Unified PD Rating Scale-III (UPDRS-III) score, an increased percentage of SNH, higher levels of plasma NSE and homocysteine (Hcy), a larger SNH area, and lower education levels compared to PD patients without CI. Gender [odds ratio (OR) =0.561, 95% confidence interval (CI): 0.330–0.954, P=0.03], age (OR =1.039; 95% CI: 1.011–1.066; P=0.005), education level (OR =0.892; 95% CI: 0.842–0.954; P<0.001), UPDRS-III scores (OR =1.026; 95% CI: 1.009–1.043; P=0.003), plasma NSE concentration (OR =1.562; 95% CI: 1.374–1.776; P<0.001), and SNH (OR =0.545; 95% CI: 0.330–0.902; P=0.02) were independent predictors of CI in patients with PD. A nomogram developed using these six factors yielded a moderate discrimination performance with an area under the curve (AUC) of 0.823 (95% CI 0.781–0.864; P<0.001). The calibration curve demonstrated acceptable agreement between predicted outcomes and actual values. Validation further confirmed the reliability of the nomogram, with an AUC of 0.864 (95% CI: 0.805–0.922; P<0.001). Conclusions The level of NSE in plasma and the SNH assessed by TCS are associated with CI in patients with PD. The proposed nomogram has the potential to facilitate the detection of cognitive decline in individuals with PD.

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Section: Discussionmentioning

confidence: 99%

A nomogram based on neuron-specific enolase and substantia nigra hyperechogenicity for identifying cognitive impairment in Parkinson’s disease

Hou,

Yang,

et al. 2024

Quant Imaging Med Surg

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“…These programmes have mostly been conducted in small group settings, an aspect which itself may contribute to the effectiveness, as social activity is cognitively stimulating. 13 However, it should be noted that these approaches can be seen as 'add-ons' to the individual care of PwD. As these intervention programmes are conceptualised with a low frequency, intervention effects may lack sustainability.…”

Section: Open Accessmentioning

confidence: 99%

Cognitive stimulation for people with dementia in nursing homes: a protocol for a feasibility study examining a new 24/7 approach (CogStim24)

Folkerts,

Seven,

Guicheteau

et al. 2024

BMJ Open

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IntroductionBased on the available evidence, cognitive stimulation is recommended as an intervention for people with dementia (PwD). Currently, cognitive stimulation is regularly offered as a group programme in care facilities. However, some residents, such as those who are bedridden, cannot participate. Furthermore, group programmes were not feasible during the pandemic. A concept that accompanies everyday life and enables cognitive stimulation in everyday communication (ie, ‘24/7’) has been missing. Therefore, this feasibility study aims to (1) assess the feasibility of a new continuous 24/7 cognitive stimulation programme (CogStim24) based on a process evaluation and (2) examine the possible effects of CogStim24 on the primary outcome of global cognition in PwD and further PwD-related and staff-related outcomes.Methods and analysisThe complex CogStim24 programme is developed to be conducted as an everyday intervention during routine care including cognitively stimulating techniques, such as reminiscence therapy, multisensory stimulation and physical activity. In this unblinded single-arm study with pre-assessments and post-assessments, four nursing homes with a total of N=20 nursing and care staff will participate in an 11-week CogStim24 training programme. The intervention will be conducted to N=60 PwD. Neuropsychological assessments will be conducted pre-staff and post-staff training, as well as after a 6-week implementation phase. A process evaluation will be performed.Ethics and disseminationEthics approval was obtained from the ethics committee of the Faculty of Medicine of the University of Cologne, Cologne, Germany. Although cognitive stimulation is known to be effective for enhancing global cognition and quality of life in PwD, it is currently undersupplied to PwD. Therefore, CogStim24 has the potential to reach many more PwD. This study has the potential to serve as a basis for a large multicentre cluster randomised controlled trial. An interdisciplinarity team and mixed-methods approach will help generate information on the practicality and mechanisms of impact of CogStim24. This is important for the further development of the intervention and for facilitating its implementation. The study results will be disseminated via presentations at scientific conferences and meetings for healthcare professionals and PwD and their relatives. Several manuscripts presenting results of the different study parts will be published in peer-reviewed journals.Trial registration numberDRKS00024381.

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“…Empirically defined classification thresholds suggested the optimal threshold to classify any impairment (MCI, dementia, IN-MCI) with 3MSE was <90.5 and for MoCA < 19.5; to classify dementia alone with 3MSE was <92. 5…”

Section: Normative Neuropsychological Functioning (Cognitive Intact)mentioning

confidence: 99%

“…However, disparities in socioeconomics, historical, and sociological factors, with accompanying higher burden of risk factors and comorbidities, are likely to result in disparate prevalence, incidence, and risk models for some groups, especially Indigenous peoples. 4 , 5 American Indians, for example, endure a high prevalence of hypertension, diabetes, and depression; low access to resources and education; but also have high social support and resilience. 6 , 7 However, despite such high risk, little is yet established about the epidemiology of ADRD in American Indians and other Indigenous peoples.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and prevalence of dementia and Alzheimer's disease in American Indians: Data from the Strong Heart Study

Suchy‐Dicey,

Domoto‐Reilly,

Nelson

et al. 2024

Alzheimer's & Dementia

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INTRODUCTIONAccurate epidemiologic estimates for dementia are lacking for American Indians, despite substantive social and health disparities.METHODSThe Strong Heart Study, a population‐based cohort of 11 American Indian tribes, conducted detailed cognitive testing and examinations over two visits approximately 7 years apart. An expert panel reviewed case materials for consensus adjudication of cognitive status (intact; mild cognitive impairment [MCI]; dementia; other impaired/not MCI) and probable etiology (Alzheimer's disease [AD], vascular bain injury [VBI], traumatic brain injury [TBI], other).RESULTSAmerican Indians aged 70–95 years had 54% cognitive impairment including 10% dementia. VBI and AD were primary etiology approximately equal proportions (>40%). Apolipoprotein (APO) Eε4 carriers were more common among those with dementia (p = 0.040). Plasma pTau, glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL) were higher among those with cognitive impairment, but not amyloid beta (Aβ). Cognitive intact had mean 3MSE 92.2 (SD 6.4) and mean Montreal Cognitive Assessment (MoCA) score of 21.3 (SD 3.2).DISCUSSIONThis is the first population‐based study to estimate the prevalence of vascular and Alzheimer's dementias in a population‐based study of American Indians.Highlights The Strong Heart Study is a population‐based cohort of American Indian tribes, conducted over 30+ years and three US geographic regions (Northern Plains, Southern Plains, Southwest). Our teams conducted detailed cognitive testing, neurological examination, and brain imaging over two visits approximately 7 years apart. An expert panel reviewed collected materials for consensus‐based adjudication of cognitive status (intact; MCI; dementia; other impaired/not MCI) and probable underlying etiology (AD; VBI; TBI; other). In this cohort of American Indians aged 70–95, 54% were adjudicated with cognitive impairment, including approximately 35% MCI and 10% dementia. These data expand on prior reports from studies using electronic health records, which had suggested prevalence, and incidence of dementia in American Indians to be more comparable to the majority population or non‐Hispanic White individuals, perhaps due to latent case undercounts in clinical settings. Vascular and neurodegenerative injuries were approximately equally responsible for cognitive impairment, suggesting that reduction of cardiovascular disease is needed for primary prevention. Traumatic injury was more prevalent than in other populations, and common among those in the “other/not MCI” cognitive impairment category. Mean scores for common dementia screening instruments—even among those adjudicated as unimpaired—were relatively low compared to other populations (mean unimpaired 3MSE 92.2, SD 6.4; mean unimpaired MoCA 21.3, SD 3.2), suggesting the need for cultural and environmental adaptation of common screening and evaluation instruments.

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Risk, protective, and biomarkers of dementia in Indigenous peoples: A systematic review

Cited by 8 publications

References 68 publications

A nomogram based on neuron-specific enolase and substantia nigra hyperechogenicity for identifying cognitive impairment in Parkinson’s disease

A nomogram based on neuron-specific enolase and substantia nigra hyperechogenicity for identifying cognitive impairment in Parkinson’s disease

Cognitive stimulation for people with dementia in nursing homes: a protocol for a feasibility study examining a new 24/7 approach (CogStim24)

Epidemiology and prevalence of dementia and Alzheimer's disease in American Indians: Data from the Strong Heart Study

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