by tyler | Jul 31, 2022 | Press Article
FROM THE ALZHEIMER’S ASSOCIATION INTERNATIONAL CONFERENCE 2022
Also, ICU Stay May Double Risk of Dementia in Older Adults
SAN DIEGO, July 31, 2022 /PRNewswire/ — New insights into factors that may predict, increase or protect against the impact of COVID-19 and the pandemic on memory and thinking skills were revealed by multiple studies reported today at the Alzheimer’s Association International Conference® (AAIC®) 2022 in San Diego and virtually.
Among the key findings reported at AAIC 2022:
- A group from Argentina found that persistent loss of the sense of smell may be a better predictor of long-term cognitive and functional impairment than severity of the initial COVID-19 disease.
- Hospitalization in the intensive care unit was associated with double the risk of dementia in older adults, according to a study by Rush Alzheimer’s Disease Center in Chicago.
- During the pandemic, female gender, not working and lower socioeconomic status were associated with more cognitive symptoms in a large study population drawn from nine Latin American countries.
- In that same Latin American population, experiencing a positive life change during the pandemic (such as more quality time with friends and family or spending more time in nature) reduced the negative impact of the pandemic on memory and thinking skills.
“COVID-19 has sickened and killed millions of people around the world, and for some, the emerging research suggests there are long-term impacts on memory and thinking as well,” said Heather M. Snyder, Ph.D., vice president of medical and scientific relations at the Alzheimer’s Association. “As this virus will likely be with us for a long time, identifying the risk and protective factors for cognitive symptoms can assist with the treatment and prevention of ‘long COVID’ moving forward.”
Persistent loss of smell better predicts cognitive impairment than severity of COVID-19
Researchers in Argentina working with the Alzheimer’s Association Consortium on Chronic Neuropsychiatric Sequelae of SARS-CoV-2 Infection followed 766 adults age 55-95 exposed to COVID-19 for one year, and conducted a series of regular physical, cognitive and neuropsychiatric tests. Of the study group, 88.4% were infected and 11.6% were controls.
Clinical assessment showed functional memory impairment in two-thirds of the infected participants, which was severe in half of them. Another group of cognitive tests identified three groups with decreased performance:
- 11.7% showed memory-only impairment.
- 8.3% had impairment in attention and executive function.
- 11.6% displayed multidomain (including memory, learning, attention and executive function) impairment.
Statistical analysis revealed that persistent loss of smell was a significant predictor of cognitive impairment, but severity of the initial COVID-19 disease was not.
“The more insight we have into what causes or at least predicts who will experience the significant long-term cognitive impact of COVID-19 infection, the better we can track it and begin to develop methods to prevent it,” said Gabriela Gonzalez-Aleman, LCP, Ph.D., professor at Pontificia Universidad Catolica Argentina, Buenos Aires.
A stay in the intensive care unit may signal higher dementia risk
Researchers from the Rush Alzheimer’s Disease Center (RADC), part of Chicago’s Rush University System for Health, used data from five diverse studies of older adults without known dementia (n=3,822) to observe intensive care unit (ICU) hospitalizations. ICU hospitalizations were previously linked to cognitive impairment in older patients, but few studies have examined whether they increase risk for dementia.
They reviewed Medicare claims records from 1991 to 2018 (pre-pandemic), and checked annually for development of Alzheimer’s and all type dementia using a standardized cognitive assessment. During an average 7.8 years follow up, 1,991 (52%) participants experienced at least one ICU hospitalization; 1,031 (27%) had an ICU stay before study enrollment; and 961 (25%) had an ICU stay during the study period.
The researchers found that, in analyses adjusted for age, sex, education and race, experiencing ICU hospitalization was associated with 63% higher risk of Alzheimer’s dementia and 71% higher risk of all type dementia. In models further adjusted for other health factors such as vascular risk factors and disease, other chronic medical conditions, and functional disabilities, the association was even stronger: ICU hospitalization was associated with 110% greater risk of Alzheimer’s and 120% greater risk of all type dementia.
“We found that ICU hospitalization was associated with double the risk of dementia in community-based older adults,” said Bryan D. James, Ph.D., epidemiologist at RADC. “These findings could be significant given the high rate of ICU hospitalization in older persons, and especially due to the tremendous upsurge in ICU hospitalizations during the COVID-19 pandemic. Understanding the link between ICU hospitalization and the development of dementia is of utmost importance now more than ever.”
“More research is necessary to replicate these findings and elucidate the factors that may increase dementia risk. For example, is it the critical illness that sends someone to the hospital or potentially modifiable procedures during the hospitalization that drives dementia risk?” James added.
One positive life change during the pandemic may buffer against cognitive symptoms
Investigators from countries across Central and South America and the United States examined whether sociodemographic factors and changes in life associated with the pandemic were related to experiencing cognitive symptoms, including problems with memory, attention and other thinking skills, during the early phases of the pandemic.
In the study reported at AAIC, 2,382 Spanish-speaking adults age 55-95 (average 65.3 years, 62.3% female) from nine countries in Latin America completed an online or telephone survey, had electronic cognitive testing, and filled out an inventory assessing the positive and negative impacts of the pandemic between May and December 2020. Of the total study population, 145 (6.09%) experienced COVID-19 symptoms.
Participants were from: Uruguay (1,423, 59.7%), Mexico (311, 13.1%), Peru (153, 6.4%), Chile (152, 6.4%), Dominican Republic (117, 4.9%), Argentina (106, 4.5%), Colombia (50, 2.1%), Ecuador (39, 1.6%), Puerto Rico (19, 0.8%) and Other (12, 0.5%)
Key findings:
- Female gender, not currently working and lower socioeconomic status were all independently associated with more cognitive symptoms during the early part of the pandemic.
- Negative life changes during the pandemic, such as economic difficulties and limited social activities, were significantly associated with more cognitive symptoms. However, this association was weaker among study participants who reported at least one positive life change during the pandemic, including spending more time with friends and family or more time outside in nature.
“Identifying risk and protective factors for cognitive symptoms during the pandemic is an important step towards the development of prevention efforts,” said María Marquine, Ph.D., associate professor in the Departments of Medicine and Psychiatry, and director of disparities research in the Division of Geriatrics, Gerontology and Palliative Care at the University of California, San Diego. “The experience of positive life changes during the pandemic might buffer the detrimental impact of negative life changes on cognitive symptoms.”
“This study is an example of how investigators from diverse countries in Latin America and the United States, many of whom had never worked together before and had limited resources, came together under difficult circumstances but with a shared goal to advance scientific understanding about Alzheimer’s, and the important contributions that such multicultural partnerships can yield,” Marquine added.
About the Alzheimer’s Association International Conference® (AAIC®)
The Alzheimer’s Association International Conference (AAIC) is the world’s largest gathering of researchers from around the world focused on Alzheimer’s and other dementias. As a part of the Alzheimer’s Association’s research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.
AAIC 2022 home page: www.alz.org/aaic/
AAIC 2022 newsroom: www.alz.org/aaic/pressroom.asp
AAIC 2022 hashtag: #AAIC22
About the Alzheimer’s Association®
The Alzheimer’s Association is a worldwide voluntary health organization dedicated to Alzheimer’s care, support and research. Our mission is to lead the way to end Alzheimer’s and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer’s and all other dementia®. Visit alz.org or call 800.272.3900.
- Gabriela Gonzalez-Aleman, LCP, Ph.D., et al.Olfactory dysfunction but not COVID-19 severity predicts severity of cognitive sequelae following SARS-CoV-2 infection in Amerindian older adults. (Funders: Fundación de Lucha contra los Trastornos Neurológicos y Psiquiátricos en Minorías (FULTRA); Alzheimer’s Association)
- Bryan James, Ph.D., et al. ICU hospitalization and incident dementia in community-based cohorts of older adults. (Funder: National Institute on Aging)
- María Marquine, Ph.D., et al. Cognitive symptoms among middle- and older-age adults in Latin America during the coronavirus disease 2019 (COVID-19) pandemic: Risk and protective factors. (Funders: Massachusetts General Hospital Executive Committee on Research, Philanthropic Gift to the University of California, San Diego Division of Geriatrics, Plan Ibirapitá Uruguay (Inclusión Digital de Personas Mayores)).
*** AAIC 2022 news releases may contain updated data that does not match what is reported in the following abstracts.
Proposal ID: 66868
Title: Olfactory dysfunction but not COVID-19 severity predicts severity of cognitive sequelae following SARS-CoV-2 infection in Amerindian older adults
Background: COVID-19 has affected more than 380 million people. Infections may result in long term sequelae, including neuropsychiatric symptoms. In older adults COVID-19 sequelae resemble early Alzheimer’s disease, and may share risk factors and blood biomarkers with it. The Alzheimer’s Association Consortium on Chronic Neuropsychiatric Sequelae of SARS-CoV-2 infection (CNS SC2) established harmonized definitions, ascertainment and assessment methodologies to evaluate and longitudinally follow up cohorts of older adults with exposure to COVID-19. We present one year data in a prospective cohort from Argentina.
Method: Participants (n=766) are older adults (≥60 years) recruited from the provincial health registry containing all SARS-CoV-2 testing data. We randomly invite older adults stratified by PCR COVID-19 testing status regardless of symptom severity, between 3 and 6 months after recovery. Assessment includes interview with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and Clinical Dementia Rating scale (CDR); neurocognitive assessment; emotional reactivity scale; and neurological assessment including semiquantitative olfactory function test, motor function, coordination and gait.
Result: We assessed 88.4% infected participants and 11.6 % controls. Education is 10.36 ± 5.6 years and age is 66.9 ± 6.14 years. Level of care during COVID-19 is described in Figure 1. Normalized cognitive Z-scores categorize the cohort in 3 groups with decreased performance compared to normal cognition: memory only impairment (Single-domain,11.7%); impairment in attention+executive function without memory impairment (Two-domain, 8.3%); and multiple domain impairment (Multiple domain,11.6%). Logistic regression showed that severity of anosmia, but not clinical status, significantly predicts cognitive impairment. No controls had olfactory dysfunction. Cognitive impairment is defined as Z-scores below (- 2) (Table 1). Clinical assessment with SCAN revealed functional memory impairment in two thirds of infected patients (CDR ≥ 1), which was severe in half of them. Phone-based follow up at 1 year revealed high adherence (4 participants declined). Five were deceased at follow up. Rates of re-infection (between 10 and 23%) were not affected by the vaccination schedule (Table 2).
Conclusion: The longitudinal cohort had very high adherence. Persistent cognitive and functional impairment after SARS-CoV-2 infection is predicted by persistent anosmia but not by the severity of the initial COVID-19 disease.
Presenting Author
Gabriela Gonzalez-Aleman, LCP, Ph.D. ([email protected])
Pontificia Universidad Catolica Argentina, Buenos Aires
Proposal ID: 61678
Title: Cognitive symptoms among middle- and older-age adults in Latin America during the coronavirus disease 2019 (COVID-19) pandemic: Risk and protective factors
Background: The COVID-19 pandemic has impacted daily life worldwide, with possible negative consequences for cognitive health. Self-reported cognitive symptoms are linked to the development of Alzheimer’s disease and related dementias (ADRDs). Identifying risk and protective factors for cognitive symptoms during the pandemic is an important step towards the development of ADRD prevention efforts. We aimed to examine correlates of cognitive symptoms among middle- and older-age adults in Latin America before the availability of vaccines to prevent COVID-19, including sociodemographic factors and changes in life.
Method: Spanish-speaking adults ages 55-95 (N=2,382, Table 1) living in Latin America completed an online survey between May and December 2020. Cognitive symptoms were assessed via the 12-item Everyday Cognition (ECog) questionnaire. Negative (e.g., economic difficulties, limited social activities) and positive (e.g., more quality time with close others, increased time in nature/outside) life changes associated with the pandemic were measured via a subset of items from the Epidemic-Pandemic Impacts Inventory. Sociodemographic factors included age, years of education, gender, occupation and socioeconomic status (SES). Covariates included time since March 2020 (estimated onset of the pandemic in Latin America), country of survey completion, and having experienced COVID-19 symptoms. Multivariable linear regression models were ran on ECog total scores including covariates and sociodemographic factors (Model 1), and then adding terms for negative and positive life changes and their interaction (Model 2).
Results: Model 1 showed female gender (p=.04), not currently working (p=.02) and lower SES (p<.001) were independently associated with more cognitive symptoms. Model 2 showed a significant interaction between negative and positive life changes (p<.001), indicating that negative life changes were significantly associated with more cognitive symptoms, but this association was weaker among participants who reported at least one positive life change during the pandemic (Figure 1).
Conclusion: Cognitive symptoms might be more common among certain segments of the Latin American population, including women, and those who are not working and have low SES. The experience of positive life changes during the pandemic might buffer the detrimental impact of negative life changes on cognitive symptoms. These risk and protective factors might be considered in ADRD prevention efforts.
Presenting Author
Maria Marquine, PhD [email protected]
University of California San Diego, La Jolla, California
Proposal ID: 67719
Title: ICU hospitalization and incident dementia in community-based cohorts of older adults
Background: Critical illness and intensive care unit (ICU) hospitalization in older patients have been shown to increase risk of long-term cognitive impairment. However, most data come from patients recruited from the ICU without controls or information on pre-ICU cognition. We are not aware of a community-based sample that allows examination of how ICU hospitalization changes risk for dementia.
Method: We used data from 5 diverse epidemiologic cohorts at the Rush Alzheimer’s Disease Center (RADC) linked to Medicare claims data from 1991 to 2018 to observe ICU hospitalizations (both prior to RADC enrollment and during RADC follow-up) in older adults enrolled without known dementia. Incident Alzheimer’s and all type dementia was assessed using standardized annual cognitive assessment. The association of ICU hospitalization with incident dementia was tested in a time-varying Cox model allowing hazard rate to change at time of ICU hospitalization during follow-up. All models were adjusted for age, sex, education, and race. Fully adjusted models also included terms for baseline measures of hypertension, diabetes, BMI, vascular risk factors, vascular disease burden, other chronic medical conditions, functional disabilities, depression, and physical activity.
Result: Participants (n=3,822; mean age=77.3, SD=7.5) were followed for an average of 7.8 years (SD=5.5) from study enrollment. ICU hospitalization was experienced by 1,992 (52.1%) of participants; 1031 (27.0%) before RADC enrollment, and 961 (25.1%) during follow-up. In models adjusted for demographics, ICU hospitalization was associated with an increased risk of Alzheimer’s (HR=1.63, 95% CI = 1.41, 1.88) and all type dementia (HR=1.71, 95% CI = 1.48, 1.97). In fully adjusted models, the association was stronger with ICU associated with double the risk of Alzheimer’s (HR=2.10, 95% CI = 1.66, 2.65) and all type dementia (HR=2.20, 95% CI = 1.75, 2.77).
Conclusion: We found that ICU hospitalization was associated with double the risk of dementia in community-based older adults compared to those who did not experience ICU hospitalization using standardized annual cognitive assessment. These findings could be significant given the high rate of ICU hospitalization in older persons, and rising ICU hospitalizations more recently during the COVID-19 pandemic.
Presenting Author
Bryan James, PhD [email protected]
Rush Alzheimer’s Disease Center, Chicago, Illinois
SOURCE Alzheimer’s Association
by tyler | Jul 31, 2022 | Press Article
FROM THE ALZHEIMER’S ASSOCIATION INTERNATIONAL CONFERENCE 2022
Also, ICU Stay May Double Risk of Dementia in Older Adults
SAN DIEGO, July 31, 2022 /PRNewswire-HISPANIC PR WIRE/ — New insights into factors that may predict, increase or protect against the impact of COVID-19 and the pandemic on memory and thinking skills were revealed by multiple studies reported today at the Alzheimer’s Association International Conference® (AAIC®) 2022 in San Diego and virtually.
Among the key findings reported at AAIC 2022:
- A group from Argentina found that persistent loss of the sense of smell may be a better predictor of long-term cognitive and functional impairment than severity of the initial COVID-19 disease.
- Hospitalization in the intensive care unit was associated with double the risk of dementia in older adults, according to a study by Rush Alzheimer’s Disease Center in Chicago.
- During the pandemic, female gender, not working and lower socioeconomic status were associated with more cognitive symptoms in a large study population drawn from nine Latin American countries.
- In that same Latin American population, experiencing a positive life change during the pandemic (such as more quality time with friends and family or spending more time in nature) reduced the negative impact of the pandemic on memory and thinking skills.
“COVID-19 has sickened and killed millions of people around the world, and for some, the emerging research suggests there are long-term impacts on memory and thinking as well,” said Heather M. Snyder, Ph.D., vice president of medical and scientific relations at the Alzheimer’s Association. “As this virus will likely be with us for a long time, identifying the risk and protective factors for cognitive symptoms can assist with the treatment and prevention of ‘long COVID’ moving forward.”
Persistent loss of smell better predicts cognitive impairment than severity of COVID-19
Researchers in Argentina working with the Alzheimer’s Association Consortium on Chronic Neuropsychiatric Sequelae of SARS-CoV-2 Infection followed 766 adults age 55-95 exposed to COVID-19 for one year, and conducted a series of regular physical, cognitive and neuropsychiatric tests. Of the study group, 88.4% were infected and 11.6% were controls.
Clinical assessment showed functional memory impairment in two-thirds of the infected participants, which was severe in half of them. Another group of cognitive tests identified three groups with decreased performance:
- 11.7% showed memory-only impairment.
- 8.3% had impairment in attention and executive function.
- 11.6% displayed multidomain (including memory, learning, attention and executive function) impairment.
Statistical analysis revealed that persistent loss of smell was a significant predictor of cognitive impairment, but severity of the initial COVID-19 disease was not.
“The more insight we have into what causes or at least predicts who will experience the significant long-term cognitive impact of COVID-19 infection, the better we can track it and begin to develop methods to prevent it,” said Gabriela Gonzalez-Aleman, LCP, Ph.D., professor at Pontificia Universidad Catolica Argentina, Buenos Aires.
A stay in the intensive care unit may signal higher dementia risk
Researchers from the Rush Alzheimer’s Disease Center (RADC), part of Chicago’s Rush University System for Health, used data from five diverse studies of older adults without known dementia (n=3,822) to observe intensive care unit (ICU) hospitalizations. ICU hospitalizations were previously linked to cognitive impairment in older patients, but few studies have examined whether they increase risk for dementia.
They reviewed Medicare claims records from 1991 to 2018 (pre-pandemic), and checked annually for development of Alzheimer’s and all type dementia using a standardized cognitive assessment. During an average 7.8 years follow up, 1,991 (52%) participants experienced at least one ICU hospitalization; 1,031 (27%) had an ICU stay before study enrollment; and 961 (25%) had an ICU stay during the study period.
The researchers found that, in analyses adjusted for age, sex, education and race, experiencing ICU hospitalization was associated with 63% higher risk of Alzheimer’s dementia and 71% higher risk of all type dementia. In models further adjusted for other health factors such as vascular risk factors and disease, other chronic medical conditions, and functional disabilities, the association was even stronger: ICU hospitalization was associated with 110% greater risk of Alzheimer’s and 120% greater risk of all type dementia.
“We found that ICU hospitalization was associated with double the risk of dementia in community-based older adults,” said Bryan D. James, Ph.D., epidemiologist at RADC. “These findings could be significant given the high rate of ICU hospitalization in older persons, and especially due to the tremendous upsurge in ICU hospitalizations during the COVID-19 pandemic. Understanding the link between ICU hospitalization and the development of dementia is of utmost importance now more than ever.”
“More research is necessary to replicate these findings and elucidate the factors that may increase dementia risk. For example, is it the critical illness that sends someone to the hospital or potentially modifiable procedures during the hospitalization that drives dementia risk?” James added.
One positive life change during the pandemic may buffer against cognitive symptoms
Investigators from countries across Central and South America and the United States examined whether sociodemographic factors and changes in life associated with the pandemic were related to experiencing cognitive symptoms, including problems with memory, attention and other thinking skills, during the early phases of the pandemic.
In the study reported at AAIC, 2,382 Spanish-speaking adults age 55-95 (average 65.3 years, 62.3% female) from nine countries in Latin America completed an online or telephone survey, had electronic cognitive testing, and filled out an inventory assessing the positive and negative impacts of the pandemic between May and December 2020. Of the total study population, 145 (6.09%) experienced COVID-19 symptoms.
Participants were from: Uruguay (1,423, 59.7%), Mexico (311, 13.1%), Peru (153, 6.4%), Chile (152, 6.4%), Dominican Republic (117, 4.9%), Argentina (106, 4.5%), Colombia (50, 2.1%), Ecuador (39, 1.6%), Puerto Rico (19, 0.8%) and Other (12, 0.5%)
Key findings:
- Female gender, not currently working and lower socioeconomic status were all independently associated with more cognitive symptoms during the early part of the pandemic.
- Negative life changes during the pandemic, such as economic difficulties and limited social activities, were significantly associated with more cognitive symptoms. However, this association was weaker among study participants who reported at least one positive life change during the pandemic, including spending more time with friends and family or more time outside in nature.
“Identifying risk and protective factors for cognitive symptoms during the pandemic is an important step towards the development of prevention efforts,” said María Marquine, Ph.D., associate professor in the Departments of Medicine and Psychiatry, and director of disparities research in the Division of Geriatrics, Gerontology and Palliative Care at the University of California, San Diego. “The experience of positive life changes during the pandemic might buffer the detrimental impact of negative life changes on cognitive symptoms.”
“This study is an example of how investigators from diverse countries in Latin America and the United States, many of whom had never worked together before and had limited resources, came together under difficult circumstances but with a shared goal to advance scientific understanding about Alzheimer’s, and the important contributions that such multicultural partnerships can yield,” Marquine added.
About the Alzheimer’s Association International Conference® (AAIC®)
The Alzheimer’s Association International Conference (AAIC) is the world’s largest gathering of researchers from around the world focused on Alzheimer’s and other dementias. As a part of the Alzheimer’s Association’s research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.
AAIC 2022 home page: www.alz.org/aaic/
AAIC 2022 newsroom: www.alz.org/aaic/pressroom.asp
AAIC 2022 hashtag: #AAIC22
About the Alzheimer’s Association®
The Alzheimer’s Association is a worldwide voluntary health organization dedicated to Alzheimer’s care, support and research. Our mission is to lead the way to end Alzheimer’s and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer’s and all other dementia®. Visit alz.org or call 800.272.3900.
- Gabriela Gonzalez-Aleman, LCP, Ph.D., et al.Olfactory dysfunction but not COVID-19 severity predicts severity of cognitive sequelae following SARS-CoV-2 infection in Amerindian older adults. (Funders: Fundación de Lucha contra los Trastornos Neurológicos y Psiquiátricos en Minorías (FULTRA); Alzheimer’s Association)
- Bryan James, Ph.D., et al. ICU hospitalization and incident dementia in community-based cohorts of older adults. (Funder: National Institute on Aging)
- María Marquine, Ph.D., et al. Cognitive symptoms among middle- and older-age adults in Latin America during the coronavirus disease 2019 (COVID-19) pandemic: Risk and protective factors. (Funders: Massachusetts General Hospital Executive Committee on Research, Philanthropic Gift to the University of California, San Diego Division of Geriatrics, Plan Ibirapitá Uruguay (Inclusión Digital de Personas Mayores)).
*** AAIC 2022 news releases may contain updated data that does not match what is reported in the following abstracts.
Proposal ID: 66868
Title: Olfactory dysfunction but not COVID-19 severity predicts severity of cognitive sequelae following SARS-CoV-2 infection in Amerindian older adults
Background: COVID-19 has affected more than 380 million people. Infections may result in long term sequelae, including neuropsychiatric symptoms. In older adults COVID-19 sequelae resemble early Alzheimer’s disease, and may share risk factors and blood biomarkers with it. The Alzheimer’s Association Consortium on Chronic Neuropsychiatric Sequelae of SARS-CoV-2 infection (CNS SC2) established harmonized definitions, ascertainment and assessment methodologies to evaluate and longitudinally follow up cohorts of older adults with exposure to COVID-19. We present one year data in a prospective cohort from Argentina.
Method: Participants (n=766) are older adults (≥60 years) recruited from the provincial health registry containing all SARS-CoV-2 testing data. We randomly invite older adults stratified by PCR COVID-19 testing status regardless of symptom severity, between 3 and 6 months after recovery. Assessment includes interview with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and Clinical Dementia Rating scale (CDR); neurocognitive assessment; emotional reactivity scale; and neurological assessment including semiquantitative olfactory function test, motor function, coordination and gait.
Result: We assessed 88.4% infected participants and 11.6 % controls. Education is 10.36 ± 5.6 years and age is 66.9 ± 6.14 years. Level of care during COVID-19 is described in Figure 1. Normalized cognitive Z-scores categorize the cohort in 3 groups with decreased performance compared to normal cognition: memory only impairment (Single-domain,11.7%); impairment in attention+executive function without memory impairment (Two-domain, 8.3%); and multiple domain impairment (Multiple domain,11.6%). Logistic regression showed that severity of anosmia, but not clinical status, significantly predicts cognitive impairment. No controls had olfactory dysfunction. Cognitive impairment is defined as Z-scores below (- 2) (Table 1). Clinical assessment with SCAN revealed functional memory impairment in two thirds of infected patients (CDR ≥ 1), which was severe in half of them. Phone-based follow up at 1 year revealed high adherence (4 participants declined). Five were deceased at follow up. Rates of re-infection (between 10 and 23%) were not affected by the vaccination schedule (Table 2).
Conclusion: The longitudinal cohort had very high adherence. Persistent cognitive and functional impairment after SARS-CoV-2 infection is predicted by persistent anosmia but not by the severity of the initial COVID-19 disease.
Presenting Author
Gabriela Gonzalez-Aleman, LCP, Ph.D. ([email protected])
Pontificia Universidad Catolica Argentina, Buenos Aires
Proposal ID: 61678
Title: Cognitive symptoms among middle- and older-age adults in Latin America during the coronavirus disease 2019 (COVID-19) pandemic: Risk and protective factors
Background: The COVID-19 pandemic has impacted daily life worldwide, with possible negative consequences for cognitive health. Self-reported cognitive symptoms are linked to the development of Alzheimer’s disease and related dementias (ADRDs). Identifying risk and protective factors for cognitive symptoms during the pandemic is an important step towards the development of ADRD prevention efforts. We aimed to examine correlates of cognitive symptoms among middle- and older-age adults in Latin America before the availability of vaccines to prevent COVID-19, including sociodemographic factors and changes in life.
Method: Spanish-speaking adults ages 55-95 (N=2,382, Table 1) living in Latin America completed an online survey between May and December 2020. Cognitive symptoms were assessed via the 12-item Everyday Cognition (ECog) questionnaire. Negative (e.g., economic difficulties, limited social activities) and positive (e.g., more quality time with close others, increased time in nature/outside) life changes associated with the pandemic were measured via a subset of items from the Epidemic-Pandemic Impacts Inventory. Sociodemographic factors included age, years of education, gender, occupation and socioeconomic status (SES). Covariates included time since March 2020 (estimated onset of the pandemic in Latin America), country of survey completion, and having experienced COVID-19 symptoms. Multivariable linear regression models were ran on ECog total scores including covariates and sociodemographic factors (Model 1), and then adding terms for negative and positive life changes and their interaction (Model 2).
Results: Model 1 showed female gender (p=.04), not currently working (p=.02) and lower SES (p<.001) were independently associated with more cognitive symptoms. Model 2 showed a significant interaction between negative and positive life changes (p<.001), indicating that negative life changes were significantly associated with more cognitive symptoms, but this association was weaker among participants who reported at least one positive life change during the pandemic (Figure 1).
Conclusion: Cognitive symptoms might be more common among certain segments of the Latin American population, including women, and those who are not working and have low SES. The experience of positive life changes during the pandemic might buffer the detrimental impact of negative life changes on cognitive symptoms. These risk and protective factors might be considered in ADRD prevention efforts.
Presenting Author
Maria Marquine, PhD [email protected]
University of California San Diego, La Jolla, California
Proposal ID: 67719
Title: ICU hospitalization and incident dementia in community-based cohorts of older adults
Background: Critical illness and intensive care unit (ICU) hospitalization in older patients have been shown to increase risk of long-term cognitive impairment. However, most data come from patients recruited from the ICU without controls or information on pre-ICU cognition. We are not aware of a community-based sample that allows examination of how ICU hospitalization changes risk for dementia.
Method: We used data from 5 diverse epidemiologic cohorts at the Rush Alzheimer’s Disease Center (RADC) linked to Medicare claims data from 1991 to 2018 to observe ICU hospitalizations (both prior to RADC enrollment and during RADC follow-up) in older adults enrolled without known dementia. Incident Alzheimer’s and all type dementia was assessed using standardized annual cognitive assessment. The association of ICU hospitalization with incident dementia was tested in a time-varying Cox model allowing hazard rate to change at time of ICU hospitalization during follow-up. All models were adjusted for age, sex, education, and race. Fully adjusted models also included terms for baseline measures of hypertension, diabetes, BMI, vascular risk factors, vascular disease burden, other chronic medical conditions, functional disabilities, depression, and physical activity.
Result: Participants (n=3,822; mean age=77.3, SD=7.5) were followed for an average of 7.8 years (SD=5.5) from study enrollment. ICU hospitalization was experienced by 1,992 (52.1%) of participants; 1031 (27.0%) before RADC enrollment, and 961 (25.1%) during follow-up. In models adjusted for demographics, ICU hospitalization was associated with an increased risk of Alzheimer’s (HR=1.63, 95% CI = 1.41, 1.88) and all type dementia (HR=1.71, 95% CI = 1.48, 1.97). In fully adjusted models, the association was stronger with ICU associated with double the risk of Alzheimer’s (HR=2.10, 95% CI = 1.66, 2.65) and all type dementia (HR=2.20, 95% CI = 1.75, 2.77).
Conclusion: We found that ICU hospitalization was associated with double the risk of dementia in community-based older adults compared to those who did not experience ICU hospitalization using standardized annual cognitive assessment. These findings could be significant given the high rate of ICU hospitalization in older persons, and rising ICU hospitalizations more recently during the COVID-19 pandemic.
Presenting Author
Bryan James, PhD [email protected]
Rush Alzheimer’s Disease Center, Chicago, Illinois
Logo – https://mma.prnewswire.com/media/1869584/AAIC22_purple_font_rgb_Logo.jpg
SOURCE Alzheimer’s Association
by tyler | Jul 31, 2022 | Press Article
SAN FRANCISCO, July 31, 2022 /PRNewswire/ — Dr. Guru Sonpavde is the Bladder Cancer Director at the Dana-Farber Cancer Institute, an Associate Professor of Medicine at Harvard Medical School, and a practicing physician. Dr. Sonpavde, along with the other members of Vial’s Oncology CRO Scientific Advisory Board, will work hand-in-hand with the Vial team to launch and optimize the new CRO.
On joining the board, Dr. Sonpavde said, “The primary focus of my career has been to develop new drugs and combinations for urinary bladder cancer as well as prostate and kidney cancer through clinical trials. With new treatments like immunotherapies, antibody drug conjugates and targeted therapies, the field is accelerating towards improved cure rates. However, the clinical trials industry needs to be accelerating at that same pace, which is why I’m looking forward to working with Vial to ensure that Oncology trials are run with the utmost efficiency.”
Vial has worked closely with Oncology sponsors and investigators to develop a deep understanding of the nuances of clinical trials and the current pain points in running them. The result of that research is a tech-enabled CRO offering that’s “Built for Sponsors.” The new Oncology CRO will leverage Vial’s streamlined trial management system that integrates eSource, ePro, EDC, and CTMS into a seamless operating system. The CRO also offers additional best-in-class services to sponsors including more efficient study startup processes, a centralized pre-screening call center, and an unparalleled approach to patient recruitment.
Dr. Sonpavde joins Dr. Arati Rao, Dr. Antoni Ribas, and Dr. Neeraj Agarwal on Vial’s Oncology CRO Scientific Advisory Board. Dr. Sonpavde is a leading urological oncologist with a specialty in bladder cancer. He also has led translational projects and developed prognostic classifications and endpoints focused on bladder cancer. In addition to his roles at the Dana-Farber Cancer Institute and Harvard Medical School, Dr. Sonpavde is a member of the Genitourinary Committee of Southwest Oncology Group (SWOG) and the Bladder Cancer Task Force of the National Cancer Institute Genitourinary Steering Committee.
See the full release here.
About Vial: Vial’s mission is to empower scientists to cure all human diseases. Vial has executed that vision by launching a next-generation Contract Research Organization (CRO) (with slated launches in Ophthalmology CRO, Oncology CRO, Gastroenterology CRO, and a Neurology CRO), a site network (Dermatology Clinical Trials, Ophthalmology Clinical Trials, Gastroenterology Clinical Trials, Women’s Health Clinical Trials, Neurology Clinical Trials), and technology platform (VialConnect CTMS) to accelerate research. Vial has over 125 employees and is based in San Francisco, California, and has contributed to over 750 trials from Phase I through Phase IV.
SOURCE Vial
by tyler | Jul 31, 2022 | Press Article
Plataforma de Open Finance da Celero permite visão completa do perfil do empreendedor com classificação automática de informações
CURITIBA, Brasil, 31 de julho de 2022 /PRNewswire/ — Com o avanço da implantação do Open Finance (modelo de sistema financeiro aberto) no Brasil, a competição no segmento bancário e de finanças tem se mostrado cada vez mais acirrada. Essa conjuntura, muito além de ser benéfica para os clientes, comprova que a oferta de serviços precisa ser mais que completa: tem de ser personalizada. Como consequência, além da ampliação dos meios de pagamentos e operações customizadas dentro das plataformas que vêm sendo criadas, a projeção de crescimento das operações abre caminho para consolidar fintechs que se preparam para atuar no segmento.
A fintech Celero é o maior exemplo desse perfil, fato comprovado com a celebração de uma importante parceria com a Visa no oferecimento de uma solução de BFM (Business Financial Management – Gestão Financeira Empresarial, em português) customizável 100% white label, permite que o parceiro (sendo bancos, credenciadores, ou outras instituições financeiras) ofereça uma solução completa de gestão financeira para o seu cliente pessoa jurídica, e dentro da solução ele poderá ofertar produtos personalizados de acordo com as informações que ele terá acesso. O BFM é constituído pela entrega de dois produtos principais: o produto para o cliente final do parceiro, e o Radar, que é a plataforma de insights para o próprio parceiro.
Inédita, a solução da Celero tem diferenciais que trazem benefícios tanto para instituições financeiras, quanto para clientes dessas instituições. Para pessoas jurídicas, a principal vantagem está na possibilidade de utilização de um sistema de administração financeira totalmente integrado ao Internet Banking, enriquecendo uma atividade já presente na rotina do gestor. Essa tecnologia, baseada em inteligência artificial, identifica onde cada CNPJ possui contas a receber e a pagar; reúne as informações; cruza e analisa os dados e, assim, permite uma experiência de gestão completa e complexa realizada de forma extremamente simplificada, de modo que os empreendedores poderão se dedicar mais ao seu negócio – deixando a tecnologia apoiá-lo na administração financeira da empresa.
Para os bancos e demais instituições financeiras que aderirem à solução, a possibilidade de antecipar melhores ofertas de crédito, produtos e serviços, além de aprimorar a abordagem com esse público de forma personalizada e eficiente, é um dos maiores atrativos. Porém, a gama de possibilidades é muito mais ampla.
“Em termos gerais, o sistema da Celero é o único capaz de, numa única plataforma, agregar uma infinidade de dados e utilizá-los para alimentar um acervo com informações fundamentais para decisões estratégicas e, ainda, executar todas as ações operacionais da instituição financeira junto aos seus clientes (empresas). Ou seja, não é só um sistema que reúne dados brutos: por meio da classificação automática de informações, ele transforma, cada dado em uma informação relevante para a instituição financeira“, explica João Augusto Betenheuzer, CFO da Celero.
Com esses diferenciais, o sistema da Celero oferece aos bancos, por exemplo, um sistema seguro para validar a oferta de crédito, gerar aumento de competitividade, elevar ao máximo a retenção de clientes e, principalmente, o benefício da principalidade à instituição financeira. “Ser o banco principal de uma pessoa jurídica é fundamental. É comum que uma empresa possua contas em diferentes bancos e utilize serviços distintos em cada um deles. Com as soluções da Celero, a instituição financeira concentra em sua própria plataforma todas as operações de PJs, inclusive de outros bancos, e, ainda, abre a possibilidade de que sejam oferecidos produtos direcionados de acordo com a necessidade de cada um“, ressalta João Augusto.
É uma ferramenta inédita e exclusiva que torna simples a rotina da gestão financeira do negócio, a previsibilidade de entrada e saída de recursos e, através dela, o usuário consegue monitorar se ele está no caminho para atingir o objetivo financeiro.
“Nosso objetivo é ajudar as empresas a atuarem de forma estratégica para tomar melhores decisões, atingir melhores resultados e gerar renda e emprego em suas áreas. É um objetivo comum à Celero e seus investidores: contribuir para a gestão saudável e para o fortalecimento dos negócios, transformando o jeito de fazer a gestão financeira e, com isso, salvar milhões de empresas, não só no Brasil“, aponta João Tosin, CEO da Celero.
Solidez da Celero
A solução de sucesso da fintech tem como base uma sólida experiência iniciada em 2014, que mostra permanentemente seus resultados e coloca a Celero na seleta lista de fintechs promissoras.
Prova disso foi o aporte recebido da Harvard Business School Alumni Angels of Brazil (HBSAAB), organização de ex-alunos brasileiros de Harvard que apoia empresas com alto potencial de crescimento, bem como da Honey Island Capital, veículo de investimentos criado pelos sócio-fundadores do EBANX, o primeiro unicórnio da região Sul do Brasil.
“A Celero avança em seu nicho com solidez. No cenário inovador do Open Finance integrar sistemas e oferecer soluções completas e customizáveis a destaca no segmento. Assim a gestão financeira para as empresas pode elevar-se a outro patamar e ainda fomentar negócios às instituições que aderirem ao sistema. A Celero tem a inovação no seu DNA“, afirma Wagner Ruiz, um dos criadores da Honey Island Capital e cofundador do EBANX.
“Dentro da nossa estratégia de negócio, estamos ampliando a nossa rede para construirmos as conexões necessárias com diferentes players. Para isso, passamos a oferecer serviços de valor agregado para todo o ecossistema financeiro, indo além da oferta de credenciais de pagamento e soluções de segurança, como é o caso da ferramenta desenvolvida pela Celero. Essa parceria representa ainda um avanço importante para a Visa, pois marca a nossa evolução no conceito de Open Banking no Brasil”, conta Juliano Manrique, diretor executivo de Soluções da Visa do Brasil.
Fintechs lideram atração de investimentos
O nicho financeiro segue liderando o ranking de investimentos em startups no Brasil, levantando, apenas no primeiro semestre deste ano, US$ 1,36 bilhão (de um total de US$ 2,92 bilhões), segundo dados do mais recente Inside Venture Capital, produzido pela plataforma de inovação Distrito. Nesse universo de investimentos, ganham espaço, portanto, aquelas empresas que conseguem comprovar eficiência e personalização das operações sem deixar de lado a segurança, e que têm a capacidade, a competência e o pioneirismo de utilizar o máximo das possibilidades que o Open Finance oferece para criar soluções inovadoras e exclusivas.
Sobre a Celero
A Celero nasceu, cresceu e segue comprometida com a melhoria contínua de seus processos, que visam facilitar o dia a dia financeiro das empresas que compõem seu portfólio. A fintech se consolida como expoente do open finance, oferecendo ao mercado segurança e customização dos processos através de uma plataforma exclusiva, que torna simples a rotina da gestão financeira das empresas e oportuniza a visão de negócios para todos os envolvidos na base de informações. Conheça as soluções em celero.com.br.
FONTE Celero
SOURCE Celero
by tyler | Jul 31, 2022 | Press Article
FROM THE ALZHEIMER’S ASSOCIATION INTERNATIONAL CONFERENCE 2022
Top Tier Clinicians and Researchers Find the Tests Are:
– Full of Revolutionary Potential
– Valuable Now For Research and Treatment Trials
– Not Ready Yet for the Healthcare Provider’s Office
CHICAGO and SAN DIEGO, July 31, 2022 /PRNewswire/ — Alzheimer’s disease blood biomarkers (BBMs) may revolutionize the diagnosis of Alzheimer’s in the future, but are not yet ready for widespread use, according to a newly-published article by leading international clinicians and researchers convened by the Alzheimer’s Association®. At the same time, they are important and valuable for current research trials and cautious initial use in specialized memory clinics.
“Blood-based markers show promise for improving, and possibly even redefining, the diagnostic work-up for Alzheimer’s,” said Maria C. Carrillo, Ph.D., Alzheimer’s Association chief science officer and a co-author of the article. “Remarkable progress has been made, but additional data are needed before BBMs can be used as a stand-alone test for diagnosis, and before considering broad use in primary care settings.”
“In this article, the expert workgroup clearly defines both short- and long-term research priorities needed to fill significant knowledge gaps that still exist, such as how well these blood-based markers work in diverse communities and in those living with multiple health conditions,” Carrillo added. “Also included are consensus appropriate use recommendations for use of BBMs in the clinic and in research trials.”
“The Alzheimer’s Association Appropriate Use Recommendations for Blood Biomarkers in Alzheimer’s Disease,” by Oskar Hansson, M.D., Ph.D., et al, is published online today by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The recommendations will be reported today and tomorrow at the Alzheimer’s Association International Conference® (AAIC®) 2022 in San Diego and online.
“Blood-based biomarkers for Alzheimer’s are already improving the design of clinical trials, and they are very likely to revolutionize the diagnosis of Alzheimer’s in the future,” said Oskar Hansson, M.D., Ph.D., director of the Center for Neurodegenerative Diseases at Lund University and Skane University Hospital, Malmo, Sweden, and first author on the newly published article. “That said, the implementation of such markers in trials and practice must be done in a careful and controlled way so as not to accidentally cause more harm than good. Much more research is needed before widespread clinical use of BBMs.”
According to the article, BBMs show “great promise” — especially markers for Alzheimer’s-related brain changes related to nerve cell damage/death, and tau and beta amyloid accumulation — for “future use in both clinical practice and trials. However, few prospective studies have investigated the implementation of such BBMs in more heterogeneous populations.”
Not ready for “prime time”
The workgroup points out that no studies have extensively evaluated BBMs for neurodegenerative diseases in primary care, and calls for “well-performed BBM studies in diverse primary care populations.” Such studies should also evaluate the impact of BBMs on diagnostic accuracy and change in patient management.
In addition, use of BBMs for general population risk screening and as direct-to-consumer risk tests are not recommended.
The workgroup also says that BBMs should not yet be used as primary endpoints in pivotal treatment trials. However, this does not preclude the use of certain BBMs for decision making in clinical trials with adaptive design, where they could be used to inform decisions on continuing a trial or not.
Many current uses
There are current uses for Alzheimer’s BBMs, according to the workgroup. For example, they “recommend use of BBMs as (pre-)screeners to identify individuals likely to have Alzheimer’s pathological changes for inclusion in trials evaluating disease-modifying therapies, provided Alzheimer’s status is confirmed with positron emission tomography (PET) or cerebrospinal fluid (CSF) testing.”
BBMs can be used as exploratory outcomes in most clinical trials in Alzheimer’s and other neurodegenerative dementias. In non-Alzheimer’s trials, BBMs can be used to identify patients who likely have Alzheimer’s-related brain changes, if that is a condition of exclusion from the study.
“We also recommend cautiously starting use of BBMs in specialized memory clinics as part of the diagnostic work-up of patients already experiencing cognitive symptoms, as long as the results are confirmed whenever possible with CSF or PET, which are the current reference standards,” said Charlotte E. Teunissen, M.D., Ph.D., head of the Neurochemistry Laboratory at Amsterdam University Medical Centers, the Netherlands and senior author on the article.
“The implementation of BBMs in primary care will likely take a much longer time because there are very few relevant and high-quality research studies on Alzheimer’s-related BBMs conducted in this setting, but more prospective studies are expected to launch in the coming years,” Teunissen added.
Establishing the path for BBMs in research
The appropriate use recommendations (AURs) provide specific guidance for current use of, and research needed on, the four most advanced types of Alzheimer’s plasma biomarkers: plasma amyloid-beta 42/ amyloid-beta 40 (Aβ42/Aβ40), phospho-tau (p-tau), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP), as well as potential combinations of markers. For example, the need for:
- Real-world studies on the robustness of plasma Aβ42/Aβ40 as a diagnostic test for cerebral Aβ pathology.
- Head-to-head studies comparing the performance of different forms of p-tau in different clinical contexts and across disease stages.
Most important and enlightening are the recommendations repeated by the authors throughout the AURs or those they say apply across the biomarkers, including:
- Perform prospective studies in primary care settings, including representative and diverse populations with cognitive symptoms. Evaluate the causes of false positives and negatives; the reference standard must be of high quality and preferably include CSF or PET.
- Study whether BBMs outperform what is already available today in primary care, and if they also improve diagnosis and management, including treatment decisions.
- [Gain] better understanding of biological and disease-associated variability and potential impact of medical comorbidities and concomitant medications.
- [Learn whether] certain BBM-based algorithms can be used alone to support an Alzheimer’s diagnosis, or should they only be used as a gatekeeper to CSF/PET.
- Eventually (a) perform head-to-head comparisons of different plasma biomarker assays, and (b) establish the most optimal combinations of easily accessible biomarkers.
Defining the need
According to the workgroup, about 25-30% of patients with a clinical diagnosis of Alzheimer’s dementia are misdiagnosed when assessed at specialized dementia clinics, and the accuracy of clinical diagnosis is similar or even lower for other dementias, including frontotemporal dementia, dementia with Lewy bodies and vascular dementia. In fact, in most countries, most patients with cognitive or behavioral symptoms are managed in primary care where the misdiagnosis is even higher. The problem is especially acute in the earliest stages of the disease.
“There is a great global need for accurate BBM-based diagnostic and prognostic algorithms that can substantially improve the accuracy of a diagnostic work-up of Alzheimer’s, particularly in the early stages of the disease,” said Reisa Sperling, M.D., professor of Neurology at Harvard Medical School and director of the Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital and Massachusetts General Hospital, and a co-author of the article.
The established CSF and PET measures have excellent diagnostic properties, but are less useful outside very specialized clinics due to limited accessibility, invasiveness (e.g., CSF measures require a lumbar puncture, and PET requires infusion of stable isotopes and exposure to radiation) and high costs. This precludes use of CSF and PET biomarkers in most primary and secondary care settings worldwide.
“A major benefit of the use of blood-based biomarkers is that the collection of blood is less invasive and likely less costly than CSF or neuroimaging markers, and more feasible for primary care practitioners,” said Adam Boxer, M.D., Ph.D., Endowed Professor in Memory in Aging at the Weill Institute for Neurosciences, University of California, San Francisco and a co-author of the article. “This may enable earlier and more equitable referral of individuals to dementia specialists and participation in clinical trials of potential new therapies.”
For full disclosures from all authors, please see the published article.
Alzheimer’s & Dementia: Journal of the Alzheimer’s Association
Alzheimer’s & Dementia: Journal of the Alzheimer’s Association bridges the knowledge gaps across a wide range of bench-to-bedside investigations. Content emphasizes interdisciplinary investigations and integrative/translational articles related to: etiology, risk factors, early detection, disease modifying interventions, prevention of dementia and applications of new technologies in health services.
About the Alzheimer’s Association International Conference® (AAIC®)
The Alzheimer’s Association International Conference (AAIC) is the world’s largest gathering of researchers from around the world focused on Alzheimer’s and other dementias. As a part of the Alzheimer’s Association’s research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.
AAIC 2022 home page: www.alz.org/aaic/
AAIC 2022 newsroom: www.alz.org/aaic/pressroom.asp
AAIC 2022 hashtag: #AAIC22
About the Alzheimer’s Association®
The Alzheimer’s Association is a worldwide voluntary health organization dedicated to Alzheimer’s care, support and research. Our mission is to lead the way to end Alzheimer”s and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer”s and all other dementia®. Visit alz.org or call 800.272.3900.
At AAIC 2022, the talk on The Alzheimer’s Association Appropriate Use Recommendations for Blood Biomarkers in Alzheimer’s Disease will be held during the developing topics session on Sunday, July 31, 2022 starting at 8 a.m. PT. They will also be discussed briefly as part of the symposium titled, “The Road To Clinical Implementation Of Plasma Biomarkers,” on Monday, Aug. 1, 2022, 11:15 a.m.-12:30 p.m. PT.
SOURCE Alzheimer’s Association
