OBJECTIVE: Sleep disturbance is considered a risk factor for cognitive decline in elderly individuals. Our aim in the current study was to investigate whether baseline sleep parameters can predict the conversion from nor...OBJECTIVE: Sleep disturbance is considered a risk factor for cognitive decline in elderly individuals. Our aim in the current study was to investigate whether baseline sleep parameters can predict the conversion from normal cognition to mild cognitive impairment or dementia at follow-up. The Hellenic Longitudinal Investigation of Aging and Diet is a longitudinal population-based study designed to estimate the prevalence and incidence of cognitive decline and dementia in the older Greek population. METHODS: A total of 955 cognitively normal older adults (aged ≥65 y) were drawn from the Hellenic Longitudinal Investigation of Aging and Diet study. A comprehensive neurological and neuropsychological assessment was conducted at baseline and a mean of 3.1 (SD = 0.85) years later, resulting in 160 individuals diagnosed with mild cognitive impairment and 34 with dementia at follow-up, whereas 761 remained cognitively normal. RESULTS: Using Cox regression analyses, no sleep parameters increased the risk of conversion status adjusting for demographics and clinical factors. Napping, however, decreased this risk by 19.3% ( P < 0.001). CONCLUSIONS: As several previous studies have proposed, napping constitutes a protective factor against cognitive decline. Thus, clinicians should encourage their elderly patients to adopt this healthy habit.
Thirumala PD, Snitz BE, Jacobsen E
… +3 more, Chang CH, Chang YF, Ganguli M
Alzheimer Dis Assoc Disord
· 2025 Jan-Mar 01 · PMID 39781640
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INTRODUCTION: Postoperative cognitive decline (POCD) is a common, but often unrecognized condition after surgery. We evaluate postsurgical cognitive changes in a longitudinal population-based study. METHODS: The study co...INTRODUCTION: Postoperative cognitive decline (POCD) is a common, but often unrecognized condition after surgery. We evaluate postsurgical cognitive changes in a longitudinal population-based study. METHODS: The study cohort comprises an age-stratified population-based random sample of individuals aged 65+ years from a small-town region of the United States. We identified as cases those participants who, during annual assessments, self-reported having undergone surgery under general anesthesia during the preceding year. We identified as controls those who reported no surgery for at least 6 consecutive years. The outcome variable changed over time (4 y) in annual cognitive test composite scores encompassing the domains of attention/processing speed, executive function, memory, language, and visuospatial functions, which were modeled using Generalized Estimating Equations. RESULTS: A total of 436 participants had the required cognitive data; 179 participants (cases) had undergone surgery, while 257 participants (controls) had not undergone surgery. After adjusting for age, years of education, gender, race, heart failure, irregular heartbeat, and stroke, participants who underwent surgery had a greater decline in executive function, memory, and attention over a 2-year period. DISCUSSION: Participants who underwent surgery had a significant subsequent decline in cognitive function over the long term.
Alzheimer Dis Assoc Disord
· 2025 Jan-Mar 01 · PMID 39588702
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BACKGROUND: The potential of Ultra-Ma, an ultrasonic head stimulator, for the supplementary treatment of dementia with Lewy bodies (DLB) was evaluated in patients with various symptoms under poor control by drug therapy....BACKGROUND: The potential of Ultra-Ma, an ultrasonic head stimulator, for the supplementary treatment of dementia with Lewy bodies (DLB) was evaluated in patients with various symptoms under poor control by drug therapy. METHODS: Patients with DLB treated with choline esterase inhibitor or L-DOPA, either alone or in combination, and who met inclusion criteria were enrolled. Four weeks of placebo stimulation was followed by 8 weeks of active ultrasonic stimulation and a 4-week follow-up. Primary endpoints were the effects of ultrasonic head stimulation on both cognitive dysfunction and behavioral and psychological symptoms of dementia (BPSD). Cognitive dysfunction was evaluated using the Japanese versions of the Mini-Mental State Examination and Montreal Cognitive Assessment, and BPSD was assessed using the Neuropsychiatric Inventory Brief Questionnaire Form. For cognitive fluctuations, the Cognitive Fluctuation Inventory served as an index. Improvements in parkinsonism, activities of daily living, and caregiver burden were examined as secondary endpoints. RESULTS: Twelve patients were enrolled. The primary endpoint was significantly improved during the active stimulation period, as were secondary endpoint ratings for parkinsonism and caregiver burden. No notable adverse events occurred. CONCLUSIONS: The findings suggest that ultrasonic head stimulation has supplementary potential when combined with drug treatment in DLB.
BACKGROUND: Previous studies were examined effects of social restriction by COVID-19 pandemic on elderly peoples or compared difference of before/after restrictions on patients with Alzheimer disease-related dementia (AD...BACKGROUND: Previous studies were examined effects of social restriction by COVID-19 pandemic on elderly peoples or compared difference of before/after restrictions on patients with Alzheimer disease-related dementia (ADRD). Here, we assessed the effects of restrictions on the cognitive function of the patients by comparing control group. METHODS: We examined the impact on cognitive function using the Alzheimer Disease Assessment Scale (Japanese version) cognitive subscale (ADAS-JCOG), in patients with mild to moderate ADRD by a post hoc subgroup analysis of double-blinded, noninferiority study of donepezil 27.5 mg patches and donepezil hydrochloride 5 mg tablets (JapicCTI-194582). After demonstrating the noninferiority of both treatments, we used combined data for this analysis. RESULTS: The analyzed subpopulation of the per-protocol set groups was balanced (n=126 and 135, respectively). Patient demographics were similar between subgroups. The difference of ADAS-JCOG scores [least-squares mean (95%CI)] between the groups was 0.388 (-0.377 to 1.152, not statistically significant). CONCLUSION: Social isolation affects cognitive function on ADRD and this knowledge should be considered in future.
BACKGROUND: Mutations in the LRRK2 gene are the most common genetic cause of Parkinson disease but are believed to play no significant role in Lewy body disease (LBD). OBJECTIVES: As the frequency of G2019S LRRK2 mutatio...BACKGROUND: Mutations in the LRRK2 gene are the most common genetic cause of Parkinson disease but are believed to play no significant role in Lewy body disease (LBD). OBJECTIVES: As the frequency of G2019S LRRK2 mutation is extremely high in North African patients with Parkinson disease, we postulate that the high prevalence of LBD in North Africa might be due to the same mutation because LBD and Parkinson disease share many clinical, pathological, and genetic features. METHODS: We screened patients with LBD or prodromal LBD for the G2019S mutation of LRRK2. RESULTS: A total of 162 patients were tested for the mutation, which was present in 5 of the 47 patients with North African ancestors. This is a much higher prevalence (10.6%) than in healthy North African subjects (1.45%) but lower than in North African patients with Parkinson disease (36% to 39%). Carriers tended to develop more often orthostatic hypotension and swallowing problems. CONCLUSIONS: Where previous studies in European and North American patients found no link between LRRK2 mutations and LBD, we found an LRRK2 mutation associated with Lewy body disease, namely the G2019S mutation that might be restricted to patients with North African ancestors. Our study illustrates the need to introduce ethnic diversity as stratifying factor in the analysis of genetic causes of neurodegenerative disorders. The current development of disease-modifying drugs modulating LRRK2 kinase activity could justify to screen North African patients with LBD for the G2019S LRRK2 mutation.
PURPOSE: The National Institute of Health Toolbox Cognition Battery (NIHTB-CB) is increasingly used in Alzheimer disease (AD) research. We examined the relation of AD biomarkers with performance in the NIHTB-CB in late m...PURPOSE: The National Institute of Health Toolbox Cognition Battery (NIHTB-CB) is increasingly used in Alzheimer disease (AD) research. We examined the relation of AD biomarkers with performance in the NIHTB-CB in late middle age. METHODS: This is a cross-sectional analysis of 334 Hispanic participants aged 64.22±3.35 years from a study of AD biomarkers. White matter hyperintensities (WMH), infarcts, and cortical thickness in AD regions (CT) were assessed with 3T magnetic resonance imaging. Amyloid and tau were assessed with 18F-Florbetaben and 18F-MK6240 positron emission tomography, respectively. RESULTS: Lower CT and infarcts were associated with worse Oral Reading Recognition and Cognition Crystallized Composite scores. Lower CT and higher WMH were associated with worse Pattern Comparison Processing Speed. Amyloid and tau were not associated with any test. DISCUSSION: Amyloid and tau, the culprits of AD, are not related to the NIHTB-CB in late middle age. Continued follow-up will reveal if AD impacts performance on the NIHTB-CB.
INTRODUCTION: There was limited evidence on the ability of people with Alzheimer disease (AD) to perceive their own emotions. We aimed to compare socioemotional self-perception in persons with mild and moderate AD to the...INTRODUCTION: There was limited evidence on the ability of people with Alzheimer disease (AD) to perceive their own emotions. We aimed to compare socioemotional self-perception in persons with mild and moderate AD to their caregivers' perspective. METHOD: Cross-sectional assessment of people with mild (n=102) and moderate (n=59) AD and caregivers. Each participant and their caregivers completed the socioemotional questionnaire (SEQ); a 30-item rating scale assessing five dimensions of socioemotional cognition (empathy, emotion recognition, social conformity, antisocial behavior, sociability). We evaluated global cognition, awareness of disease, dementia severity, functionality, neuropsychiatric symptoms, and caregiver burden. RESULTS: Participants in the mild and moderate groups showed a similar pattern of socioemotional self-perception. They differed in the anger domain of the emotion recognition subscale, in the antisocial behavior dimension, and in the sociability subscale. In contrast, the caregivers' perspective of people with mild and moderate AD showed a significant difference in the emotion recognition domain for fear, disgust, and sadness. There were also significant differences in the empathy subscale for disgust and in the sociability subscale. Cognition was correlated with self-reported reduced perception in social conformity, antisocial behavior, and sociability. Awareness was correlated with emotion recognition, antisocial behavior, and sociability. Neuropsychiatric symptoms were correlated with empathy, emotion recognition, and social conformity. CONCLUSIONS: Significant differences were found between caregivers' perspectives of socioemotional functioning in people with mild and moderate AD. Meanwhile, there were minimal differences in self-perception between the mild and moderate groups.
Shah R, Salek MS, Ali FM
… +4 more, Nixon SJ, Otwombe K, Ingram JR, Finlay AY
Alzheimer Dis Assoc Disord
· 2024 Oct-Dec 01 · PMID 39506214
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INTRODUCTION: Dementia can adversely affect the quality of life (QoL) of family members/partners of those affected. Measuring this often-neglected burden is critical to planning and providing appropriate support services...INTRODUCTION: Dementia can adversely affect the quality of life (QoL) of family members/partners of those affected. Measuring this often-neglected burden is critical to planning and providing appropriate support services. This study measures this impact using the Family-Reported Outcome Measure (FROM-16). METHODS: A large UK cross-sectional online study through patient research platforms, recruited family members/partners of people with dementia, to complete the FROM-16. RESULTS: Totally, 711 family members/partners (mean age=58.7 y, SD=12.5; females=81.3%) of patients (mean age=81.6, SD=9.6; females=66.9) with dementia completed the FROM-16. The FROM-16 mean total score was 17.5 (SD=6.8), meaning "a very large effect" on QoL of family members, with females being more adversely impacted. CONCLUSIONS: Dementia profoundly impacts the QoL of family members/partners of patients. Routine use of FROM-16 could signpost provision of care support, reducing family members' burnout. Such routine data could be used in economic analysis of the burden of dementia as well as in predicting institutionalization.
Alzheimer Dis Assoc Disord
· 2024 Oct-Dec 01 · PMID 39463154
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PURPOSE: Standardization of neuropsychological tests is crucial for consistency in cognitive assessment, as well as for validity and comparability of results across different populations. We examined the applicability an...PURPOSE: Standardization of neuropsychological tests is crucial for consistency in cognitive assessment, as well as for validity and comparability of results across different populations. We examined the applicability and measurement equivalence of the Alzheimer Disease Research Centers' Neuropsychological Test Battery (version 3) (ADRC-NTB3) in Singapore. METHODS: The ADRC-NTB3 was administered to 978 older persons with normal cognition in Singapore. To provide comparison between Singapore and US samples, a US sample with similar profile was retrieved from the National Alzheimer Coordinating Center (NACC) database. PATIENTS: Scores were compared with 1853 participants with similar profile from the United States. Score-difference between the populations was computed using multiple linear regression (adjusted for covariates), with equivalent score considered present when 90% CI of the score-difference fell within the predefined margin of equivalence. RESULTS: Tasks assessing for memory, processing speed, and executive functioning showed equivalence in scores between US and Singapore samples (adjusted-score difference=-0.94 to 0.09). Singapore sample performed marginally better on the visuospatial task (adjusted-score difference=0.50), but poorer on the language task (adjusted-score difference=-3.22). DISCUSSION: Nonequivalence of visuospatial and language tasks, which may increase potential misinterpretation of cognitive profiles and misdiagnosis, are related to educational and cultural differences. This highlights the need for different normative data for more accurate diagnostic accuracy as well as research priorities.
There is no consensus on how long antidementia medications should be administered to patients with Alzheimer disease (AD). To clarify this issue, we investigated the discontinuation of antidementia medications in Japanes...There is no consensus on how long antidementia medications should be administered to patients with Alzheimer disease (AD). To clarify this issue, we investigated the discontinuation of antidementia medications in Japanese home care settings, including community-dwelling and institutionalized patients. Using medical records from April 2017 to March 2022 at 3 clinics in Tokyo and Chiba prefectures, we selected patients with AD who started receiving home care medicine. Forty-nine patients discontinued antidementia medications during the observation period, there was no apparent deterioration in cognitive function or new occurrence of behavioral and psychological symptoms of dementia caused by the discontinuation of medications. More aggressive discontinuation of AD medications probably is recommended for patients with activities of daily living dysfunction, such as those receiving home care medicine.
Hall JB, Akter S, Rao P
… +4 more, Kiselica A, Ranum R, Thomas JM, Guess TM
Alzheimer Dis Assoc Disord
· 2024 Oct-Dec 01 · PMID 39450992
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INTRODUCTION: Early identification of clinical conditions associated with Alzheimer disease and related dementias (ADRD) is vital for intervention. One promising early detection method is the use of instrumented assessme...INTRODUCTION: Early identification of clinical conditions associated with Alzheimer disease and related dementias (ADRD) is vital for intervention. One promising early detection method is the use of instrumented assessment to identify subtle motor declines associated with ADRD. This pilot study sought to establish the feasibility of building a machine learning model to identify individuals with mild cognitive impairment (MCI) using motor function data obtained from an inexpensive, portable device. METHODS: Our novel, multimodal motor function assessment platform integrates a depth camera, forceplate, and interface board. Healthy older adults (n=28) and older adults with MCI (n=19) were assessed during static balance, gait, and sit-to-stand activities in both single- and dual-task conditions. Three machine learning models (ie, support vector machine, decision trees, and logistic regression) were trained and tested with the goal of classification of MCI. RESULTS: Our best model was decision trees, which demonstrated an accuracy of 83%, a sensitivity of 0.83, a specificity of 1.00, and an F1 score of 0.83. The top features were extracted and ranked on importance. DISCUSSION: This study demonstrates the feasibility of building a machine learning model capable of identifying individuals with mild cognitive impairment using motor function data obtained with a portable, inexpensive, multimodal device.
BACKGROUND: Psychosis in Alzheimer disease (AD) is a major burden for patients and their family. Identifying the characteristics of delusions and hallucinations in the AD population is key to understanding the interconne...BACKGROUND: Psychosis in Alzheimer disease (AD) is a major burden for patients and their family. Identifying the characteristics of delusions and hallucinations in the AD population is key to understanding the interconnection between the psychiatric and cognitive symptoms in neurocognitive disorders. The aim of this study is to compare the cognitive profiles of AD patients with and without psychosis. METHODS: We conducted a rapid review to explore the relationship between psychotic symptoms and cognitive performances in patients with AD. We used MEDLINE, Embase, and PsychINFO literature databases between January 2015 and January 2023. This rapid review was guided by the Cochrane Rapid Reviews Methods Group. RESULTS: We identified 2909 records from the initial searches. After reviewing the titles, abstracts, and full texts, we selected 8 cross-sectional and 5 cohort studies for the qualitative analysis. Among them, 6 studies were included in the final quantitative analysis. Most studies suggested a correlation between general cognitive decline and the risk of presenting psychotic symptoms. Three studies found an association between hallucinations and deficits in the visuocognitive domains (visuospatial, visuoperceptual, and visuoconstructive skills). Two studies found a relationship between psychotic symptoms and executive dysfunction. Two studies also found a correlation between psychotic symptoms and language. Our results are in line with previous data in the literature, especially regarding the outcome of psychosis on executive function and visuocognitive abilities. CONCLUSIONS: There appears to be an association between cognitive deficits and psychotic symptoms in AD, but the direction of causality is still unclear, and further studies using longitudinal designs would give more insight into the pathophysiological process of psychosis in AD.
Baker ZG, Han S, Sefcik JS
… +6 more, Petrovsky DV, Ma KPK, Smith ML, Bacsu JR, Rahemi Z, Saenz J
Alzheimer Dis Assoc Disord
· 2024 Oct-Dec 01 · PMID 39310976
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INTRODUCTION: People with dementia can have many family and friends who might be affected by their deaths. Pursuing the long-term aim of understanding how dementia deaths affect close family and friends, this project lay...INTRODUCTION: People with dementia can have many family and friends who might be affected by their deaths. Pursuing the long-term aim of understanding how dementia deaths affect close family and friends, this project lays groundwork through estimates of who those close family and friends are, with special attention to race and ethnicity. METHOD: Regression models estimated associations between dementia, race/ethnicity, and close family and friend network size, controlling for age, sex, education, marital status, and household wealth for 1386 deceased people with dementia from the Health and Retirement Study (2004 to 2018). RESULTS: Persons with dementia had an average of 9.4 close family and friends at death. But patterns of close family and friends were different among non-Latino Black (10.8), Latino (9.9), and non-Latino White (9.2) people with dementia at death. Notably, non-Latino White persons with dementia had the fewest close family (3.7), followed by non-Latino Black (5.1), and Latino (7.7) persons with dementia. DISCUSSION: Knowing who might be affected by dementia deaths is the first step to explore how dementia-related deaths impact close family and friends. Future work can now sample bereaved family and friends of people with dementia to explore their experiences and develop culturally appropriate supports.
Handedness has been a topic of scientific interest for many years. However, false and misleading ideas have dominated this field with a still limited amount of research into the association with clinical disorders like A...Handedness has been a topic of scientific interest for many years. However, false and misleading ideas have dominated this field with a still limited amount of research into the association with clinical disorders like Alzheimer disease (AD). In accordance with PRISMA guidelines, PubMed, Embase, and Cochrane Library were searched for studies regarding the association of handedness and AD. Twelve articles were included. Case-control studies show that left-handedness is not a risk factor for late-onset AD (LOAD). However, nonright handedness was found to be more prevalent in patients with early-onset AD (EOAD). Moreover, handedness does not seem to affect neuropsychological performance. We also show that collapsing versus separating mixed and left-handedness may yield different results. Future research on the relation between handedness and AD may provide new insight into disease pathogenesis, improve rehabilitation, and help identify patients who will progress, aiding the design of prevention trials.
Alzheimer disease and allergic diseases are common health problems. The aim of the study was to check the hypothesis that older patients with IgE-mediated allergies have a higher prevalence of Alzheimer disease. It was a...Alzheimer disease and allergic diseases are common health problems. The aim of the study was to check the hypothesis that older patients with IgE-mediated allergies have a higher prevalence of Alzheimer disease. It was a retrospective, multicenter cohort observation. In total, 7129 people were examined, including 3566 women and 2558 men (mean 64.9±6.9 y). The diagnosis of Alzheimer disease is based on the ICD-10 code and appropriate medical documentation. The proportion of patients with confirmed Alzheimer disease in the group of patients with diagnosed allergy compared to the group of those without allergy was as follows: 13.9% (168) versus 8.2% (484) with P=0.001. There was a positive correlation between the presence of Alzheimer disease and high serum total IgE, eosinophilia, and asthma or the presence of atopic polymorphic disease (P<0.05). IgE-dependent allergic diseases, in particular allergic asthma, and the presence of high serum IgE levels may favor the development of Alzheimer disease.
Peavy GM, Võ N, Revta C
… +6 more, Lu AT, Lupo JL, Nam P, Nguyễn KH, Wang LS, Feldman HH
Alzheimer Dis Assoc Disord
· 2024 Jul-Sep 01 · PMID 39177172
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INTRODUCTION: The objective of this pilot study was to establish the feasibility of recruiting older Vietnamese Americans for research addressing genetic and nongenetic risk factors for Alzheimer disease (AD). METHODS: T...INTRODUCTION: The objective of this pilot study was to establish the feasibility of recruiting older Vietnamese Americans for research addressing genetic and nongenetic risk factors for Alzheimer disease (AD). METHODS: Twenty-six Vietnamese Americans were recruited from communities in San Diego. A Community Advisory Board provided cultural and linguistic advice. Bilingual/bicultural staff measured neuropsychological, neuropsychiatric, lifestyle, and medical/neurological functioning remotely. Saliva samples allowed DNA extraction. A consensus team reviewed clinical data to determine a diagnosis of normal control (NC), mild cognitive impairment (MCI), or dementia. Exploratory analyses addressed AD risk by measuring subjective cognitive complaints (SCC), depression, and vascular risk factors (VRFs). RESULTS: Twenty-five participants completed the study (mean age=73.8 y). Eighty percent chose to communicate in Vietnamese. Referrals came primarily from word of mouth within Vietnamese communities. Diagnoses included 18 NC, 3 MCI, and 4 dementia. Participants reporting SCC acknowledged more depressive symptoms and had greater objective cognitive difficulty than those without SCC. Eighty-eight percent of participants reported at least 1 VRF. DISCUSSION: This pilot study supports the feasibility of conducting community-based research in older Vietnamese Americans. Challenges included developing linguistically and culturally appropriate cognitive and neuropsychiatric assessment tools. Exploratory analyses addressing nongenetic AD risk factors suggest topics for future study.
BACKGROUND: Construct validation of cognitive batteries across Africa is imperative to understanding dementia in the region. We examined construct validity and internal consistency of the neuropsychological battery of Un...BACKGROUND: Construct validation of cognitive batteries across Africa is imperative to understanding dementia in the region. We examined construct validity and internal consistency of the neuropsychological battery of Uniform Data Set version 3 (UDSNB 3.0) of the Alzheimer Coordinating Center in Nigeria older adults. METHOD: Three hundred forty-nine (220 females; age: 65 to 85) community dwellers were recruited. UDSNB 3.0 with 12 subscales were used to measure cognition. Two sets of data were collected. First was for exploratory factor analysis (EFA) and second was confirmatory factor analysis (CFA). Four models were specified for CFA. RESULT: EFA principal axis factor with varimax rotation yielded 4 factors: Executive function, memory, visual-spatial ability, and processing speed. Four CFA were performed based on 4 specified models, with only model 3 showing good model fit: CMIN/DF=2.13; confirmatory fit index=0.94; root mean square error of approximation=0.07. Model 3 had 5 latent variables: working memory, language, verbal memory, visual-spatial ability, and processing speed. UDSNB 3.0 had an overall Cronbach alpha of 0.73, suggesting strong internal reliability with ANOVA model F134,1619=183.65 significant at P<0.001 level of testing. CONCLUSIONS: Our study showed that UDSNB 3.0 has construct validity and good internal consistency in our older adult population.
OBJECTIVES: Functional impairment can be an early indicator of cognitive decline. However, its predictive utility in cognitively normal (CN) older adults remains unclear. This study aimed to determine whether mild functi...OBJECTIVES: Functional impairment can be an early indicator of cognitive decline. However, its predictive utility in cognitively normal (CN) older adults remains unclear. This study aimed to determine whether mild functional impairment (MFI) in CN older adults could predict incident dementia over 6 years, in addition to assessing its association with cognitive performance. DESIGN: A longitudinal study with a 6-year follow-up. PARTICIPANTS: A cohort of 296 community-dwelling CN older adults. MEASUREMENTS: MFI was defined by cutoffs for impairment on an objective performance-based and/or subjective questionnaire-based functional assessment. Cox regression analysis was conducted to assess the relationship between MFI and risk of incident dementia and cognitive performances over 6 years. Linear regression analysis examined the association between MFI and baseline cognitive performance. RESULTS: There were no significant longitudinal associations between MFI and incident dementia or changes in cognitive performance over 6 years. Defining MFI using both performance-based and informant-reported assessments was predictive of dementia. Cross-sectional analyses demonstrated significant associations between MFI and poorer baseline global cognition and performance in attention, visuospatial ability, and executive functioning. CONCLUSIONS: CN older adults with MFI were not at an increased risk of developing dementia over 6 years. A definition of functional impairment requiring both performance-based and informant-based assessments may be useful in predicting dementia.
Alzheimer Dis Assoc Disord
· 2024 Jul-Sep 01 · PMID 39177169
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INTRODUCTION: Alzheimer disease (AD) has a long preclinical phase in which AD pathology is accumulating without detectable clinical symptoms. It is critical to identify participants in this preclinical phase as early as...INTRODUCTION: Alzheimer disease (AD) has a long preclinical phase in which AD pathology is accumulating without detectable clinical symptoms. It is critical to identify participants in this preclinical phase as early as possible since treatment plans may be more effective in this stage. Monitoring for changes in driving behavior, as measured with GPS sensors, has been explored as a low-burden, easy-to-administer method for detecting AD risk. However, driving is a complex, multifaceted process that is likely influenced by other factors, including personality traits, that may change in preclinical AD. METHODS: We examine the moderating influence of neuroticism and conscientiousness on longitudinal changes in driving behavior in a sample of 203 clinically normal older adults who are at varying risk of developing AD. RESULTS: Neuroticism moderated rates of change in the frequency of speeding as well as the number of trips taken at night. Conscientiousness moderated rates of change in typical driving space. CONCLUSIONS: Personality traits change in early AD and also influence driving behaviors. Studies that seek to utilize naturalistic driving behavior to establish AD risk need to accommodate interpersonal differences, of which personality traits are one of many possible factors. Future studies should explicitly establish how much benefit is provided by including personality traits in predictive models of AD progression.