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Pressler SJ, Jung M, Dorsey SG, Giordani B, Titler MG, Wierenga KL, Clark DG, Smith DG, Smith AB, Gradus-Pizlo I, Pressler ML. Atrial Fibrillation and Older Age Predict Serum Brain-Derived Neurotrophic Factor Levels Among Patients With Heart Failure. J Cardiovasc Nurs 2024:00005082-990000000-00206. [PMID: 39007747 DOI: 10.1097/jcn.0000000000001110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
BACKGROUND Predictors have not been determined of serum brain-derived neurotrophic factor (BDNF) levels among patients with heart failure (HF). OBJECTIVE The primary purpose was to evaluate history of atrial fibrillation, age, gender, and left ventricular ejection fraction as predictors of serum BDNF levels at baseline, 10 weeks, and 4 and 8 months after baseline among patients with HF. METHODS This study was a retrospective cohort analyses of 241 patients with HF. Data were retrieved from the patients' health records (coded history of atrial fibrillation, left ventricular ejection fraction), self-report (age, gender), and serum BDNF. Linear multiple regression analyses were conducted. RESULTS One hundred three patients (42.7%) had a history of atrial fibrillation. History of atrial fibrillation was a significant predictor of serum BDNF levels at baseline (β = -0.16, P = .016), 4 months (β = -0.21, P = .005), and 8 months (β = -0.19, P = .015). Older age was a significant predictor at 10 weeks (β = -0.17, P = .017) and 4 months (β = -0.15, P = .046). CONCLUSIONS Prospective studies are needed to validate these results. Clinicians need to assess patients with HF for atrial fibrillation and include treatment of it in management plans.
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Jung M, Smith AB, Giordani B, Clark DG, Gradus-Pizlo I, Wierenga KL, Lake KR, Pressler SJ. Computerized Cognitive Training and 24-Month Mortality in Heart Failure. J Cardiovasc Nurs 2024; 39:E51-E58. [PMID: 37494830 PMCID: PMC10808269 DOI: 10.1097/jcn.0000000000001023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
BACKGROUND Cognitive dysfunction predicts mortality in heart failure (HF). Computerized cognitive training (CCT) has shown preliminary efficacy in improving cognitive function. However, the relationship between CCT and mortality is unclear. Aims were to evaluate (1) long-term efficacy of CCT in reducing 24-month mortality and (2) age, HF severity, global cognition, memory, working memory, depressive symptoms, and health-related quality of life as predictors of 24-month mortality among patients with HF. METHODS In this prospective longitudinal study, 142 patients enrolled in a 3-arm randomized controlled trial were followed for 24 months. Logistic regression was used to achieve the aims. RESULTS Across 24 months, 16 patients died (CCT, 8.3%; control groups, 12.8%). Computerized cognitive training did not predict 24-month mortality (odds ratio [OR], 0.65). Older age (OR, 1.08), worse global cognition (OR, 0.73), memory (OR, 0.81), and depressive symptoms (OR, 1.10) at baseline predicted 24-month mortality. CONCLUSIONS Efficacious interventions are needed to improve global cognition, memory, and depressive symptoms and reduce mortality in HF.
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Affiliation(s)
- Miyeon Jung
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202
| | - Asa B. Smith
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202
| | - Bruno Giordani
- University of Michigan, School of Medicine Department of Psychiatry Michigan Alzheimer’s Disease Research Center, Suite C, 2101 Commonwealth Blvd. Ann Arbor MI 48105
| | - David G. Clark
- Indiana University School of Medicine, 355 W. 16th Street, Suite 4020, Indianapolis, IN 46202
| | - Irmina Gradus-Pizlo
- University of California Irvine School of Medicine, 333 City Blvd, West, Suite 400, Orange, CA 92868-32988
| | - Kelly L. Wierenga
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202
| | - Kittie Reid Lake
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202
| | - Susan J. Pressler
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202
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Lyu JX, Guo DD, Song YC, Zhang MR, Ge FQ, Zhao J, Zhu H, Hang PZ. Circulating Myokines as Novel Biomarkers for Cardiovascular Diseases. Rev Cardiovasc Med 2024; 25:56. [PMID: 39077334 PMCID: PMC11263177 DOI: 10.31083/j.rcm2502056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/25/2023] [Accepted: 10/11/2023] [Indexed: 07/31/2024] Open
Abstract
Myokines are a group of cytokines or polypeptides released from skeletal muscle during exercise. Growing evidence suggests that myokines are associated with the development of cardiovascular disease (CVD). Moreover, several myokines in peripheral blood exhibit dynamic changes in different CVD stages. This review summarizes the potential roles of myokines such as myostatin, irisin, brain-derived neurotrophic factor, mitsugumin 53, meteorin-like, and apelin in various CVD, including myocardial infarction, heart failure, atherosclerosis, hypertension, and diabetes. The association of these myokines with biomarkers currently being used in clinical practice is also discussed. Furthermore, the review considers the emerging role of myokines in CVD and addresses the challenges remaining in translating these discoveries into novel clinical biomarkers for CVD.
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Affiliation(s)
- Jin-xiu Lyu
- Department of Pharmacy, Clinical Medical College, Yangzhou University,
Northern Jiangsu People's Hospital, 225001 Yangzhou, Jiangsu, China
| | - Dan-dan Guo
- Department of Pharmacy, Clinical Medical College, Yangzhou University,
Northern Jiangsu People's Hospital, 225001 Yangzhou, Jiangsu, China
- Medical College, Yangzhou University, 225009 Yangzhou, Jiangsu, China
| | - Yu-chen Song
- Department of Pharmacy, Clinical Medical College, Yangzhou University,
Northern Jiangsu People's Hospital, 225001 Yangzhou, Jiangsu, China
- Medical College, Yangzhou University, 225009 Yangzhou, Jiangsu, China
| | - Man-ru Zhang
- Department of Pharmacy, Clinical Medical College, Yangzhou University,
Northern Jiangsu People's Hospital, 225001 Yangzhou, Jiangsu, China
- College of Pharmacy, Dalian Medical University, 116044 Dalian, Liaoning,
China
| | - Feng-qin Ge
- Department of Pharmacy, Clinical Medical College, Yangzhou University,
Northern Jiangsu People's Hospital, 225001 Yangzhou, Jiangsu, China
| | - Jing Zhao
- Department of Pharmacy, Clinical Medical College, Yangzhou University,
Northern Jiangsu People's Hospital, 225001 Yangzhou, Jiangsu, China
| | - Hua Zhu
- Department of Pharmacy, Clinical Medical College, Yangzhou University,
Northern Jiangsu People's Hospital, 225001 Yangzhou, Jiangsu, China
| | - Peng-zhou Hang
- Department of Pharmacy, Clinical Medical College, Yangzhou University,
Northern Jiangsu People's Hospital, 225001 Yangzhou, Jiangsu, China
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Pressler SJ, Jung M, Giordani B, Titler MG, Gradus-Pizlo I, Lake KR, Wierenga KL, Clark DG, Perkins SM, Smith DG, Mocci E, Dorsey SG. Evaluating depressive symptoms, BDNF Val66Met, and APOE-ε4 as moderators of response to computerized cognitive training in heart failure. Heart Lung 2023; 59:146-156. [PMID: 36805256 PMCID: PMC10065971 DOI: 10.1016/j.hrtlng.2023.02.002] [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: 09/09/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND Depressive symptoms, brain-derived neurotrophic factor (BDNF) Val66Met, and apolipoprotein (APOE)-ε4 may moderate response to computerized cognitive training (CCT) interventions among patients with heart failure (HF). OBJECTIVES The purpose of this study was to examine moderators of intervention response to CCT over 8 months among patients with HF enrolled in a 3-arm randomized controlled trial. Outcomes were memory, serum BDNF, working memory, instrumental activities of daily living (IADLs), and health-related quality of life (HRQL). METHODS 256 patients with HF were randomized to CCT, computerized crossword puzzles active control, and usual care control groups for 8 weeks. Data were collected at enrollment, baseline, 10 weeks, and 4 and 8 months. Mixed effects models were computed to evaluate moderators. RESULTS As previously reported, there were no statistically significant group by time effects in outcomes among the 3 groups over 8 months. Tests of moderation indicated that depressive symptoms and presence of BDNF Val66Met and APOE-ε4 were not statistically significant moderators of intervention response in outcomes of delayed recall memory, serum BDNF, working memory, IADLs, and HRQL. In post hoc analysis evaluating baseline global cognitive function, gender, age, and HF severity as moderators, no significant effects were found. HF severity was imbalanced among groups (P = .049) which may have influenced results. CONCLUSIONS Studies are needed to elucidate biological mechanisms of cognitive dysfunction in HF and test novel interventions to improve memory, serum BDNF, working memory, IADLs and HRQL. Patients may need to be stratified or randomized by HF severity within intervention trials.
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Affiliation(s)
- Susan J Pressler
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States.
| | - Miyeon Jung
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States.
| | - Bruno Giordani
- University of Michigan, Michigan Alzheimer's Disease Research Center and Department of Psychiatry, Suite C, 2101 Commonwealth Blvd., Ann Arbor, MI 48105, United States.
| | - Marita G Titler
- University of Michigan School of Nursing, 400 North Ingalls, Ann Arbor, MI 48109-5482, United States.
| | - Irmina Gradus-Pizlo
- University of California Irvine School of Medicine, 333 City Blvd, West, Suite 400, Orange, CA 92868-32988, United States.
| | - Kittie Reid Lake
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Kelly L Wierenga
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States.
| | - David G Clark
- Indiana University School of Medicine, 355 W. 16th Street, Suite 4020, Indianapolis, IN 46202, United States.
| | - Susan M Perkins
- Indiana University School of Medicine, Department of Biostatistics and Health Data Science, 410 West 10th Street, Suite 3000, Indianapolis, IN 46202, United States.
| | - Dean G Smith
- Louisiana State University School of Public Health 2020 Gravier Street, 3rd Floor, New Orleans, LA 70112.
| | - Evelina Mocci
- University of Maryland School of Nursing, Department of Pain and Translational Science, 655 West Lombard Street, Baltimore, MD 21201, United States.
| | - Susan G Dorsey
- University of Maryland School of Nursing, Department of Pain and Translational Science, 655 West Lombard Street, Baltimore, MD 21201, United States.
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Zhao Q, Liu X, Wan X, Yu X, Cao X, Wang F, Cai Y. Non-pharmacological interventions for cognitive impairment in older adults with heart failure: A systematic review. Geriatr Nurs 2023; 51:378-387. [PMID: 37127014 DOI: 10.1016/j.gerinurse.2023.04.008] [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: 02/16/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Cognitive impairment is a prevalent issue among older adults with heart failure, and non-pharmacological approaches are recommended as the first line of treatment. However, it remains unclear which non-pharmacological interventions are the most effective for achieving optimal cognitive and physical outcomes. The aim of this study is to summarize the available evidence on the impact of non-pharmacological interventions for optimizing cognitive function in older adults with HF. METHODS A systematic research was carried out across multiple databases including PubMed, Embase, Scopus, Web of Science, PsycINFO, Cochrane Library, Chinese National Knowledge Infrastructure Database, and Wanfang Database up until May 2022. Randomized controlled trials that focused on non-pharmacological interventions for older adults with heart failure and cognitive impairment, and evaluated the impact on cognitive function were targeted. The risk bias of the selected articles was analyzed following the Cochrane handbook. Two independent reviewers were responsible for selecting the studies, extracting the data, and assessing their quality. The results were reported in a narrative format. RESULTS A total of 11 studies, which involved 1,287 patients, were reviewed and showed an acceptable risk of bias. These studies evaluated various cognitive domains, including global cognition, delayed recall memory, working memory, and verbal memory. Non-pharmacological interventions that included cognitive intervention, cognitive training combined with exercise, exercise training, and self-care management, were shown to have a positive impact on cognitive function, physical performance, and depression levels in older adults with heart failure. One study explored the effects of electrical muscle stimulation therapy, but no significant improvement in cognitive abilities was observed. CONCLUSION The available evidence for the effectiveness of non-pharmacological interventions for cognitive impairment in older adults with heart failure is limited, and further research with formal outcome measures and longer follow-up periods is necessary to provide more informed recommendations.
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Affiliation(s)
- Qing Zhao
- Department of Cardiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu, China.
| | - Xianliang Liu
- College of Nursing and Midwifery, Charles Darwin University, Brisbane 4000, Australia.
| | - Xia Wan
- Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu, China.
| | - Xin Yu
- Department of General Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu, China.
| | - Xiaodong Cao
- Department of Nursing, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu, China.
| | - Fang Wang
- Department of Cardiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu, China.
| | - Yinghua Cai
- Department of Nursing, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu, China.
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Petrella JR, Michael AM, Qian M, Nwosu A, Sneed J, Goldberg TE, Devanand DP, Doraiswamy PM. Impact of Computerized Cognitive Training on Default Mode Network Connectivity in Subjects at Risk for Alzheimer's Disease: A 78-week Randomized Controlled Trial. J Alzheimers Dis 2023; 91:483-494. [PMID: 36442202 PMCID: PMC9881022 DOI: 10.3233/jad-220946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) represents a high risk group for Alzheimer's disease (AD). Computerized Cognitive Games Training (CCT) is an investigational strategy to improve targeted functions in MCI through the modulation of cognitive networks. OBJECTIVE The goal of this study was to examine the effect of CCT versus a non-targeted active brain exercise on functional cognitive networks. METHODS 107 patients with MCI were randomized to CCT or web-based crossword puzzles. Resting-state functional MRI (fMRI) was obtained at baseline and 18 months to evaluate differences in fMRI measured within- and between-network functional connectivity (FC) of the default mode network (DMN) and other large-scale brain networks: the executive control, salience, and sensorimotor networks. RESULTS There were no differences between crosswords and games in the primary outcome, within-network DMN FC across all subjects. However, secondary analyses suggest differential effects on between-network connectivity involving the DMN and SLN, and within-network connectivity of the DMN in subjects with late MCI. Paradoxically, in both cases, there was a decrease in FC for games and an increase for the crosswords control (p < 0.05), accompanied by lesser cognitive decline in the crosswords group. CONCLUSION Results do not support a differential impact on within-network DMN FC between games and crossword puzzle interventions. However, crossword puzzles might result in cognitively beneficial remodeling between the DMN and other networks in more severely impaired MCI subjects, parallel to the observed clinical benefits.
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Affiliation(s)
- Jeffrey R. Petrella
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| | - Andrew M. Michael
- Duke Institute for Brain Sciences and the Duke Center for the Study of Aging and Human Development, Durham, NC, USA
| | - Min Qian
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Adaora Nwosu
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA
| | - Joel Sneed
- Department of Psychology, Queens College, City University of New York, Flushing, NY, USA
- Department of Psychology The Graduate Center, City University of New York, New York, NY, USA
| | - Terry E. Goldberg
- Department of Psychiatry, Columbia University Medical Center, and the New York Psychiatry Institute, New York, NY, USA
| | - Davangere P. Devanand
- Department of Psychiatry, Columbia University Medical Center, and the New York Psychiatry Institute, New York, NY, USA
| | - P. Murali Doraiswamy
- Duke Institute for Brain Sciences and the Duke Center for the Study of Aging and Human Development, Durham, NC, USA
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA
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Devanand DP, Goldberg TE, Qian M, Rushia SN, Sneed JR, Andrews HF, Nino I, Phillips J, Pence ST, Linares AR, Hellegers CA, Michael AM, Kerner NA, Petrella JR, Doraiswamy PM. Computerized Games versus Crosswords Training in Mild Cognitive Impairment. NEJM EVIDENCE 2022; 1:10.1056/evidoa2200121. [PMID: 37635843 PMCID: PMC10457124 DOI: 10.1056/evidoa2200121] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) increases the risk of dementia. The efficacy of cognitive training in patients with MCI is unclear. METHODS In a two-site, single-blinded, 78-week trial, participants with MCI - stratified by age, severity (early/late MCI), and site - were randomly assigned to 12 weeks of intensive, home-based, computerized training with Web-based cognitive games or Web-based crossword puzzles, followed by six booster sessions. In mixed-model analyses, the primary outcome was change from baseline in the 11-item Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) score, a 70 point scale in which higher scores indicate greater cognitive impairment at 78 weeks, adjusted for baseline. Secondary outcomes included change from baseline in neuropsychological composite score, University of California San Diego Performance-Based Skills Assessment (functional outcome) score, and Functional Activities Questionnaire (functional outcome) score at 78 weeks, adjusted for baseline. Changes in hippocampal volume and cortical thickness on magnetic resonance imaging were assessed. RESULTS Among 107 participants (n=51 [games]; n=56 [crosswords]), ADAS-Cog score worsened slightly for games and improved for crosswords at week 78 (least squares [LS] means difference, -1.44; 95% confidence interval [CI], -2.83 to -0.06; P=0.04). From baseline to week 78, mean ADAS-Cog score worsened for games (9.53 to 9.93) and improved for crosswords (9.59 to 8.61). The late MCI subgroup showed similar results (LS means difference, -2.45; SE, 0.89; 95% CI, -4.21 to -0.70). Among secondary outcomes, the Functional Activities Questionnaire score worsened more with games than with crosswords at week 78 (LS means difference, -1.08; 95% CI, -1.97 to -0.18). Other secondary outcomes showed no differences. Decreases in hippocampal volume and cortical thickness were greater for games than for crosswords (LS means difference, 34.07; SE, 17.12; 95% CI, 0.51 to 67.63 [hippocampal volume]; LS means difference, 0.02; SE, 0.01; 95% CI, 0.00 to 0.04 [cortical thickness]). CONCLUSIONS Home-based computerized training with crosswords demonstrated superior efficacy to games for the primary outcome of baseline-adjusted change in ADAS-Cog score over 78 weeks. (Supported by the National Institutes of Health, National Institute on Aging; ClinicalTrials.gov number, NCT03205709.).
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Affiliation(s)
- D P Devanand
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York
- Department of Psychiatry, Columbia University Medical Center, New York
| | - Terry E Goldberg
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York
- Department of Psychiatry, Columbia University Medical Center, New York
- Department of Anesthesiology, Columbia University Medical Center, New York
| | - Min Qian
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York
| | - Sara N Rushia
- The Graduate Center, City University of New York, New York
- Queens College, City University of New York, Flushing, NY
| | - Joel R Sneed
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York
- Department of Psychiatry, Columbia University Medical Center, New York
- Department of Anesthesiology, Columbia University Medical Center, New York
- The Graduate Center, City University of New York, New York
| | - Howard F Andrews
- Department of Psychiatry, Columbia University Medical Center, New York
| | - Izael Nino
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York
- Department of Psychiatry, Columbia University Medical Center, New York
| | - Julia Phillips
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York
- Department of Psychiatry, Columbia University Medical Center, New York
| | - Sierra T Pence
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC
| | - Alexandra R Linares
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC
| | - Caroline A Hellegers
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC
| | | | - Nancy A Kerner
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York
- Department of Psychiatry, Columbia University Medical Center, New York
| | | | - P Murali Doraiswamy
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC
- Duke Institute for Brain Sciences, Duke University, Durham, NC
- Center for the Study of Aging and Human Development and the Division of Geriatrics, Duke University School of Medicine, Durham, NC
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