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Brundage K, Holtzer R. Presence and Persistence of Perceived Subjective Cognitive Complaints and Incident Mild Cognitive Impairments Among Community-Residing Older Adults. Am J Geriatr Psychiatry 2023; 31:1140-1148. [PMID: 37516657 DOI: 10.1016/j.jagp.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES To examine whether Subjective Cognitive Complaints (SCCs) predicted incident mild cognitive impairment (MCI). DESIGN Prospective Study. SETTING Central Control of Mobility and Aging (CCMA), a cohort study of community-residing older adults. PARTICIPANTS Participants were dementia-free community-residing older adults. MEASUREMENTS SCCs were assessed at the baseline and via bi-monthly structured phone interviews during the first year using the Ascertain Dementia 8 (AD8). Nonpersistent status required one or two SCCs endorsements and Persistent status required three or more SCCs endorsements. Outcome, presence of mild cognitive impairments (MCI) was determined by established case conference diagnostic procedures. Participants were followed annually. Generalized estimating equations (GEE), logistic model type, were used to determine the odds of developing MCI during follow-up. SCCs served as the three-level predictor (no/nonpersistent/persistent) and cognitive status (MCI versus normal) as the binary outcome. Analyses were adjusted for age, sex, education, race, health status, depressive symptoms, and global cognition. RESULTS The sample (n=454; mean age=75.67 ± 6.43; %female=55.3) included 245 participants who reported no SCCs, 156 who reported 1-2 SCCs, and 53 who reported 3 or more SCCs. Sixty-eight participants developed MCI during follow-up. Results showed that compared to no SCCs, persistent SCCs, and nonpersistent SCCs were significantly associated with increased odds of developing MCI during follow-up. CONCLUSIONS The presence of SCCs regardless of their persistence was associated with increased odds of developing MCI even when adjusting for objectively-assessed cognitive performance.
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Affiliation(s)
- Katie Brundage
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY.
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Li C, Hong Y, Yang X, Zeng X, Ocepek-Welikson K, Eimicke JP, Kong J, Sano M, Zhu C, Neugroschl J, Aloysi A, Cai D, Martin J, Loizos M, Sewell M, Akrivos J, Evans K, Sheppard F, Greenberg J, Ardolino A, Teresi JA. The use of subjective cognitive complaints for detecting mild cognitive impairment in older adults across cultural and linguistic groups: A comparison of the Cognitive Function Instrument to the Montreal Cognitive Assessment. Alzheimers Dement 2023; 19:1764-1774. [PMID: 36222321 PMCID: PMC10090224 DOI: 10.1002/alz.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/26/2022] [Accepted: 08/11/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION This pilot study aims to explore the psychometric properties of the Cognitive Function Instrument (CFI) as a measure of subjective cognitive complaints (SCC) and its performance in distinguishing mild cognitive impairment (MCI) from normal control (NC) compared to an objective cognitive screen (Montreal Cognitive Assessment [MoCA]). METHODS One hundred ninety-four community-dwelling non-demented older adults with racial/ethnic diversity were included. Unidimensionality and internal consistency of the CFI were examined using factor analysis, Cronbach's alpha, and McDonald's omega. Logistic regression models and receiver operating characteristic (ROC) analysis were used to examine the performance of CFI. RESULTS The CFI demonstrated adequate internal consistency; however, the fit for a unidimensional model was suboptimal. The CFI distinguished MCI from NC alone or in combination with MoCA. ROC analysis showed comparable performance of the CFI and the MoCA. DISCUSSION Our findings support the use of CFI as a brief and easy-to-use screen to detect MCI in culturally/linguistically diverse older adults. HIGHLIGHT What is the key scientific question or problem of central interest of the paper? Subjective cognitive complaints (SCCs) are considered the earliest sign of dementia in older adults. However, it is unclear if SCC are equivalent in different cultures. The Cognitive Function Instrument (CFI) is a 14-item measure of SCC. This study provides pilot data suggesting that CFI is sensitive for detecting mild cognitive impairment in a cohort of older adults with racial/ethnic diversity. Comparing performance, CFI demonstrates comparable sensitivity to the Montreal Cognitive Assessment, an objective cognitive screening test. Overall, SCC may provide a non-invasive, easy-to-use method to flag possible cognitive impairment in both research and clinical settings.
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Affiliation(s)
- Clara Li
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yue Hong
- Salem Hospital, Mass General Brigham, Salem, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Xiao Yang
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaoyi Zeng
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katja Ocepek-Welikson
- Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
| | | | - Jian Kong
- Research Division, The Hebrew Home at Riverdale, Riverdale, NY, USA
| | - Mary Sano
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Carolyn Zhu
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Judith Neugroschl
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amy Aloysi
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dongming Cai
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Jane Martin
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Loizos
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret Sewell
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jimmy Akrivos
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kirsten Evans
- James J. Peters VA Medical Center, New York, NY, USA
| | - Faye Sheppard
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Greenberg
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allison Ardolino
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeanne A. Teresi
- Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
- Research Division, The Hebrew Home at Riverdale, Riverdale, NY, USA
- Mount Sinai Pepper Older Americans Independence Center, Department of Geriatrics and Palliative Medicine, Mount Sinai Medical Center, New York, NY, USA
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Numbers K, Lam BCP, Crawford JD, Kochan NA, Sachdev PS, Brodaty H. Longitudinal changes in participant and informant reports of subjective cognitive complaints are associated with dementia risk. Front Aging Neurosci 2023; 15:1044807. [PMID: 36891557 PMCID: PMC9987247 DOI: 10.3389/fnagi.2023.1044807] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/27/2023] [Indexed: 02/22/2023] Open
Abstract
Background Individuals with subjective cognitive complaints (SCCs) are at an increased risk of dementia. Questions remain about participant-reported versus informant-reported SCCs as indicators of future dementia and about longitudinal changes in participant-and informant-reported SCCs and risk of incident dementia. Method Participants were 873 older adults (M = 78.65-years; 55% female) and 849 informants from the Sydney Memory and Ageing Study. Comprehensive assessments occurred biennially, and clinical diagnoses were made by expert consensus for 10-years. SCCs were participants' and informants' responses to a single binary question concerning their/the participant's memory decline (Yes/No) over the first 6-years. Categorical latent growth curve analyses, using the logit transformation, were used to model SCC change over time. Associations of initial propensity to report SCCs at baseline, and change in propensity to report SCCs over time, with dementia risk were examined using Cox regression. Results 70% of participants reported SCCs at baseline, with a proportional increase in the odds of reporting by 11% for each additional year in the study. In contrast, 22% of informants reported SCCs at baseline, with a proportional increase by 30% in the odds of reporting per year. Participants' initial level of (p = 0.007), but not change in SCC reporting (p = 0.179), was associated with risk of dementia controlling for all covariates. Both informants' initial level of (p < 0.001), and change in (p < 0.001), SCCs significantly predicted incident dementia. When modelled together, informants' initial level of, and change in, SCCs were still independently associated with increased dementia risk (p's < 0.001). Conclusion These data suggest that informants' initial impressions, and increased reporting, of SCCs appear to be uniquely prognostic of future dementia compared to participants', even based on a single SCC question.
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Affiliation(s)
- Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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Maffoni M, Pierobon A, Fundarò C. MASCoD-Multidimensional Assessment of Subjective Cognitive Decline. Front Psychol 2022; 13:921062. [PMID: 36533024 PMCID: PMC9748696 DOI: 10.3389/fpsyg.2022.921062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/30/2022] [Indexed: 09/19/2023] Open
Abstract
Subjective cognitive decline (SCD) is a subclinical cognitive impairment that is complained by the individual without being objectively supported at clinical, diagnostic, and neuropsychological levels. It can negatively impact on patient's frailty and quality of life, as well as on the caregiver's burden. Moreover, it can be prodromal to Mild Cognitive Impairment or dementia. Although the clinical manifestations of SCD can differ along with several cognitive domains, to date there are only screening tools to investigate subjective memory complaints. Thus, the first aim of this paper is to propose a preliminary English and Italian version of a new screening tool called MASCoD (Multidimensional Assessment of Subjective Cognitive Decline); the second aim is to propose its preliminary adoption on a pilot sample. This schedule is a brief test derived from the review of the literature and the clinical experience provided by an experts panelist. From pilot tests, it seems promising as it can help the professional to make differential diagnosis and to predict the risk of developing severe cognitive impairment over time, developing a personalized care path. This screening tool is brief, easily embeddable in usual clinical assessment, and administrable by different professionals. Furthermore, following validation, it will allow to collect manifold cognitive manifestations of SCD, addressing the shortage of previous validated instruments globally assessing cognition affected by this condition.
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Affiliation(s)
- Marina Maffoni
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
| | - Cira Fundarò
- Neurophysiopatology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
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Divers R, Robinson A, Miller L, De Vito AN, Pugh E, Calamia M. Beyond depression: examining the role of anxiety and anxiety sensitivity on subjective cognition and functioning in older adults. Aging Ment Health 2022; 26:2300-2306. [PMID: 34424804 DOI: 10.1080/13607863.2021.1966747] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Subjective cognitive difficulties in the elderly may serve as potential risk-factors for future, objective decline and conversion to neurodegenerative disorders (e.g., mild cognitive impairment [MCI] and dementia). Though these subjective declines have been associated with depression, and to a lesser extent, anxiety, it is unknown if related constructs (e.g. anxiety sensitivity) and specific kinds of worries (e.g. worry about developing dementia, health anxiety) are related to subjective declines. The current study sought to examine if cognitive concerns related to anxiety sensitivity, dementia worry, and health anxiety added incremental validity beyond general symptoms of anxiety and depression in predicting subjective cognition and functioning in a sample of older adults. METHODS Participants were 429 older adults who were at least 60 years old. Participants completed questionnaires on subjective cognition, subjective everyday function, anxiety, depression, anxiety sensitivity, dementia worry, and health anxiety via Qualtrics Panels. Hierarchical multiple regressions were conducted. RESULTS Our variables of interest (anxiety sensitivity, dementia worry, and health anxiety) added significant variance in predicting subjective cognition and everyday function. Specifically, anxiety sensitivity was related to subjective cognition and functioning, while dementia worry and health anxiety were variably associated. CONCLUSION Our results suggest that constructs related to anxiety and worry have a significant relationship with subjective cognition and function in older adults beyond general symptoms of depression and anxiety. Future work should examine if interventions and education may help to decrease anxiety sensitivity and worry about dementia respectively in older adults, which may in tern protect against future subjective declines.
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Affiliation(s)
- Ross Divers
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Anthony Robinson
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Luke Miller
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Alyssa N De Vito
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Erika Pugh
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
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Pelegrini LNDC, Casemiro FG, Zanarelli P, Rodrigues RAP. Socio-cognitive mindfulness predicts memory complaint and cognitive performance of older adults with different years of education. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-8. [PMID: 36121110 DOI: 10.1080/23279095.2022.2124374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Even though the effect of education on cognitive performance has been widely reported, the relationship between socio-cognitive mindfulness, cognitive performance, and memory complaint among the elderly with heterogeneous educational levels has not yet been investigated. AIM This study aimed to analyze the potential relationship between cognitive performance, memory complaint, and socio-cognitive mindfulness in a sample of healthy older adults with different years of education. METHODS In this quantitative, cross-sectional, observational, and analytical study, participants (n = 68) were assessed with a sociodemographic questionnaire, cognitive performance test (ACE-III), levels of socio-cognitive mindfulness (LSM-21), and memory complaint (Memory Complaint Scale). Descriptive statistics, as well as Pearson's correlation, and linear regression analysis were performed, and significance was assumed if p < .05. RESULTS Years of education correlated with cognitive performance and socio-cognitive mindfulness, but not with memory complaint. Socio-cognitive mindfulness had a positive correlation with cognitive performance and a negative correlation with memory complaint. Also, socio-cognitive mindfulness predicted cognitive performance and memory complaint both in bivariate analysis and when controlling for years of education. CONCLUSION Our findings suggested that older adults with higher levels of socio-cognitive mindfulness showed better cognitive performance and less memory complaint.
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Affiliation(s)
| | | | - Paloma Zanarelli
- Department of Gerontology, Federal University of São Carlos, Sao Carlos, Brazil
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Shen T, Sheriff S, You Y, Jiang J, Schulz A, Francis H, Mirzaei M, Saks D, Chitranshi N, Gupta V, Singh MF, Klistorner A, Wen W, Sachdev P, Gupta VK, Graham SL. Evaluating associations of RNFL thickness and multifocal VEP with cognitive assessment and brain MRI volumes in older adults: Optic nerve decline and cognitive change (ONDCC) initiative. AGING BRAIN 2022; 2:100049. [PMID: 36908892 PMCID: PMC9997126 DOI: 10.1016/j.nbas.2022.100049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/31/2022] [Accepted: 08/09/2022] [Indexed: 11/20/2022] Open
Abstract
To examine the relationships of retinal structural (optical coherence tomography) and visual functional (multifocal visual evoked potentials, mfVEP) indices with neuropsychological and brain structural measurements in healthy older subjects. 95 participants (mean (SD) age 68.1 (9.0)) years were recruited in the Optic Nerve Decline and Cognitive Change (ONDCC) study in this observational clinical investigation. OCT was conducted for retinal nerve fibre layer (RNFL) and mfVEP for amplitude and latency measurements. Participants undertook neuropsychological tests for cognitive performance and MRI for volumetric evaluation of various brain regions. Generalised estimating equation models were used for association analysis (p < 0.05). The brain volumetric measures including total grey matter (GM), cortex, thalamus, hippocampal and fourth ventricular volumes were significantly associated with global and sectoral RNFL. RNFL thickness correlated with delayed recalls of California verbal learning test (CVLT) and Rey complex figure test (RCFT). The mfVEP amplitudes associated with cerebral white matter (WM) and cingulate GM volumes in MRI and CVLT, RCFT and trail making test outcomes. A significant association of mfVEP latency with logical memory delayed recall and thalamus volume was also observed. Our results suggested significant association of specific RNFL and mfVEP measures with distinctive brain region volumes and cognitive tests reflecting performance in memory, visuospatial and executive functional domains. These findings indicate that the mfVEP and RNFL measurements may parallel brain structural and neuropsychological measures in the older population.
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Affiliation(s)
- Ting Shen
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
- Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
- Corresponding authors at: Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's hospital), School of Medicine, Shanghai Jiao Tong University and Macquarie University.
| | - Samran Sheriff
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Yuyi You
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
- Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing and the Neuropsychiatric Institute, University of New South Wales, Sydney, NSW, Australia
| | - Angela Schulz
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Heather Francis
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Mehdi Mirzaei
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Danit Saks
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Nitin Chitranshi
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Veer Gupta
- Faculty of Health, Deakin University, VIC, Australia
| | | | - Alexander Klistorner
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
- Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing and the Neuropsychiatric Institute, University of New South Wales, Sydney, NSW, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing and the Neuropsychiatric Institute, University of New South Wales, Sydney, NSW, Australia
| | - Vivek K. Gupta
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
- Corresponding authors at: Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's hospital), School of Medicine, Shanghai Jiao Tong University and Macquarie University.
| | - Stuart L. Graham
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
- Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
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