Introduction Microplastics (MPs) have emerged as pervasive environmental contaminants, with growing concerns about their potential health impacts, including neurocognitive effects. In Indonesia, where plastic pollution is severe, no validated tool exists to assess public plastic use patterns and MP awareness in relation to cognitive health. Objective This study aimed to develop and validate a comprehensive questionnaire evaluating plastic consumption behaviors, MP knowledge, attitudes, and their association with cognitive function in Indonesian adults. Material and methods A cross-sectional pilot study was conducted with 30 participants (80% female, mean age 37.4±13.7 years). The questionnaire was developed through literature review, expert consultation, and focus group discussions, covering six domains: demographics, health history, MP knowledge, plastic use behaviors, environmental attitudes, and cognitive screening (AD-8). Validity was assessed using Pearson’s correlation, and reliability was measured via Cronbach’s alpha. Result The questionnaire demonstrated strong validity for knowledge (r=0.379, p=0.039), behavior (r=0.726, p<0.001), and attitude sections (r=0.385, p=0.036), with acceptable reliability (α=0.623). Neurocognitive assessment revealed significantly lower AD-8 scores in participants with cognitive decline (mean=11.14) versus normal cognition (mean=18.03, p=0.038). Key findings included high single-use plastic consumption, limited awareness of MP regulations (70% uninformed), and an attitude-behavior gap in mitigation efforts. Discussion The tool effectively identified MP knowledge gaps and behavioral risks while suggesting a plausible link between plastic exposure and cognitive impairment. The AD-8’s sensitivity and specificity supported its utility for screening, though the modest sample size limited statistical power for correlation analyses. Conclusion This validated questionnaire provides a critical foundation for assessing MP-related cognitive risks in Indonesia. Future studies should expand validation in larger cohorts and investigate causal mechanisms. The findings underscore the need for public education and policy interventions to reduce plastic exposure.

Introduction: Microplastics (MPs) are widespread environmental pollutants with possible neurotoxic effects. Exploring links between plastic use, MP awareness, and cognition is key for assessing public health risks. Objective: To examine correlations between plastic consumption, MP awareness and attitudes, and neurocognitive function among Greater Jakarta residents. Methods: A cross-sectional survey of 562 adults used a validated e-questionnaire covering plastic usage, MP knowledge, attitudes, risk perception, and cognition via the Ascertain Dementia 8 (AD-8). Analyses included chi-square, t-tests, and logistic regression. Results: Suspected cognitive impairment (AD-8 ≥ 2) was observed in 44.5% of respondents. High single-use plastic consumption correlated with worse cognition (p = 0.032), while reusable plastic use showed no association (p = 0.605). Awareness of MPs was relatively low, with 19.4% of respondents having never heard of them. Awareness and knowledge also varied significantly by age (p = 0.007), gender (p = 0.004), and education level (p = 0.027). Positive attitudes and higher risk perception aligned with greater awareness (p < 0.001) but not cognitive scores. Risk perception influenced bottled water use (p = 0.009), with low-risk groups consuming more. Conclusions: Frequent single-use plastic consumption is linked to poorer cognition, while MP awareness and risk perception do not directly affect cognitive outcomes. Educational strategies may enhance awareness and reduce exposure.

Aphasia diagnosis in Indonesia remains challenging due to limited culturally and linguistically appropriate instruments. Widely used tools such as the Boston Diagnostic Aphasia Examination (BDAE) and Western Aphasia Battery (WAB) are not adapted to the Indonesian context, while Tes Afasia untuk Diagnosis, Informasi, dan Rehabilitasi (TADIR) provides screening but lacks diagnostic accuracy. To address this gap, we developed the Instrumen Diagnosis dan Evaluasi Afasia (IDEA) for native Indonesian speakers and evaluated its validity, reliability, and normative cutoff values in cognitively healthy Indonesian adults. Eighty-three cognitively normal adults (screened using MoCA-Ina) with no history of neurological disease were assessed using IDEA, which evaluates six language domains. Items were adapted from existing tools and reviewed by experts. Content validity, internal consistency (Cronbach’s alpha), and construct validity (Exploratory Factor Analysis) were analyzed using SPSS v25. A total of 83 participants were included (median age = 55.81 years, 54% secondary education). IDEA demonstrated good feasibility, with an average completion time of 45-60 minutes depending on participant engagement. Content validity was established by unanimous expert consensus. Construct validity showed meritorious sampling adequacy (KMO = .872) and significant sphericity (Bartlett’s test χ ² (15) = 278.523, p<.001), supporting factor analysis. Internal consistency showed good reliability across six domains (Cronbach’s α = 0.896). IDEA is a valid and reliable tool for assessing aphasia in Indonesian natives. It is a culturally appropriate assessment tool which offers structured, domain-based evaluation and supports differential diagnosis of both classical and progressive aphasia syndromes. Highlight: Aphasia diagnosis in Indonesia remains challenging due to limited accurate tools. Our instrument evaluates language domains to assess aphasia and its mimics. Validation in 83 cognitively healthy participants showed good validity and reliability.

Background/Objectives: Alzheimer’s disease (AD) is a leading cause of dementia globally, yet standard diagnostic markers like cerebrospinal fluid (CSF) analysis and molecular imaging are invasive and resource-intensive. While artificial intelligence (AI)-based volumetric magnetic resonance imaging (MRI) offers a scalable and non-invasive alternative, data correlating these structural metrics with fluid biomarkers and cognitive status in Southeast Asian populations are scarce. This study addresses this critical gap by examining the within-cohort relationship between CSF biomarkers and regional brain volumes derived from AI-assisted MRI in Indonesian patients with clinically diagnosed AD, providing novel data for an underrepresented population. Methods: Twenty-one AD patients from three national referral hospitals in Indonesia underwent lumbar puncture for CSF biomarker analysis and 3 Tesla structural brain MRI. Brain volumes were analyzed using United Imaging Intelligence software, focusing on AD-relevant regions (hippocampus, entorhinal cortex, parahippocampus, precuneus, and posterior cingulate cortex [PCC]). Results: Spearman’s correlation revealed significant positive associations between CSF Aβ42 levels and several brain regions. Strong correlations were found with the right entorhinal volume indexed to intracranial volume (VICV) (r = 0.601, p = 0.004), right PCC VICV (r = 0.603, p = 0.004), right entorhinal volume (r = 0.533, p = 0.013), and right hippocampus VICV (r = 0.503, p = 0.020). Furthermore, MoCA-InA scores demonstrated highly significant positive correlations with CSF Aβ42 concentrations (r = 0.720, p < 0.001), right Hippocampus VICV (r = 0.703, p < 0.001), and right PCC VICV (r = 0.695, p < 0.001). No significant correlations were found between CSF pTau or the pTau/Aβ42 ratio and regional volumes. Conclusions: These results highlight the entorhinal cortex and PCC as early affected regions where CSF Aβ42 correlates with preserved volume, supporting their role as structural markers in early AD. The absence of pTau associations may reflect early-stage pathology or limitations of cross-sectional volumetry. In resource-limited settings, AI-assisted volumetric MRI demonstrates potential utility as a non-invasive tool for stratifying amyloid-associated brain atrophy and staging disease severity.