Journal Description
Journal of Dementia and Alzheimer's Disease
Journal of Dementia and Alzheimer's Disease
is an international, peer-reviewed, open access journal on all types of dementia, with particular interest on Alzheimer’s disease, published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- Rapid Publication: first decisions in 18 days; acceptance to publication in 4 days (median values for MDPI journals in the second half of 2024).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- JDAD is a companion journal of Brain Sciences.
- Journal Cluster of Neurosciences: Brain Sciences, Neurology International, NeuroSci, Clinical and Translational Neuroscience, Neuroglia, Psychiatry International, Clocks & Sleep and Journal of Dementia and Alzheimer's Disease.
subject
Imprint Information
Open Access
ISSN: 3042-4518
Latest Articles
Investigating the Measurement Precision of the Montreal Cognitive Assessment (MoCA) for Cognitive Screening in Parkinson’s Disease Through Item Response Theory
J. Dement. Alzheimer's Dis. 2025, 2(2), 19; https://doi.org/10.3390/jdad2020019 - 6 Jun 2025
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Background: The Montreal Cognitive Assessment (MoCA) is widely used to evaluate global cognitive function; however, its precision in measurement in heterogeneous populations—especially among patients with Parkinson’s disease (PD)—remains underexplored. Methods: In this multicenter cross-sectional study, we examined the psychometric properties of
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Background: The Montreal Cognitive Assessment (MoCA) is widely used to evaluate global cognitive function; however, its precision in measurement in heterogeneous populations—especially among patients with Parkinson’s disease (PD)—remains underexplored. Methods: In this multicenter cross-sectional study, we examined the psychometric properties of the Brazilian Portuguese MoCA in 484 PD patients (age range, 26–90 years; mean ± SD, 59.9 ± 11.1 years; disease duration range, 1–35 years; mean ± SD, 8.7 ± 5.4 years) using Item Response Theory (IRT). The Graded Response Model (GRM) was employed to estimate item difficulty and discrimination parameters, and differential item functioning (DIF) concerning age and education was investigated via a Multiple Indicators Multiple Causes (MIMIC) model. Results: The MoCA demonstrated essential unidimensionality and robust model fit. GRM analyses revealed that items within the Attention and Naming domains had high discrimination, indicating sensitivity to subtle cognitive deficits, while Memory items exhibited lower discrimination. Orientation items showed low difficulty thresholds, suggesting a propensity for ceiling effects. The MIMIC model further indicated that age and education significantly influenced overall scores: increasing age was associated with lower performance, whereas higher educational attainment correlated with better outcomes, particularly in Memory Recall and Executive/Visuospatial domains, even after accounting for their modest inverse relationship. Conclusions: Our findings support the validity of the Brazilian Portuguese MoCA for cognitive screening in PD while highlighting item-level biases linked to age and education. These results advocate for using education-adjusted norms and computerized scoring algorithms that incorporate item parameters, ultimately enhancing the reliability and fairness of cognitive assessments in diverse clinical populations.
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Open AccessArticle
Objective and Subjective Measures of Cognitive Decline in Highly Educated Older Adults: A 10-Year Longitudinal Study
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Odelia Elkana, Meitav Levy, Yael Tal Bicovsky, Noy Tal, Noga Oren and Elissa L. Ash
J. Dement. Alzheimer's Dis. 2025, 2(2), 18; https://doi.org/10.3390/jdad2020018 - 5 Jun 2025
Abstract
Background: The timely detection of cognitive decline in highly educated adults is challenging due to their resilient cognitive abilities and the limited sensitivity of neuropsychological tests for this group. Therefore, evaluating subjective facets such as subjective cognitive decline (SCD) becomes imperative, potentially enabling
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Background: The timely detection of cognitive decline in highly educated adults is challenging due to their resilient cognitive abilities and the limited sensitivity of neuropsychological tests for this group. Therefore, evaluating subjective facets such as subjective cognitive decline (SCD) becomes imperative, potentially enabling the early identification of cognitive decline. Objective: Our primary objective was to identify effective methods, both objective and subjective, for the early detection of cognitive decline in highly educated older adults. A secondary objective was to translate and validate a Hebrew adaptation of the SCD questionnaire. Methods: Initially (T0), the study included 28 highly educated participants (mean age = 72.6, SD = 4.54; mean education 17.6, SD = 3.41). By the final evaluation (T7), 20 participants remained. Annual assessments involved objective neuropsychological tests and self-report questionnaires evaluating depression, anxiety, and SCD with changes analyzed over time using repeated measures ANOVA. Results: Significant declines were observed in the following objective neuropsychological tests: Rey–Osterrieth Complex Figure Test (ROCFT) copy, F(3,57) = 9.05, p < 0.001, ηp2 = 0.32, and Rey Auditory Verbal Learning Test (RAVLT) trial six, F(1,19) = 7.32, p < 0.05, ηp2 = 0.28, which is consistent with previous findings. The Hebrew SCD questionnaire demonstrated high reliability and validity and was highly correlated with cognitive decline. Conclusions: The ROCFT copy and the Hebrew SCD questionnaire can serve as valuable indicators for the early detection of cognitive decline in highly educated older adults.
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(This article belongs to the Special Issue Novel Therapies for Neurodegenerative Disorders)
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Open AccessReview
Oxidative Stress and Mitochondrial Dysfunction in Alzheimer’s Disease: Insights into Pathophysiology and Treatment
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Amer E. Alkhalifa, Oula Alkhalifa, Iva Durdanovic, Dalia R. Ibrahim and Sofia Maragkou
J. Dement. Alzheimer's Dis. 2025, 2(2), 17; https://doi.org/10.3390/jdad2020017 - 3 Jun 2025
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Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss. Increasing evidence highlights oxidative stress as a pivotal contributor to AD pathogenesis, closely associated with hallmark features such as amyloid-β (Aβ) plaque accumulation, tau hyperphosphorylation, and synaptic
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Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss. Increasing evidence highlights oxidative stress as a pivotal contributor to AD pathogenesis, closely associated with hallmark features such as amyloid-β (Aβ) plaque accumulation, tau hyperphosphorylation, and synaptic dysfunction. This review aims to elucidate the mechanisms by which oxidative stress contributes to AD and to evaluate emerging therapeutic strategies targeting oxidative damage. Methods: We conducted an extensive literature search using PubMed and Google Scholar for studies published between 1994 and 2024. This narrative review integrates findings from in vitro, in vivo, and clinical studies focusing on oxidative stress, mitochondrial dysfunction, and their roles in AD to provide a comprehensive overview of the current research landscape. Results: ROS and RNS levels are significantly elevated in aging and AD-affected brains, leading to oxidative damage to lipids, proteins, and DNA, which compromises neuronal function and structure. Mitochondrial dysfunction plays a key role by amplifying ROS production, impairing ATP synthesis, and accelerating neurodegeneration. Oxidative stress also interacts with central AD pathologies, including Aβ aggregation, tau hyperphosphorylation, and synaptic dysfunction, creating a vicious cycle of neuronal injury. Although traditional antioxidant therapies have shown limited efficacy in clinical settings, often due to poor bioavailability, limited BBB penetration, and systemic distribution, novel strategies such as mitochondrial-targeted antioxidants and combination therapies have demonstrated improved outcomes in preclinical models. Conclusions: Oxidative stress plays a multifaceted role in the progression of AD, necessitating comprehensive therapeutic approaches. Future treatments should focus on targeting multiple aspects of oxidative stress, particularly mitochondrial dysfunction, to enhance clinical outcomes and slow neurodegeneration in AD patients.
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Open AccessArticle
Subjective Cognitive Decline and Antisaccade Latency: Exploring Early Markers of Dementia Risk
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Thomas D. W. Wilcockson, Ahmet Begde and Eef Hogervorst
J. Dement. Alzheimer's Dis. 2025, 2(2), 16; https://doi.org/10.3390/jdad2020016 - 1 Jun 2025
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Background/Objectives: Subjective cognitive decline (SCD) is a common symptom experienced by individuals in the preclinical stage of dementia. However, traditional neuropsychological tests often fail to detect subtle cognitive changes associated with SCD. People with SCD may appear to have intact cognitive function (as
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Background/Objectives: Subjective cognitive decline (SCD) is a common symptom experienced by individuals in the preclinical stage of dementia. However, traditional neuropsychological tests often fail to detect subtle cognitive changes associated with SCD. People with SCD may appear to have intact cognitive function (as measured by traditional tests), but they themselves subjectively feel that their cognition is becoming impaired. Methods: This preliminary study investigated the relationship between SCD and antisaccade performance as a potential early marker of dementia risk in a community-based sample of older adults (N = 17, mean age = 77.71 years). SCD was also explored by calculating the dissociation between objective and subjective memory performance, with SCD implied if there was a large dissociation between perceived memory performance but intact objective performance. Results: Participants with evidence of SCD exhibited significantly increased antisaccade latency compared to healthy controls, even when standard cognitive tests were normal. Antisaccade latency showed a significant correlation with self-reported cognitive complaints (r = 0.57, p = 0.018), while traditional cognitive measures did not. Conclusions: These compelling but preliminary findings suggest that antisaccade performance may be a more sensitive indicator of early cognitive decline than traditional cognitive measures, even in the preclinical stage of dementia. The results have implications for early dementia diagnosis, as antisaccade tasks could be incorporated into routine assessments to identify individuals at risk for dementia, potentially enabling earlier therapeutic intervention.
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Open AccessReview
Dysregulated Neurotransmitters and CB1 Receptor Dysfunction and Their Roles in Agitation Associated with Alzheimer’s Disease
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Jagadeesh S. Rao, María Alejandra Tangarife, Diego A. Rodríguez-Soacha, María Juanita Arbelaez, María Margarita Venegas, Laura Delgado-Murillo, Saadia Shahnawaz, Claudia Grimaldi, Evelyn Gutiérrez and Ram Mukunda
J. Dement. Alzheimer's Dis. 2025, 2(2), 15; https://doi.org/10.3390/jdad2020015 - 1 Jun 2025
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Alzheimer’s disease (AD) is characterized by the progressive loss of cognitive function and is frequently accompanied by neuropsychiatric symptoms (NPS). Pathologically, AD is defined by two hallmark features: the extracellular accumulation of β-amyloid and the intracellular hyperphosphorylation of the tau protein. In addition
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Alzheimer’s disease (AD) is characterized by the progressive loss of cognitive function and is frequently accompanied by neuropsychiatric symptoms (NPS). Pathologically, AD is defined by two hallmark features: the extracellular accumulation of β-amyloid and the intracellular hyperphosphorylation of the tau protein. In addition to these primary changes, several other abnormalities are associated with the disease, including neuroinflammation, synaptic loss, oxidative stress, neurotransmitter imbalance, and genetic and epigenetic alterations. NPS in AD encompass a range of symptoms, such as anxiety, apathy, agitation, depression, and psychosis. These symptoms are thought to arise partly from the damage caused by the pathological hallmarks of AD, which impair various neurotransmitter systems. Altered levels of several neurotransmitters, including gamma-aminobutyric acid (GABA), serotonin (5-HT), dopamine (DA), and the cholinergic and noradrenergic systems, have been implicated in the development of agitation. Additionally, reduced endocannabinoid system (ECS) functionality, particularly cannabinoid receptor 1 (CB1R), has been linked to neurobehavioral alterations. Preclinical studies suggest that a decrease in CB1R levels is associated with aggressive behavior, and CB1R agonists have demonstrated beneficial effects in alleviating agitation and related symptoms. Given these findings, the current review focuses on the therapeutic potential of targeting neurotransmitter systems and CB1R dysfunction to manage agitation in AD.
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Open AccessArticle
The Potential of Cultural Elements in the Sensory and Cognitive Stimulation of Persons with Dementia: An Exploratory Study Through Textile Artefacts
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Cláudia Lima, Susana Barreto and Catarina Sousa
J. Dement. Alzheimer's Dis. 2025, 2(2), 14; https://doi.org/10.3390/jdad2020014 - 26 May 2025
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Background/Objectives: This article addresses an exploratory design study in the framework of the REMIND research study, which is focused on the importance of cultural and biographical components for the cognitive and sensory stimulation of persons with dementia. Through a case study conducted at
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Background/Objectives: This article addresses an exploratory design study in the framework of the REMIND research study, which is focused on the importance of cultural and biographical components for the cognitive and sensory stimulation of persons with dementia. Through a case study conducted at a Day Centre from the Alzheimer Portugal association, it aims to demonstrate the relevance of including cultural elements in sensory stimulation artefacts for persons with dementia. It is hypothesised that the inclusion of cultural elements central to the biographical stories of these persons will have greater potential to stimulate their senses and reminiscences. In the context of this study, this hypothesis was explored through textile artefacts. Methods: Methods included participant observation, sensory and visual ethnography, interviews, focus groups, and a participatory design approach involving women with moderate and advanced Alzheimer’s disease and health professionals. Due to the severely compromised verbal communication abilities of some of the women, beyond-verbal communication strategies were adopted. Results: The results showed that textiles with a cultural presence tended to elicit greater reactions and reminiscences of events associated with the women’s life stories. Crochet artefacts were of particular relevance: women’s involvement in activities with crochet artefacts was substantially higher and, in certain cases of women with moderate dementia, these artefacts activated positive memories of the person, suggesting the potential of crochet for sensory stimulation. Conclusions: The results support the hypothesis; however, further research exploring other cultural elements and involving a broader demographic is needed. Based on the results obtained, a sensory blanket was developed, which is already in use at the Centre.
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Open AccessSystematic Review
Effects of Alzheimer’s Dementia Treatment on Agitation and Aggression: A Systematic Review
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Panoraia Baka, Parmenion P. Tsitsopoulos, Thomas Tegos and Effrosyni Koutsouraki
J. Dement. Alzheimer's Dis. 2025, 2(2), 13; https://doi.org/10.3390/jdad2020013 - 2 May 2025
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Introduction—Aim: Agitation and aggression are common symptoms in people with Alzheimer’s disease and other dementias. This systematic review outlines the current evidence for the effect of antidementia treatments on agitation and aggression in patients with Alzheimer’s disease. Methods: The literature search was performed
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Introduction—Aim: Agitation and aggression are common symptoms in people with Alzheimer’s disease and other dementias. This systematic review outlines the current evidence for the effect of antidementia treatments on agitation and aggression in patients with Alzheimer’s disease. Methods: The literature search was performed by manually checking articles published since 2000 in the following databases: PubMed, ResearchGate, and Google Scholar, following the PRISMA guidelines. Results: Nineteen double blinded placebo-controlled trials were included. Treatment with galantamine seems to provide more credible evidence for treating or preventing agitation/aggression. Studies on memantine often presented with an improvement of the neuropsychiatric inventory but not specifically on agitation/aggression. The trials on donepezil and rivastigmine either did not include enough information on agitation/aggression or did not provide compelling results. The incidence of agitation as an adverse event was not higher in antidementia treatments compared to placebo. Conclusions: Agitation and aggression are common symptoms of Alzheimer’s disease and have a significant impact on the patient, caregiver, and the broader healthcare system. The current literature lacks robust evidence on which of the antidementia treatments could be used to manage or prevent agitation and aggression in Alzheimer’s disease. In most included studies, no specific scores that assess those symptoms were used. Future research that specifically focuses on different disease phenotypes and behavioral profiles to enhance and facilitate the management of these symptoms is needed.
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Open AccessArticle
Exploring Functional Brain Networks in Alzheimer’s Disease Using Resting State EEG Signals
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Vangelis P. Oikonomou, Kostas Georgiadis, Ioulietta Lazarou, Spiros Nikolopoulos, Ioannis Kompatsiaris and PREDICTOM Consortium
J. Dement. Alzheimer's Dis. 2025, 2(2), 12; https://doi.org/10.3390/jdad2020012 - 2 May 2025
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Background/Objectives: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that disrupts functional brain connectivity, leading to cognitive and functional decline. Electroencephalography (EEG), a noninvasive and cost-effective technique, has gained attention as a promising tool for studying brain network alterations in AD. This
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Background/Objectives: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that disrupts functional brain connectivity, leading to cognitive and functional decline. Electroencephalography (EEG), a noninvasive and cost-effective technique, has gained attention as a promising tool for studying brain network alterations in AD. This study aims to leverage EEG-derived connectivity metrics to differentiate between healthy controls (HC), subjective cognitive decline (SCD), mild cognitive impairment (MCI), and AD, offering insights into disease progression. Methods: Using graph theory-based analysis, we extracted key connectivity metrics from resting-state EEG signals, focusing on the betweenness centrality and clustering coefficient. Statistical analysis was conducted across multiple EEG frequency bands, and discriminant analysis was applied to evaluate the classification performance of connectivity metrics. Results: Our findings revealed a progressive increase in theta-band betweenness centrality and a concurrent decrease in alpha- and beta-band centrality, reflecting AD-related network reorganization. Among the examined metrics, theta-band betweenness centrality exhibited the highest discriminative power in distinguishing AD stages. Additionally, classification performance using connectivity metrics was comparable to advanced deep learning models, highlighting their potential as predictive biomarkers. Conclusions: EEG-derived connectivity metrics demonstrate strong potential as noninvasive biomarkers for the early detection and monitoring of AD progression. Their effectiveness in capturing network alterations underscores their value in clinical diagnostic workflows, offering a scalable and interpretable alternative to deep learning-based models for AD classification.
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Open AccessArticle
Relationship Between the Severity of Subjective Cognitive Decline and Health-Related Quality of Life in Community-Dwelling Older Adults: A Cross-Sectional Study Focusing on Sex Differences
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Akio Goda, Hideki Nakano, Yuki Kikuchi, Jun Horie, Kayoko Shiraiwa, Teppei Abiko, Tsuyoshi Katsurasako, Kohei Mori and Shin Murata
J. Dement. Alzheimer's Dis. 2025, 2(2), 11; https://doi.org/10.3390/jdad2020011 - 1 May 2025
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Background/Objectives: Sex differences in the relationship between subjective cognitive decline (SCD) and health-related quality of life (HRQOL), as well as psychological and physical factors affecting this relationship, have not been fully investigated. In this study, we aimed to examine the relationship between
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Background/Objectives: Sex differences in the relationship between subjective cognitive decline (SCD) and health-related quality of life (HRQOL), as well as psychological and physical factors affecting this relationship, have not been fully investigated. In this study, we aimed to examine the relationship between SCD severity and HRQOL in community-dwelling older adults in Japan and to clarify the psychological and physical factors affecting this relationship by sex. Methods: This cross-sectional study included 456 community-dwelling older adults and was conducted in September 2024. SCD severity was evaluated using the visual analog scale, and HRQOL was assessed using the EuroQol 5-Dimensions 5-Levels. Psychological factors (depression and insomnia) and physical factors (pain and frailty) were measured, and the relationship between SCD and HRQOL was analyzed by sex. Results: In women, HRQOL decreased as SCD severity increased and was associated with depression, insomnia, and physical pain. Conversely, in men, the association between SCD and HRQOL was not significant, and HRQOL was mainly associated with physical health factors, including pain and frailty. Conclusions: There were sex differences in the relationship between SCD and HRQOL, with women’s awareness of SCD associated with a decline in HRQOL, whereas physical health was the main determinant in men. Sex-specific interventions with psychological support being effective for women and support focusing on maintaining physical health for men are warranted.
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Open AccessBrief Report
Target the Heart: A New Axis of Alzheimer’s Disease Prevention
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Lawrence I. Heller, Allison S. Lowe, Thaís Del Rosario Hernández, Sayali V. Gore, Mallika Chatterjee and Robbert Creton
J. Dement. Alzheimer's Dis. 2025, 2(2), 10; https://doi.org/10.3390/jdad2020010 - 1 May 2025
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Background/Objective: Cyclosporine A and other calcineurin inhibitors have been identified as prospective treatments for preventing Alzheimer’s disease. We previously found that calcineurin inhibitors elicit a unique behavioral profile in zebrafish larvae, characterized by increased activity, acoustic hyperexcitability, and reduced visually guided behaviors. Screening
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Background/Objective: Cyclosporine A and other calcineurin inhibitors have been identified as prospective treatments for preventing Alzheimer’s disease. We previously found that calcineurin inhibitors elicit a unique behavioral profile in zebrafish larvae, characterized by increased activity, acoustic hyperexcitability, and reduced visually guided behaviors. Screening a large library of FDA-approved compounds using Z-LaP Tracker revealed that some heart medications produce a similar behavioral profile, suggesting these drugs may exert calcineurin-inhibitor-like effects relevant to prevent-ing or ameliorating Alzheimer’s disease. Methods: Screening a large library of FDA-approved drugs using Z-LaP Tracker, a neural network model, revealed a cluster of 65 drugs demonstrating a cyclosporine A-like behavioral profile. Fourteen of these drugs were heart medications, including angiotensin receptor blockers, beta blockers, al-pha-adrenergic receptor antagonists, and a statin. Results: Dual administration of the heart medications with cyclosporine A in Z-LaP Tracker revealed synergistic effects: lower doses of each heart medication could be delivered in conjunction with a lower dose of cyclosporine A to evoke a similar or larger behavioral effect than higher doses of each drug independently. Other studies have shown that many of these heart medica-tions drugs directly or indirectly inhibit the calcineurin–NFAT pathway, like cyclo-sporine A, providing a potential mechanism. Conclusions: Co-administering a low dose of cyclosporine A with select cardiac drugs could be a potentially effective treatment strategy for preventing Alzheimer’s disease occurrence and simultaneously treating cardiovascular dysfunction, while mitigating the side effects associated with higher doses of cyclosporine A. Given that heart disease precedes Alzheimer’s disease in many patients, physicians may be able to create a treatment regimen that addresses both con-ditions. Our results suggest that a calcineurin inhibitor combined with simvastatin, irbesartan, cilostazol, doxazosin, or nebivolol is the most promising candidate for future exploration.
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Open AccessArticle
Sex Difference in the Associations of Socioeconomic Status, Cognitive Function, and Brain Volume with Dementia in Old Adults: Findings from the OASIS Study
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Sophia Z. Liu, Ghazaal Tahmasebi, Ying Sheng, Ivo D. Dinov, Dennis Tsilimingras and Xuefeng Liu
J. Dement. Alzheimer's Dis. 2025, 2(2), 9; https://doi.org/10.3390/jdad2020009 - 3 Apr 2025
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Background: Sex differences in the association of cognitive function and imaging measures with dementia have not been fully investigated. Understanding sex differences in the dementia-related socioeconomic, cognitive, and imaging measurements is crucial for uncovering sex-related pathways to dementia and facilitating early diagnosis,
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Background: Sex differences in the association of cognitive function and imaging measures with dementia have not been fully investigated. Understanding sex differences in the dementia-related socioeconomic, cognitive, and imaging measurements is crucial for uncovering sex-related pathways to dementia and facilitating early diagnosis, family planning, and cost control. Methods: We selected data from the Open Access Series of Imaging Studies, with longitudinal measurements of brain volumes, on 150 individuals aged 60 to 96 years. Dementia status was determined using the Clinical Dementia Rating (CDR) scale, and Alzheimer’s disease was diagnosed as a CDR of ≥0.5. Generalized estimating equation models were used to estimate the associations of socioeconomic, cognitive, and imaging factors with dementia in men and women. Results: The study sample consisted of 88 women (58.7%) and 62 men (41.3%), and the average age of the subjects was 75.4 years at the initial visit. A lower socioeconomic status was associated with a reduced estimated total intracranial volume in men, but not in women. Ageing and lower MMSE scores were associated with a reduced nWBV in both men and women. Lower education affected dementia more in women than in men. Age, education, Mini-Mental State Examination (MMSE), and normalized whole-brain volume (nWBV) were associated with dementia in women, while only MMSE and nWBV were associated with dementia in men. Conclusions: The association between education and the prevalence of dementia differs in men and women. Women may have more risk factors for dementia than men.
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Open AccessArticle
The Impact of Digital Cognitive Stimulation Therapy Combined with Online Hearing Training on Quality of Life in Dementia Patients
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Gregor Hohenberg, Jan Ehlers and Thomas Ostermann
J. Dement. Alzheimer's Dis. 2025, 2(2), 8; https://doi.org/10.3390/jdad2020008 - 2 Apr 2025
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Background: Dementia patients often experience a decline in both their cognitive and sensory functions, particularly hearing, which significantly impacts their quality of life. This study evaluates the effectiveness of a combined Digital Cognitive Stimulation Therapy (DKST) and online hearing training intervention in
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Background: Dementia patients often experience a decline in both their cognitive and sensory functions, particularly hearing, which significantly impacts their quality of life. This study evaluates the effectiveness of a combined Digital Cognitive Stimulation Therapy (DKST) and online hearing training intervention in enhancing the quality of life of individuals with dementia. Methods: Twenty-three patients participated in a six-month program integrating cognitive exercises and hearing rehabilitation, facilitated by trained co-therapists. Quality of life was assessed using the Quality of Life (QoL) Questionnaire, while the Mini-Mental State Examination (MMSE) was employed to categorize participants based on their cognitive status. Results: The results revealed significant improvements in the overall quality of life. Conclusions: This study demonstrates that combining DKST with hearing training effectively addresses sensory and cognitive challenges, supporting improved quality of life and highlighting the potential of digital interventions in dementia care.
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Open AccessArticle
Game on: Staff Insights into Gamified Exercise for Long-Term Care Residents Living with Dementia—A Pilot Study
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Lillian Hung, Jamie Lam, Karen Lok Yi Wong, Joey Oi Yee Wong, Lily Haopu Ren, Nibedita Chakraborty and Yong Zhao
J. Dement. Alzheimer's Dis. 2025, 2(2), 7; https://doi.org/10.3390/jdad2020007 - 1 Apr 2025
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Background/Objectives: The aging population presents significant challenges to healthcare systems, with conditions like dementia severely affecting the quality of life for older adults, especially those in long-term care. Gamification has the potential to motivate older adults to engage in exercise by transforming
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Background/Objectives: The aging population presents significant challenges to healthcare systems, with conditions like dementia severely affecting the quality of life for older adults, especially those in long-term care. Gamification has the potential to motivate older adults to engage in exercise by transforming physical activities into enjoyable experiences. Incorporating gaming elements in cycling exercises can foster a sense of interest and achievement, potentially improving health outcomes. This pilot study aims to explore interdisciplinary staff perspectives on using a digital game to motivate cycling exercise among residents living with dementia in long-term care (LTC). Methods: This study applied a qualitative description design. Using an interpretive description approach, we conducted focus groups with 29 staff members, including recreational therapists, rehabilitation therapists, nurses, care aides, and leadership in an LTC home. The consolidated framework for implementation research (CFIR) guided the data analysis to identify barriers and facilitators to adopting the digital game. Results: Engaging LTC residents living with dementia presents various challenges. Identified potential barriers to implementing the cycling game include cognitive and physical limitations, resistance to change, and intervention complexity. Frontline staff strategies include flexible invitations, social groups, making it fun, and building rapport. Success relies heavily on its cultural and individual relevance, along with strong support from leadership, peers, and family. Conclusions: This pilot study explored staff perspectives on the potential integration of a gamified cycling intervention for older adults with dementia in long-term care settings. Staff emphasized that successful implementation would depend on addressing key barriers and identifying enabling strategies. Based on these findings, practice implications were provided to support effective integration. Further research, including resident input and long-term evaluations, is needed to assess the feasibility, acceptance, and effectiveness of gamification in promoting health outcomes for this population. This study adhered to the COREQ Checklist.
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Open AccessArticle
Post-Pandemic Attitudes Towards Participation in Research on Singing: Results of an Online Survey of People with Dementia and Their Carers
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Becky Dowson and Justine Schneider
J. Dement. Alzheimer's Dis. 2025, 2(1), 6; https://doi.org/10.3390/jdad2010006 - 3 Mar 2025
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Aim: Our aim was to survey people with dementia and their carers with respect to their propensity to join a randomized trial of community singing in dementia, in the context of uncertainty following the COVID-19 pandemic. Method: We employed an online anonymous questionnaire,
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Aim: Our aim was to survey people with dementia and their carers with respect to their propensity to join a randomized trial of community singing in dementia, in the context of uncertainty following the COVID-19 pandemic. Method: We employed an online anonymous questionnaire, comparing activities before and after lockdown, worries about COVID-19, whether people would attend a singing group and what measures might make this more likely. With a target sample of 100, the survey was distributed to the general population of people with dementia and carers in the UK between June and August 2022. Results: We had a total of 168 respondents, of whom 30% were people living with dementia and 70% were carers. Those who were not worried (roughly 62%) were more likely to go out to groups. Worries about COVID-19 affected 38% of respondents but some judged the risk of going out to be worthwhile. Most felt able to take adequate precautions against infection. However, COVID-19 transmission was not the main impediment to attending a singing group and 19% of respondents were simply not interested in doing so, while mobility and shyness deterred others. Conclusions: Given recruitment problems, quantitative studies of singing in dementia need to take account of individual preferences as well as contextual barriers, including fear of virus transmission, individual perceptions of the intervention and logistical obstacles to participation.
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Open AccessArticle
Palliative Care in the Community and the Relevance of Percutaneous Endoscopic Gastrostomy Placement to Quality of Life and Survival
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Júlia Magalhães, Hugo Ribeiro, Inês Rodrigues, Elisabete Costa, João Rocha Neves, José Paulo Andrade, António Bernardes and Marília Dourado
J. Dement. Alzheimer's Dis. 2025, 2(1), 5; https://doi.org/10.3390/jdad2010005 - 1 Mar 2025
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Introduction: Percutaneous endoscopic gastrostomy (PEG) placement does not generate consensus in palliative care, given the existing doubts about whether it significantly contributes to an improvement in patient outcomes such as survival, quality of life and symptomatic control. Objective: This study explored
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Introduction: Percutaneous endoscopic gastrostomy (PEG) placement does not generate consensus in palliative care, given the existing doubts about whether it significantly contributes to an improvement in patient outcomes such as survival, quality of life and symptomatic control. Objective: This study explored the impact of percutaneous endoscopic gastrostomy placement on survival and quality of life in patients under community palliative care in Northern Portugal. Methods: This observational, retrospective cohort study involved 54 patients monitored by a specialized palliative care team between March 2020 and December 2023. The key outcomes assessed included the survival rates, the main diagnoses leading to PEG requests, and the influence of PEG placement on survival and the place of death. Results: The statistical analysis revealed that the survival time was significantly longer in females compared to males (p = 0.003). The main reason for PEG requests was dysphagia, especially in patients with dementia and oncological diseases. No significant correlations were found between PEG placement and the age at death, survival time, or palliative performance scores (PPS). However, the study identified a moderate positive correlation between the follow-up time and survival after PEG placement (r = 0.457, p < 0.001) and a low rate of complications (11% of patients with minor complications and none with severe complications). Conclusions: This study emphasizes the role of timely PEG placement and social support in improving patient outcomes. Additionally, patients whose PEG was requested by the study’s palliative care team demonstrated better survival outcomes compared to those referred by other teams. The findings underscore the need for individualized decision-making in PEG placement and suggest that this procedure is safe and increases patient longevity and quality of life, avoiding the high rate of complications associated with nasogastric tubes in fragile patients in need of specialized palliative care.
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Open AccessArticle
Alterations in Causal Functional Brain Networks in Alzheimer’s Disease: A Resting-State fMRI Study
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Rahul Biswas and SuryaNarayana Sripada
J. Dement. Alzheimer's Dis. 2025, 2(1), 4; https://doi.org/10.3390/jdad2010004 - 12 Feb 2025
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(1) Background: Alterations in brain functional connectivity (FC) precede clinical symptoms of Alzheimer’s disease (AD) by decades, presenting opportunities for early diagnosis. However, conventional FC analyses measure correlations between brain regions and do not provide insights into directional, causal interactions. Causal functional connectivity
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(1) Background: Alterations in brain functional connectivity (FC) precede clinical symptoms of Alzheimer’s disease (AD) by decades, presenting opportunities for early diagnosis. However, conventional FC analyses measure correlations between brain regions and do not provide insights into directional, causal interactions. Causal functional connectivity (CFC), which infers directed interactions between regions, addresses this limitation. This study aims to identify disrupted CFC networks in AD compared to cognitively normal (CN) individuals. (2) Methods: The recently developed Time-aware PC (TPC) algorithm was employed to infer directed CFC from functional magnetic resonance imaging (fMRI) data. These results were compared with traditional correlation-based FC obtained via sparse partial correlation. Network-based Statistics (NBS) for directed networks was used to identify altered CFC sub-networks, with corrections for multiple comparisons applied at the 5% significance level. (3) Results: Key causal networks, including the inferior frontal gyrus, superior temporal gyrus, middle temporal gyrus, and cerebellum, showed significantly reduced strength in AD compared to CN (p = 0.0299; NBS corrected). Instead of detecting disruptions at the level of individual edges, this study identifies network-level alterations, revealing systemic disruptions in brain connectivity. (4) Conclusions: This study demonstrates the utility of CFC analysis in uncovering network-level disruptions in AD. The identified disrupted networks align with published medical literature and provide a framework for future studies with larger datasets.
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Benefits of Treating Obstructive Sleep Apnea in Cognition: Systematic Literature Review
by
Júlia Montalvão Neves, Cátia Andreia Maciel and Pedro Alexandre-Sousa
J. Dement. Alzheimer's Dis. 2025, 2(1), 3; https://doi.org/10.3390/jdad2010003 - 3 Feb 2025
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Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent hypoxia, sleep fragmentation, daytime sleepiness, cognitive impairment, and brain cell damage due to brain blood flow reduction, with ischemic damage, increased microvascular reactivity, and brain tissue damage. OSAS is strongly linked to chronic,
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Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent hypoxia, sleep fragmentation, daytime sleepiness, cognitive impairment, and brain cell damage due to brain blood flow reduction, with ischemic damage, increased microvascular reactivity, and brain tissue damage. OSAS is strongly linked to chronic, neurodegenerative, and inflammatory cerebrovascular disease and cognitive impairment. Continuous positive airway pressure (CPAP) is the first-line treatment for OSAS. Objective: This article aims to evaluate the effect of CPAP treatment on neurocognitive performance in OSAS patients with mild cognitive impairment or dementia by reviewing the literature. Methods: We performed a comprehensive review of the Portuguese and English languages without a time limit using the following Mesh terms: dementia, mild cognitive impairment, obstructive sleep apnea, and CPAP. We included randomized controlled trials (RCTs), meta-analyses, and systematic reviews (SRs) where the impact of CPAP on neurocognitive performance was addressed. Results: Five SRs and three RCTs reported significant improvements in neurocognitive performance, especially in verbal, visuospatial, and working memory. Conclusion: CPAP treatment seems to improve cognitive defects associated with OSA.
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An Overview of Transgenic Mouse Models for the Study of Alzheimer’s Disease
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Paula Alexandra Lopes, Mafalda Soares Pádua and José L. Guil-Guerrero
J. Dement. Alzheimer's Dis. 2025, 2(1), 2; https://doi.org/10.3390/jdad2010002 - 10 Jan 2025
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Alzheimer’s disease (AD) is the most common cause of dementia, and no cure is currently available. The β-amyloid cascade of AD and neurofibrillary tangles are the basis of the current understanding of AD pathogenesis, driving drug investigation and other discoveries. Up until now,
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Alzheimer’s disease (AD) is the most common cause of dementia, and no cure is currently available. The β-amyloid cascade of AD and neurofibrillary tangles are the basis of the current understanding of AD pathogenesis, driving drug investigation and other discoveries. Up until now, no AD models have entirely validated the β-amyloid cascade hypothesis. AD models must be capable of recapitulating the critical events of this pathology, including β-amyloid plaques and neurofibrillary tangles. The development of plaques is probably derived from the amyloid precursor protein (APP) and presenilin 1 (PS1) familial Alzheimer’s disease (FAD) mutations, while the tangle-like pathology is determined by tau mutations. Transgenic mouse models struggle to replicate the entire spectrum of AD, particularly neuronal death stemming from β-amyloid and tau pathologies. Furthermore, the success of these transgenic mice often relies on the overexpression of APP transgenes enclosing FAD-associated mutations at levels beyond physiological. Ultimate species-specific discrepancies in genome and protein composition between the human and the mouse may hinder the accurate recapitulation of AD pathological events in mouse models. Although none of the AD models fully mirrors human pathology, these experimental in vivo animal models have provided valuable insights into β-amyloid toxicity and the overall pathophysiological basis of AD. Therefore, these experimental models have been widely used in the preclinical evaluation of therapeutic strategies and have played a pivotal role in the development of immunotherapies for AD. In this review, we sum up the main transgenic mouse models used for AD research, whether they are APP mutation-based mice, APP plus presenilin mutation-based mice, or tau mutation-based mice. The specific characteristics of each mouse model and the significance of their use for AD research, focusing on their current advantages and disadvantages, as well as on the progress made and the forthcoming challenges in replicating this neurodegenerative disease, are also highlighted.
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Open AccessArticle
Fidelity Assessment Tool for a Dementia Carers’ Group-Psychotherapy Intervention
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Mary Chiu, Laura J. Nelles, Virginia Wesson, Andrea Lawson and Joel Sadavoy
J. Dement. Alzheimer's Dis. 2025, 2(1), 1; https://doi.org/10.3390/jdad2010001 - 30 Dec 2024
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Context: The systematic evaluation of a practitioner’s adherence to and competence in delivering psychotherapeutic interventions can be complex. This study describes the development of a fidelity assessment tool for the Reitman Centre CARERS Program (RCCP), a carer group-psychotherapy intervention with multiple didactic and
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Context: The systematic evaluation of a practitioner’s adherence to and competence in delivering psychotherapeutic interventions can be complex. This study describes the development of a fidelity assessment tool for the Reitman Centre CARERS Program (RCCP), a carer group-psychotherapy intervention with multiple didactic and clinical components. The tool’s value in informing psychotherapy training and best practices for practitioners from diverse professional settings is examined. Methods: The RCCP Fidelity Assessment Tool (RCCP-FAT) was developed following an iterative process of item writing and checking. Seven components of the RCCP—Group Structure, Dementia Education, Problem-Solving Techniques, Therapeutic Simulation, Vertical Cohesion, Horizontal Cohesion, and Overall Global Rating—were assessed, with three to eight items, and a “global score” assigned to each. Fifteen trained raters were paired up to rate 36 RCCP sessions using the RCCP-FAT. Rater agreement, correlation between itemized and global scores, and correlation between global ratings and RCCP participants’ satisfaction were calculated. Results: A total of 1188 RCCP-FAT items were rated by each of the two rater groups. Rater agreement was calculated to be 54.3% (κ = 0.32; 95% CI, 0.02681–0.3729). A positive correlation was found between the itemized and global scoring for four RCCP components evaluated (R = 0.833 to 0.929; p < 0.01). The global score and the participants’ satisfaction with “Simulation” was also positively correlated (R = 0.626, p < 0.01). Conclusions: The study provided evidence for fair rater agreement for all RCCP-FAT assessment items. More importantly, the process of developing the tool systematically crystallized the clinical elements of the RCCP and helped to standardize the training methods by creating a framework for providing feedback to learners that matches the items on the RCCP-FAT. The use of the RCCP-FAT to guide the training and mentoring of incoming group leaders is essential in the scaling and dissemination of a complex training method like the RCCP to ensure fidelity to the original evidence-based intervention.
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Open AccessReview
Neural Stem Cell Therapy for Alzheimer’s Disease: A-State-of-the-Art Review
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Abdul Jalil Shah, Mohammad Younis Dar, Bisma Jan, Insha Qadir, Reyaz Hassan Mir, Jasreen Uppal, Noor Zaheer Ahmad and Mubashir Hussain Masoodi
J. Dement. Alzheimer's Dis. 2024, 1(2), 109-125; https://doi.org/10.3390/jdad1020008 - 6 Nov 2024
Cited by 2
Abstract
Alzheimer’s disease (AD) is a brain disorder that is more prevalent in developed nations and remains one of most intractable conditions so far. It is characterized by a gradual onset, a prolonged progression, and an unclear pathophysiology. At the present time, there are
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Alzheimer’s disease (AD) is a brain disorder that is more prevalent in developed nations and remains one of most intractable conditions so far. It is characterized by a gradual onset, a prolonged progression, and an unclear pathophysiology. At the present time, there are no effective treatments available for the disease. However, human neural stem cells (hNSCs) have the capacity to substitute lost neurons in a functional manner, strengthen synaptic networks that have been compromised, and repair the damaged brain. Due to the unavailability of restorative therapeutics, there is a significant global burden on the economy. When it comes to the treatment of neurodegenerative diseases, NSCs provide a potentially game-changing approach to treating Alzheimer’s disease. Through the delivery of trophic factors that promote the viability and regeneration of lost neurons in experimental animals suffering from neurodegenerative disorders, these treatments have the potential to facilitate beneficial recuperation. Positive restorative outcomes may be achieved in a variety of ways, including the replacement of lost cells, the combining of cells, the secretion of neurotrophic factors, the formation of endogenous stem cells, and transdifferentiation. Conversely, there are obstacles that need to be overcome before NSC-based treatments can be used in clinical settings. This review article discusses current developments in the use of neural stem cells (NSCs) for the treatment of Alzheimer’s disease (AD). In addition, we highlight the difficulties and opportunities that are involved with the use of neural stem cell transplant treatment for Alzheimer’s disease.
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(This article belongs to the Special Issue Novel Therapies for Neurodegenerative Disorders)
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