Introduction: Stable religious participation may have beneficial contributions to cognitive and mental health; however, less is known about how changes in religious participation, such as disengagement or increased engagement in church activities, affect these health outcomes and whether there are differences between racial groups. This study aimed to examine the association between changes in church activity and cognitive, functional, and mental health in older adults, and explore differences by race. Methods: Using data from the University of Pennsylvania Alzheimer’s Disease Research Center Aging Brain Cohort in 2021–2022, we examined associations between self-reported change in church activity with cognitive and functional health (Global Clinical Dementia Score [CDR] and Total CDR) and neuropsychiatric symptoms (Neuropsychiatric Inventory) in cognitively normal older adults (n = 158). We used multivariable regression analysis, controlling for self-reported age, sex, education, and social interaction, to examine differences between individuals who identified as either Black or White. Results: Controlling for covariates, Black participants who reported substantially more or less church activity in the last year had lower cognition and function (Global CDR, β = 0.19, 95% CI: [0.04, 0.34], p < 0.05) and Total CDR (β = 0.30, 95% CI: [0.01, 0.58], p = 0.042), and more neuropsychiatric symptoms (β = 0.63, 95% CI: [0.02, 1.24], p < 0.045). No significance was found in White older adults. Black older adults reporting major changes in church activity experienced lower cognitive, functional, and mental health. Conclusion: To explore if church activity changes could be an early sign of cognitive, functional, and mental health decline, longitudinal studies are needed.

Introduction: People with dementia are eligible for rehabilitation for functional difficulties resulting from cognitive symptoms, but no method for this is used in Norwegian municipalities. GREAT cognitive rehabilitation (CR) is an approach which has shown significant positive effects. The study aimed to explore the experiences of dementia case managers using the GREAT CR approach to address the rehabilitation goals of people with dementia. Method: Six dementia case managers, from four Norwegian municipalities, participated. The pilot study had two phases: phase 1: the participants learnt the approach, and each used it with two clients, to become CR practitioners; phase 2: the participants could use CR in their normal practice. Their experiences were explored in two focus groups. The focus groups were audiotaped, transcribed, and analysed in line with directed content analysis. Results: Three categories were described: (1) the training and written material, (2) professional development, and (3) proposals for solutions on how to use CR in clinical practice. The case managers found it both engaging and challenging to use CR. They observed that the experience had changed their usual practice: they asked people with dementia more questions about their everyday functioning and resources. The most important barrier to implementing CR was lack of time, although funds were provided to allow municipalities to provide cover for participants’ time, participants still found they lacked the time to use the approach as planned. Conclusion: This study has demonstrated that it is feasible to implement CR in a Norwegian municipality if enough time is available and sufficient resources are provided. There is an urgent need to identify how healthcare services can be enabled to make rehabilitation methods like CR a regular part of post-diagnostic support.

Introduction: Studies about dementia in Indigenous communities are still scarce worldwide, especially in low-middle-income countries, limiting timely intervention in minority groups. Our research aimed to bridge this gap by determining the prevalence of dementia and mild cognitive impairment no dementia (CIND), and the associated factors, in a multiethnic Indigenous community in Manaus, Brazil. Methods: A cross-sectional observational study evaluated the cognitive and functional performances of 141 Indigenous individuals (aged 50 and above). A panel of dementia neurologist experts independently analyzed cognitive (Mini-Mental State Exam [MMSE], Brief Cognitive Screening Battery, verbal fluency), functional (Pfeffer questionnaire) performances, and depression symptoms (Geriatric Depression Scale) to classify participants as cognitively unimpaired, CIND, and dementia. Results: CIND rate was 11.3% and 12.8% for dementia. None of the participants classified as CIND had a prior diagnosis, and only three out of 18 participants with dementia had a diagnosis. Stratified analysis showed that age (p = 0.017) and lower education (p = 0.047) were associated with higher CIND and dementia. However, only age was significantly associated with dementia in the regression models (OR = 1.078; 95% CI: 1.011–1.149). Sex, living in extreme poverty, hypertension, diabetes, smoking, or excessive alcohol use was not linked to CIND or dementia. Conclusion: The Indigenous community of Manaus exhibited higher rates of dementia and CIND than national and global estimates. These findings may set the stage for additional research into the interplay of social, economic, biological, and behavioral factors affecting dementia risk in underrepresented groups such as Indigenous communities.

Karger Publishers and the editors of Dementia and Geriatric Cognitive Disorders Extra would like to thank the reviewers for the ongoing support in reviewing manuscripts for our Journal in 2024. This year we have chosen not to disclose the names of our reviewers to preserve the principle of anonymity inherent to the single-blind peer-review we follow. Even so, this should not be in our way to sincerely thank all contributing reviewers who have volunteered their time, effort, and expertise in benefit of the quality of the manuscripts we received and published in 2024. Individual reviewers can still claim their personal “Certificate of Review” via the Journal’s manuscript submission system.

Introduction: Numerous reports regarding cognitive deficits after the coronavirus disease 2019 (COVID-19), described as “brain fog,” have been published. However, the clinical presentations and risk factors of post-COVID-19 cognitive impairment are controversial. This study aimed to assess (a) the prevalence of cognitive impairment after COVID-19 hospitalization, (b) characteristics of the cognitive deficits, (c) risk factors of post-COVID-19 cognitive impairment, and (d) comparison of cognitive function between post-COVID-19 patients and healthy people. Methods: The study comprised 34 SARS-CoV-2-infected patients, admitted to the Neurological Institute of Thailand during the peak of COVID-19 pandemic in 2021–2022. These patients came for neuropsychological and clinical evaluations at 2-week follow-up visit. The cognitive impairment and characteristics were measured by TMSE and MoCA. Clinical risk factors and post-COVID-19 cognitive impairment were assessed. The comparison of cognitive function in post-acute COVID-19 patients and 22 healthy controls was also performed. Results: The prevalence of post-COVID-19 cognitive impairment defined by a total MoCA score below 25 points was 61.76%. Years of education were the only predictive factors related to cognitive impairment. Our multivariate analysis revealed no statistical difference in cognitive outcomes between post-acute COVID-19 patients and healthy controls. Conclusion: This study showed a moderate prevalence of cognitive dysfunction after COVID-19 hospitalization similar to previous reports. However, there was no significant difference in cognitive measurements between these patients and healthy people. Whether SARS-CoV-2 infection causes cognitive dysfunction is a myth or fact that still has a long way to prove via further longitudinal study.

Introduction: Diabetes mellitus (DM) is a risk factor for Alzheimer’s disease (AD). It has also been pointed out that AD associated with DM may have unique characteristics. However, the characteristics of impairment in daily functioning when associated with DM have not been sufficiently investigated. Methods: In the present study, we compared the characteristics of 261 patients with AD diagnosed in the outpatient memory clinic of a university hospital, divided into diabetic and nondiabetic groups. The MMSE was used to assess cognitive function, and the Dementia Assessment Sheet for Community-based Integrated Care System 21-items (DASC-21) was used as an observational method to assess cognitive function and activities of daily livings. The two groups were compared. Furthermore, simple and multiple regression analysis was carried out in order to find the independent association of age, sex, education, DM, and HbA1c with the DASC-21 and each individual item of the DASC-21. Results: Diabetic subjects were as follows: MMSE 18.8 ± 4.0, DASC-21 46.0 ± 13.2, and HbA1c 7.07 ± 1.24%, respectively. On the other hand, nondiabetic subjects were as follows: MMSE 19.0 ± 4.5 and DASC-21 42.1 ± 12.2, respectively. In the diabetic group, total score of DASC-21 was higher (DM vs. nondiabetes mellitus [NDM]: 46.0 ± 13.2 vs. 42.1 ± 12.2; p < 0.05) and solving issues and common sense on the DASC-21 were higher than in the nondiabetic group (NDM) (DM vs. NDM: 8.58 ± 2.71 vs. 7.76 ± 2.66; p < 0.05). Multiple regression analysis showed that the presence of DM was the significant determinant of solving issues and common sense on the DASC-21 (p < 0.05). Conclusions: In AD patients, DM may be associated with impairment of solving issues and common sense.

Introduction: The time from symptom debut to assessment of cognitive impairment (TSA) is usually substantial, and many factors can influence the length of this interval. Our objective was to discern whether elevated alcohol consumption is associated with TSA. Methods: Alcohol consumption was measured among 3,236 older Norwegians assessed for cognitive impairment. Elevated consumption was defined as drinking 4–7 times a week. TSA was defined as the number of months between symptom debut and assessment. The association between alcohol consumption and TSA was examined with a multiple regression analysis controlled for sociodemographic and clinical covariates. Results: Mean (SD) and median TSA were 34.8 (35.8) and 24.0 months, respectively. Elevated alcohol consumption was not associated with TSA. Longer TSA was associated with being male, having a high education level, being retired or unemployed, being single, having low scores on the Mini-Mental State Examination (MMSE) or Personal Activities of Daily Living (PADL), having high subsyndrome scores of depression or agitation on The Neuropsychiatric Inventory – Questionnaire (NPI-Q), or having a spouse/cohabitant as the designated next of kin. Conclusion: This study indicates that elevated alcohol consumption does not influence TSA. Possible explanations are discussed, but further research is needed to determine the effect of alcohol definitively. We did identify other novel characteristics associated with TSA which may be important in minimizing the risk of delayed cognitive assessments and should be kept in mind when considering assessment.

Introduction: Knowledge of how perceptions of personal control change over time may provide valuable insights into how people cope with having dementia. The present study aimed to examine change in locus of control over a 12-month period in persons with dementia. Method: The study included 52 participants with dementia. Locus of control was measured with the Locus of Control of Behavior Scale (LoCB), with higher scores indicating a more external locus of control, interpreted as perceiving less personal control. A ≥5% change on the LoCB was considered clinically meaningful. We recorded sociodemographic characteristics and assessed dementia severity, cognition, ability to function independently in daily activities and physical self-maintenance, depressive symptomatology, and number of prescribed medications. Analyses were performed to examine differences between those with increases (more external) or decreases (less external) in the LoCB score after 12 months and to examine associations between baseline variables and change in the LoCB score. Results: The mean LoCB score for the total sample did not change after 12 months (baseline mean 29.33 vs. follow-up mean 30.33, p = 0.553); however, 2 subgroups emerged. Using the ≥5% cutoff revealed that the LoCB score changed for 92.3% of the sample, becoming less external (lower LoCB) for 21 participants and more external (higher LoCB) for 27 participants. At baseline, the mean LoBC score was higher in the group that became less external (33.81 vs. 24.56), p = 0.006, while this was reverse at follow-up (23.57 vs. 34.41), p = 0.001. Dementia severity and dependence in physical self-maintenance increased during the 12 months in both groups. Among those becoming more external, we also found a decline in cognition (p = 0.002), an increase in dependence in daily activities (p = 0.003), an increase in the use of prescribed medication, and a decrease in depressive symptomatology (p = 0.003). The baseline LoCB score was the only variable associated with 12-month change in LoCB scores (p = 0.001). Conclusion: Most participants showed a clinically meaningful change in locus of control after 12 months. Those with more signs of dementia progression reported a decrease in personal control but also a decrease in depressive symptoms. These findings are interesting for our understanding of coping but must be replicated with a larger sample.