Authors: Franchini, Flaminia | Musicco, Massimo | Ratto, Federica | Storti, Gabriele | Shofany, Jacob | Caltagirone, Carlo | Di Santo, Simona Gabriella
Article Type: Research Article
Abstract: Background: Alzheimer’s disease is the principal cause of dementia and is determined, in at least one third cases, by modifiable risk factors (MRF). The “Lifestyle for Brain Health (LIBRA)” index was recently developed to quantify the individual risk of progression to dementia ascribable to MRF. Objective: The aim of this study was to investigate the association between LIBRA scores and markers of cognitive performance, functional independence, and psycho-behavioral symptoms in a community-based sample of Italian elders. Methods: 308 senior participants with mild cognitive impairment (MCI) or subjective cognitive decline (SCD) were evaluated with a complete neuropsychological battery and semi-structured interviews …for the assessment of depression, apathy, and functional autonomy. All the 12 LIBRA MRF were available for the calculation of LIBRA scores. A modified version of the index (LIBRA-2) was calculated by removing depression weight from the LIBRA index. Partial correlation analyses, controlling for age and education, assessed the association between LIBRA indices and cognitive, functional, and behavioral outcomes. Separate analyses were repeated in the MCI and SCD subgroups. Results: In participants with SCD (SCDp), significant correlations existed between LIBRA and markers of impairment in global cognition, visuo-spatial attention, and semantic fluency. LIBRA-2 associated with psycho-behavioral symptoms in the whole sample and in SCDp. LIBRA-2 only associated with apathy in the MCI subgroup. Conclusions: The LIBRA index might be useful to determine the lifestyle-attributable risk of cognitive and psycho-behavioral decline in Italian seniors at risk, while in those with overt cognitive impairment, these outcomes are presumably mainly associated with non-modifiable factors. Show more
Keywords: Alzheimer’s disease, apathy, depression, LIBRA Index, modifiable risk factors, mild cognitive impairment, neuropsychological tests, subjective cognitive decline
DOI: 10.3233/JAD-190495
Citation: Journal of Alzheimer's Disease, vol. 72, no. 3, pp. 717-731, 2019
Authors: Arlati, Sara | Di Santo, Simona Gabriella | Franchini, Flaminia | Mondellini, Marta | Filiputti, Beatrice | Luchi, Matilde | Ratto, Federica | Ferrigno, Giancarlo | Sacco, Marco | Greci, Luca
Article Type: Research Article
Abstract: Background: Virtual reality (VR) has recently emerged as a promising means for the administration of cognitive training of seniors at risk of dementia. Immersive VR could result in increased engagement and performances; however, its acceptance in older adults with cognitive deficits still has to be assessed. Objective: To assess acceptance and usability of an immersive VR environment requiring real walking and active participants’ interaction. Methods: 58 seniors with mild cognitive impairment (MCI, n = 24) or subjective cognitive decline (SCD, n = 31) performed a shopping task in a virtual supermarket displayed through a head-mounted display. Subjective and objective outcomes were evaluated. …Results: Immersive VR was well-accepted by all but one participant (TAM3 positive subscales > 5.33), irrespective of the extent of cognitive decline. Participants enjoyed the experience (spatial presence 3.51±0.50, engagement 3.85±0.68, naturalness 3.85±0.82) and reported negligible side-effects (SSQ: 3.74; q1-q3:0–16.83). The environment was considered extremely realistic, such as to induce potentially harmful behaviors: one participant fell while trying to lean on a virtual shelf. Older participants needed more time to conclude trials. Participants with MCI committed more errors in grocery items’ selection and experienced less “perceived control” over the environment. Conclusion: Immersive VR was acceptable and enjoyable for older adults in both groups. Cognitive deficits could induce risky behaviors, and cause issues in the interactions with virtual items. Further studies are needed to confirm acceptance of immersive VR in individuals at risk of dementia, and to extend the results to people with more severe symptoms. Show more
Keywords: Acceptance, cybersickness, immersive virtual reality, mild cognitive impairment, subjective cognitive decline, usability
DOI: 10.3233/JAD-201431
Citation: Journal of Alzheimer's Disease, vol. 80, no. 3, pp. 1025-1038, 2021
Authors: Liguori, Claudio | Spanetta, Matteo | Izzi, Francesca | Franchini, Flaminia | Nuccetelli, Marzia | Sancesario, Giulia Maria | Di Santo, Simona | Bernardini, Sergio | Mercuri, Nicola Biagio | Placidi, Fabio
Article Type: Research Article
Abstract: Background: Alzheimer’s disease (AD) is the most common form of dementia. It is mainly characterized by a progressive deterioration of cognition, but sleep-wake cycle disturbances frequently occur. Irregular sleep-wake cycle, insomnia, and daytime napping usually occur in patients with AD in the course of the disease. Objective: The aim of the present study was to verify the sleep-wake cycle in mild to moderate AD patients compared to controls, and to evaluate the relationship between the sleep-wake cycle impairment and the neuropsychological testing, CSF AD biomarkers, and CSF orexin concentrations. Methods: Mild to moderate AD patients were enrolled and underwent 14-day …actigraphic recording, sleep diary, neuropsychological testing, and CSF biomarkers analysis. All patients were compared to controls. Results: Eighteen AD patients were compared to ten controls. AD patients showed the alteration of the sleep-wake cycle, featured by sleep dysregulation and daytime wake fragmentation, with respect to controls. Considering the correlation analysis, we documented the correlation between tau proteins and orexin CSF levels and sleep-wake cycle dysregulation. Conclusion: This study confirmed the dysregulation of sleep-wake cycle in AD patients, as reflected by the daytime wake fragmentation, irregular sleep-wake rhythm, and nocturnal sleep impairment. This sleep-wake cycle disorder correlates with AD neuropathological in vivo features and brain orexin activity. Hence, we suppose that a more marked AD pathology coupled with orexinergic system dysregulation may promote sleep-wake cycle impairment in AD patients. Show more
Keywords: Alzheimer’s disease, cognition, orexin, sleep-wake cycle, tau proteins
DOI: 10.3233/JAD-191124
Citation: Journal of Alzheimer's Disease, vol. 74, no. 2, pp. 501-508, 2020
