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Summary: Isolated rapid eye movement (REM) sleep behaviour disorder (iRBD) is a sleep disorder that is characterised by dream enactment episodes during REM sleep. It is the strongest known predictor of α‐synuclein‐related neurodegenerative disease (αNDD), such that >80% of people with iRBD will eventually develop Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy in later life. More research is needed to understand the trajectory of phenoconversion to each αNDD. Only five 'gold standard' prevalence studies of iRBD in older adults have been undertaken previously, with estimates ranging from 0.74% to 2.01%. The diagnostic recommendations for video‐polysomnography (vPSG) to confirm iRBD makes prevalence studies challenging, as vPSG is often unavailable to large cohorts. In Australia, there have been no iRBD prevalence studies, and little is known about the cognitive and motor profiles of Australian people with iRBD. The Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) Sleep Study will investigate the prevalence of iRBD in Tasmania, an island state of Australia, using validated questionnaires and home‐based vPSG. It will also explore several cognitive, motor, olfactory, autonomic, visual, tactile, and sleep profiles in people with iRBD to better understand which characteristics influence the progression of iRBD to αNDD. This paper details the ISLAND Sleep Study protocol and presents preliminary baseline results. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Finding low‐cost methods to detect early‐stage Alzheimer's disease (AD) is a research priority for neuroprotective drug development. Presymptomatic Alzheimer's is associated with gait impairment but hand motor tests, which are more accessible, have hardly been investigated. This study evaluated how home‐based Tasmanian (TAS) Test keyboard tapping tests predict episodic memory performance. METHODS: 1169 community participants (65.8 ± 7.4 years old; 73% female) without cognitive symptoms completed online single‐key and alternate‐key tapping tests and episodic memory, working memory, and executive function cognitive tests. RESULTS: All single‐key (R2adj = 8.8%, ΔAIC = 5.2) and alternate‐key (R2adj = 9.1%, ΔAIC = 8.8) motor features predicted episodic memory performance relative to demographic and mood confounders only (R2adj = 8.1%). No tapping features improved estimation of working memory. DISCUSSION: Brief self‐administered online hand movement tests predict asymptomatic episodic memory impairment. This provides a potential low‐cost home‐based method for stratification of enriched cohorts. Highlights: We devised two brief online keyboard tapping tests to assess hand motor function.1169 cognitively asymptomatic adults completed motor‐ and cognitive tests online.Impaired hand motor function predicted reduced episodic memory performance.This brief self‐administered test may aid stratification of community cohorts. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Low‐cost simple tests for preclinical Alzheimer's disease are a research priority. We evaluated whether remote unsupervised webcam recordings of finger‐tapping were associated with cognitive performance in older adults. METHODS: A total of 404 cognitively‐asymptomatic participants (64.6 [6.77] years; 70.8% female) completed 10‐second finger‐tapping tests (Tasmanian [TAS] Test) and cognitive tests (Cambridge Neuropsychological Test Automated Battery [CANTAB]) online at home. Regression models including hand movement features were compared with null models (comprising age, sex, and education level); change in Akaike Information Criterion greater than 2 (ΔAIC > 2) denoted statistical difference. RESULTS: Hand movement features improved prediction of episodic memory, executive function, and working memory scores (ΔAIC > 2). Dominant hand features outperformed nondominant hand features for episodic memory (ΔAIC = 2.5), executive function (ΔAIC = 4.8), and working memory (ΔAIC = 2.2). DISCUSSION: This brief webcam test improved prediction of cognitive performance compared to age, sex, and education. Finger‐tapping holds potential as a remote language‐agnostic screening tool to stratify community cohorts at risk for cognitive decline. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the dementia knowledge of allied health professionals and identify their specific learning needs. Methods: An online survey was conducted with allied health professionals enrolled in the Understanding Dementia Massive Open Online Course, a free course open to anyone, worldwide. The primary outcome measure was the Dementia Knowledge Assessment Scale, assessed prior to course commencement. Results: The survey was completed by 1591 participants. The mean dementia knowledge score was 35.0 (SD 8.4), with 13% (n = 207) achieving a target score of 45/50 or above, indicating comprehensive dementia knowledge. Key knowledge gaps were in the areas of dementia onset and non‐pharmacological management of behavioural and psychological symptoms of dementia. Conclusions: Allied health professionals surveyed had significant gaps in dementia knowledge. Educators planning dementia curriculum for allied health professionals could consider addressing areas of knowledge related to the identified items, with view to providing a foundation for excellence in dementia care. [ABSTRACT FROM AUTHOR]

Objectives: To explore the relationships between dose changes to antipsychotic and/or benzodiazepine medications and resident outcomes, including variations in neuropsychiatric symptoms, quality of life (QoL), and social withdrawal, within a multicomponent, interdisciplinary antipsychotic and benzodiazepine dose reduction program.Design: Prospective, observational, longitudinal study.Intervention: The Reducing Use of Sedatives (RedUSe) project involved 150 Australian Long-Term Care Facilities (LTCFs) incorporating auditing and benchmarking of prescribing, education, and multidisciplinary sedative reviews.Setting: A convenience sample of LTCFs (n = 28) involved in RedUSe between January 2015 and March 2016.Participants: Permanent residents (n = 206) of LTCFs involved in RedUSe taking an antipsychotic and/or benzodiazepine daily. Residents were excluded if they had a severe psychiatric condition where antipsychotic therapy should generally be maintained long-term (e.g., bipolar disorder, schizophrenia) or were considered end-stage palliative.Measurements: Neuropsychiatric symptoms (Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory (CMAI)), QoL (Assessment of Quality of Life-4D), and social withdrawal (Multidimensional Observation Scale for Elderly Subjects-withdrawal subscale) were measured at baseline and 4 months where nursing staff completed psychometric tests as proxy raters.Results: There was no evidence that psychometric measures were worsened following dose reductions. In fact, dose reduction was associated with small, albeit non-statistically significant, improvements in behavior, particularly less physically non-aggressive behavior with both drug groups (-0.36 points per 10% reduction in antipsychotic dose, -0.17 per 10% reduction in benzodiazepine dose) and verbally agitated behavior with benzodiazepine reduction (-0.16 per 10% dose reduction), as measured with the CMAI. Furthermore, antipsychotic reduction was associated with non-statistically significant improvements in QoL and social withdrawal.Conclusions: Antipsychotic and benzodiazepine dose reduction in LTCFs was not associated with deterioration in neuropsychiatric symptoms, QoL, or social withdrawal. Trends toward improved agitation with antipsychotic and benzodiazepine dose reduction require further evaluation in larger, prospective, controlled studies. [ABSTRACT FROM AUTHOR]

Background: The Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) is a large, online, prospective public health cohort study with nested interventions targeting modifiable dementia risk. The objective of ISLAND is to investigate the effectiveness of public health strategies aimed at increasing knowledge about behavioral and lifestyle factors associated with dementia, and to encourage behavior change to reduce future risk profiles at individual and population level. Method: Commencing October 2019, Tasmanian residents aged 50 and over were invited via a rolling media campaign to join ISLAND. Online surveys administered at baseline were repeated annually to enable tracking of changes in physical and mental health, social functioning, dementia risk knowledge, motivations and behaviors. After each survey wave, participants were provided a personal Dementia Risk Profile (DRP), a traffic‐light style report of their own risk level against nine domains, together with WHO recommendations for achieving 'low risk' status. For analyses, the DRP provides individual domain scores and a cumulative risk score, computed by summing domain scores (low = 0, medium = 0.5, high = 1). Newsletters and study information included prompts for participants to join the PD‐MOOC, a free, 4‐week online course about preventing dementia, which runs three times each year. Result: Participants who provided full data at baseline and the October 2021 annual surveys (n = 2,935) reported a significant and moderate‐sized reduction in their cumulative DRP scores (βs = ‐.36 [95%CI ‐.40, ‐.31]. Within this sample, the participants who engaged with the PD‐MOOC (1,208, 42%) reported a small additional independent benefit (βs = ‐.08 [95%CI‐.11, ‐.05]). General knowledge about dementia risk reduction increased across all respondents (βs =.11 [95%CI.06,.15]) and amongst PD‐MOOC participants, the effect was stronger (βs =.61 [95%CI.53,.70]). The results of mediation models testing the role of knowledge and motivations in observed DRP changes will be presented. Conclusion: These preliminary findings support the core hypothesis of ISLAND, that increasing knowledge about modifiable dementia risk factors is associated with action‐taking to change key risk behaviors. Future work will link dementia‐risk knowledge and behavioral patterns over time with cognitive and blood‐based markers of neurodegeneration, to understand the long‐term effects of this online public health project. [ABSTRACT FROM AUTHOR]

Abstract: Solar geolocation is used to quantify the movements of animals tagged with sensors that record ambient light with respect to time. Global location sensor (GLS) tags are small, light, and present minimal drag or wing loading. They are affordable, and some can record data for several migratory cycles. These benefits mean they can be used in applications for which satellite tags are unsuitable. However, large errors in estimated locations can result if the sensor is obscured, especially around twilight, and sometimes the data obtained is unusable by existing methods of analysis due to this source of noise. This places limitations on the usefulness of solar geolocation in conservation and monitoring efforts. All existing methods of analysis are dependent on twilights being identifiable or faithfully recorded. Instead, the method introduced here depends on the overall pattern of day and night to calculate the likelihoods for a Hidden Markov Model, where the hidden states are geographic locations. We call this a “twilight‐free” method of light‐based geolocation. This method quickly estimates locations from otherwise unusable noisy light data. We use examples to show that the method produces tracks that are comparable in accuracy and precision to other geolocation methods. Furthermore, efficiency and replicability of estimated paths are improved because the user does not have to subjectively identify twilights. Other data sources, such as sea surface temperature and land or sea masks are easily incorporated, further improving location estimates and processing speed. The twilight‐free method offers new opportunities to researchers interested in the movements of animals that routinely have obscured sensors, or to analyse previously unusable noisy light data. It offers a fast, efficient, and replicable method for analysing tag data without the need for time‐consuming pre‐ or post‐processing. By increasing the yield of usable data from GLS tagging studies, researchers can more efficiently quantify where animals are going and when, and monitor changes in habitat. This is of fundamental importance to management and conservation efforts. [ABSTRACT FROM AUTHOR]

Introduction: Motor dysfunction is an important feature of early-stage dementia. Gait provides a non-invasive biomarker across the dementia continuum. Gait speed and rhythm aid risk stratification of incident dementia in subjective cognitive impairment (SCI) and are associated with cognitive domains in mild cognitive impairment (MCI) and dementia. However, hand movement analysis, which may be more accessible, has never been undertaken in SCI and rarely in MCI or dementia. We aimed to address this gap and improve understanding of hand motor-cognitive associations across the dementia continuum., Methods: A total of 208 participants were recruited: 50 with dementia, 58 MCI, 40 SCI, and 60 healthy controls. Consensus diagnoses were made after comprehensive gold-standard assessments. A computer key-tapping test measured frequency, dwell-time, rhythm, errors, and speed. Associations between key-tapping and cognitive domains and diagnoses were analysed using regression. Classification accuracy was measured using area under receiver operating characteristic curves., Results: Hand frequency and speed were associated with memory and executive domains (p ≤ 0.001). Non-dominant hand rhythm was associated with all cognitive domains. Frequency, rhythm, and speed were associated with SCI, MCI, and dementia. Frequency and speed classified ≥94% of dementia and ≥88% of MCI from controls. Rhythm of the non-dominant hand classified ≥86% of dementia and MCI and 69% of SCI., Conclusion: Our findings show hand motor dysfunction occurs across the dementia continuum and, similar to gait, is associated with executive and memory domains and with cognitive diagnoses. Key-tapping performance differentiated dementia and MCI from healthy controls. More research is required before recommending key-tapping as a non-invasive motor biomarker of cognitive impairment., (© 2024 S. Karger AG, Basel.)

Introduction: Low-cost simple tests for preclinical Alzheimer's disease are a research priority. We evaluated whether remote unsupervised webcam recordings of finger-tapping were associated with cognitive performance in older adults., Methods: A total of 404 cognitively-asymptomatic participants (64.6 [6.77] years; 70.8% female) completed 10-second finger-tapping tests (Tasmanian [TAS] Test) and cognitive tests (Cambridge Neuropsychological Test Automated Battery [CANTAB]) online at home. Regression models including hand movement features were compared with null models (comprising age, sex, and education level); change in Akaike Information Criterion greater than 2 (ΔAIC > 2) denoted statistical difference., Results: Hand movement features improved prediction of episodic memory, executive function, and working memory scores (ΔAIC > 2). Dominant hand features outperformed nondominant hand features for episodic memory (ΔAIC = 2.5), executive function (ΔAIC = 4.8), and working memory (ΔAIC = 2.2)., Discussion: This brief webcam test improved prediction of cognitive performance compared to age, sex, and education. Finger-tapping holds potential as a remote language-agnostic screening tool to stratify community cohorts at risk for cognitive decline., Competing Interests: Author disclosures are available in the supporting information., (© 2024 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)

Introduction: Finding low-cost methods to detect early-stage Alzheimer's disease (AD) is a research priority for neuroprotective drug development. Presymptomatic Alzheimer's is associated with gait impairment but hand motor tests, which are more accessible, have hardly been investigated. This study evaluated how home-based Tasmanian (TAS) Test keyboard tapping tests predict episodic memory performance., Methods: 1169 community participants (65.8 ± 7.4 years old; 73% female) without cognitive symptoms completed online single-key and alternate-key tapping tests and episodic memory, working memory, and executive function cognitive tests., Results: All single-key (R 2 adj  = 8.8%, ΔAIC = 5.2) and alternate-key (R 2 adj  = 9.1%, ΔAIC = 8.8) motor features predicted episodic memory performance relative to demographic and mood confounders only (R 2 adj  = 8.1%). No tapping features improved estimation of working memory., Discussion: Brief self-administered online hand movement tests predict asymptomatic episodic memory impairment. This provides a potential low-cost home-based method for stratification of enriched cohorts., Highlights: We devised two brief online keyboard tapping tests to assess hand motor function. 1169 cognitively asymptomatic adults completed motor- and cognitive tests online. Impaired hand motor function predicted reduced episodic memory performance. This brief self-administered test may aid stratification of community cohorts., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Introduction: Declining cognition in later life is associated with loss of independence and quality of life. This decline in cognition may potentially be reduced or reversed through engaging in cognitively stimulating activities. This study examined the potential for university attendance in later life to enhance cognitive function in older adults., Methods: Cognitively unimpaired adults (n = 485, 69% female, median age 60 years) were given the opportunity to undertake free university study. Repeated neurocognitive assessment was performed over 7 years., Results: Participants in the university education group (n = 383) improved z = .02 SD (.01, .03) per year of the study compared to controls ( P  = .001; averaged across a battery of cognitive tests). The largest improvements were observed on tests of language and verbal learning, memory, and episodic memory., Discussion: Later-life university study was associated with improved cognitive trajectories. Later-life education may preserve cognitive function, specifically for functions associated with communication, social interaction, and maintaining independence., Competing Interests: Mathew J. Summers and James C. Vickers were awarded National Health and Medical Research Council (NHMRC) grant funding to their institutions for the current work. Aidan D. Bindoff, Mathew J. Summers, Edward Hill, Jane Alty, and James C. Vickers were awarded NHMRC grant funding to their institutions outside of the current work. Mathew J. Summers was awarded European Commission Horizon 2020 grant funding to his institution outside of the current work. James C. Vickers was awarded Medical Research Futures Fund, FightMND, and Royal Hobart Hospital Research Foundation grant funding to his institution outside of the current work. James C. Vickers has also served as an unpaid board member to Glenview Community Services and the Dementia Australia Research Foundation. Jane Alty was paid royalties for medical textbooks, and honoraria, accommodation and speaking fees paid to herself within the last 36 months, unrelated to the current work., (© 2021 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)