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Zhou LW, Panenka WJ, Al-Momen G, Gicas KM, Thornton AE, Jones AA, Woodward M, Heran MKS, Vertinsky AT, Su W, Barr AM, MacEwan GW, Lang DJ, Rauscher A, Honer WG, Field TS. Cerebral Small Vessel Disease, Risk Factors, and Cognition in Tenants of Precarious Housing. Stroke 2020; 51:3271-3278. [PMID: 33019899 DOI: 10.1161/strokeaha.120.030446] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE We aim to describe the burden, characteristics, and cognitive associations of cerebral small vessel disease in a Canadian sample living with multimorbidity in precarious housing. METHODS Participants received T1, T2-fluid-attenuated inversion recovery, and susceptibility-weighted imaging 3T magnetic resonance imaging sequences and comprehensive clinical, laboratory, and cognitive assessments. Cerebral small vessel disease burden was characterized using a modified Small Vessel Disease (mSVD) score. One point each was given for moderate-severe white matter hyperintensities, ≥1 cerebral microbleeds, and ≥1 lacune. Multivariable regression explored associations between mSVD score, risk factors, and cognitive performance. RESULTS Median age of the 228 participants (77% male) was 44.7 years (range, 23.3-63.2). In n=188 participants with consistent good quality magnetic resonance imaging sequences, mSVD scores were 0 (n=127, 68%), 1 (n=50, 27%), and 2 (n=11, 6%). Overall, one-third had an mSVD ≥1 n=61 (32%); this proportion was unchanged when adding participants with missing sequences n=72/228 (32%). The most prevalent feature was white matter hyperintensities 53/218 (24%) then cerebral microbleed 16/191 (8%) and lacunes 16/228 (7%). Older age (odds ratio, 1.10 [95% CI, 1.05-1.15], P<0.001), higher diastolic blood pressure (odds ratio, 1.05 [95% CI, 1.01-1.09], P=0.008), and a history of injection drug use (odds ratio, 3.13 [95% CI, 1.07-9.16], P=0.037) had significant independent associations with a mSVD score of ≥1 in multivariable analysis. mSVD ≥1 was associated with lower performance on tests of verbal memory, sustained attention, and decision-making, contributing 4% to 5% of the variance in each cognitive domain. CONCLUSIONS The 32% prevalence of cerebral small vessel disease in this young, socially marginalized cohort was higher than expected for age and was associated with poorer cognitive performance.
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Affiliation(s)
- Lily W Zhou
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - William J Panenka
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Ghadeer Al-Momen
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Kristina M Gicas
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Allen E Thornton
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Andrea A Jones
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Melissa Woodward
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Manraj K S Heran
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - A Talia Vertinsky
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Wayne Su
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Alasdair M Barr
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - G William MacEwan
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Donna J Lang
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Alexander Rauscher
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - William G Honer
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
| | - Thalia S Field
- Division of Neurology (L.W.Z., A.A.J., T.S.F.), University of British Columbia (UBC), Vancouver, Canada.,Department of Psychiatry (W.J.P., M.W., W.S., G.W.M., W.G.H.), University of British Columbia (UBC), Vancouver, Canada.,Department of Radiology (M.K.S.H., A.T.V., D.J.L.), University of British Columbia (UBC), Vancouver, Canada.,Department of Paediatrics (A.R.), University of British Columbia (UBC), Vancouver, Canada.,Department of Anesthesia, Pharmacology & Therapeutics (A.M.B.), University of British Columbia (UBC), Vancouver, Canada.,Department of Neurology, King Fahad medical city, Riyadh, Saudi Arabia (G.A.-M.).,Department of Psychology, York University, Toronto, Canada (K.M.G.).,Department of Psychology, Simon Fraser University, Burnaby, Canada (A.E.T.).,BC Provincial Neuropsychiatry program, Vancouver, Canada (W.J.P.).,BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada (W.J.P., M.W., W.G.H.)
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6
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Gu Y, Brickman AM, Stern Y, Habeck CG, Razlighi QR, Luchsinger JA, Manly JJ, Schupf N, Mayeux R, Scarmeas N. Mediterranean diet and brain structure in a multiethnic elderly cohort. Neurology 2015; 85:1744-51. [PMID: 26491085 DOI: 10.1212/wnl.0000000000002121] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/16/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To determine whether higher adherence to a Mediterranean-type diet (MeDi) is related with larger MRI-measured brain volume or cortical thickness. METHODS In this cross-sectional study, high-resolution structural MRI was collected on 674 elderly (mean age 80.1 years) adults without dementia who participated in a community-based, multiethnic cohort. Dietary information was collected via a food frequency questionnaire. Total brain volume (TBV), total gray matter volume (TGMV), total white matter volume (TWMV), mean cortical thickness (mCT), and regional volume or CT were derived from MRI scans using FreeSurfer program. We examined the association of MeDi (scored as 0-9) and individual food groups with brain volume and thickness using regression models adjusted for age, sex, ethnicity, education, body mass index, diabetes, and cognition. RESULTS Compared to lower MeDi adherence (0-4), higher adherence (5-9) was associated with 13.11 (p = 0.007), 5.00 (p = 0.05), and 6.41 (p = 0.05) milliliter larger TBV, TGMV, and TWMV, respectively. Higher fish (b = 7.06, p = 0.006) and lower meat (b = 8.42, p = 0.002) intakes were associated with larger TGMV. Lower meat intake was also associated with larger TBV (b = 12.20, p = 0.02). Higher fish intake was associated with 0.019 mm (p = 0.03) larger mCT. Volumes of cingulate cortex, parietal lobe, temporal lobe, and hippocampus and CT of the superior-frontal region were associated with the dietary factors. CONCLUSIONS Among older adults, MeDi adherence was associated with less brain atrophy, with an effect similar to 5 years of aging. Higher fish and lower meat intake might be the 2 key food elements that contribute to the benefits of MeDi on brain structure.
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Affiliation(s)
- Yian Gu
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
| | - Adam M Brickman
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
| | - Yaakov Stern
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
| | - Christian G Habeck
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
| | - Qolamreza R Razlighi
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
| | - José A Luchsinger
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
| | - Jennifer J Manly
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
| | - Nicole Schupf
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
| | - Richard Mayeux
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
| | - Nikolaos Scarmeas
- From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece
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