Cost-benefit of dementia insurance for cognitively-unimpaired ε4 homozygotes: A simulation study.

Background: Dementia insurance, a private insurance product covering the first diagnosis of dementia of the insured, may be beneficial for asymptomatic individuals who recognize their own high genetic risk for Alzheimer's disease.

Objective: We aimed to examine the cost-benefit of dementia insurance in cognitively unimpaired individuals, stratified by ε4 genotype.

Methods: A simulation study using 18 years of longitudinal data from National Alzheimer's Coordinating Center study to simulate the income and expenses of dementia insurance from the insured's perspective.

How many sites are enough? a novel, site-based power analysis method for real-world registry studies of anti-amyloid monoclonal antibodies.

Background: Real-world registries ALZ-NET (US) and AD-DMT (Japan) support safety surveillance of anti-amyloid antibodies. Conventional power calculations-dividing required patients by mean per-site caseload-can underestimate the number of centers needed because of patient counts variability.

Objectives: To develop and evaluate a simulation-based method for site-level sample size planning that incorporates inter-site variability.

Development of the Child Image Assessment Scale for Older Adults (CIAO): REPRINTS Cohort Study.

Although many scales measure children's image of older adults, none measure the image that older adults hold of children. This study creates a new scale with reference to previous studies. Using a preliminary survey, we examined whether the Child Image Scale originally designed for teachers could be applied to older adults; however, we found that it was insufficiently reliable.

Effect of corrections for renal function on plasma phosphorylated tau performance for Alzheimer's disease.

BackgroundBlood-based biomarkers (BBMs), including plasma phosphorylated tau (pTau), have been considered as a promising, less-invasive tool for detecting Alzheimer's disease (AD) pathology in real-world applications. Plasma pTau levels are known to be elevated in individuals with chronic kidney disease, which may require caution when corrected for renal function since it alters testing performance-decreased sensitivity and increased specificity.ObjectiveWe aimed to quantify how correcting for renal function affects BBM test performance.

Audio review as a measure of quality assurance and control of cognitive assessments in Alzheimer's disease studies: An experience from Japanese Trial-Ready Cohort Study.

Background: Clinical trials targeting preclinical Alzheimer's disease (AD) require accurate cognitive assessments to detect subtle changes over time. Audio review of assessment sessions has been proposed as a quality assurance (QA) and control (QC) measure, yet evidence regarding its effectiveness remains limited.

Objective: We aim to investigate how audio review contributes to the QA/QC process.

Therapeutic time window of disease-modifying therapy for early Alzheimer's disease.

Introduction: Recently approved disease-modifying therapies (DMT) for early Alzheimer's disease (AD), including lecanemab and donanemab, require patients to meet specific eligibility criteria for treatment. These criteria define a limited "therapeutic time window," after which patients become ineligible as the disease advances. Understanding factors influencing this window may help clinicians optimize patient management and reduce lost treatment opportunities.

Efficient labor- and cost-effective method: Validation of a paper-pencil group cognitive assessment for older adults.

Aim: With increasing rates of cognitive impairment in aging populations, efficient labor- and cost-effective screening methods are essential. The Paper-Pencil Group Cognitive Assessment (PAPLICA) is an innovative tool designed to assess cognitive function in groups, unlike traditional one-on-one cognitive assessments, saving labor and time. This study evaluated the reliability, validity, and accuracy of the PAPLICA for identifying cognitive impairment.

Factors affecting participation in web-based Alzheimer's questionnaire surveys: Lessons from the Japanese trial-ready cohort.

Background: Web-based approach is considered helpful for the research focused on screening and early detection of individuals with preclinical Alzheimer's disease (AD); obtaining sufficient responses is critical to the success of such online study.

Objectives: This study examined factors influencing response rates to an online survey about disease-modifying drugs for AD among participants in the Japanese Trial-Ready Cohort (J-TRC) webstudy.

Design: This was a retrospective observational study.

Blood-based biomarker prescreening with different testing combinations and cutoffs: A simulation study examining efficacy and cost-effectiveness in Alzheimer's disease prevention studies.

Introduction: Blood-based biomarkers (BBBMs), including plasma amyloid beta (Aβ) or phosphorylated tau (p-tau), combined with apolipoprotein E () testing, are anticipated to serve as prescreening tools before amyloid positron emission tomography (PET) for recruiting participants for Alzheimer's disease (AD) prevention studies. The predictive efficacy and cost-effectiveness of prescreening may vary with different testing combinations, sequences, and cutoff levels.

Methods: We conducted a simulation study utilizing data from our ongoing Japanese Trial-Ready Cohort (J-TRC) onsite study ( = 202) recruited online.

Sentiment analysis of social media responses to the approval of lecanemab for the treatment of Alzheimer's disease in Japan.

Lecanemab, an anti-amyloid therapy for early Alzheimer's disease, received approval by the FDA and Japan in 2023. Public response on social media was scrutinized, aiming to obtain insights into communication and treatment development. For 478 posts from X and Facebook, their sentiments on efficacy, safety, societal significance, and overall lecanemab impression were assessed by GPT-4 and the authors.

Cognitive function instrument-based anosognosia to predict amyloid status.

Anosognosia, a lack of self-awareness regarding cognitive dysfunction, often accompanies the progression of Alzheimer's disease (AD) pathology. This study explored the relationship between AD pathology and anosognosia measured by discrepancies in Cognitive Function Instrument (CFI) scores, as rated by participants and their study partners (SP). Using mixed-effects models on non-demented participant data, the results revealed that lower self-reported CFI score compared to SP ratings was significantly associated with positive amyloid PET results (odds ratio 1.

Negative perceptions toward older adults and life satisfaction among community-dwelling older citizens in Japan.

Background: With the rapid aging of the population, increasing life satisfaction among older adults is essential. Negative perceptions of older adults are internalized, leading to poor mental health. This study hypothesized that participants with more negative perceptions of older adults would have lower life satisfaction.

-ε4 allele[s]-associated adverse events reported from placebo arm in clinical trials for Alzheimer's disease: implications for anti-amyloid beta therapy.

-ε4 allele[s] is a risk factor for Alzheimer's disease (AD) and Amyloid-Related Imaging Abnormalities (ARIA) in anti-amyloid beta therapy, and is also associated with cerebrovascular risk factors such as hyperlipidemia or atherosclerosis. During AD clinical trials, -ε4 carriers may experience neuropsychiatric adverse events (AEs) related to these risks, complicating the differentiation of ARIA from cerebrovascular events based on symptoms. This study aimed to examine the hypothetical impact of considering the -ε4 allele's risk for non-ARIA AEs during AD clinical trials.

Combining plasma Aβ and p-tau217 improves detection of brain amyloid in non-demented elderly.

Background: Maximizing the efficiency to screen amyloid-positive individuals in asymptomatic and non-demented aged population using blood-based biomarkers is essential for future success of clinical trials in the early stage of Alzheimer's disease (AD). In this study, we elucidate the utility of combination of plasma amyloid-β (Aβ)-related biomarkers and tau phosphorylated at threonine 217 (p-tau217) to predict abnormal Aβ-positron emission tomography (PET) in the preclinical and prodromal AD.

Methods: We designed the cross-sectional study including two ethnically distinct cohorts, the Japanese trial-ready cohort for preclinica and prodromal AD (J-TRC) and the Swedish BioFINDER study.

Simplifying Alzheimer's Disease Monitoring: A Novel Machine-Learning Approach to Estimate the Clinical Dementia Rating Sum of Box Changes Using the Mini-Mental State Examination and Functional Activities Questionnaire.

Background: Primary outcome measure in the clinical trials of disease modifying therapy (DMT) drugs for Alzheimer's disease (AD) has often been evaluated by Clinical Dementia Rating sum of boxes (CDRSB). However, CDR testing requires specialized training and 30-50 minutes to complete, not being suitable for daily clinical practice.

Objective: Herein, we proposed a machine-learning method to estimate CDRSB changes using simpler cognitive/functional batteries (Mini-Mental State Examination [MMSE] and Functional Activities Questionnaire [FAQ]), to replace CDR testing.

Advertisement by medical facilities as an opportunity route of APOE genetic testing in Japan: a website analysis.

The APOE-ε4 allele(s) is a strong risk factor for Alzheimer's disease (AD). A significant point of access for this allele testing is through services provided by medical facilities in Japan, which advertise out-of-insurance APOE testing on their websites. There is a concern that website advertisements for APOE testing may influence the ability for individuals to adequately self-determine whether to undergo APOE testing.

[Survey on the Current Advertising and Sales of Mucuna pruriens in Consumer-to-consumer Internet Trading in Japan].

Mucuna pruriens (MP) is leguminous plant which contains 5% of L-3,4-dihydroxyphenylalanine (levodopa) in its seeds. It may have a potential to be used as an alternative therapy for Parkinson's disease (PD). Meanwhile, there is a concern in terms of public health that MP products can be overused by patients with PD.