Search Results (164)

Background: In line with international aging policies, most people with dementia receive care at home. Community-based respite services aim to relieve, support, or share caregiving responsibilities. More person-centered knowledge based on experiences from this group is needed to increase informed decisions about planning of qualitative respite care. The aim of this study is to describe how people with dementia experience respite care with alternating housing, i.e., living partly at home, partly in residential care, refer to their everyday life and well-being. Methods: A mixed-methods design was used. The qualitative approach focused on variations of dilemmas in interviews with people with dementia who were granted and received respite care (n = 8). Also, a quantitative approach focused on quality of life using behavioral and psychological symptom scores. Results: Everyday life at the respite care accommodation described by people with dementia included morning routines, variation in the environment, activities in the company of roommates, but also a lack of activities. Social belonging was described by people with dementia through living with roommates and through social contact with the healthcare staff. Quality of life and behavioral and psychological ratings varied between individuals and settings, but no consistent pattern was identified. Conclusions: Respite care appears to maintain a high quality of life and a low level of psychological symptoms for most of the people with dementia. Although the sample was small, these results are nevertheless an important contribution to the phenomenon, experiences of respite care by people with dementia, that need further research. Furthermore, these results can give decision-makers guidance for professional care efforts. Full article

Artificial intelligence-enabled technologies offer new opportunities to support healthy aging and the long-term care needs of older adults. However, inclusive practices are paramount to ensuring that accessibility, usability, privacy, and equitable use are factored into the design and deployment of these emerging technologies. This article explores the role of co-design in health technology development and highlights the application of three methodological tools—the NIH Stage Model for Behavioral Intervention Development, the Unified Theory of Acceptance and Use of Technology, and Goal Attainment Scaling—to create a smart-home-based socially assistive robot (SAR) for the care of individuals living with Alzheimer’s disease and related dementias (ADRD). Ten participants (five caregiver–care recipient dyads) from an ongoing mixed-methods pilot feasibility study trialed the SAR in their homes for 1–6 months, with the robot personalized to their daily functioning, home layout, and caregiving needs. Qualitative analysis of monthly interviews derived themes pertaining to technical design, care protocol design, training management, and complementary care. These themes, combined with goal attainment analysis, offered several insights that allowed us to iteratively scale and refine the technology tailored to ADRD care. The study offers a practical framework for future co-design efforts aimed at enhancing the adoption of AI-enabled health technologies among older adults. Full article

Background and Objectives: Functional decline is a major determinant of disability, caregiver burden, and loss of independence in behavioral variant frontotemporal dementia (bvFTD). Although bvFTD is characterized by early and rapidly progressive deterioration in everyday functioning, the multimodal contributors associated with longitudinal functional change remain insufficiently understood. The present study aimed to identify the strongest cognitive, behavioral, personality, and neuroimaging correlates of longitudinal functional deterioration in bvFTD using an integrated multimodal framework over a 12-month follow-up period. Methods: Twenty-seven patients diagnosed with bvFTD were recruited from the 2nd Neurology Clinic of the “AHEPA” University Hospital in Thessaloniki, Greece, and underwent comprehensive face-to-face neuropsychological assessment for the evaluation of a wide range of cognitive domains, alongside caregiver-based evaluations of behavioral disturbances, personality changes, and functional abilities, at baseline, 6 months, and 12 months. Brain perfusion single-photon emission computed tomography (SPECT) was acquired only at baseline, with regional cerebral blood flow (rCBF) quantified using a Brodmann area (BA)-based approach. Functional status was assessed using the Disability Assessment for Dementia (DAD) as the primary outcome, while the Frontotemporal Dementia Rating Scale (FRS) served as a secondary measure. Repeated-measures analysis of variance (ANOVA) was used to characterize longitudinal changes across cognitive, behavioral, personality, and functional domains, while linear mixed-effects (LME) models were applied to identify longitudinal correlates of functional decline and sources of inter-individual variability in functional outcomes. Results: Significant progressive decline in functional abilities was observed over the 1-year follow-up period, consistent with an aggressive and rapidly deteriorating clinical course in bvFTD. Reductions in functional performance were evident across both basic and instrumental activities of daily living, with deterioration being more pronounced in instrumental activities. Based on the final LME model, greater apathy-related (negative) behavioral symptoms, global cognitive impairment, attentional and processing speed deficits, and impaired inhibitory control were independently associated with poorer longitudinal functional outcomes (p < 0.001). At the neuroimaging level, reduced baseline perfusion in the right BA 24 within the anterior cingulate cortex was also significantly associated with greater loss of functional independence over time (p < 0.001). Conclusions: Longitudinal functional decline in bvFTD reflects the combined disruption of behavioral regulation, global cognition, executive control, and frontal–cingulate network integrity. The findings provide a preliminary foundation for future research investigating factors associated with accelerated functional decline. Further validation in larger, multicenter longitudinal cohorts is needed to determine the prognostic relevance of these factors and their potential applicability to patient stratification and individualized care planning. Full article

Current models of dementia care often perpetuate the legacies of colonization, which highlights the need for a culturally congruent approach. This research describes the necessary components to co-develop a freely available Indigenous-centered dementia model of care in partnership with Indigenous individuals living with dementia, their families, and communities. To prioritize ethical and decolonial research approaches, sequential focus groups were used alongside Keeoukaywin (The Visiting Way)—an Indigenous methodology deeply rooted in Métis and Cree ways of knowing—guided by a group of advisors and Elders. The data were co-analyzed using reflexive thematic analysis guided by Indigenous principles. Three themes were generated: Indigenization, Personalization, and the Intersection of Challenges and Innovations, to illustrate how dementia care can be operationalized and adapted to various cultural and care contexts. This research offers a foundation for developing dementia care that truly aligns with Indigenous ways of doing. Full article

Background/Objectives: Assessment of cognitive function in patients with dementia is often hindered by functional and environmental barriers. Although caregiver reports are an alternative source, their clinical utility for estimating patients’ cognitive function remains uncertain. This study aimed to estimate cognitive function using caregiver-reported data combined with patient demographics and to evaluate its clinical utility. Methods: This retrospective cross-sectional study enrolled participants who visited a memory clinic and completed the Montreal Cognitive Assessment (MoCA) for cognitive assessment, together with caregiver-reported questionnaires for activities of daily living (ADL) and neuropsychiatric symptoms (NPS). Multivariable linear regression models were constructed to predict the MoCA score, with Model 1 including demographics, ADL, and NPS as covariates and Model 2 further incorporating clinical diagnosis. The intraclass correlation coefficient, Bland–Altman analysis, and regression error characteristic curves were assessed. Results: Among 2650 participants (56.5% women; mean age, 70.4 years), the NPS variable was excluded from both models. Model 1, which included demographics and ADL, explained 65.4% of the variance, whereas Model 2, which incorporated clinical diagnosis, explained 75.9%. Model 2 yielded an intraclass correlation coefficient of 0.853, compared to 0.778 for Model 1. At a 4-point error tolerance, Model 2 yielded an accuracy of 75.5%. Bland–Altman biases were near zero, with 95% limits of agreement of approximately ±7 points for Model 2. Conclusions: MoCA scores can be estimated using caregiver-reported ADL scores, demographics, and clinical diagnosis. NPS scores provided no additional predictive value when these factors were included. These models provide valid quantitative tools for indirect cognitive assessment when in-person testing is impossible. Full article

Background/Objectives: Persons living with dementia (PLwD) receive informal care services from loved ones, commonly referred to as care partners (CPs). While the symptoms (e.g., depressive affect, cognitive impairment) experienced by PLwD are recognized to influence CP wellbeing, longitudinal investigations into the association of CP QoL and PLwD symptoms have yet to be fully explored. The present study sought to address this gap and highlight how CP QoL and PLwD symptoms systematically covary over time. Methods: Participants were composed of 33 dyads (PLwD and their CP) who partook in the Voices in Motion project, a social-cognitive intervention for dementia. CP QoL (WHOQOL-BREF), PLwD depressive symptomology (Patient Health Questionnaire-9) and PLwD global cognitive functioning (Mini-Mental State Examination) were assessed every three to four weeks in an intensive repeated-measures design. Time-varying covariation models using multilevel modeling examined systematic covariation between CP QoL and PLwD symptoms between and within dyads. Results: Increased CP psychological and social QoL were both associated with increased PLwD global cognitive functioning between dyads and vice versa (p < 0.05). Within dyads, increased CP social QoL was associated with improved PLwD depressive symptoms (p < 0.05), while increased CP environmental QoL was associated with increased depressive symptoms (p < 0.05). Conclusions: Significant coupling associations were observed both between and within dyads. Such results highlight the association between CP QoL and the symptoms experienced by their care recipient and provide important, novel longitudinal contributions to the literature. Full article

Alzheimer’s disease and related dementias (ADRD) are neurodegenerative conditions characterized by progressive cognitive and functional decline. AD pathology is associated with extracellular amyloid-β plaques, intracellular tau neurofibrillary tangles, synaptic dysfunction, and neuronal loss. AD accounts for approximately 60–80% of dementia cases globally. In 2022, AD was the seventh leading cause of death in the United States, and the number of Americans aged 65 and older living with Alzheimer’s dementia is projected to increase substantially by 2060. Despite decades of research, AD/ADRD data resources remain fragmented across clinical, imaging, genetic, genomic, and therapeutic domains. This paper addresses that gap by providing a centralized review of widely used AD/ADRD databases and computational methods. We first summarize computational approaches used to analyze these datasets, including machine learning (ML), natural language processing (NLP), and biomedical imaging. We then review eight databases classified into three categories: Clinical and Population Data, Genetics and Genomics, and Drug Discovery and Therapeutics. Finally, we discuss real-world applications, including early diagnosis, clinical decision support, personalized medicine, and drug-mechanism analysis. This review identifies opportunities for future work in data harmonization, cross-database compatibility, and robust, generalizable AI models for AD/ADRD research. Full article

Background: Home-based digital healthcare interventions are increasingly used to support people living with dementia (PLWD) and their family caregivers. However, evidence regarding their effectiveness across patient and caregiver outcomes remains heterogeneous. Methods: This systematic review followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420261302166). Six databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Scopus) were searched from January 2000 to October 2025. Randomized and quasi-experimental quantitative studies evaluating home-based or remotely delivered digital interventions for PLWD and/or informal caregivers were included. Risk of bias was assessed using RoB 2 and ROBINS-I. Due to heterogeneity, findings were synthesized narratively. Results: Fourteen studies met the inclusion criteria. Interventions included web-based psychoeducation, telecoaching, digital cognitive training, assistive technologies, and multicomponent programs. Caregiver outcomes demonstrated the most consistent benefits, including reduced burden and stress, improved self-efficacy, and improved sleep efficiency in technology-supported trials. For PLWD, small-to-moderate improvements were observed in global cognition and selected neuropsychiatric symptoms, particularly in interactive and personalized programs. Multicomponent interventions combining caregiver education with patient activation and professional feedback showed more durable effects. Conclusions: Home-based digital interventions appear feasible and beneficial, particularly for caregiver outcomes. Future large-scale trials with longer follow-up and standardized outcome measures are needed to confirm durability, equity, and cost-effectiveness. Full article

Family care partners for persons living with dementia (PLwD) adopt a variety of care management strategies to navigate care. We utilize a convergent parallel mixed-methods design to integrate family care partners’ descriptions of care challenges and associated management approaches. Primary family care partners for PLwD (n = 100) were interviewed about their management of a care challenge (qualitative), the PLwD’s function, behavior and cognition (quantitative), and their management strategies (qualitative/quantitative). Care challenges and strategies were compared across qualitative content analysis and t-tests. Care partners providing more functional (r = 0.34, p < 0.01) and cognitive (r = 0.30, p < 0.01) care used more active management strategies, whereas care partners providing greater behavioral care (r = 0.34, p < 0.001) reported more criticism, with similar themes seen qualitatively. Active management may be required when dementia severity increases, yet criticism may emerge with greater behavioral severity. Because criticism is associated with more negative outcomes, future interventions should help care partners practice more adaptive behavioral management. Full article

Aim: Brain training games offer a promising avenue for promoting cognitive engagement and healthy aging among older adults. However, little is known about how design features align with the specific needs of this demographic to promote sustained usage and thereby cognitive intervention. The aim of this study was to characterize how all aspects of the game design and player experience might influence adherence mechanisms, and assess the feasibility and acceptability of a wearable brain-activity measuring device. Methods: We use an exploratory mixed-methods approach with n = 6 community-dwelling older adults (mean age 68 ± 3.94) within a smart-home-style Living-Lab. Participants played two commercially available brain-training games. One of the games uses a wearable brain-activity measuring device. We collected System Usability Scale (SUS) and User Experience Questionnaire (UEQ) scores and conducted focus-group interviews and structured observations. We performed a qualitative theory-informed analysis through the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) framework. Results: Participants reported high motivation to play brain-training games for dementia prevention. They preferred large, high-contrast text, intuitive navigation, touch-based controls, and a relaxed pacing. The wearable device was acceptable and comfortable for home use. There were requests for a clearer meaning of brain activity scores and the integration of personalized brain data with other health apps and broader health metrics. Quantitative scales (SUS and UEQ) showed similar ratings for both games, with both meeting the threshold for acceptability. Conclusions: In this formative study, concrete design features that plausibly increase engagement, persistence and adherence were identified, alongside evidence for the feasibility of integrating a wearable brain-sensor. Our findings motivate a follow-on trial testing whether an adherence-optimized design increases the training dose and downstream cognitive outcomes. Full article

This theoretical opinion article critiques person-centered dementia care (PCDC) for overlooking the structural dimensions of Othering and stigma. In response to these limitations, we propose three key conceptual shifts essential to overcoming Othering and stigma experienced by people with dementia. First, although PCDC emphasizes individual agency, it is constrained by institutional priorities and professional perspectives, which can unintentionally reinforce structural inequalities. Centering the lived experiences of people with dementia as essential knowledge can rebalance power and validate their expertise. Second, reducing stigma means moving beyond PCDC’s individualized focus to recognize the social conditions that perpetuate Othering. This requires inclusive interactions and professional reflection that challenge biomedical assumptions. Third, PCDC is often limited to formal care settings, neglecting how people with dementia maintain social roles and a sense of community belonging. Addressing stigma, therefore, requires extending support into everyday life through contextual, strengths-based approaches that sustain social roles. Full article

Social health is increasingly recognized as a key domain in dementia research, yet interventions explicitly addressing it remain scarce. This study presents the co-creation of an empowering and meaningful social health intervention for people living with dementia. An evidence-based intervention scaffolding was enriched with the lived experiences of people living with dementia through a seven-step co-creation process, in which they held sole decision-making authority in selecting intervention topics using an adapted World Café method, shared responsibility for designing session content, and joint responsibility for implementation. Twenty-nine residents living with dementia in three long-term care facilities co-created and implemented twelve group sessions based on their “heart topics,” emphasizing personal strengths, reciprocity, and shared experiences. Each session integrated peer-led, co-creative, and sensory elements and was collaboratively prepared and implemented together with at least one peer host. The co-creation process effectively captured the lived experiences of people living with dementia and resulted in an intervention with the potential to foster and deepen social relationships in long-term care. This study calls on researchers and practitioners to take bolder steps toward empowering people living with dementia to assume active, visible, and meaningful roles in intervention development and implementation. Full article

Background: Population aging has led to a rise in dementia prevalence, increasing the demand for innovative care models. Telemedicine offers an opportunity to improve access, continuity, and caregiver support for older adults with cognitive impairment. Methods: This qualitative descriptive study was conducted at the Geriatrics and Gerontology Service of Cassiano Antônio de Moraes University Hospital (HUCAM-UFES), Brazil. Semi-structured interviews were carried out with 11 caregivers of older adults living with dementia who participated in telemedicine consultations. Data was analyzed thematically using a reflexive thematic analysis approach. Results: Caregivers considered telemedicine useful, accessible, and safe, facilitating the continuity of care and strengthening the caregiver–professional relationship. The main limitations were the absence of physical examination and occasional technical difficulties. Most caregivers favored a hybrid care model, combining remote and in-person visits. Conclusions: Telemedicine proved to be a feasible and well-accepted strategy for the care of older adults with dementia, improving caregiver support and communication with healthcare teams. Public policies should foster digital inclusion and training for both caregivers and professionals, consolidating hybrid, person-centered models of care. Full article

The global increase in dementia cases, which is predicted to exceed 152 million by 2050, poses substantial challenges to healthcare systems and caregiving structures. Concurrently, the expansion of mobile health (mHealth) technologies offers scalable, cost-effective opportunities for dementia care. This study systematically reviews 100 publicly available dementia-related mobile applications on the Apple App Store (iOS) and the Google Play Store (Android), categorised using the Mobile App Rating Scale (MARS), as well as the targeted end-users, Internet of Things (IoT) integration, data protection, and cost burden. Applications were evaluated for their utility in cognitive training, memory support, carer education, clinical decision-making, and emotional well-being. Findings indicate a predominance of carer resources and support tools, while clinically integrated platforms, cognitive assessments, and adaptive memory aids remain underrepresented. Most apps lack empirical validation, inclusive design, and integration with electronic health records, raising ethical concerns around data privacy, transparency, and informed consent. In parallel, the study identifies promising pathways for energy-optimised IoT systems, Artificial Intelligence (AI), and Ambient Assisted Living (AAL) technologies in fostering dementia-friendly, sustainable environments. Key gaps include limited use of low-power wearables, energy-efficient sensors, and smart infrastructure tailored to therapeutic needs. Application domains such as cognitive training (19 apps) and carer resources (28 apps) show early potential, while emerging innovations in neuroadaptive architecture and emotional computing remain underexplored. The findings emphasize the need for co-designed, evidence-based digital solutions that align with the evolving needs of people with dementia, carers, and clinicians. Future innovations must integrate sustainability principles, promote interoperability, and support global aging populations through ecologically responsible, person-centred dementia care ecosystems. Full article

Objectives: Relatively little research has explored whether gait and cognition are systematically associated within-persons across time, especially in persons living with dementia (PLwD). Understanding a shared mechanism between gait and cognition may help elucidate effective intervention strategies for promoting cognitive and physiological health in PLwD simultaneously. Methods: 33 PLwD enrolled in an 18-month choral intervention employing a measurement-burst design that facilitated up to 9 assessments per person. Three-level multilevel models investigated the time-varying covariation between cognition and gait velocity (indexed using a GAITRite computerized walkway) under both a walk-only and dual-task condition. Results: Significant coupling was observed between gait velocity and MMSE (mini-mental state examination) under the dual-task condition, indicating that, on occasions when an individual’s MMSE was one-unit greater than their personal average, there was a corresponding increase in dual-task gait velocity. Conclusions: This study highlights a shared within-person mechanism through which improvements in cognition may facilitate physiological advantages. Full article