Talk:Alzheimer's disease

Diagnosis of Early-onset Alzheimer's section?

Hello everyone, myself as well as Joan1087 and Joyjxu1 were thinking of adding our research on the diagnosis of Early-onset Alzheimer's disease by creating a new section for it on this article. This information is not presented here or on the Early-onset Alzheimer's article https://en.wikipedia.org/wiki/Early-onset_Alzheimer%27s_disease. It does somewhat tie into the diagnosis of Alzheimer's at its preclinical stage. But, we could also add it to the research directions section if that is preferred. Feel free to let us know your thoughts! Bharatss-SB (talk) 21:39, 29 November 2021 (UTC)

User:Bharatss-SB and User:Joan1087, Have you had a chance to see WP:SS? It is probably best to add that content to Early-onset Alzheimer's disease, and once the content there is settled, add only a one- or two-line summary back to this article. SandyGeorgia (Talk) 22:15, 29 November 2021 (UTC)

Hi @SandyGeorgia, that sounds good! We will be adding it to that article while including the two-line summary here. For the summary, however, would it be okay to make a subsection in the Diagnosis section, or should we make a new section for it in this article? Bharatss-SB (talk) 00:21, 30 November 2021 (UTC)

Ping me after you’ve added it to the sub-article, and I’ll be better to able to opine. Generally, adding one or two sentences here that use a wikilink to that article is the way to go, but if it has considerable content worthy of its own section, then we would use a WP:HATNOTE and maybe add a new section … depends on WP:DUE. SandyGeorgia (Talk) 00:34, 30 November 2021 (UTC)

PS, @Bharatss-SB and Joan1087: forgot to ping your collaborator Joyjxu1 and to mention that you all are doing amazing work. I have never before worked with student editors who were this conscientious and productive and collaborative. @Ian (Wiki Ed) and Mcbrarian: I hope you are getting an “A” for your effort! And more, I hope you will stay around after your course ends to help get this article back up to snuff. It was once a Featured article, but fell away from featured status due to neglect and becoming very outdated! SandyGeorgia (Talk) 00:40, 30 November 2021 (UTC)

Hi @SandyGeorgia Thank you for all your help, we really appreciate it and we do hope to continue editing after our course is over! We'll ping you after we've added it to the sub-article. Joan1087 (talk) 13:48, 3 December 2021 (UTC)

Hi @SandyGeorgia Adding on to what Joan1087 just said, thank you so much for all your kind words and help! We will definitely stay after the course ends to help get the article back up to a better ranking. I think this might be a newfound hobby for all of us! On a side note, one thing we were thinking of doing in the next coming days is to upgrade the ranking of the article up to a class B (after we edit it some more and ensure all the cn's are covered). Would you agree with this new ranking? If not, are there any suggestions you would like to add so that we can prioritize them in our editing for now? Thank you so much again!! We greatly appreciate all of your help :) Bharatss-SB (talk) 07:51, 5 December 2021 (UTC)

Bharatss-SB editors are not encouraged to upgrade the assessment on articles they have contributed significantly to, rather to have someone else do that re-assessment. I could do that for you, but it is pretty clear that the "Society and culture" and "Research directions" sections (at least, and maybe others) are still grossly outdated, so the article does not yet warrant a B-class assessment. You all took on a very big, and very oudated topic, and made excellent progress!

The main thing you could prioritize for now, if you want extra work (after fixing the issues I raise in the next section, #Reviewing work so far), is to carefully go through every section and make sure text is up to date. Wherever you find dated text, you could put an {{update needed}} tag next to the old citation, as that encourages other editors to make those additions. It's OK to leave an article tagged; that is not a reflection on your work, which has greatly improved the article, rather a way to get more editors to keep up the good work. I did one sample for you here; note that the sources are VERY old, and new data is surely available on this. Also, see in that edit how you can add hidden comments that future editors will see, even though they don't show in the rendered version that readers see.

With or without an upgrade to B-class, all of you have an earned an "A" in my book for your work here! SandyGeorgia (Talk) 21:00, 5 December 2021 (UTC)

Hi @SandyGeorgia, thank you so much for letting us know! We will be looking into those sections as well as the items mentioned in the #Reviewing work so far section on the talk page. Also, that's a really cool feature! Thank you for letting us know about it as we will definitely begin using it. We will also update the talk page on our progress as we adjust these newly suggested sections, thank you again! Bharatss-SB (talk) 21:12, 5 December 2021 (UTC)

Reviewing work so far

@Bharatss-SB, Joan1087, and Joyjxu1: sorry I've been busy and not keeping up with your latest edits. Reviewing this work done since I last looked in:

• Use of this technique in clinical practice is still limited, however, due to the lack of coverage by insurance companies. See MOS:CURRENT. The word still should be replaced with a date for time context. There should be no space between the end of the sentence and the ref tags. However is often redundant (see the top of User:SandyGeorgia). And, the reference to insurance companies is specific to the US. SO: my changes.
• With this text
  • (Additional research is required to understand the lifestyle effect, such as gaining insight in neuroimaging biomarkers to understand mechanisms<ref>{{cite journal | vauthors = Arenaza-Urquijo EM, Wirth M, Chételat G | title = Cognitive reserve and lifestyle: moving towards preclinical Alzheimer's disease | journal = Frontiers in Aging Neuroscience | volume = 7 | pages = 134 | date = 2015-08-10 | pmid = 26321944 | pmc = 4530312 | doi = 10.3389/fnagi.2015.00134 }}</ref>.{{MEDCN|date=November 2021}}

it's hard to tell what is intended. The citation needed tag was left, but a citation was added, so a reader wonders if only part of the sentence is covered by the citation. ALso, puncutation goes before the ref tags (except in the case of dashes). Understand ... understand ... is redundant. That source is wonderful and likely to be re-used, so I have named it. SO: my copyedit and while that source is likely to be useful in expanding lifestyle, that particular text fits better in the "Research directions" section.

• In this edit, there are several items needing clarification:
  • Prevalence estimates in 2015 were that around 47 million people worldwide had dementia. I can't decipher how to read that source, or where to locate the 47 million number, but it is unclear if the number was intended to refer to all types of dementia, or just AD. Relative to the 50 used later, it seems to apply only to AD, but the text says dementia, which is broader.
  • As the incidence and prevalence are steadily increasing, the prevalence itself is projected to triple by 2050. The text implies that this trend is global or worldwide, but the source seems to be specific to China. Since the source is not freely available, clarification is needed.
  • Some high-income countries, however, have noticed declines in their trends. A "decline in trends" needs a time reference; from what time frame to what time frame, or since when ??

References

That's all I've got; very nice work, but I hope you are able to clarify these small matters, as I can't sort how to read that source. Regards, SandyGeorgia (Talk) 20:48, 5 December 2021 (UTC)

Hi @SandyGeorgia, thanks for checking through our work! We're a little overloaded right now because of our exams, however we'll make sure to address your comments over the coming weeks! Joan1087 (talk) 01:31, 13 December 2021 (UTC)

Thank you, Joan1087; that would be grand. Good luck on your finals! SandyGeorgia (Talk) 03:00, 13 December 2021 (UTC)

Hi @SandyGeorgia, Happy New Year! Just wanted to let you know that we will still continue to work on this. The break was a bit hectic for all of us with exams, work, and now once we get settled in with our second-term courses (as course changes are happening right now), we will continue to edit the article as we did previously :) Bharatss-SB (talk) 06:37, 13 January 2022 (UTC)

Hello all! @Bharatss-SB, Joan1087, Joyjxu1, and SandyGeorgia: I am a medical student taking a course at UCSF wanting to help out with this article. I was reading through your discussions and it actually looks like the citations needed to be more current and updated, namely "Society and Culture" and "Research" sections. I want to know how I can help most. I can also go through an editing/grammar tool called Hemmingway editor to clean up the grammar too since some of the sentences throughout are a little too long and/or complex. I will be posting my Workplan by the end of tonight and will review it with my colleagues tomorrow. Let me know if you have any questions!

PS. not sure how to tag or "ping" people on here just yet but excuse me as I get used to the Wikipedia tools! Looking forward to working with you all! :) 10:35, 3 March 2022 (PST) — Preceding unsigned comment added by Dr. Sardinha (talk • contribs)

Hi, Dr. Sardinha. Unless you sign your entries, "pings" are not received by the intended editors. I have this page watchlisted, so saw your entry, and Bharatss-SB, Joan1087 and Joyjxu1 seem to be no longer editing.

You can sign your edits on talk pages by entering four tildes ( ~~~~ ) after them. I have also correctly indented/threaded your post for you; see this information about how to indent and thread conversations on Wikipedia for better readability.

I am not a fan of the results returned by the readability tools, and they have been many times rejected by many discussions on Wikipedia, as they often result in choppy sentences and dumbed down text, so I suggest first posting some examples of your intended fixes in that area. Colin is most knowledgeable in that regard.

As to where you might best work on this article, yes, the Society and culture section is not in good shape; there is ample new secondary literature on the costs, for example. The other area most in need of help is the Medications section. Thanks for the effort, SandyGeorgia (Talk) 21:20, 3 March 2022 (UTC)

Bilingualism

Medical citation needed for "Learning a second language later in life seems to delay the onset of Alzheimer's disease." Grant, A., Dennis, N.A. and Li, P. (2014). Cognitive control, cognitive reserve, and memory in the aging bilingual brain. Frontiers in Psychology, 5. — Preceding unsigned comment added by Solacialuctus (talk • contribs) 07:46, 27 January 2022 (UTC)

Thanks for that, Solacialuctus and welcome! Here is the formatted citation for that:

• Grant A, Dennis NA, Li P (2014). "Cognitive control, cognitive reserve, and memory in the aging bilingual brain". Front Psychol. 5: 1401. doi:10.3389/fpsyg.2014.01401. PMC 4253532. PMID 25520695.{{cite journal}}: CS1 maint: unflagged free DOI (link)

but I'm a bit concerned about using this source. It is flagged as a low-quality journal by Headbomb's script. It seems to be a secondary review (to comply with WP:MEDRS), but it is dated (2014, see WP:MEDDATE). And it seems to be contradicted by this more recent review:

• Brini S, Sohrabi HR, Hebert JJ, et al. (March 2020). "Bilingualism Is Associated with a Delayed Onset of Dementia but Not with a Lower Risk of Developing it: a Systematic Review with Meta-Analyses". Neuropsychol Rev. 30 (1): 1–24. doi:10.1007/s11065-020-09426-8. PMC 7089902. PMID 32036490.

So it seems that something can be said, but the text needs to be adjusted accordingly. Also, the "later in life" bit is not clear to me (but I haven't read the full studies). SandyGeorgia (Talk) 08:01, 27 January 2022 (UTC)

Wiki Education assignment: WikiMed Feb-Mar 2022 UCSF SOM

This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 February 2022 and 27 March 2022. Further details are available on the course page. Student editor(s): Dr. Sardinha (article contribs).

Work Plan

Aspect of Work Plan	Notes
Article Chosen	Alzheimer's Disease
Why this article?	My grandmother has mild to moderate Alzheimer’s which has taken an increasingly large toll on my family who takes care of her. This is a disease process I would like to learn more about. No one in my family comes from a medical background so it is important to me that the article has great readability and up to date. Additionally, this article is of Top importance with only a C quality grade. It also had a 2-5k page views/day over the past year.
Initial Anlaysis	I think the article has great potential, but as described in the Notes of previous Wikipedians, there are several statements throughout a few of the sections, specifically "Prevention," "Management - Medication," and "Society + Culture," that need to be updated. Statements are supported by resources from almost 20 years ago which would warrant a review of the current literature to examine how and if things have changed. Specifically, within the “Caregiving Burden” section, I will try to find more current information regarding the effects on the caregiver(s). In the “Media” section, I can update the list with more current representations. In the “Research Directions” section,I plan to elaborate on the statements already made but also try and look into other future research directions other than aducanumab, medication, and the ketone-diet. I also believe other causes other than HSV and fungal infections could be listed as potential causes. Otherwise, improve readability throughout the article and attempt to read through the lens of someone who is not in the medical field or familiar with the disease.

Timeline

Milepost Date	To Be Completed Before Milepost Date
Fri, March 4th	Choose article Read and evaluate article Complete work plan
Wed, March 9th	Review, update, and collect references: Prevention: Medication, Lifestyle Improve readability of section
Wed, March 16th	Review, update, and collect references: Prevention: Diet Improve readability of section
Mon, March 21st	Review, update, and collect references: Social Cost Improve readability of section
Fri, March 25th	Read and use feedback to make changes to the article accordingly!

Dr. Sardinha (talk) 21:16, 3 March 2022 (UTC)

Dr. Sardinha see my comments in the section above re Hemmingway Editor and readability. As to updating the Caregiver burden, please be sure to use sources and information specific to Alzheimer's as there is already a general article at Caring for people with dementia. Regards, SandyGeorgia (Talk) 21:29, 3 March 2022 (UTC)

@SandyGeorgia:, thank you for the feedback re: Hemmingway and I will make sure I find sources specific to Alzheimer's in my research as I know this has been an issue in other sections as well! Thank you for the help! Dr. Sardinha (talk) 21:36, 3 March 2022 (UTC)

Dr. Sardinha the caregiving section at Featured article Dementia with Lewy bodies may provide an example to guide your work: Dementia with Lewy bodies#Caregiving. SandyGeorgia (Talk) 17:46, 4 March 2022 (UTC)

@SandyGeorgia:, Awesome! I did see that you've worked on that article too! I will definitely look that over and see how I can use that as a guideline to help with my proposed edits. Thanks for the help and continued communication! Dr. Sardinha (talk) 17:50, 4 March 2022 (UTC)

Dr. Sardinha see WP:ENGVAR; although it is slipping, this article uses British English (see the template buried under Other talk page banners at the top of this page). Also, on WP:CITEVAR, it uses Vancouver style authors. You can just plug a PMID in to this tool to get a citation that conforms with the article established style. SandyGeorgia (Talk) 20:39, 7 March 2022 (UTC)

Update: "Prevention" is a larger section than I anticipated. There are many statements that need clarification since many studies examine mild cognitive impairment (MCI) or dementia rather than Alzheimer's disease specifically. So unless the review article examined articles that looks at Alzheimer's disease specifically, I had to specify that. The "Lifestyle" section also examines many different aspect of lifestyle - higher education, occupational attainment, leisure activities, physical exercise, calorie restriction (should be in diet?), and meditation all of which are very interesting but other interesting lifestyle changes I want to look into are smoking, sleep, and stress and how that may possibly prevent Alzheimer's disease.Dr. Sardinha (talk) 15:52, 9 March 2022 (UTC)(talk) 15:50, 9 March 2022 (UTC)

Update: I completed the Lifestyle section and went on to move onto the Diet section, but it was suggested most of the section be omitted and also moved to the "Management" section as evidence was not sufficient. Instead of undoing the edit, I decided to add-on a statement at the end of the diet section that states which dietary factors have been studied as I found that the review articles I looked up were noteworthy and should be mentioned, if not here, in the future direction section. I will now try update and work on the "Social Cost" subsection as many of the references have been outdated. Dr. Sardinha (talk) 15:17, 17 March 2022 (UTC)

Peer Review by Zeboman123 Overall your improvements were wonderful! You definitely improved the quality and readability of the article. I especially appreciated the changes to the lifestyle section, and it was much more thorough and coherent than prior.

Comments: On the prevention: medication section I appreciated the work you did on the commonly used meds as well as NSAIDs, putting it in the context of widely used things. I also loved your inclusion of depression as a risk factor! If there is anything else that there is to be said about why depression might be a risk factor that could be something interesting to include — but certainly not necessary. One thing that drew my attention was the line about HRT not decreasing cognitive decline — I’d think about maybe acknowledging that Alzheimers disease is separate from general cognitive decline and then justifying why that evidence is helpful or not helpful given it isn’t precisely about Alzheimers disease.

I appreciated the overview you added on relevant lifestyle interventions. I also read about the issues with the diet section on the talk page and it looked complicated — but it looked like you had some good experience figuring out where to put things in collaboration with other Wikipedians! The additions you made to the social cost were also excellent, and is often an under-appreciated part of learning about disease — not just the disease process itself but the secondary effects etc.

Overall, great job! I appreciated all the work and time you put into it, and I’m sure all the people who read the page will too (though they won’t know it was you).

On gut microbiome role in the disease

Increasing experimental, epidemiological and clinical evidences reveal that gut microbiome has a profound impact on the disease's onset and worsened course, in particular, through effects on formation of the blood-brain barrier, myelination, neurogenesis, and microglia maturation. Studies suggests that gut microbiome of patients with the disease have decreased microbial diversity and is compositionally distinct from control age- and sex-matched individuals, including decreased Firmicutes and Bifidobacterium, as well as increased Bacteroidetes. Results from germ-free animals and animals exposed to pathogenic microbial infections, antibiotics, probiotics, or fecal microbiota transplantation showed that gut microbiota modulates many aspects of animal behaviors, suggesting a role for the gut microbiota in disease related pathogenesis. — Preceding unsigned comment added by Agrivkov (talk • contribs) 18:24, 6 March 2022 (UTC)