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Aotearoa New Zealand's population is ageing. Increasing life expectancy is accompanied by increases in prevalence of Alzheimer's Disease (AD) and ageing-related disorders. The multicentre Dementia Prevention Research Clinic longitudinal study aims to improve understanding of AD and dementia in Aotearoa, in order to develop interventions that delay or prevent progression to dementia. Comprising research clinics in Auckland, Christchurch and Dunedin, this multi-disciplinary study involves community participants who undergo biennial investigations informed by international protocols and best practice: clinical, neuropsychological, neuroimaging, lifestyle evaluations, APOE genotyping, blood collection and processing. A key research objective is to identify a 'biomarker signature' that predicts progression from mild cognitive impairment to AD. Candidate biomarkers include: blood proteins and microRNAs, genetic, neuroimaging and neuropsychological markers, health, cultural, lifestyle, sensory and psychosocial factors. We are examining a range of mechanisms underlying the progression of AD pathology (e.g. faulty blood–brain barrier, excess parenchymal iron, vascular dysregulation). This paper will outline key aspects of the Dementia Prevention Research Clinic's research, provide an overview of data collection, and a summary of 266 participants recruited to date. The national outreach of the clinics is a strength; the heart of the Dementia Prevention Research Clinics are its people. [ABSTRACT FROM AUTHOR]

The New Zealand Genetic Frontotemporal Dementia Study (FTDGeNZ) is an emerging longitudinal study of a large New Zealand pedigree with genetic frontotemporal dementia (FTD). Natural history studies of genetic FTD cohorts provide a unique opportunity to identify biomarkers of pre-symptomatic dementia, as carriers can be identified and studied decades before expected symptom onset. FTDGeNZ was established in 2016 with the aim of identifying the earliest pre-symptomatic biomarkers of FTD, in collaboration with international multi-centre cohorts. We enrolled 25 participants from a single family between April 2016 and August 2018. Participants were genotyped to determine whether they were pre-symptomatic carriers of the mutation (MAPT IVS 10 + 16 C > T), or non-carrier controls. Participants have undergone clinical assessments including neuropsychological and mood assessment; olfactory testing; assessment of social cognition; and blood collection for analyses of microRNA and protein fluid biomarkers annually. We have also performed structural and functional MRI of the brain and assessment of autobiographical memory biennially, and retinal imaging at baseline. Here, we describe the full study protocol and the baseline demographic and clinical characteristics of the FTDGeNZ cohort, and we highlight the latest findings in the field. [ABSTRACT FROM AUTHOR]

Cerebral blood flow (CBF) measured with arterial spin labelling (ASL) magnetic resonance imaging (MRI) reflects cerebral perfusion, related to metabolism, and arterial transit time (ATT), related to vascular health. Our aim was to investigate the spatial coefficient of variation (sCoV) of CBF maps as a surrogate for ATT, in volunteers meeting criteria for subjective cognitive decline (SCD), amnestic mild cognitive impairment (MCI) and probable Alzheimer's dementia (AD). Whole-brain pseudo continuous ASL MRI was performed at 3 T in 122 participants (controls = 20, SCD = 44, MCI = 45 and AD = 13) across three sites in New Zealand. From CBF maps that included all grey matter, sCoV progressively increased across each group with increased cognitive deficit. A similar overall trend was found when examining sCoV solely in the temporal lobe. We conclude that sCoV, a simple to compute imaging metric derived from ASL MRI, is sensitive to varying degrees of cognitive changes and supports the view that vascular health contributes to cognitive decline associated with Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Objectives The tendency to generate overgeneral past or future events is characteristic of individuals with a history of depression. Although much research has investigated the contribution of rumination and avoidance to the reduced specificity of past events, comparatively little research has examined (1) whether the specificity of future events is differentially reduced in depression and (2) the role of executive functions in this phenomenon. Our study aimed to redress this imbalance. Methods Participants with either current or past experience of depressive symptoms ('depressive group'; N = 24) and matched controls ('control group'; N = 24) completed tests of avoidance, rumination, and executive functions. A modified Autobiographical Memory Test was administered to assess the specificity of past and future events. Results The depressive group were more ruminative and avoidant than controls, but did not exhibit deficits in executive function. Although overall the depressive group generated significantly fewer specific events than controls, this reduction was driven by a significant group difference in future event specificity. Strategic retrieval processes were correlated with both past and future specificity, and predictive of the future specificity, whereas avoidance and rumination were not. Conclusions Our findings demonstrate that future simulation appears to be particularly vulnerable to disruption in individuals with current or past experience of depressive symptoms, consistent with the notion that future simulation is more cognitively demanding than autobiographical memory retrieval. Moreover, our findings suggest that even subtle changes in executive functions such as strategic processes may impact the ability to imagine specific future events. Practitioner points Future simulation may be particularly vulnerable to executive dysfunction in individuals with current/previous depressive symptoms, with evidence of a differential reduction in the specificity of future events., Strategic retrieval abilities were associated with the degree of future event specificity whereas levels of rumination and avoidance were not., Given that the ability to generate specific simulations of the future is associated with enhanced psychological wellbeing, problem solving and coping behaviours, understanding how to increase the specificity of future simulations in depression is an important direction for future research and clinical practice., Interventions focusing on improving the ability to engage strategic processes may be a fruitful avenue for increasing the ability to imagine specific future events in depression., The autobiographical event tasks have somewhat limited ecological validity as they do not account for the many social and environmental cues present in everyday life; the development of more clinically-relevant tasks may be of benefit to this area of study. [ABSTRACT FROM AUTHOR]

Abstract: Multiple Sclerosis (MS) is one of the most common chronic diseases of the central nervous system, and in New Zealand an estimated 4000 people are currently affected. This study was conducted to examine executive functioning, memory and general ability in a community-based sample of 95 participants with MS. The sample included those with relapsing–remitting, secondary progressive, chronic progressive and benign MS with an average duration of illness of 11.8 years. Only 9% of the participants showed no indication of cognitive impairment with most exhibiting mild executive dysfunction across the range of shifting, inhibition, fluency and working memory categories. As this became more widespread, all other measures of cognitive ability and memory also showed evidence of deterioration, but in some, this may have been due to slowed information processing. Overall, there was a high degree of variability in the levels of performance and there was no ‘typical’ pattern of deficits associated with MS. Thus, a proportion of those living with MS may have to cope with noticeable and unpredictable cognitive decline in addition to their physical disabilities. [Copyright &y& Elsevier]

Introduction: Community knowledge and stroke awareness is crucial for primary prevention of stroke and timely access to stroke treatments including acute reperfusion therapies. We conducted a national telephone survey to quantify the level of community stroke awareness., Methods: A random sample of 400 adults in New Zealand (NZ), stratified by the 4 main ethnic groups, was surveyed. Eligible participants answered stroke awareness questions using both unprompted (open-ended) and prompted questions (using a list). Proportional odds logistic regression models were used to identify factors associated with stroke awareness., Results: Only 1.5% of participants named stroke as a major cause of death. The stroke signs and symptoms most frequently identified from a list were sudden speech difficulty (94%) and sudden 1-sided weakness (92%). Without prompting, 78% of participants correctly identified at least 1 risk factor, 62% identified at least 2, and 35% identified 3 or more. When prompted with the list, scores increased 10-fold compared with unprompted responses. Ethnic disparities were observed, with Pacific peoples having the lowest level of awareness among the 4 ethnic groups. Higher education level, higher income, and personal experience of stroke were predictive of greater awareness (P ≤ .05)., Conclusions: Stroke was not recognized as a major cause of death. Although identification of stroke risk factors was high with prompting, awareness was low without prompting, particularly among those with lower education and income. Nationwide, culturally tailored public awareness campaigns are necessary to improve knowledge of stroke risk factors, recognition of stroke in the community and appropriate actions to take in cases of suspected stroke., (Copyright © 2019 Elsevier Inc. All rights reserved.)