Creativity during COVID-19: Evaluating an online TimeSlips storytelling program for people living with dementia during quarantine in Colombia.

BACKGROUND AND OBJECTIVES: Since its first implementation in 1998, evidence has been presented of the positive impact of the TimeSlips storytelling method for people with dementia in long-term care (LTC) settings. This paper extends this evidence in important new directions: it is the longest TimeSlips study to date and the first to evaluate the feasibility of online delivery of the method (in response to COVID-19 quarantine) and the impact of this on the personhood, quality of life and psychological well-being of Spanish-speaking participants in non-LTC settings in the Global South. RESEARCH DESIGN AND METHODS: Trained facilitators provided weekly, one-hour TimeSlips sessions via Zoom over 32 consecutive weeks to eight participants with dementia. Semi-structured interviews of participants and care partners were conducted within one week of the final intervention. Thematic analysis evaluated the resultant qualitative data. RESULTS: This online implementation of the TimeSlips creative expression (CE) method reinforced key facets of participants' personhood (self-expression and self-perception, which led in turn to increased care partner appreciation), had a positive impact on key domains of quality of life (mood, energy levels and cognitive function) and stimulated a key aspect of psychological well-being (the formation and maintenance of social ties). DISCUSSION AND IMPLICATIONS: The online delivery of the TimeSlips method to participants who remain in their own homes is feasible and effective. Future research should compare the benefits of online versus face-to-face delivery of this CE method.

Multi-Variate Risk Measures under Wasserstein Barycenter

When the uni-variate risk measure analysis is generalized into the multi-variate setting, many complex theoretical and applied problems arise, and therefore the mathematical models used for risk quantification usually present model risk. As a result, regulators have started to require that the internal models used by financial institutions are more precise. For this task, we propose a novel multi-variate risk measure, based on the notion of the Wasserstein barycenter. The proposed approach robustly characterizes the company's exposure, filtering the partial information available from individual sources into an aggregate risk measure, providing an easily computable estimation of the total risk incurred. The new approach allows effective computation of Wasserstein barycenter risk measures in any location–scatter family, including the Gaussian case. In such cases, the Wasserstein barycenter Value-at-Risk belongs to the same family, thus it is characterized just by its mean and deviation. It is important to highlight that the proposed risk measure is expressed in closed analytic forms which facilitate its use in day-to-day risk management. The performance of the new multi-variate risk measures is illustrated in United States market indices of high volatility during the global financial crisis (2008) and during the COVID-19 pandemic situation, showing that the proposed approach provides the best forecasts of risk measures not only for 'normal periods';, but also for periods of high volatility.

Lactoferrin as Immune-Enhancement Strategy for SARS-CoV-2 Infection in Alzheimer's Disease Patients.

Coronavirus 2 (SARS-CoV2) (COVID-19) causes severe acute respiratory syndrome. Severe illness of COVID-19 largely occurs in older people and recent evidence indicates that demented patients have higher risk for COVID-19. Additionally, COVID-19 further enhances the vulnerability of older adults with cognitive damage. A balance between the immune and inflammatory response is necessary to control the infection. Thus, antimicrobial and anti-inflammatory drugs are hopeful therapeutic agents for the treatment of COVID-19. Accumulating evidence suggests that lactoferrin (Lf) is active against SARS-CoV-2, likely due to its potent antiviral and anti-inflammatory actions that ultimately improves immune system responses. Remarkably, salivary Lf levels are significantly reduced in different Alzheimer's disease (AD) stages, which may reflect AD-related immunological disturbances, leading to reduced defense mechanisms against viral pathogens and an increase of the COVID-19 susceptibility. Overall, there is an urgent necessity to protect AD patients against COVID-19, decreasing the risk of viral infections. In this context, we propose bovine Lf (bLf) as a promising preventive therapeutic tool to minimize COVID-19 risk in patients with dementia or AD.

Lactoferrin as Immune-Enhancement Strategy for SARS-CoV-2 Infection in Alzheimer’s Disease Patients

Coronavirus 2 (SARS-CoV2) (COVID-19) causes severe acute respiratory syndrome. Severe illness of COVID-19 largely occurs in older people and recent evidence indicates that demented patients have higher risk for COVID-19. Additionally, COVID-19 further enhances the vulnerability of older adults with cognitive damage. A balance between the immune and inflammatory response is necessary to control the infection. Thus, antimicrobial and anti-inflammatory drugs are hopeful therapeutic agents for the treatment of COVID-19. Accumulating evidence suggests that lactoferrin (Lf) is active against SARS-CoV-2, likely due to its potent antiviral and anti-inflammatory actions that ultimately improves immune system responses. Remarkably, salivary Lf levels are significantly reduced in different Alzheimer’s disease (AD) stages, which may reflect AD-related immunological disturbances, leading to reduced defense mechanisms against viral pathogens and an increase of the COVID-19 susceptibility. Overall, there is an urgent necessity to protect AD patients against COVID-19, decreasing the risk of viral infections. In this context, we propose bovine Lf (bLf) as a promising preventive therapeutic tool to minimize COVID-19 risk in patients with dementia or AD.

Addressing the disparities in dementia risk, early detection and care in Latino populations: Highlights from the second Latinos & Alzheimer's Symposium.

The Alzheimer's Association hosted the second Latinos & Alzheimer's Symposium in May 2021. Due to the COVID-19 pandemic, the meeting was held online over 2 days, with virtual presentations, discussions, mentoring sessions, and posters. The Latino population in the United States is projected to have the steepest increase in Alzheimer's disease (AD) in the next 40 years, compared to other ethnic groups. Latinos have increased risk for AD and other dementias, limited access to quality care, and are severely underrepresented in AD and dementia research and clinical trials. The symposium highlighted developments in AD research with Latino populations, including advances in AD biomarkers, and novel cognitive assessments for Spanish-speaking populations, as well as the need to effectively recruit and retain Latinos in clinical research, and how best to deliver health-care services and to aid caregivers of Latinos living with AD.

Strategies for activity maintenance in patient and family care and clinical trial adherence of GNA social plan in context of COVID-19 health emergency

Background The current pandemic COVID-19 caused by SARS-CoV2 has become a public health challenge, causing difficulty in patient care and follow up of people with cognitive impairment due to Alzheimer's disease. This situation motivated changes and adjustments to the Group of Neurosciences of Antioquia?s (GNA) Social Plan to guarantee effective continuity in patient care, family follow-up, community interventions and adherence to the Alzheimer?s Prevention Initiative (API) Colombia clinical trial. This was an opportunity to innovate, create, reinvent and expand forms of care and intervention during confinement and pandemic to promote access through virtual media and the well-being of beneficiaries. Methods The Social Plan program involves free access to basic care supplies for patients, home-visits, support groups, cognitive stimulation groups and virtual community outreach activities like workshops for caregivers/interested public, Alzheimer's Day Commemoration ?Cuidarme ? Cuidarte? event (with available recorded resources), symposiums for caregivers, and informative meetings with participants of the API Colombia clinical trial. Results In the period of mandatory preventive confinement, 30 families obtained diapers, 23 families received prescription drugs not provided by health maintenance organizations (HMO) and 48 families received groceries. A total of 32 home-visits were made: 7 in rural areas and 25 in urban areas. At the end of the mandatory preventive confinement, outpatient medical consults were resumed, no participants withdrew from the trial during this period. Thirty-six people with MCI or dementia participated in virtual cognitive stimulation activities. Caregiver remote workshops held in the first semester of 2020 had a total attendance of 80 people, and events held in the second semester, such as the Commemoration of Alzheimer's Day and the Symposium for Caregivers, had a total attendance of 1,665 people and 1,000 people respectively. Conclusion GNA?s Social Plan and the amended which includes strategies of social support, knowledge and patient/caregiver empowerment strengthened the interaction between the community and GNA and likely favorably influenced adherence and retention in the API Colombia clinical trial in the face of challenges from the global pandemic.

Psychological status in the participants of the API ADAD Colombia trial assisted by a comprehensive mental health program during COVID 19 pandemic

Background Due to the global SARS-CoV2 pandemic it has been hard to conduct research, including research related to prevention of neurodegenerative diseases. The Alzheimer?s Prevention Initiative (API) Autosomal Dominant Alzheimer?s Disease (ADAD) Colombia trial is being conducted in participants with family history of early-onset dementia due to the PSEN1 E280A mutation who are cognitively unimpaired at baseline. Participants are enduring three stressors: 1) fear of developing dementia;2) logistic changes to the study caused by the public health emergency due to the pandemic;and 3) concern about getting infected by SARS-CoV2. Objective: To describe the frequency of new or exacerbated psychological disorders among the participants of the API ADAD Colombia trial assisted by a comprehensive mental health team during the COVID-19 pandemic. Method Participants in the API ADAD Colombia trial have free access to psychology and psychiatry services, either in person or through teleassistance, as well as psychoeducational offerings. These mental health services are provided by the site, outside of the study protocol, and are supported by Health and Social plans which were created to support participants? wellbeing during the trial. Descriptive statistics (mean, standard deviation and percentages) were used to analyze characteristics and frequency of mental health issues in the participants. Result 66 participants (53 women, 80.3%) were treated by the Mental Health Team from March 1st, 2020 through December 31st, 2020. Mean age was 44.09 (SD 6.97) y.o. Before and after the pandemic onset, the most common psychological problems were anxiety (before 36.4%, after 63.6%) and depression (before 34.8 %, after 37.9%). From people who received psychological and psychiatric services, 70% vs. 81.6% felt that those services helped them, respectively. Among participants who received psychological vs. psychiatric assistance, 71.4% vs. 86.9% of patients with depression, 70.3% vs 75% of patients with anxiety and 60% vs 76.2% of patients with other disorders, felt the services helped them with these conditions. Conclusion A comprehensive mental health program immersed in a trial to prevent or treat devastating diseases as dementia, could mitigate the psychological effects of the COVID-19 pandemic in study participants.