Background Japan is experiencing rapid population aging, accompanied by increasing long-term care demand and workforce constraints, particularly in rural and semi-rural regions where rehabilitation professionals are scarce. Many daycare facilities continue to operate within a traditional service culture focused on routine caregiving rather than autonomy-supportive, preventive engagement. To address this practice gap, a quality improvement (QI) initiative introduced a structured dialogical approach designed to support intrinsic motivation and voluntary daily activity among older adults attending a daycare center. Methods This project was conducted as a practice-based QI initiative embedded within routine service delivery at a community daycare (day service) center in Kitami City, Hokkaido, Japan. The initiative was embedded in routine service delivery and consisted of semi-structured dialogues and follow-up conversations at each daycare visit that emphasized value clarification, reflective goal-setting, and self-directed activity planning. Participants who were not receiving external rehabilitation services and who engaged in at least one full dialogue cycle were included. QI outcomes were examined through (1) practice-based observations focusing on intervention adaptation and behavioral change and (2) exploratory quantitative assessment using the Short-Form Berg Balance Scale (SF-BBS) at baseline, six months, and 12 months. Results Thirty-seven users met eligibility criteria; 34 completed the six-month and 14 completed the 12-month follow-up. While guided by a common dialogical framework, practice-based adaptations emerged during implementation, particularly for participants with cognitive impairment, where repetition and simplified reflection appeared to support value recall and engagement. Descriptive observations suggested increased engagement in self-directed activity and voluntary participation in home-based exercise. Non-planned practice-based observations included enhanced peer interaction, autonomous use of the training area, and increased user-initiated requests for functional training. Exploratory SF-BBS analyses suggested a positive functional trend among participants with available follow-up data, within the limitations of a non-controlled QI context. Conclusions This QI initiative suggests that autonomy-supportive, dialogical engagement may represent a feasible practice-based modification of routine daycare interactions even within daycare facilities characterized by traditionally structured caregiving practices. The findings underscore the importance of relational dialogue, contextual adaptation, and practice-based learning in real-world implementation. Such an approach may offer transferable insights for geriatric and preventive care in aging societies, although further replication across multiple settings and with more comprehensive outcome assessment is warranted.
The clinical swallow examination, including palpation of hyo-laryngeal motion, is an important screening technique for dysphagia. However, this method lacks objectivity and precision, and it cannot reliably quantify hyoid movement velocity, which may be more closely associated with the risk of penetration and aspiration. This prospective observational study aimed to evaluate the predictive value of ultrasonographic hyoid motion parameters for identifying penetration, aspiration, and pharyngeal residue across International Dysphagia Diet Standardisation Initiative (IDDSI) food textures. Forty-seven adults with suspected oropharyngeal dysphagia underwent submental ultrasonography alongside either videofluoroscopic swallowing study or flexible endoscopic evaluation of swallowing. Six kinematic parameters, including hyoid displacement and velocity metrics, were measured and compared to instrumental swallowing outcomes. Penetration and aspiration were most prevalent with thin liquids (IDDSI Level 0, 57.4%). At this consistency, reduced maximal hyoid displacement was significantly associated with higher Penetration-Aspiration Scale scores (odds ratio [OR] = 0.75, p = .036). In contrast, in the present study, vallecular residue showed stronger associations with the velocity-based parameters examined. At IDDSI Level 2, lower average velocity of anterior hyoid bone excursion (HBE; OR = 0.18, p = .036) and lower average velocity of maximal HBE (OR = 0.24, p = .036) were associated with increased vallecular stasis severity. Similar associations were observed at Level 5, with area under the curve values up to .69. Pyriform sinus residue showed limited association with hyoid motion parameters. Receiver operating characteristic analysis and ordinal logistic regression demonstrated consistency-dependent associations between specific sonographic parameters and swallowing outcomes. Submental ultrasonography allows noninvasive quantification of hyoid motion during swallowing. Certain kinematic parameters demonstrated associations with airway invasion and vallecular residue at specific food consistencies. However, integration with complementary assessments remains essential for comprehensive evaluation. https://doi.org/10.23641/asha.32616798.
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Internal medicine residents frequently encounter arrhythmias on admission and telemetry, yet studies consistently demonstrate suboptimal electrocardiogram (ECG) interpretation accuracy and inadequate formal training. We implemented a 14-week structured "burst-learning" ECG curriculum at a single safety-net academic internal medicine residency, comprising twelve 15- to 30-minute case-based sessions covering 20 high-acuity rhythms aligned with American College of Cardiology/American Heart Association guidelines.A 20-item knowledge quiz and scenario-linked 5-point Likert confidence survey were administered before and after the curriculum (unpaired cohorts). Twenty-six residents completed baseline and 15 completed postcurriculum assessments. Mean confidence rose from 2.81 ± 0.94 to 3.48 ± 0.87 (P = 0.03); knowledge scores did not change meaningfully (from 7.38 ± 2.35 to 7.87 ± 1.64; P = 0.45). Postcurriculum status independently predicted higher confidence (β = 0.61; 95% CI: 0.04-1.19; P = 0.038). A brief, low-cost burst curriculum was associated with increased resident ECG confidence and was durably incorporated into the residency schedule. However, diagnostic accuracy gains will require a longer dose and paired measurement.
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Studies have shown that use of immunomodulators during the acute phase of SARS-CoV-2 infection may decrease development of post-acute sequelae of SARS-CoV-2 (PASC) or long COVID; however, such studies have not been conducted in children. Evaluate the effectiveness of steroid use during the acute phase of SARS-CoV-2 infection in preventing long COVID in children. We conducted a retrospective cohort study using target trial emulation methodology to compare children and youth who did and did not receive dexamethasone, prednisone, prednisolone or methylprednisolone within 12 days of SARS-CoV-2 infection. Inverse propensity of treatment weighting was used to balance covariates between treated and untreated patients in hospitalized and outpatient groups. The primary outcome was the development of PASC in the 1-6 months following acute infection using a computable phenotype definition. Secondary outcomes included respiratory, musculoskeletal, gastrointestinal and neurological subphenotypes and the PASC ICD-10-CM diagnosis code. We calculated hazard ratios from Cox proportional models with 95% confidence intervals. From a starting cohort of 854,128 children/youth, of whom 768,845 (90.0%) were outpatients and 85,283 (10.0%) were inpatients at the time of SARS-CoV-2 infection, the weighted outpatient cohort included 22,085 steroid-treated children and 20,373 in the non-steroid group. Following weighting, the hospitalized cohort included 11,250 steroid-treated children and 10,340 untreated children. In hospitalized patients, there were no significant treatment differences in the development of PASC in the 1-6 months following acute SARS-CoV-2 infection except for a lower risk of gastrointestinal PASC in treated patients (HR: 0.58; [95% CI: 0.39-0.85], p = 0.01). In outpatients, no treatment differences were observed in the development of PASC subphenotypes. Steroids administered during acute SARS-CoV-2 infection did not lead to a decreased risk of PASC, with the exception of gastrointestinal presentations. Additional studies are needed to confirm the benefit of steroids and other immunomodulators in preventing long COVID.
Globally, there is growing recognition of the need to advance approaches to involve people with lived experience of dementia as collaborators in policy, advocacy and research activities. Involvement is viewed as a right by dementia advocates and others, and some organizations have developed mechanisms to support this collaboration, such as through dedicated resources for infrastructure or as a condition of research funding. However, there is limited literature on how national and international organizations support the involvement of people with lived experience of dementia. In this perspective article, we describe different approaches to involving people with lived experience in policy, advocacy and research activities across national and international network contexts. We outline and compare the approaches taken by the Engagement of People with Lived Experience of Dementia program and advisory group (Canadian Consortium on Neurodegeneration in Aging), Alzheimer Society Research Network (Alzheimer's Society UK), European Working Group of People With Dementia and European Dementia Carers Working Group (Alzheimer Europe), and the Lived Experience Advisory Group (Global Brain Health Institute, Trinity College Dublin). For each example presented, we describe the initiative (e.g., purpose, brief history, structure). We discuss the four initiatives in order to identify common and context-specific barriers and enablers to involvement. We hope that the findings will help others to develop their own initiatives to involve people with lived experience of dementia.
Language access significantly affects patient-provider communication, patient safety, and healthcare outcomes. Eliminating language barriers improves care quality. As a result, the use of professional interpreters or language concordant care is recommended. Yet, persistent barriers remain. We conducted a policy-oriented narrative review of peer-reviewed studies, federal regulations and professional guidelines published between 2004 and 2025 on language access, interpreter services, and U.S. Health System reform. We found there is a solid foundation in place to support several needed steps to strengthen language supports for non-English-preferring patients in the United States. We recommend practical, evidence-based strategies for healthcare organizations, state and federal polices, and joint multi-stakeholder initiatives. To drive meaningful change, both federal and state initiatives that financially incentivize improved language supports are needed, alongside enhanced regulatory and enforcement mechanisms to penalize underperforming providers. Healthcare systems must prioritize professional interpretation, develop systematic methods to assess and utilize the language skills of bilingual providers, and ensure consistent availability of professional high-quality language services. Integrating language access and supports into technology standards is also crucial for effectively mitigating language barriers. Substantial changes are necessary to enhance healthcare experiences and outcomes for patients who communicate in languages other than English.
Potentially inappropriate prescribing (PIP) has been associated with various adverse clinical outcomes, particularly in the context of ageing, multimorbidity and polypharmacy. Despite growing interest in front door frailty initiatives in the emergency department (ED) and acute geriatric units (AGUs), no review has focused specifically on interventions targeting PIP, as defined by validated criteria, across both ED and AGU settings. This scoping review aimed to map the evidence on interventions addressing PIP in older adults attending EDs or AGUs, identify evidence gaps and highlight areas for future research. This scoping review was conducted in accordance with Joanna Briggs Institute (JBI) methodology and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Medline, Embase, CINAHL Ultimate, Web of Science, Cochrane CENTRAL and grey literature sources were searched from 1991 to 2025 for studies evaluating interventions targeting PIP, defined using validated criteria, in adults aged ≥ 65 years attending the ED or AGUs. Our search returned 8643 results. Twenty-one studies were identified for inclusion, four of which were randomised controlled trials. The 18 interventions identified encompassed pharmacist-led medication reviews, clinical decision support systems (CDSS), educational/academic detailing programmes or combined approaches. While PIP was frequently a primary outcome measure, few studies reported clinical outcomes or explored prescriber adherence and experiences of older adults and prescribers. Pharmacist-led medication reviews, CDSS and educational/academic detailing were the main intervention approaches identified. Evidence was heterogeneous and focused mainly on prescribing-related outcomes, with limited assessment of clinical outcomes, prescriber adherence, communication pathways and stakeholder feedback. Future studies should incorporate longer-term follow-up and evaluate patient-centred and implementation outcomes.
Personalised medicine represents a key direction of modern healthcare, enabling the adaptation of prevention, diagnosis and treatment based on individual patient characteristics. The European Partnership for Personalised Medicine (EP PerMed) was established as a strategic European Union initiative to coordinate research, innovation and implementation of personalised medicine across Member States. This article provides a comprehensive overview of the origin, objectives, programmes and major challenges of EP PerMed, with a particular focus on its relevance for clinicians and researchers and on the participation of the Czech Republic. Special attention is dedicated to the role of the Czech Health Research Council (AZV ČR) as a key national coordinating and funding body facilitating the involvement of Czech teams in EP PerMed joint transnational calls. The article discusses benefits and future perspectives of personalised medicine in both the European and Czech contexts.
The quality of medical services in public hospitals is significantly influenced by managerial styles, which shape organizational efficiency, patient satisfaction, and hospital accreditation outcomes. This study examines the impact of managerial leadership styles and organizational characteristics on accreditation performance in Romanian public hospitals. Using survey data from hospital managers, the study employs a structured analytical approach combining Chi-square tests and cross-tabulations, Kendall's Tau correlations, the Kruskal-Wallis H test, ordinal regression modeling, and exploratory K-means cluster analysis to examine how hospital size, managerial education, employee consultation, team motivation, and access to information are associated with accreditation outcomes. Results indicate that hospital administration type, field of study, and team motivation are significant predictors of accreditation success, while hospital size negatively correlates with accreditation scores, suggesting larger hospitals face greater challenges in meeting accreditation standards. Conversely, employee consultation and information transparency show no statistically significant impact on accreditation performance. These findings highlight the critical role of managerial education and team engagement in achieving higher accreditation outcomes. Strengthening leadership training and team-based quality initiatives could enhance accreditation performance in public hospitals. Policy makers should prioritize managerial development programs and strategic leadership approaches to improve healthcare quality and compliance.
In the aftermath of the Second World War, Poland faced immense public health challenges amidst widespread destruction and political transformation. This article explores the largely overlooked medical mission of the Unitarian Service Committee (USC) in Poland, situating it within both humanitarian and geopolitical contexts. Drawing on archival research and press accounts, the study reconstructs the USC's multifaceted aid efforts, including its Medical Teaching Mission, the establishment of the Piekary Śląskie hospital, and tuberculosis control initiatives. The analysis highlights how the USC combined direct medical assistance with educational outreach, aiming to support long-term recovery. However, operating behind the Iron Curtain, the Committee's activities were subject to both surveillance and propaganda, revealing the entanglement of health and politics in Cold War Europe. This case offers new insights into the role of non-governmental actors in shaping postwar public health and diplomacy in Eastern Europe.
Trauma is a team sport in which surgeons remain central to the management of severely injured patients, from resuscitation and operative decision-making through inpatient care, discharge and follow-up. Contemporary trauma systems in Australia and Aotearoa New Zealand are guided by surgical society standards that emphasise verification, quality improvement and adaptable models of service delivery across metropolitan and regional settings. Effective trauma leadership requires not only clinical expertise but also coordination across specialties, governance, education, research and advocacy. As trauma services evolve, surgeons continue to play key leadership roles within hospitals, professional bodies and training pathways, supported by initiatives such as the Australian and New Zealand Association for the Surgery of Trauma and the Post-Fellowship Education and Training Program in Trauma. Sustaining optimal outcomes for polytrauma patients will depend on strengthening multidisciplinary collaboration while ensuring robust surgical leadership across the trauma continuum.
For more than two decades, United States foreign assistance, particularly through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), has been central to Nigeria's HIV response, supporting antiretroviral therapy (ART), laboratory systems, and community-based prevention initiatives. Among these are programs for orphans and vulnerable children (OVC) and the Families Matter! Program (FMP), which equips parents and caregivers to guide adolescents away from behaviours that increase HIV risk and help reduce HIV-related stigma within families and communities.The temporary freeze on U.S. foreign aid announced in January 2025 disrupted these interventions and raised concerns about the sustainability of Nigeria's HIV response. While much attention has focused on the risk of treatment interruptions and ART stock-outs, less attention has been given to the suspension of OVC and FMP programs despite their role in prevention, psychosocial support, and household stability.This paper examines the short-and long-term implications of the aid freeze for Nigeria's HIV response, with particular focus on adolescents, vulnerable children, and family-centred prevention initiatives. It argues that disruptions to these programs may undermine prevention gains and weaken social protection systems, while also highlighting the need for stronger domestic resource mobilisation and institutionalisation of community-based HIV interventions to ensure a more sustainable and resilient response.
The health system has been identified as a key lever for increasing access to birth registration (BR) directly after birth. BR is critical for upholding human rights and accessing essential services, yet many low- and middle-income countries struggle with low BR rates. In this realist synthesis, we reviewed literature on two separate interventions that are designed to increase access to BR services. This included (1) embedding or appointing an official to register births in health facilities and (2) incorporating education on BR in routine perinatal care programmes. This study aimed to support the knowledge base on how these interventions work, why, and for whom, within health facility contexts. We followed the RAMESES I publication guidelines for realist syntheses. Iterative searches were carried out in PubMed, Scopus and Web of Science. The search also included grey literature, policy documents and insights from a key informant in South Africa. We adopted an iterative cycle of searches guided by review team exchanges, stakeholders' insights and sequential snowballing searches for theory and background information. We developed two initial programme theories, presented as ICAMO configurations, that were then refined against empirical evidence from 17 included studies, with publication dates ranging from 1992 to 2021. Our review findings highlight that the interventions improved BR rates by lowering logistical barriers, raising awareness and supporting BR staff, (i.e., personnel responsible for conducting BR within health facilities). Literature from LMICs suggest that the effectiveness of facility-level BR interventions is often affected by access to care, travel distances, transportation costs, as well as by the availability of resources, BR infrastructure, and staff motivation within healthcare facilities. These factors may, in turn, affect BR demand, parents' self-efficacy, and the extent to which BR initiatives align with parents' real-life contexts.
Pulmonary arterial hypertension (PAH) is a rare, progressive disorder defined by elevated pulmonary arterial pressure and vascular resistance, ultimately leading to right ventricular failure and premature death. Once considered a disease of pure vasoconstriction, PAH is now recognized as a complex vasculopathy involving endothelial dysfunction, inflammation, metabolic dysregulation, and genetic susceptibility. The pulmonary vasculature is dynamically narrowed by vasoconstriction, structurally obstructed by smooth muscle and endothelial proliferation, and pathologically stiffened by fibrosis and extracellular matrix deposition. Multiple cell types including endothelial cells, smooth muscle cells, fibroblasts, and immune cells contribute to this remodeling process. At the molecular level, hyperproliferative, apoptosis-resistant phenotypes emerge through mitochondrial dysfunction, oxidative stress, and endothelial-to-mesenchymal transition, which together drive a Warburg-like metabolic shift favoring glycolysis over oxidative phosphorylation. Chronic immune activation, characterized by cytokine release, T-cell and macrophage infiltration, and disrupted immune regulation, further amplifies vascular injury. Genetic studies have identified mutations in BMPR2, TBX4, SOX17, and other regulators of the bone morphogenic protein (BMP)/transform-ing growth factor-β (TGF-β) pathway as key contributors to heritable and idiopathic forms of PAH, highlighting impaired endothelial repair and aberrant signaling as central mechanisms. Recent translational breakthroughs have yielded novel therapeutic strategies beyond traditional vasodilators. Agents targeting the BMP/TGF-β axis (e.g., sotatercept), growth factor signaling (seralutinib), inflammatory pathways (tocilizumab, rituximab), and metabolic remodeling (pyruvate dehydrogenase kinases [PDK] and fatty acid oxidation [FAO] modulators) are redefining treatment paradigms. Concurrently, large-scale multi-omics initiatives such as PVDOMICS and PHOENIKS enable deep phenotyping, which unravels molecular endotypes and informs precision medicine approaches. This review summarizes the pathophysiology of PAH and the ongoing clinical trials in the PAH field.
Increasing clinical complexity, rising admission volumes and shorter hospital stays have intensified demands on internal medicine residents. A 2015 time and motion study at our institution showed that residents spent nearly half of their day on computer work, with frequent task-switching and limited patient contact. These findings prompted organisational reforms to redistribute workload and improve workflow. We aimed to assess how resident time allocation changed after organisational reforms. We performed a before-and-after time and motion study in the division of internal medicine in a tertiary care centre in Switzerland. Direct observations were conducted over identical periods (May-July) in 2015 (baseline, before implementation of organisational reforms) and 2018 (first assessment after full implementation of these reforms). All residents were eligible. Shifts were randomly selected and stratified by weekday, with two shifts per resident observed whenever possible. Trained observers used a standardised electronic tool to record 22 mutually exclusive activities and contextual factors. The primary outcome was time spent on administrative tasks (patient-related and non-patient-related administration, discharge summaries, information retrieval). Secondary outcomes included task-switching rate, mismatch rate (deviation from planned schedule) and shift duration. Division workload data were collected to adjust analyses. Seventy-five residents were observed over 142 shifts (1478 hours). From 2015 to 2018, mean administrative time increased from 92 to 139 minutes/day (p <0.001) and mean task-switching from 15 to 20 per hour (p <0.001), while mean mismatch rate decreased (38.8% to 31.7%, p <0.001). The mean shift duration shortened (11h38m to 10h45m, p <0.001), with mean personal time increasing (32 to 63 minutes, p <0.001). Mean bedside time declined (113 to 92 minutes, p = 0.011) and mean computer use slightly decreased (327 to 290 minutes, p = 0.009). Mean weekly admissions rose (96 to 146, p <0.001) and mean length of stay was halved (15.5 to 8.5 days, p <0.001). Results were consistent after adjustment for division workload. Targeted reforms improved schedule alignment and work-rest balance but failed to reduce administrative burden in a high-turnover environment. Local time-management interventions should be integrated with hospital-wide strategies addressing workflow complexity, interprofessional communication and task distribution. These results may inform similar initiatives in other high-pressure inpatient training settings. ISRCTN 69703381, https://doi.org/10.1186/ISRCTN69703381.
There are significant opportunities for speech-language pathologists (SLPs) to play important roles in the primary and secondary prevention of Alzheimer's disease and related dementias (ADRD) beyond current practices. This tutorial, developed by members of the Joint Committee on Interprofessional Relations between the American Psychological Association and the American Speech-Language-Hearing Association, is intended to support SLPs in these efforts and to facilitate collaboration between SLPs and neuropsychologists. This tutorial synthesizes interdisciplinary literature on cognitive aging, ADRD, public health, clinical psychology, speech-language pathology, and motivational interviewing. We provide an evidence-based overview of cognitive aging, ADRD, modifiable aspects of brain health, and practical strategies for engaging with middle-age and older adults to promote brain health across the lifespan. While discussions about cognitive aging, Alzheimer's disease, and dementia have long been avoided, stigmatized, and demoralizing, there is much more to be positive about than in the past. Forty-five percent or more cases of dementia can be delayed or prevented by addressing modifiable risk factors across the lifespan, and brain health and resilience can be improved at any age. As the population ages worldwide, it will require SLPs and neuropsychologists working together and with other helping professions to raise awareness, contribute to public health initiatives, advocate for reimbursement for efficacious services, and educate and motivate their clients to improve brain health. Even small effects in the primary and secondary prevention of dementia can translate into significant personal and societal outcomes.
Digital health services are expanding, yet community readiness for digital care varies widely. Without a validated, granular measure of readiness, health systems and policymakers cannot reliably enable targeted support or monitor equitable deployment. To develop and validate a reproducible census tract-level index of community digital health readiness integrating socioeconomic conditions, access to care, and digital connectivity. This cross-sectional index development and validation study analyzed public data from 2018 to 2022. The Digital Health Index (DHI) was constructed from 21 indicators with equal weighting representing 3 domains: socioeconomic, health access, and connectivity. Content validity was assessed using a 2-round Delphi panel including 37 experts. Structural validity was assessed with exploratory and confirmatory factor analyses. Convergent validity was assessed against the Social Vulnerability Index (SVI), Area Deprivation Index (ADI), and Digital Divide Index (DDI). External validity was assessed using health care spending. Robustness was assessed using leave-one-out, weight-perturbation, and group-based cross-validation analysis. Data were analyzed between June 2023 and April 2026. Primary outcomes were validation metrics, including factor structure fit indices, correlations with established indices, association with health care spending per capita, and Delphi consensus rates for each indicator. Robustness outcomes included stability of tract rankings under indicator removal or weight changes. The DHI was computed for 85 396 US census tracts across all 50 states. DHI scores correlated with SVI, ADI, and DDI scores (Spearman ρ = 0.61-0.84) but prioritized different low-readiness communities, with only 33% to 44% overlap between tracts in the highest DHI decile and those in the highest SVI, ADI, or DDI deciles. Health care spending showed similar inverse associations across indices. DHI rankings remained stable in sensitivity analyses. All 21 indicators met Delphi consensus criteria after 1 or 2 rounds. In this cross-sectional index development and validation study, a reproducible measure of community digital health readiness was constructed at the census tract level, integrating socioeconomic, access, and connectivity factors. The DHI may help health systems, public agencies, and researchers identify communities requiring support and track readiness over time as digital health and artificial intelligence initiatives expand.
BackgroundInterleukin-8 (IL-8) exhibits dual roles in Alzheimer's disease (AD), yet how the metabolic milieu of type 2 diabetes mellitus (T2DM) influences its impact in mild cognitive impairment (MCI) remains unclear.ObjectiveThis study aimed to investigate how T2DM status moderates the longitudinal association between baseline plasma IL-8 levels and AD-related outcomes, including cognitive decline, amyloid-β (Aβ) deposition, and neurodegeneration.MethodsData from 373 MCI participants (Alzheimer's Disease Neuroimaging Initiative cohort) were analyzed. Moderation analyses examined the IL-8 × T2DM interaction on cognitive trajectories, amyloid-β (Aβ) accumulation, and regional atrophy, adjusting for key covariates.ResultsIn the T2DM group, higher baseline IL-8 was significantly associated with a slower longitudinal increase in Clinical Dementia Rating-Sum of Boxes (p = 0.005), indicating preserved clinical function. Furthermore, elevated IL-8 in the T2DM cohort correlated with lower hippocampal Aβ burden (p = 0.041) and attenuated atrophy rates in the parahippocampal cortex (p = 0.044). In contrast, no significant associations between IL-8 and any AD biomarkers or cognitive trajectories were observed in the non-T2DM group.ConclusionsThis research demonstrates that the role of IL-8 in MCI is "context-dependent," contingent upon the patient's metabolic state. The author suggests that under chronic metabolic stress, IL-8 may reflect an adaptive immune response that mitigates amyloid pathology and slows neurodegeneration. These results emphasize the necessity of integrating metabolic profiles into the interpretation of neuroinflammatory biomarkers to facilitate personalized therapeutic strategies for AD.