UNASSIGNED: Advance care planning in dementia includes supporting the person and their family to consider important goals of care. International research reports the importance of psycho-social-spiritual aspects towards end of life.
UNASSIGNED: To develop a multidimensional international palliative care goals model in dementia for use in practice.
UNASSIGNED: International Delphi study integrating consensus and evidence from a meta-qualitative study. The Delphi panel rated statements about the model on a 5-point agreement scale. The criteria for consensus were pre-specified.
UNASSIGNED: Seventeen researchers from eight countries developed an initial model, and 169 candidate panellists were invited to the international online Delphi study.
UNASSIGNED: Panellists (107; response 63.3%) resided in 33 countries. The model comprised four main care goals: (1) Comfort ensured; (2) Control over function maintained; (3) Identity protected and personhood respected and (4) Coping with grief and loss-person and caregiver supported. The model reflects how needs and care goals change over time with the progression of dementia, concluding with bereavement support. The first version of the model achieved a consensus after which it was slightly refined based on feedback. We did not achieve a consensus on adding a goal of life prolongation, and on use of the model by people with dementia and family themselves.
UNASSIGNED: A new palliative care goals model for people with dementia and their families includes relationship aspects for use by professionals and achieved a consensus among a panel with diverse cultural background. The position of life prolongation in relation to palliative care goals needs further research.

The behavioral variant of frontotemporal dementia (bvFTD) is the second most common cause of dementia for individuals <65 years old, but accurate diagnosis is often delayed for several years. While previous criteria have increased the ability of diagnosticians to distinguish between bvFTD and other neurocognitive disorders such as Alzheimer\'s disease, distinguishing bvFTD from a primary psychiatric disorder (PPD) has been more challenging. In early 2020, the Neuropsychiatric International Consortium for Frontotemporal Dementia published the first consensus recommendations to help clinicians distinguish between bvFTD and PPD. These recommendations were produced by a consortium of 45 scientists and clinicians from more than 15 different countries, who explored aspects of history taking, neuropsychological assessments, clinical scales, neuroimaging, CSF and serum biomarkers, and genetics. A multidisciplinary approach is encouraged throughout. In this article, the authors also review those consensus recommendations and highlight use of novel tests and techniques. Additionally, they indicate where further research is needed, including methods to assess the dissemination and implementation of these recommendations. In this way, future efforts by clinicians and researchers alike to improve accurate recognition of bvFTD are encouraged, thereby expanding opportunities for improved guidance and management.

The cognitive disease consensus was prepared by panels of health and public representatives based on actual clinical practice in Geriatric Departments in Chinese hospitals and a systematic literature review. This consensus reflects the medical knowledge accumulated by those experts and provides information about professional medical care and advice. A multidisciplinary panel of specialists (neurologists, psychiatrists, and nursing specialists) reports an expert consensus on the medical knowledge accumulated from those experts and provides information about professional medical care and advice. The recommendations focus on the care and management of older adults with mild cognitive impairment, the objectives and methods of maintaining cognition and training, the assessments and measures of daily care for patients at different stages of dementia, the assessments and coping strategies for the behavioral and psychological symptoms of dementia, principles and suggestions for an appropriate living environment, arrangements for recreational activities, the care and management of patients with end-stage dementia, and suggestions for addressing stress in caregivers.

Cognitive abilities, such as memory, learning, language, problem solving, and planning, involve the frontal lobe and other brain areas. Not much is known yet about the molecular basis of cognitive abilities, but it seems clear that cognitive abilities are determined by the interplay of many genes. One approach for analyzing the genetic networks involved in cognitive functions is to study the coexpression networks of genes with known importance for proper cognitive functions, such as genes that have been associated with cognitive disorders like intellectual disability (ID) or autism spectrum disorders (ASD). Because many of these genes are gene regulatory factors (GRFs) we aimed to provide insights into the gene regulatory networks active in the human frontal lobe. Using genome wide human frontal lobe expression data from 10 independent data sets, we first derived 10 individual coexpression networks for all GRFs including their potential target genes. We observed a high level of variability among these 10 independently derived networks, pointing out that relying on results from a single study can only provide limited biological insights. To instead focus on the most confident information from these 10 networks we developed a method for integrating such independently derived networks into a consensus network. This consensus network revealed robust GRF interactions that are conserved across the frontal lobes of different healthy human individuals. Within this network, we detected a strong central module that is enriched for 166 GRFs known to be involved in brain development and/or cognitive disorders. Interestingly, several hubs of the consensus network encode for GRFs that have not yet been associated with brain functions. Their central role in the network suggests them as excellent new candidates for playing an essential role in the regulatory network of the human frontal lobe, which should be investigated in future studies.