Wenpeng You

Background: Poor social connection and ageing-related biological processes are recognised contributors to Alzheimer’s disease and related dementias. However, cross-national evidence linking structural indicators of social connection with dementia and broader neurological dis-ease burden remains limited. This ecological study examined country-level associations be-tween average household size and modelled neurological disease incidence estimates. Methods: Country- and territory-level data from up to 204 settings were analysed. Average household size was the primary exposure, and model-derived, age-standardised incidence-rate estimates for Alzheimer’s disease and other dementias were the primary outcome. Par-kinson’s disease, motor neuron disease, multiple sclerosis, idiopathic epilepsy, headache dis-orders, and total neurological disorders were examined as comparative secondary outcomes. The Henneberg Index, life expectancy at age 60, GDP per capita, and urban living were in-cluded as contextual covariates. Analyses included Pearson and Spearman correlations, par-tial correlations, principal component analysis, and multivariable linear regression. Results: Household size was strongly and inversely associated with Alzheimer’s disease and other dementias incidence estimates (Pearson r=−.841, p<.001). The association remained after adjustment for the included covariates (β=−.569, p<.001). Significant inverse adjusted associations were also observed for Parkinson’s disease, motor neuron disease, and total neurological disorders, whereas patterns differed for other neurological outcomes. Principal component analysis identified a single ageing–development dimension explaining 72.1% of the variance, with household size loading inversely against life expectancy at age 60, econom-ic affluence, urban living, and the Henneberg Index. Conclusion: Smaller average household size was associated with higher modelled incidence estimates for dementia and selected neurodegenerative diseases at the country level. These findings should be interpreted as ecological associations rather than evidence of individual-level causation and suggest that household structure is embedded within broader demograph-ic, socioeconomic, and ageing-related processes.

Aim To develop and undertake a preliminary psychometric evaluation of a questionnaire assessing nursing students’ capability to recognise and respond to possible early dementia in women, and to examine factors associated with questionnaire scores. Design A cross-sectional questionnaire-development and preliminary psychometric evaluation study. Methods An expert-reviewed and pilot-tested 25-item questionnaire was administered to Australian entry-to-practice nursing students. The analytic sample comprised 133 non-preview responses with more than 50% survey progress. Item performance, principal axis factoring with oblimin rotation and parallel analysis, internal consistency, preliminary construct validity, known-groups differences and multivariable associations were examined. Results Item-level missingness ranged from 0.0% to 3.0%, and corrected item–total correlations ranged from .520 to .719. All items demonstrated ceiling effects. Exploratory factor analysis of 114 complete cases, supported by parallel analysis, identified two correlated factors: contextual, safety and professional response (15 items) and symptom recognition and clinical interpretation (10 items). Sampling adequacy was good (Kaiser–Meyer–Olkin = .869), Bartlett’s test of sphericity was significant (p < .001), and the two-factor solution explained 50.96% of the variance. Internal consistency was high for Factor 1 (α = .932; ω = .935), Factor 2 (α = .907; ω = .908) and the total 25-item set (α = .945). After adjustment for older-adult placement and study year, dementia-specific education was associated with higher Factor 1 (B = 0.297, p = .012) and Factor 2 scores (B = 0.497, p < .001). Conclusion The questionnaire demonstrated promising preliminary structure and internal consistency. Substantial ceiling effects, borderline cross-loadings and the modest complete-case sample require confirmation and refinement in a larger independent sample.

Background: Periodontal disease is common among adults with diabetes, yet periodontal screening is rarely incorporated into routine outpatient diabetes care. The Oral Health Assessment Tool (OHAT) is a structured observational tool designed for non‐dental healthcare professionals; however, its relationship with periodontal screening findings remains unclear. Objectives: To examine the association between OHAT findings and periodontal screening outcomes in adults attending diabetes outpatient clinics. Methods: This cross‐sectional study included adults with type 1 or type 2 diabetes at a tertiary hospital in Sydney, Australia. Periodontal screening was performed using the Periodontal Screening and Recording (PSR) system, and oral health was assessed using OHAT. Periodontal status was dichotomized as no/mild (PSR 0–2) versus moderate‐to‐severe (PSR ≥ 3). Logistic regression examined associations of OHAT domains and total OHAT burden with periodontal status. Covariate‐adjusted models assessed robustness. Screening performance was evaluated using sensitivity, specificity, and predictive values. Results: Among 120 participants (mean age 61.5 years, 64.2% with type 2 diabetes), 71.4% demonstrated moderate‐to‐severe periodontal findings. Mean OHAT score was 4.99 (SD 2.02). Change/unhealthy ratings for tongue (OR 3.23, 95% CI 1.30–8.02), gums and oral tissues (OR 4.59, 95% CI 1.78–11.85), and increasing categories of decayed teeth (OR 2.06, 95% CI 1.05–4.05) were associated with moderate‐to‐severe findings. Higher total OHAT score (> 5 vs. ≤ 5) was strongly associated with moderate‐to‐severe periodontal findings (OR 7.00, 95% CI 2.25–21.76), with consistent results. This threshold showed high specificity (87.5%) and positive predictive value (90.9%), but moderate sensitivity (50.0%). Conclusion: OHAT findings were associated with moderate‐to‐severe periodontal screening findings among adults with diabetes, supporting further evaluation of OHAT as a pragmatic screening and referral aid in settings where formal periodontal assessment is not routinely available. Its performance when administered by non‐dental clinicians requires further investigation.

1. Dementia is a major and growing global public health challenge, placing substantial strain on healthcare systems, social care infrastructure, and economic sustainability [1–3]. As populations ag...

Purpose This study examined three-year changes in functional change, cognitive symptoms, frailty and depressive symptoms among older Chinese-speaking adults in Australia. Method A longitudinal cohort of 114 participants was followed across 2023, 2024 and 2025. Outcomes were assessed using the Healthy Brain Ageing–Functional Assessment Questionnaire, AD8, FRAIL Scale and five-item Geriatric Depression Scale, and analysed using linear mixed-effects models. Major findings Functional change and cognitive symptom scores increased significantly from 2023 to 2024 and remained stable in 2025. Frailty scores were stable between 2023 and 2024 but increased significantly in 2025, whereas depressive symptom scores showed no significant change. Complete-case sensitivity analyses supported these findings. Conclusions The results suggest that functional and cognitive vulnerability may emerge before measurable increases in frailty. Longitudinal, culturally responsive monitoring may support earlier identification and timely intervention among older Chinese-speaking.

Depression and dementia frequently co-occur, yet sex-specific population-level associations remain unclear. This ecological study examined cross-national relationships between sex-specific depressive disorder incidence and dementia incidence using Institute for Health Metrics and Evaluation data. Analyses included sex-stratified scatterplots, Pearson and Spearman correlations, principal component analysis, partial correlations adjusting for macro-structural factors, and sex-specific multiple linear regression. Visual analyses suggested positive associations in both sexes, but patterns were stronger and more structured among females. Female depressive disorder incidence correlated with dementia incidence in females and males, clustered with structural-development indicators, and remained associated after adjustment. Male depressive disorder incidence showed no significant associations. Overall, depressive disorder incidence was independently associated with dementia incidence among females but not males, supporting a sex-differentiated population-level mental health–dementia relationship with implications for global women’s health and ageing. These findings inform sex-sensitive surveillance, prevention, and policy frameworks in rapidly ageing societies worldwide, particularly within resource-constrained transitional contexts.

Background: Hearing loss is a well-established modifiable risk factor for dementia at the individual level, but less is known about whether hearing loss prevalence aligns with dementia prevalence at the country level across diverse socioeconomic and demographic contexts. This study examined sex-stratified country-level associations between hearing loss prevalence and dementia prevalence, while avoiding causal interpretation of ecological associations. Methods: Country-level sex-specific prevalence estimates for hearing loss and dementia prevalence were obtained from the Global Burden of Disease data resources. Analyses were conducted separately for females and males and included descriptive sample summaries, Pearson and Spearman correlations, principal component analysis, partial correlations used as sequential robustness checks, and theory-informed multivariable linear regression. Variables were log10-transformed for the primary analyses. Models adjusted for economic development, urbanisation, the Henneberg Index, and sex-specific life expectancy at age 60. Formal sex comparison was evaluated using coefficient-comparison testing of the hearing-loss effect from comparable adjusted models. Results: The global bivariate association between hearing loss prevalence and dementia prevalence was strong in females (Pearson r = 0.827; Spearman rho = 0.845; p < 0.001) and males (Pearson r = 0.848; Spearman rho = 0.855; p < 0.001). Principal component analyses indicated that hearing loss prevalence clustered with socioeconomic and demographic indicators in both sexes, explaining more than 70% of total variance. In multivariable regression models, adding hearing loss increased explanatory power in females (R ² from 0.661 to 0.827) and males (R ² from 0.674 to 0.811). A formal coefficient-comparison test did not indicate a statistically meaningful difference between the female and male hearing-loss coefficients in the fully adjusted models (z = 0.82; p = 0.41). Conclusions: Hearing loss prevalence is strongly associated with dementia prevalence at the country level in both females and males after adjustment for macro-level socioeconomic and demographic covariates. The findings support the population-level relevance of hearing health for dementia surveillance and prevention, while indicating broad convergence rather than clear sex-based divergence in the hearing loss-dementia association.