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Clinical Therapy in Dementia and Related Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: 20 March 2026 | Viewed by 3527

Special Issue Editor

Special Issue Information

Dear Colleagues,

With the rapid aging of society, dementia has become a growing global concern, imposing substantial medical and economic burdens. Despite ongoing efforts, the absence of fundamental treatments and the critical need for advanced early diagnostic technologies remain significant challenges. At the same time, scientifically validated preventive strategies, non-pharmacological treatments, and approaches to enhance patients' quality of life (QOL) are increasingly recognized as essential.

A comprehensive, society-wide response is necessary to address this multifaceted issue. Clinical research and social support systems are pivotal areas of focus, demanding innovative solutions and interdisciplinary collaboration. This research topic seeks contributions addressing the following topics:

  1. Development of disease-modifying therapies (DMTs);
  2. Advancements in early diagnostic technologies;
  3. Lifestyle interventions for dementia prevention;
  4. Management of multimorbidity in dementia patients;
  5. Validation of non-pharmacological treatments;
  6. Genetic factors and personalized medicine;
  7. Targeted treatments for dementia subtypes;
  8. Improving care quality and nursing support;
  9. Digital health technologies in diagnosis and treatment;
  10. Other emerging dementia-related topics.

Dr. Takao Yamasaki
Guest Editor

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Keywords

  • dementia
  • aging society
  • disease-modifying therapies (DMT)
  • early diagnosis
  • lifestyle interventions
  • multimorbidity management
  • non-pharmacological treatments
  • personalized medicine
  • quality of life (QOL)
  • digital health technologies

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Published Papers (3 papers)

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Research

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15 pages, 236 KB  
Article
Immersive, Open-World Virtual Reality for Dementia Care: NeuroVRX Pilot Study
by Martin Eckert, Thomas Ostermann, Jan Peter Ehlers and Gregor Hohenberg
J. Clin. Med. 2025, 14(23), 8465; https://doi.org/10.3390/jcm14238465 - 28 Nov 2025
Viewed by 435
Abstract
Background: The increasing prevalence of Alzheimer’s disease and related dementia are a global problem generating social and economic burdens. Cognitive Stimulation Therapy is a non-pharmaceutical aid for people with dementia. In this context, digital and virtual reality approaches are underinvestigated, especially with [...] Read more.
Background: The increasing prevalence of Alzheimer’s disease and related dementia are a global problem generating social and economic burdens. Cognitive Stimulation Therapy is a non-pharmaceutical aid for people with dementia. In this context, digital and virtual reality approaches are underinvestigated, especially with respect to explorable open-world environments. The pilot aims to evaluate the feasibility, acceptability, and safety of an immersive, open-world virtual reality application for people with dementia. Methods: We conducted a single-arm, unrandomised study with three male participants diagnosed with dementia. The intervention consisted of a single virtual reality session in an immersive, open-world environment, where participants were able to explore freely while seated, using arm movements and head control to navigate an avatar. Results: All three participants finished the session without the occurrence of adverse events. The mean session time was 28 min, and the average walking distance was 0.9 km, with 1210 steps on average. Questionnaire results indicate acceptance and a positive attitude toward the usability of the intervention. We measured minimal changes in mood. Anecdotal reports indicate high immersion and autobiographical stimulation. We detected no adverse events or occurrences of cybersickness. Conclusions: Immersive, open-world virtual reality proved to be feasible, safe, and well accepted by the participants. The combination of state-of-the-art hardware and exploration-based software design enabled cognitive and motoric stimulation. The results indicate strong feasibility for the application of exploratory three dimensional virtual reality applications and further support the execution of controlled trials to assess therapeutic outcomes. Full article
(This article belongs to the Special Issue Clinical Therapy in Dementia and Related Diseases)
16 pages, 1447 KB  
Article
Personalized Prediction of Clozapine Treatment Response Using Therapeutic Drug Monitoring Data in Japanese Patients with Treatment-Resistant Schizophrenia
by Tatsuo Nakahara, Yukiko Harada, Naho Nakayama, Kijiro Hashimoto, Naoya Kida, Toshiaki Onitsuka, Hiroo Noda, Kenji Murasugi, Yoshihiro Takimoto, Wataru Omori, Tsuruhei Sukegawa, Jun Shiraishi, Kouji Tanaka, Hitoshi Maesato and Takefumi Ueno
J. Clin. Med. 2025, 14(21), 7892; https://doi.org/10.3390/jcm14217892 - 6 Nov 2025
Viewed by 1287
Abstract
Background: Clozapine is the only antipsychotic medication proven effective in patients with treatment-resistant schizophrenia (TRS). However, many patients have serum concentrations outside the recommended therapeutic window, and clozapine exhibits substantial interindividual variability. This study aimed to (1) examine clozapine dosage and blood [...] Read more.
Background: Clozapine is the only antipsychotic medication proven effective in patients with treatment-resistant schizophrenia (TRS). However, many patients have serum concentrations outside the recommended therapeutic window, and clozapine exhibits substantial interindividual variability. This study aimed to (1) examine clozapine dosage and blood concentrations in patients with TRS; (2) investigate the effects of sex and age on dosage and blood concentrations; (3) assess clinical response to clozapine treatment; and (4) develop a random forest (RF) model to predict therapeutic response using clinical and therapeutic drug monitoring (TDM) data. Methods: Dried blood spots were used to measure concentrations of clozapine, norclozapine, and clozapine N-oxide. Clinical symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). The RF algorithm was applied to analyze the relationships between biochemical and demographic factors and clinical response to clozapine. Results: A total of 754 blood samples from 167 patients were analyzed. Men received higher doses than women, and glucose levels were elevated in both sexes. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.986 for the training set and 0.852 for the testing set. Accuracy, precision, recall, and F1-score (training/testing) were 0.938/0.786, 0.936/0.736, 0.934/0.780, and 0.935/0.757, respectively. The SHapley Additive exPlanations (SHAP) analysis indicated that baseline BPRS score, treatment duration, age, and clozapine concentration were important variables contributing to the output of the model. Conclusions: Our model achieved satisfactory predictive performance for clinical response and provides valuable insights into personalized prediction of clozapine efficacy. Full article
(This article belongs to the Special Issue Clinical Therapy in Dementia and Related Diseases)
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Review

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17 pages, 595 KB  
Review
Bridging Dementia Care in Japan: The Emerging Role of General Medicine Physicians
by Takao Yamasaki
J. Clin. Med. 2025, 14(21), 7889; https://doi.org/10.3390/jcm14217889 - 6 Nov 2025
Viewed by 1346
Abstract
As global populations age, dementia has become a major public health challenge that warrants sustainable, person-centered, and community-integrated models of care. In Japan, the recent introduction of board-certified general medicine (GM) physicians, trained across both family medicine and hospital general medicine, has created [...] Read more.
As global populations age, dementia has become a major public health challenge that warrants sustainable, person-centered, and community-integrated models of care. In Japan, the recent introduction of board-certified general medicine (GM) physicians, trained across both family medicine and hospital general medicine, has created an opportunity to strengthen dementia care through improved continuity and coordination. This narrative review conceptually examines the emerging role of GM physicians within Japan’s Community-Based Integrated Care System and compares this evolving model with dementia care structures in the United States, the United Kingdom, and Canada. By synthesizing policy documents and published literature, this review outlines how GM physicians can serve as integrative actors bridging outpatient and inpatient care, collaborating with dementia specialists, Initial-phase Intensive Support Teams, and Community-based Comprehensive Support Centers to enhance person-centered support throughout the disease trajectory. While empirical outcome data remain limited, this conceptual framework highlights potential contributions of GM physicians to early detection, care transitions, and interdisciplinary collaboration in dementia care. However, challenges persist, including training variability, workforce shortages, and systemic fragmentation. By situating Japan’s experience within an international context, this review provides a conceptual basis for future empirical studies and policy development aimed at strengthening generalist-led dementia care in aging societies. Full article
(This article belongs to the Special Issue Clinical Therapy in Dementia and Related Diseases)
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