Translation and cultural adaptation of tools to assess diverse Asian American and Asian Canadian subgroups: The Asian Cohort for Alzheimer's Disease (ACAD) Study

Alzheimer s & Dementia · 2025-06-01 · 4 citations

INTRODUCTION: The availability of sociocultural and language-appropriate study materials and instruments is critical for the assessment of cognitive function in people from diverse backgrounds. This report describes the translations and cultural adaptations of study materials for the Asian Cohort for Alzheimer's Disease (ACAD) study. METHODS: We performed translations and cultural adaptations in accordance with the World Health Organization (WHO) translation guidelines to ensure reliable, complete, and culturally appropriate translations from English to the specified Asian languages. RESULTS: We developed Asian language versions of the ACAD documents (consent, data collection packet, and community and social media outreach materials) reflecting the sociocultural backgrounds of the ACAD target population (i.e., older Asian adults) DISCUSSION: The multistep translation process accounting for distinctive Asian sociocultural and language backgrounds provides an important guideline for Alzheimer's disease and related dementias (ADRD) researchers to promote health literacy and research with underrepresented Asian American and Canadian adults. HIGHLIGHTS: Asian American and Asian Canadian older adults are the fastest-growing populations. A lack of linguistically and culturally appropriate cognitive assessment tools creates barriers for quality healthcare and clinical research. We report the translations and cultural adaptations of the Asian Cohort for Alzheimer's Disease (ACAD) study materials into Chinese, Korean, and Vietnamese. This translation methodology should be extended to Asian Indians, Filipinos, and other Asian American or Asian Canadian populations.

Author Correction: High inter-rater reliability in consensus diagnoses and overall assessment in the Asian Cohort for Alzheimer’s Disease Study

npj Dementia · 2025-11-21

High Inter-Rater Reliability in Consensus Diagnoses and Overall Assessment in the Asian Cohort for Alzheimer’s Disease Study (P1-3.002)

Neurology · 2025-04-07

This study assesses the inter-rater reliability of consensus diagnoses for Alzheimer’s disease (AD) across multiple sites in the Asian Cohort for Alzheimer’s Disease (ACAD) study

High inter-rater reliability in consensus diagnoses and overall assessment in the Asian Cohort for Alzheimer’s Disease Study

npj Dementia · 2025-07-30

The Asian Cohort for Alzheimer's Disease (ACAD) study is a collaborative investigation of genetic and non-genetic risk factors for AD among Asian Americans and Canadians. Harmonization of diagnostic procedures across recruiting sites will be key to the dataset's efficacy. Forty-two participants who completed the consensus process across seven ACAD recruiting sites were re-reviewed by two further impartial raters. Cohen's Kappa coefficient was used to evaluate inter-rater agreement. The findings reveal the highest level of observed agreement at 88% and a Cohen's Kappa of 0.835, among site consensus participants and two levels of external review, affirming the reliability of our protocol. ACAD has developed a data collection and diagnostic process that allows consistency among sites that serve Asians speaking Korean, Chinese, and Vietnamese languages.

Temporal relationship between neurofilament light chain and cytokines involved in T helper-17 lymphocyte signaling in the blood of experimental autoimmune encephalomyelitis mice

Multiple Sclerosis and Related Disorders · 2025-04-21

Prevalence of Dementia among Malawian adults with HIV and without HIV: A Medical Record Review

Alzheimer s & Dementia · 2024-12-01

Abstract Background Malawians, in Sub‐Saharan Africa (SSA), face the double burden of HIV and Alzheimer’s disease and related dementia (ADRD). The life expectancy among HIV‐positive people on antiretroviral therapy has increased consistently over the past 25 years. The purpose of the study was to determine the prevalence of dementia among people living with HIV (PLWHIV) and the general population without HIV as a comparison group in Malawi. Methods We conducted a retrospective medical records review of four hundred consecutive patients from a single tertiary health center (200 PLWHIV from the HIV clinic and 200 without HIV from an outpatient clinic) in Lilongwe, Malawi. Since there was no electronic medical records system in Malawi, trained data collectors manually reviewed the medical records based on the instrument devices and the definitions between August 2023 and October 2023. We examined dementia prevalence and clinical characteristics including age, gender, and other clinical history between PLWHIV and the comparison group. Results The PLWHIV group was significantly younger than the comparison group (mean age = 44.23±8.07 vs. 57.67±16.28; p<2e‐16), while there was no significant difference in sex (male 55% vs. 50%; p = 0.37). The overall prevalence of dementia was higher in PLWHIV than that in the comparison group (22% vs. 10%; p = 1.4e‐03 before adjusting for age and p = 1.9e‐07 after adjusting for age). Prevalence difference was higher in the older individuals (age>50; 39% vs. 13%; p = 3.2e‐4 before adjusting for age and p = 4.9e‐07 after adjusting for age). Dementia increased with age in both groups: 13% (age<45), 17% (45‐64), and 22% (65 and over), but more rapidly in PLWHIV than in the comparison group (17%, 28% and 50% vs. 5%, 4% and 20% respectively). Conclusion This is the first study to demonstrate prevalence of dementia in PLWHIV was significantly higher than that of the general population in Malawi. We confirmed the increased risk of dementia in PLWHIV and provided valuable groundwork for future ADRD research in SSA, specifically in Malawi.

Preclinical Assessment of EPO-Derived Peptide JM4 in Experimental Autoimmune Neuritis (P10-5.008)

Neurology · 2023-04-25

Determine clinical efficacy of JM4, a synthetic erythropoietin-derived 19-mer peptide in experimental autoimmune neuritis (EAN).

Using community-based geographical information system (GIS) to recruit older Asian Americans in an Alzheimer’s disease study

BMJ Open · 2023-08-01 · 8 citations

OBJECTIVE: This study aims to show the usefulness of incorporating a community-based geographical information system (GIS) in recruiting research participants for the Asian Cohort for Alzheimer's Disease (ACAD) study for using the subgroup of Korean American (KA) older adults. The ACAD study is the first large study in the USA and Canada focusing on the recruitment of Chinese, Korean and Vietnamese older adults to address the issues of under-representation of Asian Americans in clinical research. METHODS: To promote clinical research participation of racial/ethnic minority older adults with and without dementia, we used GIS by collaborating with community members to delineate boundaries for geographical clusters and enclaves of church and senior networks, and KA serving ethnic clinics. In addition, we used socioeconomic data identified as recruitment factors unique to KA older adults which was analysed for developing recruitment strategies. RESULTS: GIS maps show a visualisation of the heterogeneity of the sociodemographic characteristics and the resources of faith-based organisations and KA serving local clinics. We addressed these factors that disproportionately affect participation in clinical research and successfully recruited the intended participants (N=60) in the proposed period. DISCUSSION: Using GIS maps to locate KA provided innovative inroads to successful research outreach efforts for a pilot study that may be expanded to other underserved populations across the USA in the future. We will use this tool subsequently on a large-scale clinical genetic epidemiology study. POLICY IMPLICATION: This approach responds to the call from the National Institute on Aging to develop strategies to improve the health status of older adults in diverse populations. Our study will offer a practical guidance to health researchers and policymakers in identifying understudied and hard-to-reach specific Asian American populations for clinical studies or initiatives. This would further contribute in reducing the health and research disparity gaps among older minority populations.

Erythropoietin-derived peptide treatment reduced neurological deficit and neuropathological changes in a mouse model of tauopathy

Alzheimer s Research & Therapy · 2021 · 14 citations

• Neuroscience
• Medicine
• Psychology

BACKGROUND: Prominent activation of microglial immune/inflammatory processes is a characteristic feature of brains of patients with tauopathies including Alzheimer's disease (AD), suggesting that neuroinflammation may be a critical factor in their pathogenesis. Strategies aimed at developing new therapeutics for tauopathies based on anti-inflammation or immunomodulation are likely to be promising avenues of research. We previously developed JM4-a 19'mer cyclic peptide derived from the first loop of human erythropoietin. This peptide possesses beneficial immune modulatory and tissue protective effects while lacking the undesirable side effects of full-length erythropoietin. In this preclinical study, we investigated the effect of chronic JM4 treatment on the PS19 mouse that carries the P301S mutant human tau gene, linked to a form of frontotemporal dementia. This transgenic mouse has been widely used as a model of tauopathies including AD and related dementias. METHODS: Daily subcutaneous treatment of female PS19 mice with JM4 was initiated before disease onset and continued on for the animals' lifespan. The progression of neurological deficit and the lifespan of these mice were assessed. To evaluate the effect of JM4 treatment on cognition of these animals, the PS19 mice underwent Barnes maze test and elevated plus maze test. In addition, neuronal loss, phosphorylated tau aggregation, and microglial activation were assessed using immunohistochemistry of PS19 mouse brain sections. RESULTS: JM4 treatment of PS19 mice initiated before disease onset reduced neurological deficit, prolonged lifespan, and rescued memory impairment. The beneficial effects of JM4 were accompanied by reductions in neuronal loss, phosphorylated tau aggregation, and microglial activation in the PS19 mouse brain. LIMITATIONS: Use of a single dose of JM4 and female mice only. CONCLUSION: JM4 is a potential novel therapeutic agent for the treatment of tauopathies including AD and related dementias.

Prolonged Beneficial Effect of Brief Erythropoietin Peptide JM4 Therapy on Chronic Relapsing EAE

Neurotherapeutics · 2020 · 10 citations

• Medicine
• Immunology
• Pharmacology

Potent beneficial immunomodulatory and anti-inflammatory effects of whole-molecule erythropoietin have been demonstrated in a variety of animal disease models including experimental autoimmune encephalomyelitis (EAE); however, excessive hematopoiesis limits its use in clinical applications. Our group previously generated an Epo-derived small peptide JM4 that is side-effect free and has strong neuroprotective activity without hematologic effects. Here, we investigated the long-term clinical effects of brief treatment with JM4 in chronic relapsing EAE using bioluminescence imaging (BLI) in transgenic mice containing the luciferase gene driven by the murine GFAP promoter. EAE mice treated with JM4 exhibited marked improvement in clinical scores and showed fewer disease flareups than control animals. JM4 therapy concomitantly led to markedly decreased GFAP bioluminescence in the brain and spinal cord in both acute and chronic relapsing EAE mouse models. We found a marker for toxic A1 astrocytes, complement component C3, that is upregulated in the brain and cord of EAE mice and sharply reduced in JM4-treated animals. In addition, an abnormally leaky neurovascular unit permeability was rapidly normalized within 5 days by JM4 therapy. The prolonged therapeutic benefit seen following brief JM4 treatment in EAE mice closely resemble that recently described in humans receiving pulsed immune reconstitution therapy with the disease-modifying compounds, alemtuzumab and cladribine. Our study suggests that JM4 therapy may have widespread clinical applicability for long-term treatment of inflammatory demyelinating diseases and that BLI is a useful noninvasive means of monitoring murine disease activity of the central nervous system.