Protocol for the IDEAL-2 longitudinal study: Following the experiences of people with dementia and their primary carers to understand what contributes to living well with dementia and enhances active life

Background There is a major need for longitudinal research examining the experiences of people with dementia and their primary carers, as relatively little is known about how the factors associated with capability to ‘live well’ vary over time. The main aim of the IDEAL-2 study is to investigate how and why, over time, people with dementia and their primary carers might vary in their capability to live well with dementia, whilst exploring both their use of health and care services and their unmet needs. Methods IDEAL-2 will build on the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort of 1547 people (who, at recruitment between July 2014 and July 2016, had mild-to-moderate dementia), and their 1283 primary carers in Great Britain. The existing cohort will be enriched with additional participants with mild-to-moderate dementia (and their primary carers where available and willing) from the following groups: people with rarer forms of dementia, and/or those who are ≥90 years or < 65 years of age at time of recruitment. We will assess the primary outcome, capability to live well with dementia, and the factors influencing it using questionnaires at yearly intervals for 3 years. Additionally, we will seek to link the cohort data with administrative data to obtain information about health service use. Some participants will be invited for in-depth face-to-face interviews. The cohort study will be supplemented by linked research focusing on: the co-production of new measures of living well; including the perspectives of people with advanced dementia living in residential care settings; including people with dementia from black, Asian, and minority ethnic groups; and understanding the experience of people living with undiagnosed dementia. Discussion IDEAL-2 will provide evidence about the key indicators of, and factors associated with, living well over the course of dementia and how these differ for particular subgroups. It will tell us which combinations of services and support are most beneficial and cost-effective. Moreover, the IDEAL-2 study will gather evidence from under-researched groups of people with dementia, who are likely to have their own distinct perceptions of living well.Alzheimer’s Society & The University of Exete

Registration of High Angular Resolution Diffusion MRI Images Using 4 th Order Tensors ⋆

Abstract. Registration of Diffusion Weighted (DW)-MRI datasets has been commonly achieved to date in literature by using either scalar or 2 nd-order tensorial information. However, scalar or 2 nd-order tensors fail to capture complex local tissue structures, such as fiber crossings, and therefore, datasets containing fiber-crossings cannot be registered accurately by using these techniques. In this paper we present a novel method for non-rigidly registering DW-MRI datasets that are represented by a field of 4 th-order tensors. We use the Hellinger distance between the normalized 4 th-order tensors represented as distributions, in order to achieve this registration. Hellinger distance is easy to compute, is scale and rotation invariant and hence allows for comparison of the true shape of distributions. Furthermore, we propose a novel 4 th-order tensor retransformation operator, which plays an essential role in the registration procedure and shows significantly better performance compared to the re-orientation operator used in literature for DTI registration. We validate and compare our technique with other existing scalar image and DTI registration methods using simulated diffusion MR data and real HARDI datasets.