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Karstens AJ, Christianson TJ, Lundt ES, Machulda MM, Mielke MM, Fields JA, Kremers WK, Graff-Radford J, Vemuri P, Jack CR, Knopman DS, Petersen RC, Stricker NH. Mayo normative studies: regression-based normative data for ages 30-91 years with a focus on the Boston Naming Test, Trail Making Test and Category Fluency. J Int Neuropsychol Soc 2024; 30:389-401. [PMID: 38014536 PMCID: PMC11014770 DOI: 10.1017/s1355617723000760] [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] [Indexed: 11/29/2023]
Abstract
OBJECTIVE Normative neuropsychological data are essential for interpretation of test performance in the context of demographic factors. The Mayo Normative Studies (MNS) aim to provide updated normative data for neuropsychological measures administered in the Mayo Clinic Study of Aging (MCSA), a population-based study of aging that randomly samples residents of Olmsted County, Minnesota, from age- and sex-stratified groups. We examined demographic effects on neuropsychological measures and validated the regression-based norms in comparison to existing normative data developed in a similar sample. METHOD The MNS includes cognitively unimpaired adults ≥30 years of age (n = 4,428) participating in the MCSA. Multivariable linear regressions were used to determine demographic effects on test performance. Regression-based normative formulas were developed by first converting raw scores to normalized scaled scores and then regressing on age, age2, sex, and education. Total and sex-stratified base rates of low scores (T < 40) were examined in an older adult validation sample and compared with Mayo's Older Americans Normative Studies (MOANS) norms. RESULTS Independent linear regressions revealed variable patterns of linear and/or quadratic effects of age (r2 = 6-27% variance explained), sex (0-13%), and education (2-10%) across measures. MNS norms improved base rates of low performance in the older adult validation sample overall and in sex-specific patterns relative to MOANS. CONCLUSIONS Our results demonstrate the need for updated norms that consider complex demographic associations on test performance and that specifically exclude participants with mild cognitive impairment from the normative sample.
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Affiliation(s)
- Aimee J. Karstens
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Teresa J. Christianson
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Emily S. Lundt
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary M. Machulda
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
- Department of Gerontology and Geriatric Medicine, Wake
Forest University School of Medicine, Winston-Salem, NC, USA
| | - Julie A. Fields
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter K. Kremers
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | | | | | - Nikki H. Stricker
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
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Dorado-Martínez C, Montiel-Flores E, Ordoñez-Librado JL, Gutierrez-Valdez AL, Garcia-Caballero CA, Sanchez-Betancourt J, Reynoso-Erazo L, Tron-Alvarez R, Rodríguez-Lara V, Avila-Costa MR. Histological and Memory Alterations in an Innovative Alzheimer's Disease Animal Model by Vanadium Pentoxide Inhalation. J Alzheimers Dis 2024; 99:121-143. [PMID: 38640149 DOI: 10.3233/jad-230818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Background Previous work from our group has shown that chronic exposure to Vanadium pentoxide (V2O5) causes cytoskeletal alterations suggesting that V2O5 can interact with cytoskeletal proteins through polymerization and tyrosine phosphatases inhibition, causing Alzheimer's disease (AD)-like hippocampal cell death. Objective This work aims to characterize an innovative AD experimental model through chronic V2O5 inhalation, analyzing the spatial memory alterations and the presence of neurofibrillary tangles (NFTs), amyloid-β (Aβ) senile plaques, cerebral amyloid angiopathy, and dendritic spine loss in AD-related brain structures. Methods 20 male Wistar rats were divided into control (deionized water) and experimental (0.02 M V2O5 1 h, 3/week for 6 months) groups (n = 10). The T-maze test was used to assess spatial memory once a month. After 6 months, histological alterations of the frontal and entorhinal cortices, CA1, subiculum, and amygdala were analyzed by performing Congo red, Bielschowsky, and Golgi impregnation. Results Cognitive results in the T-maze showed memory impairment from the third month of V2O5 inhalation. We also noted NFTs, Aβ plaque accumulation in the vascular endothelium and pyramidal neurons, dendritic spine, and neuronal loss in all the analyzed structures, CA1 being the most affected. Conclusions This model characterizes neurodegenerative changes specific to AD. Our model is compatible with Braak AD stage IV, which represents a moment where it is feasible to propose therapies that have a positive impact on stopping neuronal damage.
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Affiliation(s)
- Claudia Dorado-Martínez
- Neuromorphology Lab, Facultad de Estudios Superiores Iztacala, UNAM, Los Reyes Iztacala, Tlalnepantla, Edo. Mex., Mexico
| | - Enrique Montiel-Flores
- Neuromorphology Lab, Facultad de Estudios Superiores Iztacala, UNAM, Los Reyes Iztacala, Tlalnepantla, Edo. Mex., Mexico
| | - Jose Luis Ordoñez-Librado
- Neuromorphology Lab, Facultad de Estudios Superiores Iztacala, UNAM, Los Reyes Iztacala, Tlalnepantla, Edo. Mex., Mexico
| | - Ana Luisa Gutierrez-Valdez
- Neuromorphology Lab, Facultad de Estudios Superiores Iztacala, UNAM, Los Reyes Iztacala, Tlalnepantla, Edo. Mex., Mexico
| | - Cesar Alfonso Garcia-Caballero
- Neuromorphology Lab, Facultad de Estudios Superiores Iztacala, UNAM, Los Reyes Iztacala, Tlalnepantla, Edo. Mex., Mexico
| | | | - Leonardo Reynoso-Erazo
- Health Education Project, Facultad de Estudios Superiores Iztacala, UNAM, Mexico City, Mexico
| | - Rocio Tron-Alvarez
- Health Education Project, Facultad de Estudios Superiores Iztacala, UNAM, Mexico City, Mexico
| | - Vianey Rodríguez-Lara
- Department of Cell and Tissue Biology, Faculty of Medicine, UNAM, Mexico City, Mexico
| | - Maria Rosa Avila-Costa
- Neuromorphology Lab, Facultad de Estudios Superiores Iztacala, UNAM, Los Reyes Iztacala, Tlalnepantla, Edo. Mex., Mexico
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Terstege DJ, Epp JR. Parvalbumin as a sex-specific target in Alzheimer's disease research - A mini-review. Neurosci Biobehav Rev 2023; 153:105370. [PMID: 37619647 DOI: 10.1016/j.neubiorev.2023.105370] [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: 05/23/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Alzheimer's disease (AD) is the most common form of dementia, and both the incidence of this disease and its associated cognitive decline disproportionally effect women. While the etiology of AD is unknown, recent work has demonstrated that the balance of excitatory and inhibitory activity across the brain may serve as a strong predictor of cognitive impairments in AD. Across the cortex, the most prominent source of inhibitory signalling is from a class of parvalbumin-expressing interneurons (PV+). In this mini-review, the impacts of sex- and age-related factors on the function of PV+ neurons are examined within the context of vulnerability to AD pathology. These primary factors of influence include changes in brain metabolism, circulating sex hormone levels, and inflammatory response. In addition to positing the increased vulnerability of PV+ neurons to dysfunction in AD, this mini-review highlights the critical importance of presenting sex stratified data in the study of AD.
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Affiliation(s)
- Dylan J Terstege
- Department of Cell Biology and Anatomy, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Jonathan R Epp
- Department of Cell Biology and Anatomy, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada.
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Spencer RJ, Williams TF, Kordovski VM, Patrick SD, Lengu K, Gradwohl BD, Hammers DB. A quantitative review of competing learning slope metrics: effects of age, sex, and clinical diagnosis. J Clin Exp Neuropsychol 2023; 45:744-757. [PMID: 38357915 DOI: 10.1080/13803395.2024.2314741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 12/27/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION In learning and memory tests that involve multiple presentations of the same material, learning slope refers to the degree to which examinees improve performances over successive learning trials. We aimed to quantitatively review the traditional raw learning slope (RLS), and the newly created learning ratio (LR) to understand the effects of demographic variables and clinical diagnoses on learning slope (e.g., limited improvement over multiple trials), and to develop demographically sensitive norms. METHOD A systematic literature search was conducted to evaluate the potential for these aims to be examined across the most popular contemporary multi-trial learning tests. Two databases were searched. Following this, hierarchical linear modeling was used to examine how demographic variables predict learning slope indices. These results were in turn used to contrast the performance of clinical groups with the predicted performance of demographically similar healthy controls. Finally, preliminary normative estimates for learning slope indices were presented. RESULTS A total of 82 studies met criteria for inclusion in this study. However, the Rey Auditory Verbal Learning Test (RAVLT) was the only test to have sufficient trial-level learning and demographic data. Fifty-eight samples from 19 studies were quantitatively examined. Hierarchical linear models provided evidence of sex differences and a curvilinear decline in learning slope with age, with strongest and most consistent effects for LR relative to RLS. Regression-based norms for demographically corrected RLS and LR scores for the RAVLT are presented. The effect of clinical diagnoses was consistently stronger for LR, and Alzheimer's disease had the strongest effect, followed by invalid performances, severe traumatic brain injury, and seizures/epilepsy. CONCLUSION Overall, LR enjoys both conceptual and demonstrated psychometric advantages over RLS. Replication of these findings can be completed by reanalyzing existing datasets. Further work may focus on the utility of using LR in diagnosis and prediction of clinical prognosis.
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Affiliation(s)
- Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Trevor F Williams
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Victoria M Kordovski
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Sarah D Patrick
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Ketrin Lengu
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Physical Medicine and Rehabilitation, The MetroHealth System, Cleveland, OH, USA
| | - Brian D Gradwohl
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Trinity Health Hauenstein Neurosciences, Trinity Health, Muskegon, MI, USA
| | - Dustin B Hammers
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
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Affiliation(s)
- Liisa Am Galea
- Centre for Addiction and Mental Health, Department of Psychiatry, Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Rulan S Parekh
- Departments of Medicine, Paediatrics, Epidemiology, and Health Policy and Management Evaluation at Women's College Hospital, Hospital for Sick Children, and University of Toronto, Toronto, Canada
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Castro-Aldrete L, Moser MV, Putignano G, Ferretti MT, Schumacher Dimech A, Santuccione Chadha A. Sex and gender considerations in Alzheimer’s disease: The Women’s Brain Project contribution. Front Aging Neurosci 2023; 15:1105620. [PMID: 37065460 PMCID: PMC10097993 DOI: 10.3389/fnagi.2023.1105620] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
The global population is expected to have about 131.5 million people living with Alzheimer’s disease (AD) and other dementias by 2050, posing a severe health crisis. Dementia is a progressive neurodegenerative condition that gradually impairs physical and cognitive functions. Dementia has a variety of causes, symptoms, and heterogeneity concerning the influence of sex on prevalence, risk factors, and outcomes. The proportion of male-to-female prevalence varies based on the type of dementia. Despite some types of dementia being more common in men, women have a greater lifetime risk of developing dementia. AD is the most common form of dementia in which approximately two-thirds of the affected persons are women. Profound sex and gender differences in physiology and pharmacokinetic and pharmacodynamic interactions have increasingly been identified. As a result, new approaches to dementia diagnosis, care, and patient journeys should be considered. In the heart of a rapidly aging worldwide population, the Women’s Brain Project (WBP) was born from the necessity to address the sex and gender gap in AD. WBP is now a well-established international non-profit organization with a global multidisciplinary team of experts studying sex and gender determinants in the brain and mental health. WBP works with different stakeholders worldwide to help change perceptions and reduce sex biases in clinical and preclinical research and policy frameworks. With its strong female leadership, WBP is an example of the importance of female professionals’ work in the field of dementia research. WBP-led peer-reviewed papers, articles, books, lectures, and various initiatives in the policy and advocacy space have profoundly impacted the community and driven global discussion. WBP is now in the initial phases of establishing the world’s first Sex and Gender Precision Medicine Institute. This review highlights the contributions of the WBP team to the field of AD. This review aims to increase awareness of potentially important aspects of basic science, clinical outcomes, digital health, policy framework and provide the research community with potential challenges and research suggestions to leverage sex and gender differences. Finally, at the end of the review, we briefly touch upon our progress and contribution toward sex and gender inclusion beyond Alzheimer’s disease.
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Affiliation(s)
- Laura Castro-Aldrete
- Women’s Brain Project, Guntershausen bei Aadorf, Switzerland
- *Correspondence: Laura Castro-Aldrete,
| | | | - Guido Putignano
- Women’s Brain Project, Guntershausen bei Aadorf, Switzerland
| | | | - Annemarie Schumacher Dimech
- Women’s Brain Project, Guntershausen bei Aadorf, Switzerland
- Faculty of Medicine and Health Sciences, University of Lucerne, Lucerne, Switzerland
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Sex-Specific Neurocognitive Impairment. Neurol Clin 2023; 41:359-369. [PMID: 37030963 DOI: 10.1016/j.ncl.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
This article explores sex-specific neurocognitive impairment. It first defines relevant terms such as gender and sex. Next, it describes the nature of the problem including under-representation of women and other gender and sexual minorities in neuroscience research, including cognitive studies. A biopsychosocial framework is employed to account for structural and social determinants of health in sex/gender-specific neurocognitive impairment. Issues in assessment including the use of gender/sex-specific normative data are also discussed. Lastly, the article covers the current state of research as it relates to sex/gender-specific neurocognitive impairment across a range of medical conditions including neurodegenerative diseases and coronavirus disease-2019.
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8
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Khate K, Chaudhary V, Longkumer I, Saraswathy KN, Devi NK. Gender-specific association of blood lipids and reproductive trajectory with cognitive impairment: A community based cross-sectional study from India. Front Psychol 2023; 14:1107152. [PMID: 36923148 PMCID: PMC10008908 DOI: 10.3389/fpsyg.2023.1107152] [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: 12/12/2022] [Accepted: 02/08/2023] [Indexed: 03/01/2023] Open
Abstract
Background Abnormal blood lipid levels in the general population and adverse reproductive events among women have been associated with cognitive impairment (CI). However, their relationship has not been extensively studied in community settings. Hence, this study aims to explore the association of CI with blood lipid levels in both sexes and reproductive events/trajectory among women. Methods A cross-sectional study was conducted among a North Indian rural population. A total of 808 adults were recruited through door-to-door household survey. Data on socio-demographic variables, reproductive profile of women, and cognitive impairment status were collected. Fasting blood sample was collected to estimate serum lipid profile. Multivariate logistic regression was performed to test for association. Results The study demonstrated a lack of association between lipid profile and cognitive impairment among males. Surprisingly, low HDL-C among females was found to be protective against moderate/severe cognitive impairment (value of p = 0.049). Further, menopausal women and those having five or higher live births were found to be at higher risk of CI than pre-menopausal women and those with 1-2 live births, respectively. Conclusion The present study hints toward a gender-specific association of blood lipid levels with CI. Further, higher live births and menopause appear to be important risk factors for CI among women.
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Affiliation(s)
- Kevingu Khate
- Department of Anthropology, University of Delhi, New Delhi, India
| | - Vineet Chaudhary
- Department of Anthropology, University of Delhi, New Delhi, India
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Mielke MM, Aggarwal NT, Vila‐Castelar C, Agarwal P, Arenaza‐Urquijo EM, Brett B, Brugulat‐Serrat A, DuBose LE, Eikelboom WS, Flatt J, Foldi NS, Franzen S, Gilsanz P, Li W, McManus AJ, van Lent DM, Milani SA, Shaaban CE, Stites SD, Sundermann E, Suryadevara V, Trani J, Turner AD, Vonk JMJ, Quiroz YT, Babulal GM. Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective. Alzheimers Dement 2022; 18:2707-2724. [PMID: 35394117 PMCID: PMC9547039 DOI: 10.1002/alz.12662] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/15/2022] [Accepted: 02/20/2022] [Indexed: 01/31/2023]
Abstract
Sex or gender differences in the risk of Alzheimer's disease and related dementias (ADRD) differ by world region, suggesting that there are potentially modifiable risk factors for intervention. However, few epidemiological or clinical ADRD studies examine sex differences; even fewer evaluate gender in the context of ADRD risk. The goals of this perspective are to: (1) provide definitions of gender, biologic sex, and sexual orientation. and the limitations of examining these as binary variables; (2) provide an overview of what is known with regard to sex and gender differences in the risk, prevention, and diagnosis of ADRD; and (3) discuss these sex and gender differences from a global, worldwide perspective. Identifying drivers of sex and gender differences in ADRD throughout the world is a first step in developing interventions unique to each geographical and sociocultural area to reduce these inequities and to ultimately reduce global ADRD risk. HIGHLIGHTS: The burden of dementia is unevenly distributed geographically and by sex and gender. Scientific advances in genetics and biomarkers challenge beliefs that sex is binary. Discrimination against women and sex and gender minority (SGM) populations contributes to cognitive decline. Sociocultural factors lead to gender inequities in Alzheimer's disease and related dementias (ADRD) worldwide.
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Affiliation(s)
- Michelle M. Mielke
- Division of Epidemiology, Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Neelum T. Aggarwal
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Clara Vila‐Castelar
- Department of Psychiatry, Harvard Medical SchoolMassachusetts General HospitalMassachusettsBostonUSA
| | - Puja Agarwal
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Internal MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Eider M. Arenaza‐Urquijo
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - Benjamin Brett
- Department of NeurosurgeryMedical College of WisconsinWisconsinMilwaukeeUSA
| | - Anna Brugulat‐Serrat
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
- Atlantic Fellow for Equity in Brain HealthThe University of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lyndsey E. DuBose
- Department of Medicine, Division of GeriatricsUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Willem S. Eikelboom
- Department of NeurologyErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Jason Flatt
- Social and Behavioral Health Program, School of Public HealthUniversity of Nevada, Las VegasLas VegasNevadaUSA
| | - Nancy S. Foldi
- Department of Psychology, Queens College and The Graduate CenterCity University of New YorkNew YorkUSA
- Department of PsychiatryNew York University Long Island School of MedicineNew YorkUSA
| | - Sanne Franzen
- Department of NeurologyErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Paola Gilsanz
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
| | - Wei Li
- Department of Clinical and Diagnostic SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Alison J. McManus
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Debora Melo van Lent
- UT Health San AntonioGlenn Biggs Institute for Alzheimer's and Neurodegenerative diseasesSan AntonioTexasUSA
- Framingham Heart StudyFraminghamMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
| | - Sadaf Arefi Milani
- Division of Geriatrics & Palliative Medicine, Department of Internal MedicineUniversity of Texas Medical BranchGalvestonTexasUSA
| | - C. Elizabeth Shaaban
- Department of EpidemiologyGraduate School of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Shana D. Stites
- Department of PsychiatryPerlman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Erin Sundermann
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Vidyani Suryadevara
- Department of Orthopedic SurgeryRush University Medical CenterChicagoIllinoisUSA
| | - Jean‐Francoise Trani
- Department of Public HealthWashington University in St. LouisSt. LouisMissouriUSA
| | - Arlener D. Turner
- Department of Psychiatry & Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Jet M. J. Vonk
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
- Julius Center for Health Sciences and Primary CareDepartment of EpidemiologyUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Yakeel T. Quiroz
- Department of Psychiatry, Harvard Medical SchoolMassachusetts General HospitalMassachusettsBostonUSA
- Grupo de Neurociencias de Antioquia of Universidad de AntioquiaMedellinColumbiaUSA
| | - Ganesh M. Babulal
- Department of NeurologyWashington University in St. LouisSt. LouisMississippiUSA
- Department of Clinical Research and LeadershipThe George Washington University School of Medicine and Health SciencesWashingtonDCUSA
- Department of Psychology, Faculty of HumanitiesUniversity of JohannesburgJohannesburgSouth Africa
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10
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Harms RL, Ferrari A, Meier IB, Martinkova J, Santus E, Marino N, Cirillo D, Mellino S, Catuara Solarz S, Tarnanas I, Szoeke C, Hort J, Valencia A, Ferretti MT, Seixas A, Santuccione Chadha A. Digital biomarkers and sex impacts in Alzheimer's disease management - potential utility for innovative 3P medicine approach. EPMA J 2022; 13:299-313. [PMID: 35719134 PMCID: PMC9203627 DOI: 10.1007/s13167-022-00284-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022]
Abstract
Digital biomarkers are defined as objective, quantifiable physiological and behavioral data that are collected and measured by means of digital devices. Their use has revolutionized clinical research by enabling high-frequency, longitudinal, and sensitive measurements. In the field of neurodegenerative diseases, an example of a digital biomarker-based technology is instrumental activities of daily living (iADL) digital medical application, a predictive biomarker of conversion from mild cognitive impairment (MCI) due to Alzheimer's disease (AD) to dementia due to AD in individuals aged 55 + . Digital biomarkers show promise to transform clinical practice. Nevertheless, their use may be affected by variables such as demographics, genetics, and phenotype. Among these factors, sex is particularly important in Alzheimer's, where men and women present with different symptoms and progression patterns that impact diagnosis. In this study, we explore sex differences in Altoida's digital medical application in a sample of 568 subjects consisting of a clinical dataset (MCI and dementia due to AD) and a healthy population. We found that a biological sex-classifier, built on digital biomarker features captured using Altoida's application, achieved a 75% ROC-AUC (receiver operating characteristic - area under curve) performance in predicting biological sex in healthy individuals, indicating significant differences in neurocognitive performance signatures between males and females. The performance dropped when we applied this classifier to more advanced stages on the AD continuum, including MCI and dementia, suggesting that sex differences might be disease-stage dependent. Our results indicate that neurocognitive performance signatures built on data from digital biomarker features are different between men and women. These results stress the need to integrate traditional approaches to dementia research with digital biomarker technologies and personalized medicine perspectives to achieve more precise predictive diagnostics, targeted prevention, and customized treatment of cognitive decline. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-022-00284-3.
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Affiliation(s)
| | | | | | - Julie Martinkova
- Women’s Brain Project, Guntershausen, Switzerland
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Enrico Santus
- Women’s Brain Project, Guntershausen, Switzerland
- Bayer, NJ USA
| | - Nicola Marino
- Women’s Brain Project, Guntershausen, Switzerland
- Dipartimento Di Scienze Mediche E Chirurgiche, Università Degli Studi Di Foggia, Foggia, Italy
| | - Davide Cirillo
- Women’s Brain Project, Guntershausen, Switzerland
- Barcelona Supercomputing Center, Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | | | | | - Ioannis Tarnanas
- Altoida Inc., Houston, TX USA
- Global Brain Health Institute, Dublin, Ireland
| | - Cassandra Szoeke
- Women’s Brain Project, Guntershausen, Switzerland
- Centre for Medical Research, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Australia
| | - Jakub Hort
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St Anne’s University Hospital Brno, Brno, Czech Republic
| | - Alfonso Valencia
- Barcelona Supercomputing Center, Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
- ICREA - Institució Catalana de Recerca I Estudis Avançats, Pg. Lluís Companys 23, 08010 Barcelona, Spain
| | | | - Azizi Seixas
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136 USA
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