Multi-Domain Interventions for Dementia Prevention - A Systematic Review

Validity and reliability of the Turkish version of the Australian National University-Alzheimer's Disease Risk Index (ANU-ADRI)

INTRODUCTION

There is still a requirement for concise, practical scales that can be readily incorporated into everyday schedules and predict the likelihood of dementia onset in individuals without dementia. This study aimed to assess the reliability of the ANU-ADRI (Australian National University Alzheimer's Disease Risk Index)-Short Form in Turkish geriatric patients.

METHODS

This methodological study involved 339 elderly patients attending the geriatric outpatient clinic for various reasons. The known-group validity and divergent validity were assessed. The ANU-ADRI was administered during the baseline test and again within one week for retest purposes. Alongside the ANU-ADRI, all participants underwent a comprehensive geriatric assessment, including Activities of Daily Living (ADL), mobility assessment (Performance-Oriented Mobility Assessment (POMA) and Timed Up and Go Test), nutritional assessment (Mini Nutritional Assessment (MNA)), and global cognition evaluation (Mini-Mental State Examination (MMSE)).

RESULTS

The scale demonstrated satisfactory linguistic validity. A correlation was observed between the mean scores of the ANU-ADRI test and retest (r = 0.997, p < 0.001). Additionally, there existed a moderate negative linear association between the ANU-ADRI and MMSE scores (r = -0.310, p < 0.001), POMA (r = -0.406, p < 0.001), Basic ADL (r = -0.359, p < 0.001), and Instrumental ADL (r = -0.294, p < 0.001). Moreover, a moderate positive linear association was found between the ANU-ADRI and the Timed Up and Go Test duration (r = 0.538, p < 0.001).

CONCLUSION

The ANU-ADRI-Short Form was proved as a valuable tool for clinical practice, facilitating the assessment of Alzheimer's disease risk within the Turkish geriatric population.

The rise of Parkinson's disease is a global challenge, but efforts to tackle this must begin at a national level: a protocol for national digital screening and "eat, move, sleep" lifestyle interventions to prevent or slow the rise of non-communicable diseases in Thailand

The rising prevalence of Parkinson's disease (PD) globally presents a significant public health challenge for national healthcare systems, particularly in low-to-middle income countries, such as Thailand, which may have insufficient resources to meet these escalating healthcare needs. There are also many undiagnosed cases of early-stage PD, a period when therapeutic interventions would have the most value and least cost. The traditional "passive" approach, whereby clinicians wait for patients with symptomatic PD to seek treatment, is inadequate. Proactive, early identification of PD will allow timely therapeutic interventions, and digital health technologies can be scaled up in the identification and early diagnosis of cases. The Parkinson's disease risk survey (TCTR20231025005) aims to evaluate a digital population screening platform to identify undiagnosed PD cases in the Thai population. Recognizing the long prodromal phase of PD, the target demographic for screening is people aged ≥ 40 years, approximately 20 years before the usual emergence of motor symptoms. Thailand has a highly rated healthcare system with an established universal healthcare program for citizens, making it ideal for deploying a national screening program using digital technology. Designed by a multidisciplinary group of PD experts, the digital platform comprises a 20-item questionnaire about PD symptoms along with objective tests of eight digital markers: voice vowel, voice sentences, resting and postural tremor, alternate finger tapping, a "pinch-to-size" test, gait and balance, with performance recorded using a mobile application and smartphone's sensors. Machine learning tools use the collected data to identify subjects at risk of developing, or with early signs of, PD. This article describes the selection and validation of questionnaire items and digital markers, with results showing the chosen parameters and data analysis methods to be robust, reliable, and reproducible. This digital platform could serve as a model for similar screening strategies for other non-communicable diseases in Thailand.

A Longitudinal Study on Cognitive Training for Cognitively Preserved Adults in Liguria, Italy

In this study, we examined the effects of memory training on cognitive function and depressive symptoms in a cohort of 794 healthy adults aged 50 years or older. Participants were divided into an active intervention group and a passive intervention group, with various cognitive measures assessed over a one-year period. Univariate analysis revealed that the active intervention group consistently outperformed the passive group in measures of memory self-perception (Memory Complaint Questionnaire-MACQ), depressive symptoms (Geriatric Depression Scale-GDS-4), verbal memory and recall ability (A3LP), and verbal fluency (VF). Significant differences in MACQ scores were observed between the two groups at all time points, indicating enhanced memory self-perception in the active group. GDS-4 scores consistently favored the active group, suggesting a reduction in depressive symptoms. A3LP scores demonstrated that the active group had better verbal memory and recall abilities. VF scores consistently favored the active group, indicating superior language skills and cognitive flexibility. Linear regression model and mixed linear regression model reinforced these findings, with highly significant interaction effects observed between the active/passive group, gender, age, education, and time. These effects were particularly pronounced for MACQ and A3LP scores, indicating the combined impact of these factors on memory self-perception and verbal memory. This study highlights the positive impact of memory training intervention on cognitive function and depressive symptoms in older adults and underscores the importance of considering gender, age, and education in cognitive interventions. Notably, these benefits persist for up to six months from the end of the program. The results provide valuable insights into cognitive changes in aging populations and suggest that tailored memory training programs can yield significant improvements.