A decision-making algorithm for remote digital assessments of Alzheimer's Disease.

INTRODUCTION: Remote digital assessments (RDA) such as voice recording, video and motor sensors, olfactory, hearing and vision screenings are now starting to be employed to complement classical biomarker and clinical evidence to identify patients in the early AD stages. Choosing which RDA can be proposed to individual patients is not trivial, and often time consuming. This position paper presents a decision-making algorithm for using RDA during teleconsultations in memory clinic settings. METHOD: The algorithm was developed by an expert panel following the Delphi methodology. RESULTS: The decision-making algorithm is structured as a series of yes-no questions. The resulting questionnaire is freely available online. DISCUSSION: We suggest that the use of screening questionnaires in the context of Memory clinics may help accelerating the adoption of remote digital assessment in everyday clinical practice.

Alzheimer's early detection in post-acute COVID-19 syndrome: a systematic review and expert consensus on preclinical assessments.

Introduction: The risk of developing Alzheimer's disease (AD) in older adults increasingly is being discussed in the literature on Post-Acute COVID-19 Syndrome (PACS). Remote digital Assessments for Preclinical AD (RAPAs) are becoming more important in screening for early AD, and should always be available for PACS patients, especially for patients at risk of AD. This systematic review examines the potential for using RAPA to identify impairments in PACS patients, scrutinizes the supporting evidence, and describes the recommendations of experts regarding their use. Methods: We conducted a thorough search using the PubMed and Embase databases. Systematic reviews (with or without meta-analysis), narrative reviews, and observational studies that assessed patients with PACS on specific RAPAs were included. The RAPAs that were identified looked for impairments in olfactory, eye-tracking, graphical, speech and language, central auditory, or spatial navigation abilities. The recommendations' final grades were determined by evaluating the strength of the evidence and by having a consensus discussion about the results of the Delphi rounds among an international Delphi consensus panel called IMPACT, sponsored by the French National Research Agency. The consensus panel included 11 international experts from France, Switzerland, and Canada. Results: Based on the available evidence, olfaction is the most long-lasting impairment found in PACS patients. However, while olfaction is the most prevalent impairment, expert consensus statements recommend that AD olfactory screening should not be used on patients with a history of PACS at this point in time. Experts recommend that olfactory screenings can only be recommended once those under study have reported full recovery. This is particularly important for the deployment of the olfactory identification subdimension. The expert assessment that more long-term studies are needed after a period of full recovery, suggests that this consensus statement requires an update in a few years. Conclusion: Based on available evidence, olfaction could be long-lasting in PACS patients. However, according to expert consensus statements, AD olfactory screening is not recommended for patients with a history of PACS until complete recovery has been confirmed in the literature, particularly for the identification sub-dimension. This consensus statement may require an update in a few years.

Benefits of a 3-month cycle of weekly virtual museum tours in community dwelling older adults: Results of a randomized controlled trial.

Background: Museums can be instrumental in fostering social inclusion and may improve the overall health of the older population. Over the course of the 2019 coronavirus pandemic, many older adults suffered as a result of confinement measures, which may have accelerated the processes that lead to physical frailty and increased mental health risks. This study aims to examine whether a 3-month cycle of weekly virtual tours of the Montreal Museum of Fine Arts (MMFA) may have improved feelings of social inclusion, wellbeing and quality of life, and reduced physical frailty in older adults living within the community of Montreal. Methods and design: A total of 106 older adults, who were community-dwellers living in Montreal (Quebec, Canada), were recruited for a randomized controlled trial in two parallel groups (intervention with n = 53 vs control with n = 53) between January and April 2022. The intervention consisted of a 3-month cycle of weekly virtual museum tours of the MMFA. Social isolation, wellbeing, quality of life and frailty were evaluated using validated scales that were assessed on a web platform at baseline (M0) and after 3 months (M3) in the intervention group. The control group completed the same assessment according to the same schedule. The outcomes were the mean scores at M0 and M3, and changes in mean scores between M0 and M3. Results: The intervention group showed significant improvements in their social isolation, wellbeing, quality of life and frailty scores when compared to the control group, the highest benefits being observed with frailty. Conclusion: The results suggest that the 3-month cycle of weekly virtual MMFA tours may improve social inclusion, physical and mental health in community-dwelling older adults living in Montreal. Trial registration: https://clinicaltrials.gov/ct2/show/NCT05046288, identifier NCT05046288.

Ageism and COVID-19: what does our society's response say about us?

The goal of this commentary is to highlight the ageism that has emerged during the COVID-19 pandemic. Over 20 international researchers in the field of ageing have contributed to this document. This commentary discusses how older people are misrepresented and undervalued in the current public discourse surrounding the pandemic. It points to issues in documenting the deaths of older adults, the lack of preparation for such a crisis in long-term care homes, how some 'protective' policies can be considered patronising and how the initial perception of the public was that the virus was really an older adult problem. This commentary also calls attention to important intergenerational solidarity that has occurred during this crisis to ensure support and social-inclusion of older adults, even at a distance. Our hope is that with this commentary we can contribute to the discourse on older adults during this pandemic and diminish the ageist attitudes that have circulated.