1
|
Wilkins V, Evans J, Park C, Fitzpatrick AL, Creevy KE, Ruple A. Validation of the shortened version of the Canine Behavioral Assessment and Research Questionnaire (C-BARQ) using participants from the Dog Aging Project. PLoS One 2024; 19:e0299973. [PMID: 38603705 PMCID: PMC11008875 DOI: 10.1371/journal.pone.0299973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/19/2024] [Indexed: 04/13/2024] Open
Abstract
The Canine Behavioral Assessment and Research Questionnaire (C-BARQ) is a 100-item owner-completed survey instrument used for assessing behavior and temperament of companion dogs. The shortened version of the C-BARQ (C-BARQ(S)) consists of 42 items of the long C-BARQ. We aimed to validate the shortened C-BARQ(S) by comparing it with the long questionnaire in the same human-dog pair. We examined data from a nationwide cohort of companion dogs enrolled in the large-scale longitudinal Dog Aging Project (DAP) study. Among 435 participating owners who completed both the long and shortened versions of the C-BARQ within 60 days of each other, agreement between individual questions of the long and shortened C-BARQ using an unweighted kappa statistic and percent agreement was examined. Associations between the two questionnaires for mean behavior and temperament domain scores and mean miscellaneous category scores were assessed using Pearson correlation coefficients. Of 435 dogs in the study, the mean (SD) age was 7.3 (4.3) years and 216 (50%) were female. Kappa values between the long and shortened C-BARQ for individual questions within the 14 behavior and temperament domains and a miscellaneous category ranged from fair to moderate (0.23 to 0.40 for 21 items and 0.41 to 0.58 for 26 items, respectively). Pearson correlation coefficients above 0.60 between both questionnaires for 12 of the 14 mean behavior and temperament domain scores and a category of miscellaneous items were observed. Kappa values for individual questions between the long and shortened C-BARQ ranged from fair to moderate and correlations between mean domain scores ranged from moderate to strong.
Collapse
Affiliation(s)
- Vanessa Wilkins
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas, United States of America
| | - Jeremy Evans
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas, United States of America
| | - Christina Park
- Department of Epidemiology, University of Washington, Seattle, WA, United States of America
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, WA, United States of America
- Department of Family Medicine, University of Washington, Seattle, WA, United States of America
| | - Kate E Creevy
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas, United States of America
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, United States of America
| |
Collapse
|
2
|
Hughes TM, Tanley J, Chen H, Schaich CL, Yeboah J, Espeland MA, Lima JAC, Ambale-Venkatesh B, Michos ED, Ding J, Hayden K, Casanova R, Craft S, Rapp SR, Luchsinger JA, Fitzpatrick AL, Heckbert SR, Post WS, Burke GL. Subclinical vascular composites predict clinical cardiovascular disease, stroke, and dementia: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2024; 392:117521. [PMID: 38552474 DOI: 10.1016/j.atherosclerosis.2024.117521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/26/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND AND AIMS Subclinical cardiovascular disease (CVD) measures may reflect biological pathways that contribute to increased risk for coronary heart disease (CHD) events, stroke, and dementia beyond conventional risk scores. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) followed 6814 participants (45-84 years of age) from baseline in 2000-2002 to 2018 over 6 clinical examinations and annual follow-up interviews. MESA baseline subclinical CVD procedures included: seated and supineblood pressure, coronary calcium scan, radial artery tonometry, and carotid ultrasound. Baseline subclinical CVD measures were transformed into z-scores before factor analysis to derive composite factor scores. Time to clinical event for all-cause CVD, CHD, stroke and ICD code-based dementia events were modeled using Cox proportional hazards models reported as area under the curve (AUC) with 95% Confidence Intervals (95%CI) at 10 and 15 years of follow-up. All models included all factor scores together, and adjustment for conventional risk scores for global CVD, stroke, and dementia. RESULTS After factor selection, 24 subclinical measures aggregated into four distinct factors representing: blood pressure, atherosclerosis, arteriosclerosis, and cardiac factors. Each factor significantly predicted time to CVD events and dementia at 10 and 15 years independent of each other and conventional risk scores. Subclinical vascular composites of atherosclerosis and arteriosclerosis best predicted time to clinical events of CVD, CHD, stroke, and dementia. These results were consistent across sex and racial and ethnic groups. CONCLUSIONS Subclinical vascular composites of atherosclerosis and arteriosclerosis may be useful biomarkers to inform the vascular pathways contributing to events of CVD, CHD, stroke, and dementia.
Collapse
Affiliation(s)
- Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
| | - Jordan Tanley
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Haiying Chen
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Christopher L Schaich
- Department of Surgery, Hypertension and Vascular Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Joseph Yeboah
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Mark A Espeland
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Joao A C Lima
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Bharath Ambale-Venkatesh
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Erin D Michos
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jingzhong Ding
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Kathleen Hayden
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Ramon Casanova
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Suzanne Craft
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - José A Luchsinger
- Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY, United States
| | | | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Wendy S Post
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| |
Collapse
|
3
|
Vu QM, Fitzpatrick AL, Cope JR, Bertolli J, Sotoodehnia N, West TE, Gentile N, Unger ER. Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection. Emerg Infect Dis 2024; 30:539-547. [PMID: 38407166 PMCID: PMC10902536 DOI: 10.3201/eid3003.231194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
This study aimed to estimate the incidence rates of post-COVID-19 fatigue and chronic fatigue and to quantify the additional incident fatigue caused by COVID-19. We analyzed electronic health records data of 4,589 patients with confirmed COVID-19 during February 2020-February 2021 who were followed for a median of 11.4 (interquartile range 7.8-15.5) months and compared them to data from 9,022 propensity score-matched non-COVID-19 controls. Among COVID-19 patients (15% hospitalized for acute COVID-19), the incidence rate of fatigue was 10.2/100 person-years and the rate of chronic fatigue was 1.8/100 person-years. Compared with non-COVID-19 controls, the hazard ratios were 1.68 (95% CI 1.48-1.92) for fatigue and 4.32 (95% CI 2.90-6.43) for chronic fatigue. The observed association between COVID-19 and the significant increase in the incidence of fatigue and chronic fatigue reinforces the need for public health actions to prevent SARS-CoV-2 infections.
Collapse
|
4
|
Ong SS, Peavey JJ, Hiatt KD, Whitlow CT, Sappington RM, Thompson AC, Lockhart SN, Chen H, Craft S, Rapp SR, Fitzpatrick AL, Heckbert SR, Luchsinger JA, Klein BEK, Meuer SM, Cotch MF, Wong TY, Hughes TM. Association of fractal dimension and other retinal vascular network parameters with cognitive performance and neuroimaging biomarkers: The Multi-Ethnic Study of Atherosclerosis (MESA). Alzheimers Dement 2024; 20:941-953. [PMID: 37828734 PMCID: PMC10916935 DOI: 10.1002/alz.13498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/16/2023] [Accepted: 09/09/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Retinal vascular network changes may reflect the integrity of the cerebral microcirculation, and may be associated with cognitive impairment. METHODS Associations of retinal vascular measures with cognitive function and MRI biomarkers were examined amongst Multi-Ethnic Study of Atherosclerosis (MESA) participants in North Carolina who had gradable retinal photographs at Exams 2 (2002 to 2004, n = 313) and 5 (2010 to 2012, n = 306), and detailed cognitive testing and MRI at Exam 6 (2016 to 2018). RESULTS After adjustment for covariates and multiple comparisons, greater arteriolar fractal dimension (FD) at Exam 2 was associated with less isotropic free water of gray matter regions (β = -0.0005, SE = 0.0024, p = 0.01) at Exam 6, while greater arteriolar FD at Exam 5 was associated with greater gray matter cortical volume (in mm3 , β = 5458, SE = 20.17, p = 0.04) at Exam 6. CONCLUSION Greater arteriolar FD, reflecting greater complexity of the branching pattern of the retinal arteries, is associated with MRI biomarkers indicative of less neuroinflammation and neurodegeneration.
Collapse
Affiliation(s)
- Sally S. Ong
- Department of OphthalmologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Jeremy J. Peavey
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Kevin D. Hiatt
- Department of RadiologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Christopher T. Whitlow
- Department of RadiologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Rebecca M. Sappington
- Department of OphthalmologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
- Department of BiochemistryWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Atalie C. Thompson
- Department of OphthalmologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Samuel N. Lockhart
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Haiying Chen
- Department of Psychiatry and Behavioral MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Suzanne Craft
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Stephen R. Rapp
- Biostatistics and Data ScienceWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Annette L. Fitzpatrick
- Department of EpidemiologySchool of Public HealthUniversity of WashingtonSeattleWashingtonUSA
| | - Susan R. Heckbert
- Department of EpidemiologySchool of Public HealthUniversity of WashingtonSeattleWashingtonUSA
| | - José A. Luchsinger
- Departments of Medicine and EpidemiologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Barbara E. K. Klein
- Department of Ophthalmology and Visual SciencesUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Stacy M Meuer
- Department of Ophthalmology and Visual SciencesUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | | | - Tien Y. Wong
- Singapore Eye Research InstituteSingapore National Eye CenterOphthalmology and Visual Sciences Academic Clinical ProgramDuke‐NUS Medical SchoolSingapore
- Tsinghua MedicineTsinghua UniversityBeijingChina
| | - Timothy M. Hughes
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| |
Collapse
|
5
|
Mei H, Simino J, Li L, Jiang F, Bis JC, Davies G, Hill WD, Xia C, Gudnason V, Yang Q, Lahti J, Smith JA, Kirin M, De Jager P, Armstrong NJ, Ghanbari M, Kolcic I, Moran C, Teumer A, Sargurupremraj M, Mahmud S, Fornage M, Zhao W, Satizabal CL, Polasek O, Räikkönen K, Liewald DC, Homuth G, Callisaya M, Mather KA, Windham BG, Zemunik T, Palotie A, Pattie A, van der Auwera S, Thalamuthu A, Knopman DS, Rudan I, Starr JM, Wittfeld K, Kochan NA, Griswold ME, Vitart V, Brodaty H, Gottesman R, Cox SR, Psaty BM, Boerwinkle E, Chasman DI, Grodstein F, Sachdev PS, Srikanth V, Hayward C, Wilson JF, Eriksson JG, Kardia SLR, Grabe HJ, Bennett DA, Ikram MA, Deary IJ, van Duijn CM, Launer L, Fitzpatrick AL, Seshadri S, Bressler J, Debette S, Mosley TH. Multi-omics and pathway analyses of genome-wide associations implicate regulation and immunity in verbal declarative memory performance. Alzheimers Res Ther 2024; 16:14. [PMID: 38245754 PMCID: PMC10799499 DOI: 10.1186/s13195-023-01376-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Uncovering the functional relevance underlying verbal declarative memory (VDM) genome-wide association study (GWAS) results may facilitate the development of interventions to reduce age-related memory decline and dementia. METHODS We performed multi-omics and pathway enrichment analyses of paragraph (PAR-dr) and word list (WL-dr) delayed recall GWAS from 29,076 older non-demented individuals of European descent. We assessed the relationship between single-variant associations and expression quantitative trait loci (eQTLs) in 44 tissues and methylation quantitative trait loci (meQTLs) in the hippocampus. We determined the relationship between gene associations and transcript levels in 53 tissues, annotation as immune genes, and regulation by transcription factors (TFs) and microRNAs. To identify significant pathways, gene set enrichment was tested in each cohort and meta-analyzed across cohorts. Analyses of differential expression in brain tissues were conducted for pathway component genes. RESULTS The single-variant associations of VDM showed significant linkage disequilibrium (LD) with eQTLs across all tissues and meQTLs within the hippocampus. Stronger WL-dr gene associations correlated with reduced expression in four brain tissues, including the hippocampus. More robust PAR-dr and/or WL-dr gene associations were intricately linked with immunity and were influenced by 31 TFs and 2 microRNAs. Six pathways, including type I diabetes, exhibited significant associations with both PAR-dr and WL-dr. These pathways included fifteen MHC genes intricately linked to VDM performance, showing diverse expression patterns based on cognitive status in brain tissues. CONCLUSIONS VDM genetic associations influence expression regulation via eQTLs and meQTLs. The involvement of TFs, microRNAs, MHC genes, and immune-related pathways contributes to VDM performance in older individuals.
Collapse
Affiliation(s)
- Hao Mei
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.
- Gertrude C. Ford Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA.
| | - Jeannette Simino
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.
- Gertrude C. Ford Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA.
| | - Lianna Li
- Department of Biology, Tougaloo College, Jackson, MS, USA
| | - Fan Jiang
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Joshua C Bis
- Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Gail Davies
- Department of Psychology, Lothian Birth Cohorts Group, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - W David Hill
- Department of Psychology, Lothian Birth Cohorts Group, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Charley Xia
- Department of Psychology, Lothian Birth Cohorts Group, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- The National Heart Lung and Blood Institute's Framingham Heart Study, Framingham, MA, USA
| | - Jari Lahti
- Turku Institute for Advanced Research, University of Turku, Turku, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Mirna Kirin
- Work completed while at The University of Edinburgh, Edinburgh, UK
| | - Philip De Jager
- Taub Institute for Research On Alzheimer's Disease and the Aging Brain, Columbia Irving University Medical Center, New York, NY, USA
- Center for Translational and Computational Neuro-Immunology, Columbia University Medical Center, New York, NY, USA
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | | | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus Medical Center University Medical Center, Rotterdam, The Netherlands
| | - Ivana Kolcic
- School of Medicine, University of Split, Split, Croatia
| | - Christopher Moran
- Department of Geriatric Medicine, Frankston Hospital, Peninsula Health, Melbourne, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Murali Sargurupremraj
- Inserm, Bordeaux Population Health Research Center, Team VINTAGE, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Shamsed Mahmud
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Myriam Fornage
- The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Claudia L Satizabal
- The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ozren Polasek
- School of Medicine, University of Split, Split, Croatia
- Algebra University College, Ilica 242, Zagreb, Croatia
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - David C Liewald
- Department of Psychology, Lothian Birth Cohorts Group, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Michele Callisaya
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Karen A Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - B Gwen Windham
- Gertrude C. Ford Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Medicine, Division of Geriatrics, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Aarno Palotie
- Department of Medicine, Department of Neurology and Department of Psychiatry, Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- The Stanley Center for Psychiatric Research and Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Alison Pattie
- Department of Psychology, Lothian Birth Cohorts Group, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Sandra van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | | | - Igor Rudan
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - John M Starr
- Department of Psychology, Lothian Birth Cohorts Group, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Rostock, Germany
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Michael E Griswold
- Gertrude C. Ford Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Veronique Vitart
- Medical Research Council Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
- Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW, Australia
| | - Rebecca Gottesman
- Stroke, Cognition, and Neuroepidemiology (SCAN) Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Simon R Cox
- Department of Psychology, Lothian Birth Cohorts Group, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Bruce M Psaty
- Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Eric Boerwinkle
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Daniel I Chasman
- Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Francine Grodstein
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Velandai Srikanth
- Department of Geriatric Medicine, Frankston Hospital, Peninsula Health, Melbourne, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - James F Wilson
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- Medical Research Council Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Public Health Solutions, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Rostock, Germany
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center University Medical Center, Rotterdam, The Netherlands
| | - Ian J Deary
- Department of Psychology, Lothian Birth Cohorts Group, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Cornelia M van Duijn
- Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Lenore Launer
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Bethesda, MD, USA
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Family Medicine, University of Washington, Seattle, WA, USA
| | - Sudha Seshadri
- The National Heart Lung and Blood Institute's Framingham Heart Study, Framingham, MA, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Jan Bressler
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Stephanie Debette
- Inserm, Bordeaux Population Health Research Center, Team VINTAGE, UMR 1219, University of Bordeaux, Bordeaux, France
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, CHU de Bordeaux, Bordeaux, France
| | - Thomas H Mosley
- Gertrude C. Ford Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Neurology, University of Mississippi Medical Center, Jackson, MS, USA
| |
Collapse
|
6
|
Sun X, Bulekova K, Yang J, Lai M, Pitsillides AN, Liu X, Zhang Y, Guo X, Yong Q, Raffield LM, Rotter JI, Rich SS, Abecasis G, Carson AP, Vasan RS, Bis JC, Psaty BM, Boerwinkle E, Fitzpatrick AL, Satizabal CL, Arking DE, Ding J, Levy D, Liu C. Association analysis of mitochondrial DNA heteroplasmic variants: methods and application. medRxiv 2024:2024.01.12.24301233. [PMID: 38260412 PMCID: PMC10802757 DOI: 10.1101/2024.01.12.24301233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
We rigorously assessed a comprehensive association testing framework for heteroplasmy, employing both simulated and real-world data. This framework employed a variant allele fraction (VAF) threshold and harnessed multiple gene-based tests for robust identification and association testing of heteroplasmy. Our simulation studies demonstrated that gene-based tests maintained an appropriate type I error rate at α=0.001. Notably, when 5% or more heteroplasmic variants within a target region were linked to an outcome, burden-extension tests (including the adaptive burden test, variable threshold burden test, and z-score weighting burden test) outperformed the sequence kernel association test (SKAT) and the original burden test. Applying this framework, we conducted association analyses on whole-blood derived heteroplasmy in 17,507 individuals of African and European ancestries (31% of African Ancestry, mean age of 62, with 58% women) with whole genome sequencing data. We performed both cohort- and ancestry-specific association analyses, followed by meta-analysis on both pooled samples and within each ancestry group. Our results suggest that mtDNA-encoded genes/regions are likely to exhibit varying rates in somatic aging, with the notably strong associations observed between heteroplasmy in the RNR1 and RNR2 genes (p<0.001) and advance aging by the Original Burden test. In contrast, SKAT identified significant associations (p<0.001) between diabetes and the aggregated effects of heteroplasmy in several protein-coding genes. Further research is warranted to validate these findings. In summary, our proposed statistical framework represents a valuable tool for facilitating association testing of heteroplasmy with disease traits in large human populations.
Collapse
Affiliation(s)
- Xianbang Sun
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Katia Bulekova
- Research Computing Services, Boston University, Boston, MA 02215, USA
| | - Jian Yang
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Meng Lai
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA
| | | | - Xue Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Yuankai Zhang
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Qian Yong
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD 21224, USA
| | - Laura M. Raffield
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Stephen S. Rich
- Department of Public Health Services, Center for Public Health Genomics, University of Virginia, Charlottesville, VA 22908, USA
| | - Goncalo Abecasis
- TOPMed Informatics Research Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - April P. Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Ramachandran S. Vasan
- Sections of Preventive Medicine and Epidemiology, and Cardiovascular Medicine, Boston University School of Medicine, Boston, MA, 02118, USA
- Framingham Heart Study, NHLBI/NIH, Framingham, MA 01702, USA
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA 98101, USA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA 98101, USA
- Departments of Epidemiology, and Health Services, University of Washington, Seattle, WA 98101, USA
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Annette L. Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, WA 98195, USA
| | - Claudia L. Satizabal
- Framingham Heart Study, NHLBI/NIH, Framingham, MA 01702, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Dan E. Arking
- McKusick-Nathans Institute, Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, MD 21205, USA
| | - Jun Ding
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Daniel Levy
- Framingham Heart Study, NHLBI/NIH, Framingham, MA 01702, USA
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Chunyu Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA
- Framingham Heart Study, NHLBI/NIH, Framingham, MA 01702, USA
| |
Collapse
|
7
|
Adam CE, Fitzpatrick AL, Leary CS, Ilango SD, Phelan EA, Semmens EO. The impact of falls on activities of daily living in older adults: A retrospective cohort analysis. PLoS One 2024; 19:e0294017. [PMID: 38170712 PMCID: PMC10763967 DOI: 10.1371/journal.pone.0294017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/25/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Falls contribute to impairments in activities of daily living (ADLs), resulting in significant declines in the quality of life, safety, and functioning of older adults. Understanding the magnitude and duration of the effect of falls on ADLs, as well as identifying the characteristics of older adults more likely to have post-fall ADL impairment is critical to inform fall prevention and post-fall intervention. The purpose of this study is to 1) Quantify the association between falls and post-fall ADL impairment and 2) Model trajectories of ADL impairment pre- and post-fall to estimate the long-term impact of falls and identify characteristics of older adults most likely to have impairment. METHOD Study participants were from the Ginkgo Evaluation of Memory Study, a randomized controlled trial in older adults (age 75+) in the United States. Self-reported incident falls and ADL scores were ascertained every 6 months over a 7-year study period. We used Cox proportional hazards analyses (n = 2091) to quantify the association between falls and ADL impairment and latent class trajectory modeling (n = 748) to visualize trajectories of ADL impairment pre-and post-fall. RESULTS Falls reported in the previous 6 months were associated with impairment in ADLs (HR: 1.42; 95% CI 1.32, 1.52) in fully adjusted models. Based on trajectory modeling (n = 748), 19% (n = 139) of participants had increased, persistent ADL impairment after falling. Participants who were female, lived in a neighborhood with higher deprivation, or experienced polypharmacy were more likely to have ADL impairment post-fall. CONCLUSIONS Falls are associated with increased ADL impairment, and this impairment can persist over time. It is crucial that all older adults, and particularly those at higher risk of post-fall ADL impairment have access to comprehensive fall risk assessment and evidence-based fall prevention interventions, to help mitigate the negative impacts on ADL function.
Collapse
Affiliation(s)
- Claire E. Adam
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
| | - Annette L. Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Cindy S. Leary
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
| | - Sindana D. Ilango
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Elizabeth A. Phelan
- Division of Gerontology and Geriatric Medicine, School of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Erin O. Semmens
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
| |
Collapse
|
8
|
Ruderman SA, Drumright LN, Delaney JAC, Webel AR, Fitzpatrick AL, Whitney BM, Nance RM, Hahn AW, Ma J, Mixson LS, Eltonsy S, Willig AL, Mayer KH, Napravnik S, Greene M, McCaul M, Cachay E, Kritchevsky SB, Austad SN, Landay A, Saag MS, Kitahata MM, Lau B, Lesko C, Chander G, Crane HM, Odden MC. Evaluating the Sick Quitting Hypothesis for Frailty Status and Reducing Alcohol Use Among People With HIV in a Longitudinal Clinical Cohort Study. J Assoc Nurses AIDS Care 2024; 35:5-16. [PMID: 38150572 DOI: 10.1097/jnc.0000000000000441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
ABSTRACT "Sick quitting," a phenomenon describing reductions in alcohol consumption following poor health, may explain observations that alcohol appears protective for frailty risk. We examined associations between frailty and reductions in drinking frequency among people with HIV (PWH). At six Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites between January 2012 and August 2021, we assessed whether frailty, measured through validated modified frailty phenotype, precedes reductions in drinking frequency. We associated time-updated frailty with quitting and reducing frequency of any drinking and heavy episodic drinking (HED), adjusted for demographic and clinical characteristics in Cox models. Among 5,654 PWH reporting drinking, 60% reported >monthly drinking and 18% reported ≥monthly HED. Over an average of 5.4 years, frail PWH had greater probabilities of quitting (HR: 1.56, 95% confidence interval [95% CI] [1.13-2.15]) and reducing (HR: 1.35, 95% CI [1.13-1.62]) drinking frequency, as well as reducing HED frequency (HR: 1.58, 95% CI [1.20-2.09]) versus robust PWH. Sick quitting likely confounds the association between alcohol use and frailty risk, requiring investigation for control.
Collapse
Affiliation(s)
- Stephanie A Ruderman
- Stephanie A. Ruderman, PhD, MPH, is a Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. Lydia N. Drumright, PhD, MPH, is a Clinical Assistant Professor, School of Nursing, University of Washington, Seattle, Washington, USA. Joseph A. C. Delaney, PhD, is a Research Associate Professor, College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada, and School of Medicine, University of Washington, Seattle, Washington, USA. Allison R. Webel, RN, PhD, is an Associate Dean for Research, School of Nursing, University of Washington, Seattle, Washington, USA. Annette L. Fitzpatrick, PhD, is a Research Professor, Department of Epidemiology, University of Washington, Seattle, Washington, USA. Bridget M. Whitney, PhD, MPH, is a Senior Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. Robin M. Nance, PhD, is a Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. Andrew W. Hahn, MD, is a Clinical Assistant Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Jimmy Ma, MD, is an Infectious Disease Specialist, School of Medicine, University of Washington, Seattle, Washington, USA. L. Sarah Mixson, MPH, is a Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. Sherif Eltonsy, PhD, is an Assistant Professor, College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada. Amanda L Willig, PhD, RD, is an Associate Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Kenneth H. Mayer, MD, is a Professor, Harvard Medical School, Fenway Institute, Boston, Massachusetts, USA. Sonia Napravnik, PhD, MPH, is an Associate Professor, Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA. Meredith Greene, MD, is an Associate Professor, Department of Medicine, University of California San Francisco, San Francisco, California, USA. Mary McCaul, PhD, is a Professor, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. Edward Cachay, MD, is a Professor, Department of Medicine, University of California San Diego, San Diego, California, USA. Stephen B. Kritchevsky, PhD, is a Professor, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. Steven N. Austad, PhD, is a Distinguished Professor, Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA. Alan Landay, PhD, is a Professor, Department of Internal Medicine, Rush University, Chicago, Illinois, USA. Michael S. Saag, MD, is a Professor and Associate Dean, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Mari M. Kitahata, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Bryan Lau, PhD, is a Professor, Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA. Catherine Lesko, PhD, MPH, is an Assistant Professor, Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA. Geetanjali Chander, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Heidi M. Crane, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Michelle C. Odden, PhD, is an Associate Professor, Department of Epidemiology, Stanford University, Stanford, California, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Guo B, Zhao C, He MZ, Senter C, Zhou Z, Peng J, Li S, Fitzpatrick AL, Lindström S, Stebbins RC, Noppert GA, Li C. Identifying patterns of reported findings on long-term cardiac complications of COVID-19: a systematic review and meta-analysis. BMC Med 2023; 21:468. [PMID: 38017426 PMCID: PMC10685580 DOI: 10.1186/s12916-023-03162-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION Prior reviews synthesized findings of studies on long-term cardiac complications of COVID-19. However, the reporting and methodological quality of these studies has not been systematically evaluated. Here, we conducted a systematic review and meta-analysis on long-term cardiac complications of COVID-19 and examined patterns of reported findings by study quality and characteristics. METHODS We searched for studies examining long-term cardiac complications of COVID-19 that persisted for 4 weeks and over. A customized Newcastle-Ottawa scale (NOS) was used to evaluate the quality of included studies. Meta-analysis was performed to generate prevalence estimates of long-term cardiac complications across studies. Stratified analyses were further conducted to examine the prevalence of each complication by study quality and characteristics. The GRADE approach was used to determine the level of evidence for complications included in the meta-analysis. RESULTS A total number of 150 studies describing 57 long-term cardiac complications were included in this review, and 137 studies reporting 17 complications were included in the meta-analysis. Only 25.3% (n = 38) of studies were of high quality based on the NOS quality assessment. Chest pain and arrhythmia were the most widely examined long-term complications. When disregarding study quality and characteristics, summary prevalence estimates for chest and arrhythmia were 9.79% (95% CI 7.24-13.11) and 8.22% (95% CI 6.46-10.40), respectively. However, stratified analyses showed that studies with low-quality scores, small sample sizes, unsystematic sampling methods, and cross-sectional design were more likely to report a higher prevalence of complications. For example, the prevalence of chest pain was 22.17% (95% CI 14.40-32.55), 11.08% (95% CI 8.65-14.09), and 3.89% (95% CI 2.49-6.03) in studies of low, medium, and high quality, respectively. Similar patterns were observed for arrhythmia and other less examined long-term cardiac complications. CONCLUSION There is a wide spectrum of long-term cardiac complications of COVID-19. Reported findings from previous studies are strongly related to study quality, sample sizes, sampling methods, and designs, underscoring the need for high-quality epidemiologic studies to characterize these complications and understand their etiology.
Collapse
Affiliation(s)
- Boya Guo
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Chenya Zhao
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mike Z He
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Camilla Senter
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Zhenwei Zhou
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA
| | - Jin Peng
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY, USA
| | - Song Li
- Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA
| | - Annette L Fitzpatrick
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Family Medicine, University of Washington, Seattle, WA, USA
| | - Sara Lindström
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Rebecca C Stebbins
- Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Grace A Noppert
- Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA.
| | - Chihua Li
- Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA.
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
- Department of Epidemiology, School of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| |
Collapse
|
10
|
Tin A, Fohner AE, Yang Q, Brody JA, Davies G, Yao J, Liu D, Caro I, Lindbohm JV, Duggan MR, Meirelles O, Harris SE, Gudmundsdottir V, Taylor AM, Henry A, Beiser AS, Shojaie A, Coors A, Fitzpatrick AL, Langenberg C, Satizabal CL, Sitlani CM, Wheeler E, Tucker-Drob EM, Bressler J, Coresh J, Bis JC, Candia J, Jennings LL, Pietzner M, Lathrop M, Lopez OL, Redmond P, Gerszten RE, Rich SS, Heckbert SR, Austin TR, Hughes TM, Tanaka T, Emilsson V, Vasan RS, Guo X, Zhu Y, Tzourio C, Rotter JI, Walker KA, Ferrucci L, Kivimäki M, Breteler MMB, Cox SR, Debette S, Mosley TH, Gudnason VG, Launer LJ, Psaty BM, Seshadri S, Fornage M. Identification of circulating proteins associated with general cognitive function among middle-aged and older adults. Commun Biol 2023; 6:1117. [PMID: 37923804 PMCID: PMC10624811 DOI: 10.1038/s42003-023-05454-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/12/2023] [Indexed: 11/06/2023] Open
Abstract
Identifying circulating proteins associated with cognitive function may point to biomarkers and molecular process of cognitive impairment. Few studies have investigated the association between circulating proteins and cognitive function. We identify 246 protein measures quantified by the SomaScan assay as associated with cognitive function (p < 4.9E-5, n up to 7289). Of these, 45 were replicated using SomaScan data, and three were replicated using Olink data at Bonferroni-corrected significance. Enrichment analysis linked the proteins associated with general cognitive function to cell signaling pathways and synapse architecture. Mendelian randomization analysis implicated higher levels of NECTIN2, a protein mediating viral entry into neuronal cells, with higher Alzheimer's disease (AD) risk (p = 2.5E-26). Levels of 14 other protein measures were implicated as consequences of AD susceptibility (p < 2.0E-4). Proteins implicated as causes or consequences of AD susceptibility may provide new insight into the potential relationship between immunity and AD susceptibility as well as potential therapeutic targets.
Collapse
Grants
- N01 HC095163 NHLBI NIH HHS
- RC2 HL102419 NHLBI NIH HHS
- HHSN268201500003C NHLBI NIH HHS
- UH3 NS100605 NINDS NIH HHS
- R01 HL103612 NHLBI NIH HHS
- 75N92020D00002 NHLBI NIH HHS
- U01 HL096812 NHLBI NIH HHS
- MC_UU_00006/1 Medical Research Council
- UF1 NS125513 NINDS NIH HHS
- 75N92020D00005 NHLBI NIH HHS
- N01AG12100 NIA NIH HHS
- N01HC95160 NHLBI NIH HHS
- R01 AG054076 NIA NIH HHS
- R01 HL120393 NHLBI NIH HHS
- BB/F019394/1 Biotechnology and Biological Sciences Research Council
- RF1 AG059421 NIA NIH HHS
- R01 HL131136 NHLBI NIH HHS
- N01 HC095168 NHLBI NIH HHS
- UL1 RR025005 NCRR NIH HHS
- R01 AG015928 NIA NIH HHS
- HHSN268201800004I NHLBI NIH HHS
- U01 HL080295 NHLBI NIH HHS
- N01HC95163 NHLBI NIH HHS
- N01 AG012100 NIA NIH HHS
- HHSN268201500001C NHLBI NIH HHS
- UL1 TR001079 NCATS NIH HHS
- N01 HC085082 NHLBI NIH HHS
- U01 HL096917 NHLBI NIH HHS
- R01 HL059367 NHLBI NIH HHS
- U01 HL130114 NHLBI NIH HHS
- HHSN268200800007C NHLBI NIH HHS
- R01 HL085251 NHLBI NIH HHS
- N01HC95169 NHLBI NIH HHS
- R01 NS087541 NINDS NIH HHS
- 75N92020D00001 NHLBI NIH HHS
- R01 HL086694 NHLBI NIH HHS
- R01 AG054628 NIA NIH HHS
- U01 HL096902 NHLBI NIH HHS
- R01 HL087652 NHLBI NIH HHS
- N01 HC095162 NHLBI NIH HHS
- U01 HG004402 NHGRI NIH HHS
- N01HC95164 NHLBI NIH HHS
- N01 HC085086 NHLBI NIH HHS
- N01HC55222 NHLBI NIH HHS
- R01 AG049607 NIA NIH HHS
- R01 AG065596 NIA NIH HHS
- N01 HC095165 NHLBI NIH HHS
- N01HC95162 NHLBI NIH HHS
- MR/R024227/1 Medical Research Council
- N01HC85086 NHLBI NIH HHS
- 75N92020D00003 NHLBI NIH HHS
- R01 HL105756 NHLBI NIH HHS
- N01HC95168 NHLBI NIH HHS
- N01 HC095169 NHLBI NIH HHS
- HHSN268201800003I NHLBI NIH HHS
- P30 DK063491 NIDDK NIH HHS
- HHSN268201800007I NHLBI NIH HHS
- HHSN268201700002C NHLBI NIH HHS
- R01 AG066524 NIA NIH HHS
- RF1 AG063507 NIA NIH HHS
- HHSN268201200036C NHLBI NIH HHS
- R01 HL144483 NHLBI NIH HHS
- HHSN268201800001C NHLBI NIH HHS
- HHSN268201700001I NHLBI NIH HHS
- R01 AG056477 NIA NIH HHS
- HHSN268201700004I NHLBI NIH HHS
- N01HC95165 NHLBI NIH HHS
- N01 HC095159 NHLBI NIH HHS
- U01 AG058589 NIA NIH HHS
- N01HC95159 NHLBI NIH HHS
- N01 HC095161 NHLBI NIH HHS
- HHSN268201500001I NHLBI NIH HHS
- HHSN271201200022C NIDA NIH HHS
- N01 HC025195 NHLBI NIH HHS
- N01HC95161 NHLBI NIH HHS
- UL1 TR001420 NCATS NIH HHS
- 75N92020D00004 NHLBI NIH HHS
- U01 HL096814 NHLBI NIH HHS
- P30 AG066509 NIA NIH HHS
- R01 HL132320 NHLBI NIH HHS
- 75N92020D00007 NHLBI NIH HHS
- P30 AG066546 NIA NIH HHS
- R01 AG033040 NIA NIH HHS
- MR/S011676/1 Medical Research Council
- U01 AG052409 NIA NIH HHS
- HHSN268201500003I NHLBI NIH HHS
- K01 AG071689 NIA NIH HHS
- 75N92021D00006 NHLBI NIH HHS
- R01 AG026307 NIA NIH HHS
- R01 AG020098 NIA NIH HHS
- HHSN268201700005C NHLBI NIH HHS
- HHSN268201700001C NHLBI NIH HHS
- N01HC85082 NHLBI NIH HHS
- HHSN268201700003C NHLBI NIH HHS
- N01 HC095166 NHLBI NIH HHS
- N01HC95167 NHLBI NIH HHS
- N01HC85083 NHLBI NIH HHS
- UH2 NS100605 NINDS NIH HHS
- N01HC25195 NHLBI NIH HHS
- 75N92019D00031 NHLBI NIH HHS
- U01 HL096899 NHLBI NIH HHS
- HHSN268201700004C NHLBI NIH HHS
- UL1 TR000040 NCATS NIH HHS
- HHSN268201700002I NHLBI NIH HHS
- HHSN268201700005I NHLBI NIH HHS
- P30 AG072947 NIA NIH HHS
- R01 AG025941 NIA NIH HHS
- Chief Scientist Office
- 75N92020D00006 NHLBI NIH HHS
- N01HC95166 NHLBI NIH HHS
- R01 AG023629 NIA NIH HHS
- R01 HL087641 NHLBI NIH HHS
- N01HC85079 NHLBI NIH HHS
- N01 HC085080 NHLBI NIH HHS
- UL1 TR001881 NCATS NIH HHS
- N01 HC095167 NHLBI NIH HHS
- HHSN268201800005I NHLBI NIH HHS
- N01HC85080 NHLBI NIH HHS
- HHSN268201700003I NHLBI NIH HHS
- HHSN268201800006I NHLBI NIH HHS
- N01 HC095164 NHLBI NIH HHS
- N01HC85081 NHLBI NIH HHS
- N01 HC095160 NHLBI NIH HHS
- The ARIC study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services (contract numbers HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I and HHSN268201700005I), R01HL087641, R01HL059367 and R01HL086694; National Human Genome Research Institute contract U01HG004402; and National Institutes of Health contract HHSN268200625226C. Funding was also supported by 5RC2HL102419, R01NS087541 and R01HL131136. Neurocognitive data were collected by U01 2U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01HL096917 from the NIH (NHLBI, NINDS, NIA and NIDCD). Infrastructure was partly supported by Grant Number UL1RR025005, a component of the National Institutes of Health and NIH Roadmap for Medical Research. This Cardiovascular Heath Study (CHS) research was supported by NHLBI contracts HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, 75N92021D00006; and NHLBI grants U01HL080295, R01HL087652, R01HL105756, R01HL103612, R01HL120393, R01HL085251, R01HL144483, and U01HL130114 with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided through R01AG023629, R01AG15928, and R01AG20098 from the National Institute on Aging (NIA). AEF is supported by K01AG071689. The Framingham Heart Study is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with Boston University (Contract No. N01-HC-25195, HHSN268201500001I and 75N92019D00031). This work was also supported by grant R01AG063507, R01AG054076, R01AG049607, R01AG059421, R01AG033040, R01AG066524, P30AG066546, U01 AG052409, U01 AG058589 from from the National Institute on Aging and R01 AG017950, UH2/3 NS100605, UF1 NS125513 from National Institute of Neurological Disorders and Stroke and R01HL132320. AGES has been funded by NIA contracts N01-AG012100 and HSSN271201200022C, NIH Grant No. 1R01AG065596-01A1, Hjartavernd (the Icelandic Heart Association), and the Althingi (the Icelandic Parliament). M. R. Duggan, T. Tanaka, J. Candia, K. A. Walker, L. Ferrucci, L.J. Launer, O. Meirelles are funded by the National Institute on Aging Intramural Research Program. This study was funded, in part, by the National Institute on Aging Intramural Research Program. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). The LBC1921 was supported by the UK’s Biotechnology and Biological Sciences Research Council (BBSRC), The Royal Society, and The Chief Scientist Office of the Scottish Government. Genotyping was funded by the BBSRC (BB/F019394/1). LBC1936 is supported by the Biotechnology and Biological Sciences Research Council, and the Economic and Social Research Council [BB/W008793/1], Age UK (Disconnected Mind project), and the University of Edinburgh. Genotyping was funded by the BBSRC (BB/F019394/1). The Olink® Neurology Proteomics assay was supported by a National Institutes of Health (NIH) research grant R01AG054628. Phenotype harmonization, data management, sample-identity QC, and general study coordination, were provided by the TOPMed Data Coordinating Center (3R01HL-120393-02S1), and TOPMed MESA Multi-Omics (HHSN2682015000031/HSN26800004). The MESA projects are conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with MESA investigators. Support for the Multi-Ethnic Study of Atherosclerosis (MESA) projects are conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with MESA investigators. Support for MESA is provided by contracts 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169, UL1-TR-000040, UL1-TR-001079, UL1-TR-001420, UL1TR001881, DK063491, and R01HL105756. The Three City (3C) Study is conducted under a partnership agreement among the Institut National de la Santé et de la Recherche Médicale (INSERM), the University of Bordeaux, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Mutuelle Générale de l’Education Nationale (MGEN), Institut de la Longévité, Conseils Régionaux of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research–INSERM Programme “Cohortes et collections de données biologiques.” Ilana Caro received a grant from the EUR digital public health. This PhD program is supported within the framework of the PIA3 (Investment for the future). Project reference 17-EURE-0019.
Collapse
Affiliation(s)
- Adrienne Tin
- Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Alison E Fohner
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
- Institute for Public Health Genetics, University of Washington, Seattle, WA, USA.
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA.
| | - Qiong Yang
- Department of Biostatistics, Boston University, Boston, MA, USA
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Gail Davies
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Dan Liu
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Ilana Caro
- University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, Bordeaux, France
| | - Joni V Lindbohm
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, The Klarman Cell Observatory, Cambridge, MA, USA
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael R Duggan
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Osorio Meirelles
- National Institute on Aging, National Institutes of Health, Laboratory of Epidemiology and Population Science, Bethesda, MD, USA
| | - Sarah E Harris
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Valborg Gudmundsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Icelandic Heart Association, Kopavogur, Iceland
| | - Adele M Taylor
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Albert Henry
- Institute of Cardiovascular Science, University of London, London, UK
| | - Alexa S Beiser
- Department of Biostatistics, Boston University, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Ali Shojaie
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Annabell Coors
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Departments of Family Medicine, University of Washington, Seattle, WA, USA
| | - Claudia Langenberg
- Precision Healthcare Institute, Queen Mary University of London, London, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Computational Medicine, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia L Satizabal
- Framingham Heart Study, Framingham, MA, USA
- Department of Population Health Sciences and Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Colleen M Sitlani
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Eleanor Wheeler
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Jan Bressler
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Julián Candia
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Lori L Jennings
- Novartis Institutes for Biomedical Research, 22 Windsor Street, Cambridge, MA, USA
| | - Maik Pietzner
- Precision Healthcare Institute, Queen Mary University of London, London, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Computational Medicine, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Oscar L Lopez
- Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Paul Redmond
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Robert E Gerszten
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Stephen S Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Thomas R Austin
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Valur Emilsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Icelandic Heart Association, Kopavogur, Iceland
| | - Ramachandran S Vasan
- Framingham Heart Study, Framingham, MA, USA
- University of Texas School of Public Health in San Antonio, San Antonio, TX, USA
- University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Yineng Zhu
- Department of Biostatistics, Boston University, Boston, MA, USA
| | - Christophe Tzourio
- University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, Bordeaux, France
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Keenan A Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Mika Kivimäki
- UCL Brain Sciences, University College London, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Simon R Cox
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Stephanie Debette
- University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, Bordeaux, France
- Department of Neurology, Institute for Neurodegenerative Diseases, CHU de Bordeaux, Bordeaux, France
| | - Thomas H Mosley
- Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Lenore J Launer
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Bruce M Psaty
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Department of Population Health Sciences and Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - Myriam Fornage
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
11
|
Andrews JS, Gold LS, Reed MJ, Hough CL, Garcia JM, McClelland RL, Fitzpatrick AL, Covinsky KE, Crane PK, Yaffe K, Cawthon PM. Appendicular Lean Mass, Grip Strength, and the Incidence of Dementia Among Older Adults in the Health ABC Study. J Gerontol A Biol Sci Med Sci 2023; 78:2070-2076. [PMID: 36548124 PMCID: PMC10613012 DOI: 10.1093/gerona/glac254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Identification of novel risk factors for dementia in older adults could facilitate development of methods to identify patients most at risk and improve their cognitive outcomes. We aimed to determine whether lower appendicular lean mass (ALM), assessed by dual-energy x-ray absorptiometry (DXA), and lower grip strength are associated with a greater likelihood of incident dementia among older adults in the Health Aging and Body Composition Study (Health ABC). METHODS Health ABC data from 1997 to 2008 were analyzed (n = 2 704). Baseline ALM to body mass index (BMI) ratio (ALMBMI) was assessed by DXA. Baseline grip strength was assessed by hand-held dynamometry. Incident dementia diagnosis was defined as either (i) dementia-related hospitalization plus a Modified Mini-Mental State Examination (3MS) score of ≤ 90; or (ii) record of prescription for anti-dementia medication; or (iii) decline of at least 1.5 SDs on the 3MS score compared to baseline. Cox proportional hazard models estimated associations of ALMBMI and grip strength with incident dementia over follow-up with and without adjusting for covariates, stratified by sex. RESULTS Among older men, each standard deviation decrement in ALMBMI (adjusted hazard ratio [aHR]: 1.33; 95% confidence interval [CI]: 1.07, 1.65) or grip strength (aHR 1.22; 95% CI: 1.06, 1.41) was associated with increased likelihood of incident dementia. CONCLUSIONS Lower ALMBMI and grip strength may be important risk factors for the development of dementia among older men. How these factors may belong to a causal pathway of dementia must be elucidated in future work.
Collapse
Affiliation(s)
- James S Andrews
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Laura S Gold
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - May J Reed
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Catherine L Hough
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Jose M Garcia
- Department of Medicine, University of Washington, Seattle, Washington, USA
- GRECC, VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Robyn L McClelland
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Annette L Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, Washington, USA
| | - Ken E Covinsky
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, and University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
12
|
Liu X, Sun X, Zhang Y, Jiang W, Lai M, Wiggins KL, Raffield LM, Bielak LF, Zhao W, Pitsillides A, Haessler J, Zheng Y, Blackwell TW, Yao J, Guo X, Qian Y, Thyagarajan B, Pankratz N, Rich SS, Taylor KD, Peyser PA, Heckbert SR, Seshadri S, Boerwinkle E, Grove ML, Larson NB, Smith JA, Vasan RS, Fitzpatrick AL, Fornage M, Ding J, Carson AP, Abecasis G, Dupuis J, Reiner A, Kooperberg C, Hou L, Psaty BM, Wilson JG, Levy D, Rotter JI, Bis JC, Satizabal CL, Arking DE, Liu C. Association Between Whole Blood-Derived Mitochondrial DNA Copy Number, Low-Density Lipoprotein Cholesterol, and Cardiovascular Disease Risk. J Am Heart Assoc 2023; 12:e029090. [PMID: 37804200 PMCID: PMC10757530 DOI: 10.1161/jaha.122.029090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 09/08/2023] [Indexed: 10/09/2023]
Abstract
Background The relationship between mitochondrial DNA copy number (mtDNA CN) and cardiovascular disease remains elusive. Methods and Results We performed cross-sectional and prospective association analyses of blood-derived mtDNA CN and cardiovascular disease outcomes in 27 316 participants in 8 cohorts of multiple racial and ethnic groups with whole-genome sequencing. We also performed Mendelian randomization to explore causal relationships of mtDNA CN with coronary heart disease (CHD) and cardiometabolic risk factors (obesity, diabetes, hypertension, and hyperlipidemia). P<0.01 was used for significance. We validated most of the previously reported associations between mtDNA CN and cardiovascular disease outcomes. For example, 1-SD unit lower level of mtDNA CN was associated with 1.08 (95% CI, 1.04-1.12; P<0.001) times the hazard for developing incident CHD, adjusting for covariates. Mendelian randomization analyses showed no causal effect from a lower level of mtDNA CN to a higher CHD risk (β=0.091; P=0.11) or in the reverse direction (β=-0.012; P=0.076). Additional bidirectional Mendelian randomization analyses revealed that low-density lipoprotein cholesterol had a causal effect on mtDNA CN (β=-0.084; P<0.001), but the reverse direction was not significant (P=0.059). No causal associations were observed between mtDNA CN and obesity, diabetes, and hypertension, in either direction. Multivariable Mendelian randomization analyses showed no causal effect of CHD on mtDNA CN, controlling for low-density lipoprotein cholesterol level (P=0.52), whereas there was a strong direct causal effect of higher low-density lipoprotein cholesterol on lower mtDNA CN, adjusting for CHD status (β=-0.092; P<0.001). Conclusions Our findings indicate that high low-density lipoprotein cholesterol may underlie the complex relationships between mtDNA CN and vascular atherosclerosis.
Collapse
Affiliation(s)
- Xue Liu
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Xianbang Sun
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Yuankai Zhang
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Wenqing Jiang
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Meng Lai
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWAUSA
| | - Laura M. Raffield
- Department of GeneticsUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Lawrence F. Bielak
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMIUSA
| | - Wei Zhao
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMIUSA
- Survey Research Center, Institute for Social ResearchUniversity of MichiganAnn ArborMIUSA
| | | | - Jeffrey Haessler
- Fred Hutchinson Cancer Center, Division of Public Health ScienceSeattleWAUSA
| | - Yinan Zheng
- Feinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | | | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Yong Qian
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of HealthBaltimoreMDUSA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and PathologyUniversity of MinnesotaMinneapolisMNUSA
| | - Nathan Pankratz
- Department of Computational PathologyUniversity of MinnesotaMinneapolisMNUSA
| | - Stephen S. Rich
- Center for Public Health GenomicsUniversity of VirginiaCharlottesvilleVAUSA
| | - Kent D. Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Patricia A. Peyser
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMIUSA
| | - Susan R. Heckbert
- Cardiovascular Health Research Unit and Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative DiseasesUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
- Department of NeurologyBoston University School of MedicineBostonMAUSA
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental SciencesThe University of Texas Health Science Center at HoustonHoustonTXUSA
- Human Genome Sequencing Center, Baylor College of MedicineHoustonTXUSA
| | - Megan L. Grove
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental SciencesThe University of Texas Health Science Center at HoustonHoustonTXUSA
| | - Nicholas B. Larson
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and ScienceRochesterMNUSA
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMIUSA
- Survey Research Center, Institute for Social ResearchUniversity of MichiganAnn ArborMIUSA
| | - Ramachandran S. Vasan
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
- Sections of Preventive Medicine and Epidemiology, and Cardiovascular MedicineBoston University School of MedicineBostonMAUSA
| | - Annette L. Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global HealthUniversity of WashingtonSeattleWAUSA
| | - Myriam Fornage
- Center for Human GeneticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Jun Ding
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of HealthBaltimoreMDUSA
| | - April P. Carson
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Goncalo Abecasis
- TOPMed Informatics Research CenterUniversity of MichiganAnn ArborMIUSA
| | - Josée Dupuis
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global HealthMcGill University Faculty of Medicine and Health SciencesMontréalQuebecCanada
| | - Alexander Reiner
- Fred Hutchinson Cancer Center, Division of Public Health ScienceSeattleWAUSA
| | - Charles Kooperberg
- Fred Hutchinson Cancer Center, Division of Public Health ScienceSeattleWAUSA
| | - Lifang Hou
- Feinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWAUSA
- Departments of Epidemiology, and Health Systems and Population HealthUniversity of WashingtonSeattleWAUSA
| | - James G. Wilson
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical CenterBostonMAUSA
| | - Daniel Levy
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
- Population Sciences BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthMDBethesdaUSA
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWAUSA
| | | | - Claudia L. Satizabal
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative DiseasesUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
- Department of NeurologyBoston University School of MedicineBostonMAUSA
| | - Dan E. Arking
- McKusick‐Nathans InstituteDepartment of Genetic MedicineJohns Hopkins University School of MedicineMDBaltimoreUSA
| | - Chunyu Liu
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
| |
Collapse
|
13
|
Ruderman SA, Odden MC, Webel AR, Fitzpatrick AL, Crane PK, Nance RM, Drumright LN, Whitney BM, Mixson LS, Ma J, Willig AL, Haidar L, Eltonsy S, Mayer KH, O'Cleirigh C, Cropsey KL, Eron JJ, Napravnik S, Greene M, McCaul M, Chander G, Cachay E, Lober WB, Kritchevsky SB, Austad S, Landay A, Pandya C, Cartujano-Barrera F, Saag MS, Kamen C, Hahn AW, Kitahata MM, Delaney JAC, Crane HM. Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV. J Acquir Immune Defic Syndr 2023; 94:135-142. [PMID: 37368939 PMCID: PMC10527292 DOI: 10.1097/qai.0000000000003242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Tobacco smoking increases frailty risk among the general population and is common among people with HIV (PWH) who experience higher rates of frailty at younger ages than the general population. METHODS We identified 8608 PWH across 6 Centers for AIDS Research Network of Integrated Clinical Systems sites who completed ≥2 patient-reported outcome assessments, including a frailty phenotype measuring unintentional weight loss, poor mobility, fatigue, and inactivity, and scored 0-4. Smoking was measured as baseline pack-years and time-updated never, former, or current use with cigarettes/day. We used Cox models to associate smoking with risk of incident frailty (score ≥3) and deterioration (frailty score increase by ≥2 points), adjusted for demographics, antiretroviral medication, and time-updated CD4 count. RESULTS The mean follow-up of PWH was 5.3 years (median: 5.0), the mean age at baseline was 45 years, 15% were female, and 52% were non-White. At baseline, 60% reported current or former smoking. Current (HR: 1.79; 95% confidence interval: 1.54 to 2.08) and former (HR: 1.31; 95% confidence interval: 1.12 to 1.53) smoking were associated with higher incident frailty risk, as were higher pack-years. Current smoking (among younger PWH) and pack-years, but not former smoking, were associated with higher risk of deterioration. CONCLUSIONS Among PWH, smoking status and duration are associated with incident and worsening frailty.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jimmy Ma
- University of Washington, Seattle, WA, USA
| | | | - Lara Haidar
- University of Manitoba, Winnipeg, Manitoba, CA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Suchsland MZ, Gaster B, Raetz J, Belza B, McGuire L, Olivari B, Tracy K, Fitzpatrick AL. Developing a cognitive assessment toolkit for primary care: qualitative assessment of providers' needs and perceptions of usability in clinical practice. BMC Health Serv Res 2023; 23:1006. [PMID: 37726722 PMCID: PMC10507963 DOI: 10.1186/s12913-023-09991-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 08/30/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Burden of dementia is expected to substantially increase. Early dementia is underdiagnosed in primary care. Given the benefits of active management of dementia, earlier detection in primary care is imperative. The aim of this study was to understand primary care provider (PCP) perceptions of implementing a cognitive assessment toolkit in primary care. METHODS PCPs in a large health system in the US were recruited to a qualitative study utilizing semi-structured interviews. Interviews captured provider perceptions of options for implementing a cognitive assessment toolkit derived from the Gerontological Society of America (GSA) KAER (Kickstart, Assess, Evaluate, Refer) toolkit, including a workflow and adapted clinical tools. A content analysis approach distinguished themes and exemplary quotes. RESULTS Ten PCPs were interviewed. They found the toolkit useful, felt the term Kickstart was not specific to dementia care, and stressed that addressing cognitive evaluation would need to be easy to implement in a clinical workflow. Finally, providers knew many resources for referral but were unsure how to help patients navigate options. CONCLUSIONS Providers stressed simplicity, ease, and efficiency for implementation of a cognitive assessment toolkit. Incorporating these findings into the development of clinical tools and workflows may increase cognitive evaluations conducted by PCPs.
Collapse
Affiliation(s)
- Monica Zigman Suchsland
- Department of Family Medicine, University of Washington, 1959 NE Pacific St, Box 356390, Seattle, WA, 98195-6390, USA.
| | - Barak Gaster
- Department of Medicine, University of Washington, 1959 NE Pacific St, Box 356420, Seattle, WA, 98195-6390, USA
| | - Jaqueline Raetz
- Department of Family Medicine, University of Washington, 1959 NE Pacific St, Box 356390, Seattle, WA, 98195-6390, USA
| | - Basia Belza
- School of Nursing, University of Washington, 1959 NE Pacific St, Box 357260, Seattle, WA, 98195- 6390, USA
| | - Lisa McGuire
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329-4027, USA
| | - Benjamin Olivari
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329-4027, USA
| | - Karen Tracy
- The Gerontological Society of America, 1220 L Street NW, Suite 901, Washington, DC, 20005, USA
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, 1959 NE Pacific St, Box 356390, Seattle, WA, 98195-6390, USA
- Departments of Epidemiology and Global Health, University of Washington, UW Box 351619, Seattle, WA, 98195, USA
| |
Collapse
|
15
|
Weber MB, Baumann AA, Rakhra A, Akwanalo C, Gladys Amaning Adjei K, Andesia J, Apusiga K, Ha DA, Hosseinipour MC, Muula AS, Nguyen HL, Price LN, Ramirez-Zea M, Fitzpatrick AL, Fort MP. Global implementation research capacity building to address cardiovascular disease: An assessment of efforts in eight countries. PLOS Glob Public Health 2023; 3:e0002237. [PMID: 37708090 PMCID: PMC10501667 DOI: 10.1371/journal.pgph.0002237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/01/2023] [Indexed: 09/16/2023]
Abstract
Cardiovascular diseases are the leading causes of morbidity and mortality worldwide, but implementation of evidence-based interventions for risk factors such as hypertension is lacking, particularly in low and middle income countries (LMICs). Building implementation research capacity in LMICs is required to overcome this gap. Members of the Global Research on Implementation and Translation Science (GRIT) Consortium have been collaborating in recent years to establish a research and training infrastructure in dissemination and implementation to improve hypertension care. GRIT includes projects in Ghana, Guatemala, India, Kenya, Malawi, Nepal, Rwanda, and Vietnam. We collected data from each site on capacity building activities using the Potter and Brough (2004) model, mapping formal and informal activities to develop (a) structures, systems and roles, (b) staff and infrastructure, (c) skills, and (d) tools. We captured information about sites' needs assessments and metrics plus program adaptations due to the COVID-19 pandemic. All sites reported capacity building activities in each layer of the Capacity Pyramid, with the largest number of activities in the Skills and Tools categories, the more technical and easier to implement categories. All sites included formal and informal training to build Skills. All sites included a baseline needs assessment to guide capacity building activities or assess context and inform intervention design. Sites implementing evidence-based hypertension interventions used common implementation science frameworks to evaluate implementation outcomes. Although the COVID-19 pandemic affected timelines and in-person events, all projects were able to pivot and carry out planned activities. Although variability in the activities and methods used existed, GRIT programs used needs assessments to guide locally appropriate design and implementation of capacity building activities. COVID-19 related changes were necessary, but strong collaborations and relationships with health ministries were maintained. The GRIT Consortium is a model for planning capacity building in LMICs.
Collapse
Affiliation(s)
- Mary Beth Weber
- Hubert Department of Global Health, Emory University, Rollins School of Public Health, Atlanta, Georgia, United States of America
| | - Ana A. Baumann
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Ashlin Rakhra
- Department of Population Health, NYU Grossman School of Medicine, New York City, New York, United States of America
| | | | - Kezia Gladys Amaning Adjei
- Department of Physiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
| | - Josephine Andesia
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Kingsley Apusiga
- Department of Physiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
| | - Duc A. Ha
- Health Strategy and Policy Institute, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Mina C. Hosseinipour
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Adamson S. Muula
- College of Medicine, University of Malawi and the Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Hoa L. Nguyen
- University of Massachusetts Chan Medical School, Boston, Massachusetts, United States of America
| | - LeShawndra N. Price
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Annette L. Fitzpatrick
- School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Meredith P. Fort
- Colorado School of Public Health, University of Colorado – Anschutz Medical Campus, Aurora, Colorado, United States of America
| |
Collapse
|
16
|
Thompson MJ, Suchsland MZ, Hardy V, Lavallee DC, Lord S, Devine EB, Jarvik JG, Findlay S, Trikalinos TA, Walter FM, Chou R, Green BB, Wernli KJ, Fitzpatrick AL, Bossuyt PM. Patient-centred outcomes of imaging tests: recommendations for patients, clinicians and researchers. BMJ Qual Saf 2023; 32:536-545. [PMID: 34615733 PMCID: PMC10447372 DOI: 10.1136/bmjqs-2021-013311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/11/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Imaging tests are one of the most frequently used diagnostic modalities in healthcare, but the benefits of their direct impacts on clinical decision-making have been countered by concerns that they can be overused. Assessing the relative value of imaging tests has largely focused on measures of test accuracy, which overlooks more comprehensive benefits and risks of imaging tests, particularly their impact on patient-centred outcomes (PCOs). We present the findings of the Patient Reported Outcomes of Diagnostics (PROD) research study in response to a methodological gap in the area of diagnostic test comparative effectiveness research. METHODS Over a 3-year period, the PROD Study engaged with multiple stakeholders to identify existing conceptual models related to PCOs for imaging testing, conducted primary research and evidence synthesis, and developed consensus recommendations to describe and categorise PCOs related to imaging testing. RESULTS The PROD framework categorises PCOs from imaging studies within four main domains: information or knowledge yielded, physical impact, emotional outcomes and test burden. PCOs interact with each other and influence effects across domains, and can be modified by factors related to the patient, clinical situation, healthcare team and the testing environment. CONCLUSIONS Using PCOs to inform healthcare decision-making will require ways of collating and presenting information on PCOs in ways that can inform patient-provider decision-making, and developing methods to determine the relative importance of outcomes (including test accuracy) to one another.
Collapse
Affiliation(s)
- Matthew J Thompson
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
| | | | - Victoria Hardy
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Danielle C Lavallee
- Department of Health Systems and Population Research, University of Washington, Seattle, Washington, USA
| | - Sally Lord
- The University of Sydney, Sydney, New South Wales, Australia
| | - Emily Beth Devine
- The Comparative Health Outcomes, Policy and Economics (CHOICE) Institute, School of Pharmacy, University of Washington School of Pharmacy, Seattle, Washington, USA
| | - Jeffrey G Jarvik
- Departments of Radiology and Neurological Surgery, University of Washington, Seattle, Washington, USA
| | | | - Thomas A Trikalinos
- Departments of Health Services, Policy & Practice, and Biostatistics, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Fiona M Walter
- Wolfson Institute of Population Health Science, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Roger Chou
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA
| | - Beverly B Green
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Annette L Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, Washington, USA
| | - Patrick M Bossuyt
- Epidemiology & Data Science, Amsterdam Public Health, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| |
Collapse
|
17
|
Bancks MP, Byrd G, Caban-Holt A, Fitzpatrick AL, Forrester SN, Hayden KM, Heckbert SR, Kershaw KN, Rapp SR, Sachs BC, Hughes TM. Self-reported experiences of discrimination and incident dementia. Alzheimers Dement 2023; 19:3119-3128. [PMID: 36724324 PMCID: PMC10390651 DOI: 10.1002/alz.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/09/2022] [Accepted: 12/20/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Discrimination negatively impacts health and may contribute to racial/ethnic disparities in dementia risk. METHODS Experiences of lifetime and everyday discrimination were assessed among 6509 Multi-Ethnic Study of Atherosclerosis (MESA) participants. We assessed the association of discrimination with incidence of dementia including adjustment for important risk factors, cohort attrition, and we assessed for effect modification by race/ethnicity. RESULTS Prevalence of any lifetime discrimination in MESA was 42%, highest among Black adults (72%). Over a median 15.7 years of follow-up, there were 466 incident cases of dementia. Lifetime discrimination, but not everyday discrimination, was associated with incident dementia (Wald p = 0.03). Individuals reporting lifetime discrimination in ≥2 domains (compared to none) had greater risk for dementia (hazard ratio: 1.40; 95%: 1.08, 1.82) after adjustment for sociodemographic, clinical, and behavioral risk factors. Associations did not differ by race/ethnicity. CONCLUSIONS These findings demonstrate an association of greater experiences of lifetime discrimination with incident dementia.
Collapse
Affiliation(s)
| | - Goldie Byrd
- Wake Forest University School of Medicine, Winston-Salem, NC
| | | | | | | | | | | | | | - Stephen R. Rapp
- Wake Forest University School of Medicine, Winston-Salem, NC
| | - Bonnie C. Sachs
- Wake Forest University School of Medicine, Winston-Salem, NC
| | | |
Collapse
|
18
|
Melvin RL, Ruple A, Pearson EB, Olby NJ, Fitzpatrick AL, Creevy KE. A review of frailty instruments in human medicine and proposal of a frailty instrument for dogs. Front Vet Sci 2023; 10:1139308. [PMID: 37441560 PMCID: PMC10333704 DOI: 10.3389/fvets.2023.1139308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Over the last few decades, frailty has become a pillar of research and clinical assessment in human gerontology. This complex syndrome, characterized by loss of physiologic reserves leading to decreased resilience to stressors, is of critical importance because it predicts higher risks of poor health outcomes, including mortality. Thus, identifying frailty among the elderly human population has become a key focus of gerontology. This narrative review presents current scientific literature on frailty in both humans and animals. The authors discuss the need for an accessible frailty instrument for companion dogs suitable for general use in veterinary medicine and the advances that would be facilitated by this instrument. A phenotypic frailty instrument for companion dogs, utilizing components that are easily collected by owners, or in the general practice setting, is proposed. The authors elaborate on the domains (physical condition, physical activity, mobility, strength, cognitive task performance, and social behavior), factors that will be included, and the data from the Dog Aging Project that inform each domain.
Collapse
Affiliation(s)
- Rachel L. Melvin
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Elizabeth B. Pearson
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| | - Natasha J. Olby
- Department of Clinical Sciences, NC State University College of Veterinary Medicine, Raleigh, NC, United States
| | | | - Kate E. Creevy
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| |
Collapse
|
19
|
Ilango SD, Leary CS, Ritchie E, Semmens EO, Park C, Fitzpatrick AL, Kaufman JD, Hajat A. An Examination of the Joint Effect of the Social Environment and Air Pollution on Dementia Among US Older Adults. Environ Epidemiol 2023; 7:e250. [PMID: 37304341 PMCID: PMC10256342 DOI: 10.1097/ee9.0000000000000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/06/2023] [Indexed: 06/13/2023] Open
Abstract
Evidence suggests exposure to air pollution increases the risk of dementia. Cognitively stimulating activities and social interactions, made available through the social environment, may slow cognitive decline. We examined whether the social environment buffers the adverse effect of air pollution on dementia in a cohort of older adults. Methods This study draws from the Ginkgo Evaluation of Memory Study. Participants aged 75 years and older were enrolled between 2000 and 2002 and evaluated for dementia semi-annually through 2008. Long-term exposure to particulate matter and nitrogen dioxide was assigned from spatial and spatiotemporal models. Census tract-level measures of the social environment and individual measures of social activity were used as measures of the social environment. We generated Cox proportional hazard models with census tract as a random effect and adjusted for demographic and study visit characteristics. Relative excess risk due to interaction was estimated as a qualitative measure of additive interaction. Results This study included 2,564 individuals. We observed associations between increased risk of dementia and fine particulate matter (µg/m3), coarse particulate matter (µg/m3), and nitrogen dioxide (ppb); HRs per 5 unit increase were 1.55 (1.01, 2.18), 1.31 (1.07, 1.60), and 1.18 (1.02, 1.37), respectively. We found no evidence of additive interaction between air pollution and the neighborhood social environment. Conclusions We found no consistent evidence to suggest a synergistic effect between exposure to air pollution and measures of the social environment. Given the many qualities of the social environment that may reduce dementia pathology, further examination is encouraged.
Collapse
Affiliation(s)
- Sindana D Ilango
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Cindy S Leary
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Emily Ritchie
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Erin O Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Christina Park
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Family Medicine and Global Health, University of Washington, Seattle, Washington, USA
| | - Joel D Kaufman
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| |
Collapse
|
20
|
Adam CE, Fitzpatrick AL, Leary CS, Hajat A, Ilango SD, Park C, Phelan EA, Semmens EO. Change in gait speed and fall risk among community-dwelling older adults with and without mild cognitive impairment: a retrospective cohort analysis. BMC Geriatr 2023; 23:328. [PMID: 37231344 PMCID: PMC10214622 DOI: 10.1186/s12877-023-03890-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/14/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Although slow gait speed is an established risk factor for falls, few studies have evaluated change in gait speed as a predictor of falls or considered variability in effects by cognitive status. Change in gait speed may be a more useful metric because of its potential to identify decline in function. In addition, older adults with mild cognitive impairment are at an elevated risk of falls. The purpose of this research was to quantify the association between 12-month change in gait speed and falls in the subsequent 6 months among older adults with and without mild cognitive impairment. METHODS Falls were self-reported every six months, and gait speed was ascertained annually among 2,776 participants in the Ginkgo Evaluation of Memory Study (2000-2008). Adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for fall risk relative to a 12-month change in gait speed. RESULTS Slowing gait speed over 12 months was associated with increased risk of one or more falls (HR:1.13; 95% CI: 1.02 to 1.25) and multiple falls (HR:1.44; 95% CI: 1.18 to 1.75). Quickening gait speed was not associated with risk of one or more falls (HR 0.97; 95% CI: 0.87 to 1.08) or multiple falls (HR 1.04; 95% CI: 0.84 to 1.28), relative to those with a less than 0.10 m/s change in gait speed. Associations did not vary by cognitive status (pinteraction = 0.95 all falls, 0.25 multiple falls). CONCLUSIONS Decline in gait speed over 12 months is associated with an increased likelihood of falls among community-dwelling older adults, regardless of cognitive status. Routine checks of gait speed at outpatient visits may be warranted as a means to focus fall risk reduction efforts.
Collapse
Affiliation(s)
- Claire E Adam
- School of Public and Community Health Sciences, University of Montana, Missoula, USA.
- Center for Population Health Research, University of Montana, Missoula, USA.
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
| | - Cindy S Leary
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
- Center for Population Health Research, University of Montana, Missoula, USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Sindana D Ilango
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Christina Park
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Elizabeth A Phelan
- Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Erin O Semmens
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
- Center for Population Health Research, University of Montana, Missoula, USA
| |
Collapse
|
21
|
Zhang Y, Liu X, Wiggins KL, Kurniansyah N, Guo X, Rodrigue AL, Zhao W, Yanek LR, Ratliff SM, Pitsillides A, Aguirre Patiño JS, Sofer T, Arking DE, Austin TR, Beiser AS, Blangero J, Boerwinkle E, Bressler J, Curran JE, Hou L, Hughes TM, Kardia SLR, Launer LJ, Levy D, Mosley TH, Nasrallah IM, Rich SS, Rotter JI, Seshadri S, Tarraf W, González KA, Ramachandran V, Yaffe K, Nyquist PA, Psaty BM, DeCarli CS, Smith JA, Glahn DC, González HM, Bis JC, Fornage M, Heckbert SR, Fitzpatrick AL, Liu C, Satizabal CL. Association of Mitochondrial DNA Copy Number With Brain MRI Markers and Cognitive Function: A Meta-analysis of Community-Based Cohorts. Neurology 2023; 100:e1930-e1943. [PMID: 36927883 PMCID: PMC10159770 DOI: 10.1212/wnl.0000000000207157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/20/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Previous studies suggest that lower mitochondrial DNA (mtDNA) copy number (CN) is associated with neurodegenerative diseases. However, whether mtDNA CN in whole blood is related to endophenotypes of Alzheimer disease (AD) and AD-related dementia (AD/ADRD) needs further investigation. We assessed the association of mtDNA CN with cognitive function and MRI measures in community-based samples of middle-aged to older adults. METHODS We included dementia-free participants from 9 diverse community-based cohorts with whole-genome sequencing in the Trans-Omics for Precision Medicine (TOPMed) program. Circulating mtDNA CN was estimated as twice the ratio of the average coverage of mtDNA to nuclear DNA. Brain MRI markers included total brain, hippocampal, and white matter hyperintensity volumes. General cognitive function was derived from distinct cognitive domains. We performed cohort-specific association analyses of mtDNA CN with AD/ADRD endophenotypes assessed within ±5 years (i.e., cross-sectional analyses) or 5-20 years after blood draw (i.e., prospective analyses) adjusting for potential confounders. We further explored associations stratified by sex and age (<60 vs ≥60 years). Fixed-effects or sample size-weighted meta-analyses were performed to combine results. Finally, we performed mendelian randomization (MR) analyses to assess causality. RESULTS We included up to 19,152 participants (mean age 59 years, 57% women). Higher mtDNA CN was cross-sectionally associated with better general cognitive function (β = 0.04; 95% CI 0.02-0.06) independent of age, sex, batch effects, race/ethnicity, time between blood draw and cognitive evaluation, cohort-specific variables, and education. Additional adjustment for blood cell counts or cardiometabolic traits led to slightly attenuated results. We observed similar significant associations with cognition in prospective analyses, although of reduced magnitude. We found no significant associations between mtDNA CN and brain MRI measures in meta-analyses. MR analyses did not reveal a causal relation between mtDNA CN in blood and cognition. DISCUSSION Higher mtDNA CN in blood is associated with better current and future general cognitive function in large and diverse communities across the United States. Although MR analyses did not support a causal role, additional research is needed to assess causality. Circulating mtDNA CN could serve nevertheless as a biomarker of current and future cognitive function in the community.
Collapse
Affiliation(s)
- Yuankai Zhang
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Xue Liu
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Kerri L Wiggins
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Nuzulul Kurniansyah
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Xiuqing Guo
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Amanda L Rodrigue
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Wei Zhao
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Lisa R Yanek
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Scott M Ratliff
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Achilleas Pitsillides
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Juan Sebastian Aguirre Patiño
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Tamar Sofer
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Dan E Arking
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Thomas R Austin
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Alexa S Beiser
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - John Blangero
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Eric Boerwinkle
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Jan Bressler
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Joanne E Curran
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Lifang Hou
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Timothy M Hughes
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Sharon L R Kardia
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Lenore J Launer
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Daniel Levy
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Thomas H Mosley
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Ilya M Nasrallah
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Stephen S Rich
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Jerome I Rotter
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Sudha Seshadri
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Wassim Tarraf
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Kevin A González
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Vasan Ramachandran
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Kristine Yaffe
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Paul A Nyquist
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Bruce M Psaty
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Charles S DeCarli
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Jennifer A Smith
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - David C Glahn
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Hector M González
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Joshua C Bis
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Myriam Fornage
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Susan R Heckbert
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Annette L Fitzpatrick
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Chunyu Liu
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle
| | - Claudia L Satizabal
- From the Department of Biostatistics (Y.Z., X.L., A.P., A.S.B., C.L.), School of Public Health, Boston University, MA; Cardiovascular Health Research Unit (K.L.W., J.C.B.), Department of Medicine, University of Washington, Seattle; Brigham and Women's Hospital (N.K., T.S.), Boston, MA; The Institute for Translational Genomics and Population Sciences (X.G., J.I.R.), Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance; Department of Psychiatry and Behavioral Sciences (A.L.R., D.C.G.), Boston Children's Hospital, MA; Department of Psychiatry (A.L.R., D.C.G.), Harvard Medical School, Boston Children's Hospital, MA; Department of Epidemiology (W.Z., S.M.R., S.L.R.K., J.A.S.), School of Public Health, University of Michigan, Ann Arbor; GeneSTAR Research Program (L.R.Y.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; School of Medicine (J.S.A.P.), Universidad de Los Andes, Bogotá, Colombia; Harvard Medical School (T.S.), Boston, MA; McKusick-Nathans Institute (D.E.A.), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology (T.R.A.), University of Washington, Seattle; Department of Neurology (A.S.B.), School of Medicine, Boston University, MA; Framingham Heart Study (A.S.B., D.L., S.S., V.R., C.L., C.L.S.), Framingham, MA; Department of Human Genetics and South Texas Diabetes and Obesity Institute (J. Blangero, J.E.C.), University of Texas Rio Grande, Brownsville; Human Genetics Center (E.B., J. Bressler), School of Public Health, The University of Texas Health Science Center at Houston; Human Genome Sequencing Center (E.B.), Baylor College of Medicine, Houston, TX; Department of Preventive Medicine (L.H.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Internal Medicine (T.M.H.), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC; National Institute on Aging (L.J.L.), and Population Sciences Branch National Heart, Lung, and Blood Institute (D.L.), NIH, Bethesda, MD; Memory Impairment and Neurodegenerative Dementia (MIND) Center (T.H.M.), School of Medicine, University of Mississippi Medical Center, Jackson; Center for Biomedical Image Computing and Analytics (I.M.N.), Department of Radiology, University of Pennsylvania, Philadelphia; Center for Public Health Genomics (S.S.R.), University of Virginia School of Medicine, Charlottesville; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (S.S., C.L.S.), University of Texas Health Science Center at San Antonio; Institute of Gerontology & Department of Healthcare Sciences (W.T.), Wayne State University, Detroit, MI; Department of Neurosciences (K.A.G.) and Shiley-Marcos Alzheimer's Disease Center (H.M.G.), University of California, San Diego, La Jolla; Department of Medicine (V.R.), School of Medicine, and Department of Epidemiology, Boston University, MA; University of California, San Francisco (K.Y.); Department of Neurology (P.A.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle; Department of Neurology (C.S.D.), UC Davis, CA; Institute of Molecular Medicine (M.F.), McGovern Medical School; and Human Genetics Center (M.F.), School of Public Health, University of Texas Health Science Center at Houston; and Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.), and Departments of Family Medicine, Epidemiology, and Global Health (A.L.F.), University of Washington, Seattle.
| |
Collapse
|
22
|
Hughes TM, Tanley J, Chen H, Schaich CL, Yeboah J, Espeland MA, Lima JAC, Ambale-Venkatesh B, Michos ED, Ding J, Hayden K, Casanova R, Craft S, Rapp SR, Luchsinger JA, Fitzpatrick AL, Heckbert SR, Post WS, Burke GL. Subclinical Vascular Composites Predict Clinical Cardiovascular Disease, Stroke, and Dementia: The Multi-Ethnic Study of Atherosclerosis (MESA). medRxiv 2023:2023.05.01.23289364. [PMID: 37205504 PMCID: PMC10187443 DOI: 10.1101/2023.05.01.23289364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Background Subclinical cardiovascular disease (CVD) measures may reflect biological pathways that contribute to increased risk for coronary heart disease (CHD) events, stroke, and dementia beyond conventional risk scores. Methods The Multi-Ethnic Study of Atherosclerosis (MESA) followed 6,814 participants (45-84 years of age) from baseline in 2000-2002 to 2018 over 6 clinical examinations and annual follow-up interviews. MESA baseline subclinical CVD procedures included: seated and supine blood pressure, coronary calcium scan, radial artery tonometry, and carotid ultrasound. Baseline subclinical CVD measures were transformed into z-scores before factor analysis to derive composite factor scores. Time to clinical event for all CVD, CHD, stroke and ICD code-based dementia events were modeled using Cox proportional hazards models reported as area under the curve (AUC) with 95% Confidence Intervals (95%CI) at 10 and 15 years of follow-up. All models included all factor scores together and adjustment for conventional risk scores for global CVD, stroke, and dementia. Results After factor selection, 24 subclinical measures aggregated into four distinct factors representing: blood pressure, arteriosclerosis, atherosclerosis, and cardiac factors. Each factor significantly predicted time to CVD events and dementia at 10 and 15 years independent of each other and conventional risk scores. Subclinical vascular composites of arteriosclerosis and atherosclerosis best predicted time to clinical events of CVD, CHD, stroke, and dementia. These results were consistent across sex and racial and ethnic groups. Conclusions Subclinical vascular composites of arteriosclerosis and atherosclerosis may be useful biomarkers to inform the vascular pathways contributing to events of CVD, CHD, stroke, and dementia.
Collapse
|
23
|
Ruderman SA, Webel AR, Willig AL, Drumright LN, Fitzpatrick AL, Odden MC, Cleveland JD, Burkholder G, Davey CH, Fleming J, Buford TW, Jones R, Nance RM, Whitney BM, Mixson LS, Hahn AW, Mayer KH, Greene M, Saag MS, Kamen C, Pandya C, Lober WB, Kitahata MM, Crane PK, Crane HM, Delaney JAC. Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States. J Assoc Nurses AIDS Care 2023; 34:158-170. [PMID: 36652200 PMCID: PMC10088432 DOI: 10.1097/jnc.0000000000000389] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
ABSTRACT Modifications to Fried's frailty phenotype (FFP) are common. We evaluated a self-reported modified frailty phenotype (Mod-FP) used among people with HIV (PWH). Among 522 PWH engaged in two longitudinal studies, we assessed validity of the four-item Mod-FP compared with the five-item FFP. We compared the phenotypes via receiver operator characteristic curves, agreement in classifying frailty, and criterion validity via association with having experienced falls. Mod-FP classified 8% of PWH as frail, whereas FFP classified 9%. The area under the receiver operator characteristic curve for Mod-FP classifying frailty was 0.93 (95% CI = 0.91-0.96). We observed kappa ranging from 0.64 (unweighted) to 0.75 (weighted) for categorizing frailty status. Both definitions found frailty associated with a greater odds of experiencing a fall; FFP estimated a slightly greater magnitude (i.e., OR) for the association than Mod-FP. The Mod-FP has good performance in measuring frailty among PWH and is reasonable to use when the gold standards of observed assessments (i.e., weakness and slowness) are not feasible.
Collapse
Affiliation(s)
- Stephanie A Ruderman
- Stephanie A. Ruderman, MPH, is a PhD candidate, Department of Epidemiology, University of Washington, Seattle, Washington, USA. Allison R. Webel, RN, PhD, is an Associate Dean for Research, School of Nursing, University of Washington, Seattle, Washington, USA. Amanda L. Willig, PhD, RD, is an Associate Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Lydia N. Drumright, PhD, MPH, is a Clinical Assistant Professor, School of Nursing, University of Washington, Seattle, Washington, USA. Annette L. Fitzpatrick, PhD, is a Research Professor, Department of Epidemiology, University of Washington, Seattle, Washington, USA. Michelle C. Odden, PhD, is an Associate Professor, Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California, USA. John D. Cleveland, MS, is a Statistician, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA. Greer Burkholder, MD, is an Assistant Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Christine H. Davey, RN, PhD, is a Postdoctoral Fellow, School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA. Julia Fleming, MD, is an Infectious Disease Specialist, Harvard Medical School, Fenway Institute, Boston, Massachusetts, USA. Thomas W. Buford, PhD, is a Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA and Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama, USA. Raymond Jones, PhD, is an Assistant Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Robin M. Nance, PhD, is a Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. Bridget M. Whitney, PhD, MPH, is a Senior Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. L. Sarah Mixson, MPH, is a Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. Andrew W. Hahn, MD, is a Clinical Assistant Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Kenneth H. Mayer, MD, is a Professor, Harvard Medical School, Fenway Institute, Boston, Massachusetts, USA. Meredith Greene, MD, is an Associate Professor, Department of Medicine, University of California San Francisco, San Francisco, California, USA. Michael S. Saag, MD, is a Professor and Associate Dean, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Charles Kamen, PhD, MPH, is an Associate Professor, Department of Surgery, University of Rochester, Rochester, New York, USA. Chintan Pandya, PhD, is an Assistant Scientist, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. William B. Lober, MD, MS, is a Professor, School of Nursing, University of Washington, Seattle, Washington, USA. Mari M. Kitahata, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Paul K. Crane, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Heidi M. Crane, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Joseph A. C. Delaney, PhD, is an Associate Professor, College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, California, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Hajat A, Park C, Adam C, Fitzpatrick AL, Ilango SD, Leary C, Libby T, Lopez O, Semmens EO, Kaufman JD. Air pollution and plasma amyloid beta in a cohort of older adults: Evidence from the Ginkgo Evaluation of Memory study. Environ Int 2023; 172:107800. [PMID: 36773564 PMCID: PMC9974914 DOI: 10.1016/j.envint.2023.107800] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/20/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Air pollution has been linked to Alzheimer's disease and related dementias (ADRD), but the mechanisms connecting air pollution to ADRD have not been firmly established. Air pollution may cause oxidative stress and neuroinflammation and contribute to the deposition of amyloid beta (Aβ) in the brain. We examined the association between fine particulate matter<2.5 μm in diameter (PM2.5), particulate matter<10 μm in diameter (PM10), nitrogen dioxide (NO2), and plasma based measures of Aβ1-40, Aβ1-42 and Aβ1-42/Aβ1-40 using data from 3044 dementia-free participants of the Ginkgo Evaluation of Memory Study (GEMS). Air pollution exposures were estimated at residential addresses that incorporated address histories dating back to 1980, resulting in one-, five-, 10- and 20- year exposure averages. Aβ was measured at baseline (2000-2002) and then again at the end of the study (2007-2008) allowing for linear regression models to assess cross-sectional associations and linear random effects models to evaluate repeated measures. After adjustment for socio-demographic and behavioral covariates, we found small positive associations between each air pollutant and Aβ1-40 but no association with Aβ1-42 or the ratio measures in cross sectional analysis. In repeat measures analysis, we found larger positive associations between each air pollutant and all three outcomes. We observed a 4.43% (95% CI 3.26%, 5.60%) higher Aβ1-40 level, 9.73% (6.20%, 13.38%) higher Aβ1-42 and 1.57% (95% CI: 0.94%, 2.20%) higher Aβ1-42/Aβ1-40 ratio associated with a 2 µg/m3 higher 20-year average PM2.5. Associations with other air pollutants were similar. Our study contributes to the broader evidence base on air pollution and ADRD biomarkers by evaluating longer air pollution exposure averaging periods to better mimic disease progression and provides a modifiable target for ADRD prevention.
Collapse
Affiliation(s)
- Anjum Hajat
- University of Washington, Department of Epidemiology, 3980 15th Ave NE, Seattle, WA 98195, USA.
| | - Christina Park
- University of Washington, Department of Epidemiology, 3980 15th Ave NE, Seattle, WA 98195, USA
| | - Claire Adam
- University of Montana, School of Public and Community Health Sciences, Skaggs Building, 32 Campus Drive Missola, MT 59812, USA
| | - Annette L Fitzpatrick
- University of Washington, Department of Family Medicine, 4225 Roosevelt Ave NE Seattle, WA 98195, USA
| | - Sindana D Ilango
- University of Washington, Department of Epidemiology, 3980 15th Ave NE, Seattle, WA 98195, USA
| | - Cindy Leary
- University of Montana, School of Public and Community Health Sciences, Skaggs Building, 32 Campus Drive Missola, MT 59812, USA
| | - Tanya Libby
- University of Washington, Department of Epidemiology, 3980 15th Ave NE, Seattle, WA 98195, USA
| | - Oscar Lopez
- University of Pittsburgh, Department of Neurology, 811 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15123, USA
| | - Erin O Semmens
- University of Montana, School of Public and Community Health Sciences, Skaggs Building, 32 Campus Drive Missola, MT 59812, USA
| | - Joel D Kaufman
- University of Washington, Department of Environmental and Occupational Health and Epidemiology, 4225 Roosevelt Ave NE, Seattle, WA 98195, USA
| |
Collapse
|
25
|
Semmens EO, Leary CS, Fitzpatrick AL, Ilango SD, Park C, Adam CE, DeKosky ST, Lopez O, Hajat A, Kaufman JD. Air pollution and dementia in older adults in the Ginkgo Evaluation of Memory Study. Alzheimers Dement 2023; 19:549-559. [PMID: 35436383 PMCID: PMC9576823 DOI: 10.1002/alz.12654] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Growing evidence implicates air pollution as a risk factor for dementia, but prior work is limited by challenges in diagnostic accuracy and assessing exposures in the decades prior to disease development. We evaluated the impact of long-term fine particulate matter (PM2.5 ) exposures on incident dementia (all-cause, Alzheimer's disease [AD], and vascular dementia [VaD]) in older adults. METHODS A panel of neurologists adjudicated dementia cases based on extensive neuropsychological testing and magnetic resonance imaging. We applied validated fine-scale air pollutant models to reconstructed residential histories to assess exposures. RESULTS An interquartile range increase in 20-year PM2.5 was associated with a 20% higher risk of dementia (95% confidence interval [CI]: 5%, 37%) and an increased risk of mixed VaD/AD but not AD alone. DISCUSSION Our findings suggest that air pollutant exposures over decades contribute to dementia and that effects of current exposures may be experienced years into the future.
Collapse
Affiliation(s)
- Erin O. Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Cindy S. Leary
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Annette L. Fitzpatrick
- Departments of Family Medicine and Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Sindana D. Ilango
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Christina Park
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Claire E. Adam
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Steven T. DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, Florida, USA
| | - Oscar Lopez
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Joel D. Kaufman
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
- Departments of Environmental and Occupational Health Sciences and Medicine, School of Public Health, University of Washington, Seattle, Washington, USA
| |
Collapse
|
26
|
Guo B, Zhao C, He MZ, Senter C, Zhou Z, Peng J, Li S, Fitzpatrick AL, Lindström S, Stebbins RC, Noppert GA, Li C. Long-term cardiac symptoms following COVID-19: a systematic review and meta-analysis. medRxiv 2023:2023.01.16.23284620. [PMID: 36711624 PMCID: PMC9882562 DOI: 10.1101/2023.01.16.23284620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background There is growing body of literature on the long-term cardiac symptoms following COVID-19. We conducted a systematic review and meta-analysis to synthesize and evaluate related evidence to inform clinical management and future studies. Methods We searched two preprint and seven peer-reviewed article databases from January 1, 2020 to January 8, 2022 for studies investigating cardiac symptoms that persisted for at least 4 weeks among individuals who survived COVID-19. A customized Newcastle-Ottawa scale was used to evaluate the quality of included studies. Random-effects meta-analyses were performed to estimate the proportion of symptoms with 95% confidence intervals (CI), and stratified analyses were conducted to quantify the proportion of symptoms by study characteristics and quality. Results A total of 101 studies describing 49 unique long-term cardiac symptoms met the inclusion criteria. Based on quality assessment, only 15.8% of the studies (n=16) were of high quality, and most studies scored poorly on sampling representativeness. The two most examined symptoms were chest pain and arrhythmia. Meta-analysis showed that the proportion of chest pain was 10.1% (95% CI: 6.4-15.5) and arrhythmia was 9.8% (95% CI: 5.4-17.2). Stratified analyses showed that studies with low-quality score, small sample size, unsystematic sampling method, and cross-sectional design were most likely to report high proportions of symptoms. For example, the proportion of chest pain was 21.3% (95% CI: 10.5-38.5), 9.3% (95% CI: 6.0-14.0), and 4.0% (95% CI: 1.3-12.0) in studies with low, medium, and high-quality scores, respectively. Similar patterns were observed for other cardiac symptoms including hypertension, cardiac abnormalities, myocardial injury, thromboembolism, stroke, heart failure, coronary disease, and myocarditis. Discussion There is a wide spectrum of long-term cardiac symptoms following COVID-19. Findings of existing studies are strongly related to study quality, size and design, underscoring the need for high-quality epidemiologic studies to characterize these symptoms and understand their etiology.
Collapse
Affiliation(s)
- Boya Guo
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - Chenya Zhao
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Mike Z He
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Camilla Senter
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - Zhenwei Zhou
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA
| | - Jin Peng
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY
| | - Song Li
- Division of Cardiology, University of Washington Medical Center, Seattle, WA
| | - Annette L Fitzpatrick
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
- Department of Family Medicine, University of Washington, Seattle, WA
| | - Sara Lindström
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Rebecca C Stebbins
- Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Grace A Noppert
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Chihua Li
- Institute for Social Research, University of Michigan, Ann Arbor, MI
- Department of Epidemiology, School of Public Health, University of Michigan, MI, USA
- Department of Epidemiology, School of Public Health, Johns Hopkins Bloomberg School of Public Health, MD, USA
| |
Collapse
|
27
|
Lastwika KJ, Kunihiro A, Solan JL, Zhang Y, Taverne LR, Shelley D, Rho JH, Randolph TW, Li CI, Grogan EL, Massion PP, Fitzpatrick AL, MacPherson D, Houghton AM, Lampe PD. Posttranslational modifications induce autoantibodies with risk prediction capability in patients with small cell lung cancer. Sci Transl Med 2023; 15:eadd8469. [PMID: 36630482 PMCID: PMC10117289 DOI: 10.1126/scitranslmed.add8469] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Small cell lung cancer (SCLC) elicits the generation of autoantibodies that result in unique paraneoplastic neurological syndromes. The mechanistic basis for the formation of such autoantibodies is largely unknown but is key to understanding their etiology. We developed a high-dimensional technique that enables detection of autoantibodies in complex with native antigens directly from patient plasma. Here, we used our platform to screen 1009 human plasma samples for 3600 autoantibody-antigen complexes, finding that plasma from patients with SCLC harbors, on average, fourfold higher disease-specific autoantibody signals compared with plasma from patients with other cancers. Across three independent SCLC cohorts, we identified a set of common but previously unknown autoantibodies that are produced in response to both intracellular and extracellular tumor antigens. We further characterized several disease-specific posttranslational modifications within extracellular proteins targeted by these autoantibodies, including citrullination, isoaspartylation, and cancer-specific glycosylation. Because most patients with SCLC have metastatic disease at diagnosis, we queried whether these autoantibodies could be used for SCLC early detection. We created a risk prediction model using five autoantibodies with an average area under the curve of 0.84 for the three cohorts that improved to 0.96 by incorporating cigarette smoke consumption in pack years. Together, our findings provide an innovative approach to identify circulating autoantibodies in SCLC with mechanistic insight into disease-specific immunogenicity and clinical utility.
Collapse
Affiliation(s)
- Kristin J Lastwika
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Andrew Kunihiro
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Joell L Solan
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Yuzheng Zhang
- Department of Biostatistics, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Lydia R Taverne
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - David Shelley
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Jung-Hyun Rho
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Timothy W Randolph
- Department of Biostatistics, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Christopher I Li
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Eric L Grogan
- Departments of Surgery, Medicine Radiology, and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Pierre P Massion
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt Ingram Cancer Center, Nashville, TN 37232, USA
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, WA 98195, USA
- Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, WA 98195, USA
| | - David MacPherson
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
- Human Biology Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - A McGarry Houghton
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
- Human Biology Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Paul D Lampe
- Translational Research Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
- Human Biology Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| |
Collapse
|
28
|
Quaye E, Galecki AT, Tilton N, Whitney R, Briceño EM, Elkind MSV, Fitzpatrick AL, Gottesman RF, Griswold M, Gross AL, Heckbert SR, Hughes TM, Longstreth WT, Sacco RL, Sidney S, Windham BG, Yaffe K, Levine DA. Association of Obesity With Cognitive Decline in Black and White Americans. Neurology 2023; 100:e220-e231. [PMID: 36257719 PMCID: PMC9841449 DOI: 10.1212/wnl.0000000000201367] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There are disparities in the prevalence of obesity by race, and the relationship between obesity and cognitive decline is unclear. The objective of this study was to determine whether obesity is independently associated with cognitive decline and whether the association between obesity and cognitive decline differs in Black and White adults. We hypothesized that obesity is associated with greater cognitive decline compared with normal weight and that the effect of obesity on cognitive decline is more pronounced in Black adults compared with their White counterparts. METHODS We pooled data from 28,867 participants free of stroke and dementia (mean, SD: age 61 [10.7] years at the first cognitive assessment, 55% female, 24% Black, and 29% obese) from 6 cohorts. The primary outcome was the annual change in global cognition. We performed linear mixed-effects models with and without time-varying cumulative mean systolic blood pressure (SBP) and fasting plasma glucose (FPG). Global cognition was set to a t-score metric (mean 50, SD 10) at a participant's first cognitive assessment; a 1-point difference represents a 0.1 SD difference in global cognition across the 6 cohorts. The median follow-up was 6.5 years (25th percentile, 75th percentile: 5.03, 20.15). RESULTS Obese participants had lower baseline global cognition than normal-weight participants (difference in intercepts, -0.36 [95% CI, -0.46 to -0.17]; p < 0.001). This difference in baseline global cognition was attenuated but was borderline significant after accounting for SBP and FPG (adjusted differences in intercepts, -0.19 [95% CI, -0.39 to 0.002]; p = 0.05). There was no difference in the rate of decline in global cognition between obese and normal-weight participants (difference in slope, 0.009 points/year [95% CI, -0.009 to 0.03]; p = 0.32). After accounting for SBP and FPG, obese participants had a slower decline in global cognition (adjusted difference in slope, 0.03 points/year slower [95% CI, 0.01 to 0.05]; p < 0.001). There was no evidence that race modified the association between body mass index and global cognitive decline (p = 0.34). DISCUSSION These results suggest that obesity is associated with lower initial cognitive scores and may potentially attenuate declines in cognition after accounting for BP and FPG.
Collapse
Affiliation(s)
- Emmanuel Quaye
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Andrzej T Galecki
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Nicholas Tilton
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Rachael Whitney
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Emily M Briceño
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Mitchell S V Elkind
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Annette L Fitzpatrick
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Rebecca F Gottesman
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Michael Griswold
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Alden L Gross
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Susan R Heckbert
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Timothy M Hughes
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - W T Longstreth
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Ralph L Sacco
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Stephen Sidney
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - B Gwen Windham
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Kristine Yaffe
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco
| | - Deborah A Levine
- From the University of Michigan Medical School (E.Q.), Ann Arbor; Departments of Internal Medicine and Cognitive Health Services Research Program (A.T.G., N.T., R.W., D.A.L.), Biostatistics (A.T.G.), Psychiatry and Michigan Alzheimer's Disease Center (E.M.B.), and Neurology and Stroke Program (D.A.L.), University of Michigan, Ann Arbor; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (A.L.F., S.R.H., M.D.J.), School of Public Health, University of Washington, Seattle; Department of Neurology (R.F.G.), and Department of Epidemiology (A.L.G.), Bloomberg School of PublicHealth, Johns Hopkins University, Baltimore, MD; Department of Biostatistics (M.G.), University of Mississippi School of Medicine, Jackson, MS; Departments of Internal Medicine and Epidemiology and Prevention (T.M.H.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology (M.D.J.), School of Medicine, University of Washington, Seattle; Department of Neurology (R.L.S./M.S.), University of Miami Leonard School of Medicine, FL; Kaiser Permanente Northern California Division of Research (S.S.), Oakland; Department of Internal Medicine (B.G.W.), University of Mississippi School of Medicine, Jackson; and Departments of Psychiatry (K.Y.), Neurology and Epidemiology, University of California, San Francisco.
| |
Collapse
|
29
|
Godina SL, Rosso AL, Hirsch JA, Besser LM, Lovasi GS, Donovan GH, Garg PK, Platt JM, Fitzpatrick AL, Lopez OL, Carlson MC, Michael YL. Neighborhood greenspace and cognition: The cardiovascular health study. Health Place 2023; 79:102960. [PMID: 36603455 PMCID: PMC9928891 DOI: 10.1016/j.healthplace.2022.102960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/04/2022] [Accepted: 12/14/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES We examined whether greenspace measures (overall percent greenspace and forest, and number of greenspace types) were associated with clinically adjudicated dementia status. METHODS In a sample of non-demented older adults (n = 2141, average age = 75.3 years) from the Cardiovascular Health and Cognition Study, Cox proportional hazard and logistic regression analyses were used to estimate associations of baseline greenspace with risks of incident dementia and MCI, respectively, while adjusting for demographics, co-morbidities, and other neighborhood factors. We derived quartiles of percent greenness (greenspace), forest (percent tree canopy cover), and tertiles of greenspace diversity (number of greenspace types) for 5-km radial buffers around participant's residences at study entry (1989-1990) from the 1992 National Land Cover Dataset. Dementia status and mild cognitive impairment (MCI) over 10 years was clinically adjudicated. RESULTS We observed no significant association between overall percent greenspace and risk of mild cognitive impairment or dementia and mostly null results for forest and greenspace diversity. Forest greenspace was associated with lower odds of MCI (OR quartile 4 versus 1: 0.54, 95% CI: 0.29-0.98) and greenspace diversity was associated with lower hazard of incident dementia (HR tertile 2 versus 1: 0.70, 95% CI = 0.50-0.99). DISCUSSION We found divergent results for different types of greenspace and mild cognitive impairment or dementia. Improved greenspace type and diversity measurement could better characterize the association between greenspace and cognition.
Collapse
Affiliation(s)
- Sara L Godina
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, 130 DeSoto Street, Pittsburgh, PA, 15261, USA.
| | - Andrea L Rosso
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
| | - Jana A Hirsch
- Drexel University Dornsife School of Public Health, Urban Health Collaborative, 3600 Market Street, 7th Floor, Philadelphia, PA, 19104, USA
| | - Lilah M Besser
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, 7700 W Camino Real, Suite 200, Boca Raton, FL, 33433, USA
| | - Gina S Lovasi
- Drexel University Dornsife School of Public Health, Urban Health Collaborative, 3600 Market Street, 7th Floor, Philadelphia, PA, 19104, USA
| | - Geoffrey H Donovan
- U.S. Department of Agriculture Forest Service, PNW Research Station, 620 SW Main, Suite 502, Portland, OR, 97205, USA
| | - Parveen K Garg
- University of Southern California Keck School of Medicine, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | - Jonathan M Platt
- The University of Iowa, College of Public Health, 145 N. Riverside Drive, Iowa City, IA, 52242, USA
| | - Annette L Fitzpatrick
- University of Washington School of Public Health, Department of Epidemiology, 3980 15th Avenue NE, Seattle, WA, 98195, USA
| | - Oscar L Lopez
- University of Pittsburgh School of Medicine, Department of Neurology, Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA
| | - Michelle C Carlson
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Yvonne L Michael
- Drexel University Dornsife School of Public Health, Urban Health Collaborative, 3600 Market Street, 7th Floor, Philadelphia, PA, 19104, USA
| |
Collapse
|
30
|
Kunihiro AG, Sarrett SM, Lastwika KJ, Solan JL, Pisarenko T, Keinänen O, Rodriguez C, Taverne LR, Fitzpatrick AL, Li CI, Houghton AM, Zeglis BM, Lampe PD. CD133 as a Biomarker for an Autoantibody-to-ImmunoPET Paradigm for the Early Detection of Small Cell Lung Cancer. J Nucl Med 2022; 63:1701-1707. [PMID: 35483965 PMCID: PMC9635686 DOI: 10.2967/jnumed.121.263511] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Small cell lung cancer (SCLC) is a deadly neuroendocrine tumor for which there are no screening methods sensitive enough to facilitate early, effective intervention. We propose targeting the neuroendocrine tumor neoantigen CD133 via antibody-based early detection and PET (immunoPET) to facilitate earlier and more accurate detection of SCLC. Methods: RNA sequencing datasets, immunohistochemistry, flow cytometry, and Western blots were used to quantify CD133 expression in healthy and SCLC patients. CD133 was imaged in vivo using near-infrared fluorescence (NIRF) immunoimaging, and 89Zr immunoPET. Anti(α)-CD133 autoantibody levels were measured in SCLC patient plasma using antibody microarrays. Results: Across 6 publicly available datasets, CD133 messenger RNA was found to be higher in SCLC tumors than in other tissues, including healthy or normal adjacent lung and non-SCLC samples. Critically, the upregulation of CD133 messenger RNA in SCLC was associated with a significant increase (hazard ratio, 2.62) in death. CD133 protein was expressed in primary human SCLC, in SCLC patient-derived xenografts, and in both SCLC cell lines tested (H82 and H69). Using an H82 xenograft mouse model, we first imaged CD133 expression with NIRF. Both in vivo and ex vivo NIRF clearly showed that a fluorophore-tagged αCD133 homed to lung tumors. Next, we validated the noninvasive visualization of subcutaneous and orthotopic H82 xenografts via immunoPET. An αCD133 antibody labeled with the positron-emitting radiometal 89Zr demonstrated significant accumulation in tumor tissue while producing minimal uptake in healthy organs. Finally, plasma αCD133 autoantibodies were found in subjects from cohort studies up to 1 year before SCLC diagnosis. Conclusion: In light of these findings, we conclude that the presence of αCD133 autoantibodies in a blood sample followed by CD133-targeted 89Zr-immunoPET could be an effective early detection screening strategy for SCLC.
Collapse
Affiliation(s)
- Andrew G Kunihiro
- Translational Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Samantha M Sarrett
- Department of Chemistry, Hunter College, City University of New York, New York, New York
- Ph.D. Program in Biochemistry, City University of New York, New York, New York
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kristin J Lastwika
- Translational Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Joell L Solan
- Translational Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Tatyana Pisarenko
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Outi Keinänen
- Department of Chemistry, Hunter College, City University of New York, New York, New York
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cindy Rodriguez
- Department of Chemistry, Hunter College, City University of New York, New York, New York
- Ph.D. Program in Biochemistry, City University of New York, New York, New York
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lydia R Taverne
- Translational Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, Washington
- Department of Global Health, University of Washington, Seattle, Washington
| | - Christopher I Li
- Translational Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - A McGarry Houghton
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; and
| | - Brian M Zeglis
- Department of Chemistry, Hunter College, City University of New York, New York, New York;
- Ph.D. Program in Biochemistry, City University of New York, New York, New York
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medical College, New York, New York
| | - Paul D Lampe
- Translational Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington;
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; and
| |
Collapse
|
31
|
Lahti J, Tuominen S, Yang Q, Pergola G, Ahmad S, Amin N, Armstrong NJ, Beiser A, Bey K, Bis JC, Boerwinkle E, Bressler J, Campbell A, Campbell H, Chen Q, Corley J, Cox SR, Davies G, De Jager PL, Derks EM, Faul JD, Fitzpatrick AL, Fohner AE, Ford I, Fornage M, Gerring Z, Grabe HJ, Grodstein F, Gudnason V, Simonsick E, Holliday EG, Joshi PK, Kajantie E, Kaprio J, Karell P, Kleineidam L, Knol MJ, Kochan NA, Kwok JB, Leber M, Lam M, Lee T, Li S, Loukola A, Luck T, Marioni RE, Mather KA, Medland S, Mirza SS, Nalls MA, Nho K, O'Donnell A, Oldmeadow C, Painter J, Pattie A, Reppermund S, Risacher SL, Rose RJ, Sadashivaiah V, Scholz M, Satizabal CL, Schofield PW, Schraut KE, Scott RJ, Simino J, Smith AV, Smith JA, Stott DJ, Surakka I, Teumer A, Thalamuthu A, Trompet S, Turner ST, van der Lee SJ, Villringer A, Völker U, Wilson RS, Wittfeld K, Vuoksimaa E, Xia R, Yaffe K, Yu L, Zare H, Zhao W, Ames D, Attia J, Bennett DA, Brodaty H, Chasman DI, Goldman AL, Hayward C, Ikram MA, Jukema JW, Kardia SLR, Lencz T, Loeffler M, Mattay VS, Palotie A, Psaty BM, Ramirez A, Ridker PM, Riedel-Heller SG, Sachdev PS, Saykin AJ, Scherer M, Schofield PR, Sidney S, Starr JM, Trollor J, Ulrich W, Wagner M, Weir DR, Wilson JF, Wright MJ, Weinberger DR, Debette S, Eriksson JG, Mosley TH, Launer LJ, van Duijn CM, Deary IJ, Seshadri S, Räikkönen K. Genome-wide meta-analyses reveal novel loci for verbal short-term memory and learning. Mol Psychiatry 2022; 27:4419-4431. [PMID: 35974141 PMCID: PMC9734053 DOI: 10.1038/s41380-022-01710-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 12/14/2022]
Abstract
Understanding the genomic basis of memory processes may help in combating neurodegenerative disorders. Hence, we examined the associations of common genetic variants with verbal short-term memory and verbal learning in adults without dementia or stroke (N = 53,637). We identified novel loci in the intronic region of CDH18, and at 13q21 and 3p21.1, as well as an expected signal in the APOE/APOC1/TOMM40 region. These results replicated in an independent sample. Functional and bioinformatic analyses supported many of these loci and further implicated POC1. We showed that polygenic score for verbal learning associated with brain activation in right parieto-occipital region during working memory task. Finally, we showed genetic correlations of these memory traits with several neurocognitive and health outcomes. Our findings suggest a role of several genomic loci in verbal memory processes.
Collapse
Affiliation(s)
- Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
- Turku Institute of Advanced Studies, University of Turku, Turku, Finland.
| | - Samuli Tuominen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Qiong Yang
- Department of Biostatistics, Boston University, Boston, MA, USA
| | - Giulio Pergola
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Nicola J Armstrong
- Department of Mathematics and Statistics, Murdoch University, Murdoch, WA, Australia
| | - Alexa Beiser
- Department of Biostatistics, Boston University, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Eric Boerwinkle
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Jan Bressler
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Qiang Chen
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - Janie Corley
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Gail Davies
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Philip L De Jager
- Center for Translational and Computational Neuroimmunology, Columbia University Medical Center, New York, NY, USA
| | - Eske M Derks
- Translational Neurogenomics Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jessica D Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Alison E Fohner
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Institute of Public Health Genetics, University of Washington, Seattle, WA, USA
| | - Ian Ford
- Robertson Center for Biostatistics, University of Glasgow, Glasgow, UK
| | - Myriam Fornage
- McGovern Medical School, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Zachary Gerring
- Translational Neurogenomics Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases, Greifswald, Germany
| | - Francine Grodstein
- Channing Laboratory, Brigham and Women's Hospital, Boston, MA, USA
- Harvard School of Public Health, Boston, MA, USA
| | - Vilmundur Gudnason
- Icelandic Heart Assocation, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Eleanor Simonsick
- Translational Gerontology Branch, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Elizabeth G Holliday
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Peter K Joshi
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki and Oulu, Oulu, Finland
- Hospital for Children and Adolescents, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Pauliina Karell
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Luca Kleineidam
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Maria J Knol
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - John B Kwok
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Markus Leber
- Department of Psychiatry, University of Cologne, Cologne, Germany
| | - Max Lam
- Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Teresa Lee
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Shuo Li
- Department of Biostatistics, Boston University, Boston, MA, USA
| | - Anu Loukola
- Helsinki Biobank, University of Helsinki Central Hospital, Helsinki, Finland
| | - Tobias Luck
- Department of Economic and Social Sciences & Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research, University of Applied Sciences Nordhausen, Nordhausen, Germany
- University of Leipzig, Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig, Germany
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Karen A Mather
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Sunnybrook Health Sciences Centre, University of Toronto, Randwick, NSW, Australia
| | - Sarah Medland
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Saira S Mirza
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, USA
- Data Tecnica International, Glen Echo, MD, USA
| | - Kwangsik Nho
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Adrienne O'Donnell
- Department of Biostatistics, Boston University, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Christopher Oldmeadow
- Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Jodie Painter
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Alison Pattie
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Simone Reppermund
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Shannon L Risacher
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Richard J Rose
- Department of Psychological & Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
| | - Vijay Sadashivaiah
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - Markus Scholz
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Claudia L Satizabal
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Peter W Schofield
- Neuropsychiatry Service, Hunter New England Local Health District, Charlestown, NSW, Australia
| | - Katharina E Schraut
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- Centre for Cardiovascular Sciences, Queen's Medical Research Institute, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK
| | - Rodney J Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Jeannette Simino
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Albert V Smith
- Icelandic Heart Assocation, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Jennifer A Smith
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
- Institute of Social Research, Survey Research Center, University of Michigan, Ann Arbor, MI, USA
| | - David J Stott
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ida Surakka
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Stella Trompet
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Stephen T Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Sven J van der Lee
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Day Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, Department Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases, Greifswald, Germany
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Rui Xia
- Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Habil Zare
- Department of Cell Systems & Anatomy, The University of Texas Health Science Center, San Antonio, TX, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas, San Antonio, TX, USA
- University of Texas Health Sciences Center, Houston, NA, US
| | - Wei Zhao
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - David Ames
- National Ageing Research Institute, Parkville, Melbourne, VIC, Australia
- University of Melbourne, Academic Unit for Psychiatry of Old Age, St George's Hospital, Melbourne, VIC, Australia
| | - John Attia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Aaron L Goldman
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sharon L R Kardia
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Todd Lencz
- Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Venkata S Mattay
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
- Food and Drug Administration, Washington, DC, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Stanley Center for Psychiatric Research and Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology and Department of Health Services, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Heath Research Institute, Seattle, WA, USA
| | - Alfredo Ramirez
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
- Department of Psychiatry, University of Cologne, Cologne, Germany
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Martin Scherer
- Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter R Schofield
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Stephen Sidney
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, USA
| | - John M Starr
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Julian Trollor
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - William Ulrich
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - Michael Wagner
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - David R Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - James F Wilson
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Margaret J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Daniel R Weinberger
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephanie Debette
- Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, University of Bordeaux, Bordeaux, France
- Bordeaux University Hospital (CHU Bordeaux), Department of Neurology, Bordeaux, France
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Helsinki, Singapore
| | - Thomas H Mosley
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Public Health, Oxford University, Oxford, UK
| | - Ian J Deary
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| |
Collapse
|
32
|
McCarthy K, Laird E, O'Halloran AM, Walsh C, Healy M, Fitzpatrick AL, Walsh JB, Hernández B, Fallon P, Molloy AM, Kenny RA. Association between vitamin D deficiency and the risk of prevalent type 2 diabetes and incident prediabetes: A prospective cohort study using data from The Irish Longitudinal Study on Ageing (TILDA). EClinicalMedicine 2022; 53:101654. [PMID: 36147626 PMCID: PMC9486023 DOI: 10.1016/j.eclinm.2022.101654] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND It is hypothesized that vitamin D contributes to the aetiology of type 2 diabetes mellitus (diabetes). This study's objective was to examine the relationships between baseline vitamin D status (as measured by plasma 25-hydroxyvitamin D concentration) and both prevalent diabetes and prospective risk of developing diabetes, including prediabetes, in a population with historically low levels of vitamin D. METHODS In this prospective cohort study, data from The Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort of adults aged ≥50 years residing in Ireland were analysed, including wave 1 (October 2009-June 2011) (n = 5272) and wave 3 (March 2014-October 2015) (n = 3828). Those aged <50 years at baseline or who did not complete the health assessment were excluded. Logistic regression models examined the associations between baseline vitamin D concentration (nmol/L) with prevalent diabetes status and incident diabetes/prediabetes collected at a 4-year follow-up. Models were adjusted for age, sex, education, body mass index, smoking history, physical activity, use of statins, and the season in which the vitamin D concentration was sampled. FINDINGS Deficient baseline vitamin D concentration was cross-sectionally associated with an increased likelihood of having prevalent diabetes (Relative Risk Ratio [RRR] 1·5, 95% CI: 1·03, 2·18; p = 0·037). In longitudinal analyses evaluating diabetes status 4 years later, there was a 62% increased likelihood (RRR: 1·62, 95% CI: 1·12, 2·35; p = 0·011) of developing prediabetes for those with vitamin D <30 nmol/L compared to those with ≥75 nmol/L. The rate of progression from prediabetes to diabetes between wave 1 and 3 was observed to be 32·5%. INTERPRETATION Those with lower concentrations of vitamin D, as measured by 25-hydroxyvitamin D, may have different risk profiles with regards to their glycaemic status. Our study had limited power due to the low incidence of diabetes but showed strong associations with incident prediabetes, so further research is required. Optimising vitamin D status at a population level may significantly reduce diabetes. FUNDING TILDA is funded by Atlantic Philanthropies, the Irish Department of Health, and Irish Life, while additional funding was provided by the Irish Department of Agriculture, Food and the Marine (13F492) to cover the cost of 25-hydroxyvitamin D analysis.
Collapse
Affiliation(s)
- Kevin McCarthy
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Corresponding author at: The Irish Longitudinal Study on Ageing (TILDA), Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.
| | - Eamon Laird
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Aisling M. O'Halloran
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Cathal Walsh
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Martin Healy
- Biochemistry Department, Laboratory Medicine & Molecular Pathology, St James's Hospital, Dublin, Ireland
| | - Annette L. Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, Washington, United States of America
| | - James B. Walsh
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Belinda Hernández
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Padraic Fallon
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Anne M. Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
33
|
Schaich CL, Yeboah J, Espeland MA, Baker LD, Ding J, Hayden KM, Sachs BC, Craft S, Rapp SR, Luchsinger JA, Fitzpatrick AL, Heckbert SR, Post WS, Burke GL, Allen NB, Hughes TM. Association of Vascular Risk Scores and Cognitive Performance in a Diverse Cohort: The Multi-Ethnic Study of Atherosclerosis. J Gerontol A Biol Sci Med Sci 2022; 77:1208-1215. [PMID: 34216214 PMCID: PMC9159669 DOI: 10.1093/gerona/glab189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Vascular risk scores are associated with incident dementia. Information regarding their association with cognitive performance and decline in racially/ethnically diverse cohorts is lacking. METHOD In 4 392 Multi-Ethnic Study of Atherosclerosis participants (aged 60.1 ± 9.4 years; 53% women; 41% White, 11% Chinese American, 26% African American, 21% Hispanic), we compared associations of Exam 1 (2000-2002) Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE), Framingham Stroke Risk Profile (FSRP), and atherosclerotic cardiovascular disease pooled cohort equation (ASCVD-PCE) risk scores with Exam 5 (2010-2012) Cognitive Abilities Screening Instrument (CASI), Digit Symbol Coding (DSC), and Digit Span (DS) cognitive test performance using multivariable linear regression, and examined racial/ethnic interactions. In 1 838 participants with repeat CASI data at Exam 6 (2016-2018), we related risk scores to odds of a 1-SD decline in CASI performance using multivariable logistic regression. RESULTS SD increments in each risk score were associated with worse cognitive performance. CAIDE had stronger associations with CASI performance than the FSRP and ASCVD-PCE, but associations of ASCVD-PCE with the DSC and DS were similar to CAIDE (difference in β [95% CI] = -0.57 [-1.48, 0.34] and -0.21 [-0.43, 0.01], respectively). Race/ethnicity modified associations. For example, associations between CAIDE and CASI were greater in African Americans and Hispanics than in Whites (difference in β = 0.69 [0.02, 1.36] and 1.67 [0.95, 2.39], respectively). Risk scores were comparably associated with decline in CASI performance. CONCLUSIONS Antecedent vascular risk scores are associated with cognitive performance and decline in the 4 most common U.S. racial/ethnic groups, but associations differ among risk scores and by race/ethnicity.
Collapse
Affiliation(s)
- Christopher L Schaich
- Department of Surgery/Hypertension, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Joseph Yeboah
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark A Espeland
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Laura D Baker
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jingzhong Ding
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Bonnie C Sachs
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Suzanne Craft
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - José A Luchsinger
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, USA
- Department of Family Medicine, University of Washington, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, USA
| | - Wendy S Post
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Norrina B Allen
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
34
|
Schwartz SM, Urfer SR, White M, Megquier K, Shrager S, Akey JM, Benton B, Borenstein E, Castelhano MG, Coleman AE, Creevy KE, Crowder K, Wilfond BS, Dunbar MD, Fajt VR, Fitzpatrick AL, Jeffery U, Jonlin EC, Kaeberlein M, Karlsson EK, Kerr KF, Levine JM, Ma J, McClelland RL, Promislow DEL, Ruple A, Schwartz SM, Shrager S, Snyder‐Mackler N, Tolbert MK, Urfer SR, Wilfond BS, Ruple A. Lifetime prevalence of malignant and benign tumors in companion dogs: cross‐sectional analysis of Dog Aging Project (DAP) baseline survey. Vet Comp Oncol 2022; 20:797-804. [PMID: 35574975 PMCID: PMC10089278 DOI: 10.1111/vco.12839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/25/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
Although cancer is widely regarded as a major contributor to canine morbidity and mortality, its frequency in companion dogs has only infrequently been characterised. We analysed cross-sectional data from the baseline survey of owners of 27 541 living companion dogs enrolled in the Dog Aging Project as of 31 December 2020 to estimate the lifetime prevalence of malignant and benign tumours and several potentially-associated characteristics. Survey questions elicited information on history of 'cancer or tumors' including organ site and histologic type. Owners reported 819 malignant tumours (56% sited in the skin, muscle or other soft tissue) and 404 benign tumours (69% sited in the skin, muscle or other soft tissue). The lifetime prevalence of malignant tumours (29.7/1000 dogs) was approximately double the lifetime prevalence of benign tumours (14.7/1000 dogs). Lifetime prevalence of both malignant and benign tumours increased with dog age at survey completion. There were no statistically discernable differences in age-adjusted lifetime prevalence of malignant (prevalence ratio (PR) = 0.93 [95% confidence interval (CI) 0.82, 1.07] or benign tumours (PR = 1.10, 95% CI 0.91, 1.34) in mixed vs. purebred dogs. The lifetime prevalence of malignant tumours increased with increasing dog size class; compared to toy and small dogs, the age-adjusted PRs (95% CIs) for medium, standard, large, and giant dogs were 1.65 (1.28, 2.11), 2.92 (2.35, 3.64), 3.67 (2.92, 4.62) and 2.99 (1.23, 4.02), respectively. Similar though less pronounced patterns in relation to dog size class were observed for benign tumours. Ongoing prospective data collection will permit future studies on risk factors for canine tumour incidence.
Collapse
Affiliation(s)
- Stephen M. Schwartz
- Epidemiology Program, Fred Hutchinson Cancer Research Center Seattle WA
- Department of Epidemiology University of Washington Seattle WA
| | - Silvan R. Urfer
- Department of Laboratory Medicine and Pathology University of Washington Seattle WA
| | - Michelle White
- Program in Molecular Medicine University of Massachusetts Medical School Worcester MA
- The Broad Institute of Harvard and MIT Cambridge MA
| | | | - Sandi Shrager
- Department of Biostatistics University of Washington Seattle WA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Audrey Ruple
- Department of Population Health Sciences Virginia‐Maryland College of Veterinary Medicine, Virginia Tech Blacksburg VA
| | | |
Collapse
|
35
|
Hwang PH, Longstreth WT, Thielke SM, Francis CE, Carone M, Kuller LH, Fitzpatrick AL. Longitudinal Changes in Hearing and Visual Impairments and Risk of Dementia in Older Adults in the United States. JAMA Netw Open 2022; 5:e2210734. [PMID: 35511175 PMCID: PMC9073563 DOI: 10.1001/jamanetworkopen.2022.10734] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Hearing and vision problems are individually associated with increased dementia risk, but the impact of having concurrent hearing and vision deficits, ie, dual sensory impairment (DSI), on risk of dementia, including its major subtypes Alzheimer disease (AD) and vascular dementia (VaD), is not well known. OBJECTIVE To evaluate whether DSI is associated with incident dementia in older adults. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study from the Cardiovascular Health Study (CHS) was conducted between 1992 and 1999, with as many as 8 years of follow-up. The multicenter, population-based sample was recruited from Medicare eligibility files in 4 US communities with academic medical centers. Of 5888 participants aged 65 years and older in CHS, 3602 underwent cranial magnetic resonance imaging and completed the modified Mini-Mental State Examination in 1992 to 1994 as part of the CHS Cognition Study. A total of 227 participants were excluded due to prevalent dementia, leaving a total of 3375 participants without dementia at study baseline. The study hypothesis was that DSI would be associated with increased risk of dementia compared with no sensory impairment. The association between the duration of DSI with risk of dementia was also evaluated. Data analysis was conducted from November 2019 to February 2020. EXPOSURES Hearing and vision impairments were collected via self-report at baseline and as many as 5 follow-up visits. MAIN OUTCOMES AND MEASURES All-cause dementia, AD, and VaD, classified by a multidisciplinary committee using standardized criteria. RESULTS A total of 2927 participants with information on hearing and vision at all available study visits were included in the analysis (mean [SD] age, 74.6 [4.8] years; 1704 [58.2%] women; 455 [15.5%] African American or Black; 2472 [85.5%] White). Compared with no sensory impairment, DSI was associated with increased risk of all-cause dementia (hazard ratio [HR], 2.60; 95% CI, 1.66-2.06; P < .001), AD (HR, 3.67; 95% CI, 2.04-6.60; P < .001) but not VaD (HR, 2.03; 95% CI, 1.00-4.09; P = .05). CONCLUSIONS AND RELEVANCE In this cohort study, DSI was associated with increased risk of dementia, particularly AD. Evaluation of hearing and vision in older adults may help to identify those at high risk of developing dementia.
Collapse
Affiliation(s)
- Phillip H Hwang
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - W T Longstreth
- Department of Epidemiology, University of Washington, Seattle
- Department of Neurology, University of Washington, Seattle
| | - Stephen M Thielke
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
- Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center, Seattle, Washington
| | | | - Marco Carone
- Department of Biostatistics, University of Washington, Seattle
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
- Department of Family Medicine, University of Washington, Seattle
| |
Collapse
|
36
|
C. Chi G, Liu Y, MacDonald JW, M. Reynolds L, Enquobahrie DA, L. Fitzpatrick A, Kerr KF, J. Budoff M, Lee SI, Siscovick D, D. Kaufman J. Epigenome-wide analysis of long-term air pollution exposure and DNA methylation in monocytes: results from the Multi-Ethnic Study of Atherosclerosis. Epigenetics 2022; 17:297-313. [PMID: 33818294 PMCID: PMC8920186 DOI: 10.1080/15592294.2021.1900028] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Air pollution might affect atherosclerosis through DNA methylation changes in cells crucial to atherosclerosis, such as monocytes. We conducted an epigenome-wide study of DNA methylation in CD14+ monocytes and long-term ambient air pollution exposure in adults participating in the Multi-Ethnic Study of Atherosclerosis (MESA). We also assessed the association between differentially methylated signals and cis-gene expression. Using spatiotemporal models, one-year average concentrations of outdoor fine particulate matter (PM2.5) and oxides of nitrogen (NOX) were estimated at participants' homes. We assessed DNA methylation and gene expression using Illumina 450k and HumanHT-12 v4 Expression BeadChips, respectively (n = 1,207). We used bump hunting and site-specific approaches to identify differentially methylated signals (false discovery rate of 0.05) and used linear models to assess associations between differentially methylated signals and cis-gene expression. Four differentially methylated regions (DMRs) located on chromosomes 5, 6, 7, and 16 (within or near SDHAP3, ZFP57, HOXA5, and PRM1, respectively) were associated with PM2.5. The DMRs on chromosomes 5 and 6 also associated with NOX. The DMR on chromosome 5 had the smallest p-value for both PM2.5 (p = 1.4×10-6) and NOX (p = 7.7×10-6). Three differentially methylated CpGs were identified for PM2.5, and cg05926640 (near TOMM20) had the smallest p-value (p = 5.6×10-8). NOX significantly associated with cg11756214 within ZNF347 (p = 5.6×10-8). Several differentially methylated signals were also associated with cis-gene expression. The DMR located on chromosome 7 was associated with the expression of HOXA5, HOXA9, and HOXA10. The DMRs located on chromosomes 5 and 16 were associated with expression of MRPL36 and DEXI, respectively. The CpG cg05926640 was associated with expression of ARID4B, IRF2BP2, and TOMM20. We identified differential DNA methylation in monocytes associated with long-term air pollution exposure. Methylation signals associated with gene expression might help explain how air pollution contributes to cardiovascular disease.
Collapse
Affiliation(s)
- Gloria C. Chi
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA,CONTACT Gloria C. Chi 1 DNA Way, South San Francisco, CA 94080
| | - Yongmei Liu
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - James W. MacDonald
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Lindsay M. Reynolds
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Daniel A. Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Annette L. Fitzpatrick
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA,Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, USA,Department of Global Health, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Kathleen F. Kerr
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Matthew J. Budoff
- Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor–UCLA Medical Center, Torrance, California, USA
| | - Su-in Lee
- Department of Computer Science & Engineering, University of Washington, Seattle, Washington, USA,Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | | | - Joel D. Kaufman
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA,Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| |
Collapse
|
37
|
Bressler J, Davies G, Smith AV, Saba Y, Bis JC, Jian X, Hayward C, Yanek L, Smith JA, Mirza SS, Wang R, Adams HHH, Becker D, Boerwinkle E, Campbell A, Cox SR, Eiriksdottir G, Fawns-Ritchie C, Gottesman RF, Grove ML, Guo X, Hofer E, Kardia SLR, Knol MJ, Koini M, Lopez OL, Marioni RE, Nyquist P, Pattie A, Polasek O, Porteous DJ, Rudan I, Satizabal CL, Schmidt H, Schmidt R, Sidney S, Simino J, Smith BH, Turner ST, van der Lee SJ, Ware EB, Whitmer RA, Yaffe K, Yang Q, Zhao W, Gudnason V, Launer LJ, Fitzpatrick AL, Psaty BM, Fornage M, Arfan Ikram M, van Duijn CM, Seshadri S, Mosley TH, Deary IJ. Correction: Association of low-frequency and rare coding variants with information processing speed. Transl Psychiatry 2022; 12:88. [PMID: 35232957 PMCID: PMC8888652 DOI: 10.1038/s41398-022-01852-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jan Bressler
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Gail Davies
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | | | - Yasaman Saba
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Graz, Austria
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
- Generation Scotland, Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Lisa Yanek
- Department of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Saira S Mirza
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ruiqi Wang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Hieab H H Adams
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, Vrieje Universiteit Medical Center, Amsterdam, The Netherlands
| | - Diane Becker
- Department of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eric Boerwinkle
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Health Data Research UK, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | | | - Chloe Fawns-Ritchie
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Rebecca F Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Megan L Grove
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Maria J Knol
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Marisa Koini
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Paul Nyquist
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Alison Pattie
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ozren Polasek
- Faculty of Medicine, University of Split, Split, Croatia
- Gen-Info Ltd, Zagreb, Croatia
| | - David J Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Claudia L Satizabal
- Framingham Heart Study, Framingham, MA, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Helena Schmidt
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Graz, Austria
| | - Reinhold Schmidt
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Stephen Sidney
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Jeannette Simino
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Blair H Smith
- Division of Population Health and Genomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Stephen T Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | | | - Erin B Ware
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, UK
| | - Rachel A Whitmer
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Kristine Yaffe
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Intramural Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - M Arfan Ikram
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Public Health, Oxford University, Oxford, UK
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Thomas H Mosley
- Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ian J Deary
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
38
|
Slawsky ED, Hajat A, Rhew IC, Russette H, Semmens EO, Kaufman JD, Leary CS, Fitzpatrick AL. Neighborhood greenspace exposure as a protective factor in dementia risk among U.S. adults 75 years or older: a cohort study. Environ Health 2022; 21:14. [PMID: 35033073 PMCID: PMC8760791 DOI: 10.1186/s12940-022-00830-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/06/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults. METHODS Greenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer's disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics-Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park-were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD. RESULTS Compared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies. CONCLUSIONS This study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.
Collapse
|
39
|
Mouttham L, Castelhano MG, Akey JM, Benton B, Borenstein E, Castelhano MG, Coleman AE, Creevy KE, Crowder K, Dunbar MD, Ernst HR, Fajt VR, Fitzpatrick AL, Garrison SJ, Herndon RS, Jaramilla D, Jeffery U, Jonlin EC, Kaeberlein M, Karlsson EK, Kerr KF, Levine JM, Ma J, McClelland RL, Prescott JO, Promislow DEL, Ruple A, Schwartz SM, Shrager S, Snyder-Mackler N, Tinkle AK, Tolbert MK, Urfer SR, Wilfond BS. Purpose, Partnership, and Possibilities: The Implementation of the Dog Aging Project Biobank. Biomark Insights 2022; 17:11772719221137217. [PMID: 36468152 PMCID: PMC9716607 DOI: 10.1177/11772719221137217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Biobanks have been supporting longitudinal prospective and retrospective studies by providing standardized services for the acquisition, transport, processing, storage, and distribution of high-quality biological material and associated data. Here, we describe how the Dog Aging Project (DAP), a large-scale longitudinal study of the domestic dog ( Canis familiaris) with translational applications for humans, developed a biobank of canine biospecimens and associated data. Design and methods: This was accomplished by working with the Cornell Veterinary Biobank, the first biobank in the world to receive accreditation to ISO 20387:2018—General Requirements for Biobanking. The biobank research team was involved in the early collection stages of the DAP, contributing to the development of appropriate workflows and processing fit-for-purpose biospecimens. In support of a dynamic strategy for real-time adjustment of processes, a pilot phase was implemented to develop, test, and optimize the biospecimen workflows, followed by an early phase of collection, processing, and banking of specimens from DAP participants. Results: During the pilot and early phases of collection, the DAP Biobank stored 164 aliquots of whole blood, 273 aliquots of peripheral blood mononuclear cells, 130 aliquots of plasma, and 70 aliquots of serum, and extracted high molecular weight genomic DNA suitable for whole-genome sequencing from 109 whole blood specimens. These specimens, along with their associated preanalytical data, have been made available for distribution to researchers. Conclusion: We discuss the challenges and opportunities encountered during the implementation of the DAP Biobank, along with novel strategies for promoting biobanking sustainability such as partnering with a DAP quality assurance manager and a DAP marketing and communication specialist and developing a pilot grant structure to fund small innovative research projects.
Collapse
Affiliation(s)
- Lara Mouttham
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Marta G Castelhano
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Joshua M Akey
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA
| | - Brooke Benton
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Elhanan Borenstein
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
- Santa Fe Institute, Santa Fe, NM, USA
| | - Marta G Castelhano
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Amanda E Coleman
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Kate E Creevy
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Kyle Crowder
- Department of Sociology, University of Washington, Seattle, WA, USA
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, USA
| | - Matthew D Dunbar
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, USA
| | - Holley R Ernst
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Virginia R Fajt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Susan J Garrison
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Reba S Herndon
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Debra Jaramilla
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Unity Jeffery
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Erica C Jonlin
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, USA
| | - Matt Kaeberlein
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Elinor K Karlsson
- Bioinformatics and Integrative Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kathleen F Kerr
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Jonathan M Levine
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Jing Ma
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Jena O Prescott
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Daniel EL Promislow
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
- Department of Biology, University of Washington, Seattle, WA, USA
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Stephen M Schwartz
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sandi Shrager
- Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Noah Snyder-Mackler
- School of Life Sciences, Arizona State University, Tempe, AZ, USA
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
- School for Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Amanda K Tinkle
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Silvan R Urfer
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Benjamin S Wilfond
- Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Pediatrics, Division of Bioethics and Palliative Care, University of Washington School of Medicine, Seattle, WA, USA
| |
Collapse
|
40
|
Fitzpatrick AL, Belza B, Raetz JG, Suchsland MZ, Illes J, Gaster B. Evaluating a system to promote timely detection of cognitive impairment in primary care practice. Alzheimers Dement 2022. [PMID: 34971216 DOI: 10.1002/alz.055084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Dementia and mild cognitive impairment (MCI) are underdiagnosed with evidence indicating that clinical diagnoses frequently occur late in the process of cognitive decline. Increasing evidence that dementia may be preventable or delayed has led to an international focus on earlier evaluation, diagnosis and intervention. METHOD Using the impetus of "Memory Brain Wellness" as a priority growth program at University of Washington (UW) Medicine, we are developing synergistic strategies to improve timely detection of cognitive impairment across primary care in 15 neighborhood clinics in the Pacific Northwest. This presentation will describe current quality-improvement efforts to promote engagement across multiple stakeholders including health-care system leadership, practice care management, primary care providers (PCPs) and clinic staff. This lifespan approach is based on the KAER (Kickstart-Assess-Evaluate and Refer) Model and Toolkit (2020 Edition) developed by the Gerontological Society of America (GSA). RESULTS Program activities to be described include 1) results of interviews with the primary care team to determine acceptability and support needed to implement timely cognitive evaluation; 2) implementation of a training intervention to initiate discussions, conduct cognitive assessment, and manage care; and 3) identification of support services and resources to be used in provider consultation. Input from a Technical Advisory Committee and local Community Advisory Board were incorporated into the training and resource inventory for patient/caregiver support. Topics in the training include normalizing the conversation, team approach, moving toward evaluation, assessment tools, alternate diagnoses/modifiable risk factors, multi-disciplinary and community referrals, patient counseling, long-term management, and advance care planning. Changes in practice patterns of PCPs will be reviewed using extracted data from the electronic health record (EHR). Details of each strategy will be provided to explain system-wide decisions, pragmatic applications, results of trainings held to-date and feed-back from the primary care team. CONCLUSION This is the first study to refine and utilize the GSA KAER toolkit addressing change in practice patterns in a large multi-clinic primary care system. Results of this program will be used to extend efforts beyond the Seattle region to address timely cognitive evaluation across the 5-state WWAMI region (Washington, Wyoming, Alaska. Montana and Idaho) served by UW Medicine.
Collapse
Affiliation(s)
| | | | | | | | - Judit Illes
- The Gerontological Society of America, Washington, DC, USA
| | | |
Collapse
|
41
|
Park C, Hajat A, Leary CS, Ilango S, Semmens EO, Adam C, Fitzpatrick AL, Lopez OL, Kaufman JD. Associations between long‐term air pollution exposure and plasma amyloid beta in very old adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.054700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
42
|
Hwang PH, Longstreth W, Thielke S, Francis CE, Carone M, Kuller LH, Fitzpatrick AL. Longitudinal changes in hearing and visual impairments associated with risk of dementia in older adults: The Cardiovascular Health Study. Alzheimers Dement 2021. [DOI: 10.1002/alz.049110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Stephen Thielke
- University of Washington Seattle WA USA
- VAPSHCS/GRECC Seattle WA USA
| | | | | | | | | |
Collapse
|
43
|
Zhang Y, Liu X, Wiggins KL, Sofer T, Guo X, DeCarli CS, Glahn DC, González HM, Levy D, Nyquist P, Pitsillides AN, Psaty BM, Rodrigue AL, Rotter JI, Smith JA, Yanek LR, Seshadri S, Bis JC, Heckbert S, Fitzpatrick AL, Fornage M, Liu C, Satizabal CL. Association of mitochondrial DNA copy number with brain MRI and cognitive function in the TOPMed Program. Alzheimers Dement 2021. [DOI: 10.1002/alz.056243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Yuankai Zhang
- Boston University School of Public Health Boston MA USA
| | - Xue Liu
- Boston University School of Medicine Boston MA USA
| | | | - Tamar Sofer
- Brigham and Women's Hospital Boston MA USA
- Harvad Medical School Boston MA USA
| | | | | | | | | | - Daniel Levy
- Framingham Heart Study, NHLBI Framingham MA USA
- Population Sciences Branch of the National Heart, Lung, and Blood Institute of the National Institutes of Health Framingham MA USA
| | - Paul Nyquist
- Johns Hopkins School of Medicine Baltimore MD USA
| | | | | | | | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences and Department of Pediatrics Los Angeles Biomedical Research Institute Torrance CA USA
| | | | | | - Sudha Seshadri
- Framingham Heart Study, NHLBI Framingham MA USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases University of Texas Health Sciences Center San Antonio TX USA
| | | | | | | | - Myriam Fornage
- The University of Texas Health Science Center at Houston Houston TX USA
| | - Chunyu Liu
- Boston University School of Public Health Boston MA USA
- Framingham Heart Study, NHLBI Framingham MA USA
| | - Claudia L. Satizabal
- Framingham Heart Study, NHLBI Framingham MA USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases University of Texas Health Sciences Center San Antonio TX USA
| |
Collapse
|
44
|
Daniel GD, Chen H, Bertoni AG, Rapp SR, Fitzpatrick AL, Luchsinger JA, Wood AC, Hughes TM, Burke GL, Hayden KM. DASH diet adherence and cognitive function: Multi-ethnic study of atherosclerosis. Clin Nutr ESPEN 2021; 46:223-231. [PMID: 34857201 PMCID: PMC8812811 DOI: 10.1016/j.clnesp.2021.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 09/16/2021] [Accepted: 10/04/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS The Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet has been associated with better cognitive function in studies of predominantly White participants; few studies have examined this association in diverse cohorts. Our objective was to examine the association between the DASH diet and cognitive function in the diverse Multi-Ethnic Study of Atherosclerosis (MESA) cohort. METHODS Among 4169 MESA participants, we evaluated prospectively, the association between DASH diet adherence and cognitive function. Participants completed a food frequency questionnaire at baseline (2000-2002) and cognitive function was assessed using the Cognitive Abilities Screening Instrument (CASI), Digit Symbol Coding (DSC), and Digit Span (DS) at Exam 5 in 2010-2012 and Exam 6 (2016-2019). Regression analyses were used to evaluate the association between quintiles of DASH diet adherence with CASI, DSC, and DS performance and decline, adjusting for potential confounders. Effect modification by hypertension, diabetes, race/ethnicity, acculturation, and exercise were evaluated. RESULTS DASH diet adherence was not associated with cognitive performance or decline for any of the measures. There were no differences by racial/ethnic groups, with the exception that Hispanic participants reporting greater DASH diet adherence, performed worse on DS at Exam 5 (p = 0.05). Components of the DASH diet were differentially correlated with test performance: increased consumption of nuts/legumes was associated with better performance on the CASI at Exam 5 (p = 0.003) and Exam 6 (p = 0.007). Increased consumption of whole grains was associated with better DSC performance at Exam 5 (p = 0.04) and better DS performance at Exam 6 (p = 0.01). CONCLUSIONS DASH diet adherence was nominally associated with cognitive function with a suggestion of differences by race/ethnicity. Future work should examine more closely, the relationships between racial and ethnic groups and the impact of diet on cognitive function.
Collapse
Affiliation(s)
- George D Daniel
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Haiying Chen
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen R Rapp
- Department of Psychiatry & Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - José A Luchsinger
- Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Timothy M Hughes
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| |
Collapse
|
45
|
Koch M, Cronjé HT, Furtado JD, DeKosky ST, Fitzpatrick AL, Lopez OL, Kuller LH, Mukamal KJ, Jensen MK. Plasma antioxidants and phospholipids and brain imaging biomarkers among non‐demented older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.056473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Manja Koch
- Harvard T.H. Chan School of Public Health Boston MA USA
| | | | | | - Steven T DeKosky
- McKnight Brain Institute, University of Florida Gainesville FL USA
| | | | | | | | - Ken J Mukamal
- Harvard T.H. Chan School of Public Health Boston MA USA
- Beth Israel Deaconess Medical Center Boston MA USA
| | - Majken K Jensen
- Harvard T.H. Chan School of Public Health Boston MA USA
- University of Copenhagen Copenhagen Denmark
| |
Collapse
|
46
|
Leary CS, Hajat A, Fitzpatrick AL, Park C, Ilango S, Adam C, Kaufman JD, Semmens E. Evaluating the importance of historical address histories in an air pollution and dementia study. Alzheimers Dement 2021. [DOI: 10.1002/alz.053407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
47
|
Moored KD, Parisi JM, Snitz BE, DeKosky ST, Williamson JD, Fitzpatrick AL, Carlson MC. Levels and trajectories of domain‐specific cognition differ across lifestyle engagement subgroups of older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.050773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Jeanine M Parisi
- Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - Beth E Snitz
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer's Disease Research Center Pittsburgh PA USA
| | - Steven T DeKosky
- McKnight Brain Institute, University of Florida Gainesville FL USA
| | | | | | | |
Collapse
|
48
|
Andrews JS, Gold LS, Reed MJ, Garcia JM, McClelland RL, Fitzpatrick AL, Hough CL, Cawthon PM, Covinsky KE. Appendicular Lean Mass, Grip Strength, and the Development of Hospital-Associated Activities of Daily Living Disability among Older Adults in the Health ABC Study. J Gerontol A Biol Sci Med Sci 2021; 77:1398-1404. [PMID: 34734252 PMCID: PMC9255680 DOI: 10.1093/gerona/glab332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Half of all physical disability, including activity of daily living (ADL) disability, among older adults occurs in the setting of hospitalization. This study examines whether appendicular lean mass (ALM) and grip strength, which are commonly included in various definitions of sarcopenia, are associated with development of hospital-associated ADL disability in older adults in the Health ABC Study. METHODS Individuals hospitalized during the first 5 years of follow-up (n=1,724) were analyzed. ALM to body mass index (BMI) ratio (ALMBMI), by dual energy x-ray absorptiometry (DXA), and grip strength, by hand-held dynamometery, were assessed annually. Development of new ADL disability was assessed at the time of the next annual assessment after hospitalization. Separate regression analyses modeled the association of pre-hospitalization ALMBMI or grip strength with death before the next scheduled annual assessment. Next, among those who survived to the next annual assessment, separate regression analyses modeled the association of ALMBMI or grip strength with development of ADL disability. RESULTS Each standard deviation decrement in pre-hospitalization grip strength was associated with an adjusted 1.80 odds of new ADL disability at follow-up (95% CI: 1.18, 2.74). Low, compared to not low, grip strength (per FNIH definition) was associated with an adjusted 2.36 odds of ADL disability at follow-up (95% CI: 1.12, 4.97). ALM measures were not associated with development of hospital-associated ADL disability. ALM and grip strength measures were not associated with death. CONCLUSIONS Pre-hospitalization lower grip strength may be an important risk factor for ADL disability among older adult survivors of hospitalization.
Collapse
Affiliation(s)
| | - Laura S Gold
- Department of Radiology, University of Washington
| | - May J Reed
- Department of Medicine, University of Washington
| | - Jose M Garcia
- Department of Medicine, University of Washington.,GRECC, VA Puget Sound Health Care System
| | | | - Annette L Fitzpatrick
- Department Family Medicine, Epidemiology, and Global Health, University of Washington
| | | | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, University of California San Francisco
| | - Ken E Covinsky
- Department of Medicine, University of California San Francisco
| |
Collapse
|
49
|
Koch M, Aroner SA, Fitzpatrick AL, Longstreth WT, Furtado JD, Mukamal KJ, Jensen MK. HDL (High-Density Lipoprotein) Subspecies, Prevalent Covert Brain Infarcts, and Incident Overt Ischemic Stroke: Cardiovascular Health Study. Stroke 2021; 53:1292-1300. [PMID: 34645286 DOI: 10.1161/strokeaha.121.034299] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE Whether HDL (high-density lipoprotein) is associated with risk of vascular brain injury is unclear. HDL is comprised of many apo (apolipoprotein) species, creating distinct subtypes of HDL. METHODS We utilized sandwich ELISA to determine HDL subspecies from plasma collected in 1998/1999 from 2001 CHS (Cardiovascular Health Study) participants (mean age, 80 years). RESULTS In cross-sectional analyses, participants with higher apoA1 in plasma and lower apoE in HDL were less likely to have prevalent covert magnetic resonance imaging-defined infarcts: odds ratio for apoA1 Q4 versus Q1, 0.68 (95% CI, 0.50-0.93), and odds ratio for apoE Q4 versus Q1, 1.36 (95% CI, 1.01-1.84). Similarly, apoA1 in the subspecies of HDL that lacked apoC3, apoJ, or apoE was inversely related to covert infarcts, and apoE in the subspecies of HDL that lacked apoC3 or apoJ was directly related to covert infarcts in prospective analyses. In contrast, the concentrations of apoA1 and apoE in the complementary subspecies of HDL that contained these apos were unrelated to covert infarcts. Patterns of associations between incident overt ischemic stroke and apoA1, apoE, and apoA1 and apoE in subspecies of HDL were similar to those observed for covert infarcts but less pronounced. CONCLUSIONS This study highlights HDL subspecies defined by apo content as relevant biomarkers of covert and overt vascular brain injury.
Collapse
Affiliation(s)
- Manja Koch
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (M.K., S.A.A., J.D.F., K.J.M., M.K.J.)
| | - Sarah A Aroner
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (M.K., S.A.A., J.D.F., K.J.M., M.K.J.).,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (S.A.A.)
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle. (A.L.F.).,Department of Epidemiology, University of Washington, Seattle. (A.L.F.).,Department of Global Health, University of Washington, Seattle. (A.L.F.)
| | - W T Longstreth
- Department of Neurology, University of Washington, Seattle. (W.T.L.).,Department of Epidemiology, University of Washington, Seattle. (W.T.L.)
| | - Jeremy D Furtado
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (M.K., S.A.A., J.D.F., K.J.M., M.K.J.)
| | - Kenneth J Mukamal
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (M.K., S.A.A., J.D.F., K.J.M., M.K.J.).,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.)
| | - Majken K Jensen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (M.K., S.A.A., J.D.F., K.J.M., M.K.J.).,Department of Public Health, Section of Epidemiology, University of Copenhagen, Denmark (M.K.J.)
| |
Collapse
|
50
|
Senter CC, Bush NR, Loftus CT, Szpiro AA, Fitzpatrick AL, Carroll KN, LeWinn KZ, Mason WA, Sathyanarayana S, Akingbade OA, Karr CJ. Maternal Stressful Life Events during Pregnancy and Atopic Dermatitis in Children Aged Approximately 4-6 Years. Int J Environ Res Public Health 2021; 18:9696. [PMID: 34574621 PMCID: PMC8470006 DOI: 10.3390/ijerph18189696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/11/2021] [Accepted: 09/12/2021] [Indexed: 12/02/2022]
Abstract
The prevalence of atopic dermatitis (AD) in children has steadily increased over time, yet it remains largely unknown how maternal factors during pregnancy are associated with child AD. Few studies have specifically assessed the relationship between prenatal stress and child AD, with inconsistent findings. In this prospective cohort study following 426 mother-child dyads from pregnancy to middle childhood, women reported stressful life events (SLEs) experienced during the 12 months before delivery and AD outcomes in children aged approximately 4-6 years, including current, location-specific, and ever AD. We used Poisson regression to estimate risk ratios (RRs) and corresponding 95% confidence intervals (CIs) associated with a 1-unit increase in prenatal SLEs, adjusting for potential confounders. We also assessed whether the association between prenatal SLEs and child AD was modified by child sex, history of maternal atopy, or prenatal maternal resilient coping. The mean (standard deviation) of prenatal SLEs reported in the overall sample was 1.4 (1.6), with 37.1% of women reporting none. A 1-unit increase in prenatal SLEs was not significantly associated with current AD (RR: 1.08, 95% CI: 0.89, 1.31), location-specific AD (RR: 1.09, 95% CI: 0.78, 1.52), or ever AD (RR: 0.97, 95% CI: 0.87, 1.09). We did not find evidence of effect modification. Findings from this study suggest no association between prenatal SLEs and AD in middle childhood, although larger longitudinal studies with enhanced case definition and higher variability of SLE experience may more fully inform this question.
Collapse
Affiliation(s)
- Camilla C. Senter
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; (A.L.F.); (C.J.K.)
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94143, USA; (N.R.B.); (K.Z.L.)
- Department of Pediatrics, University of California, San Francisco, CA 94143, USA
| | - Christine T. Loftus
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA; (C.T.L.); (S.S.); (O.A.A.)
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA;
| | - Annette L. Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; (A.L.F.); (C.J.K.)
- Department of Family Medicine, University of Washington, Seattle, WA 98195, USA
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Kecia N. Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94143, USA; (N.R.B.); (K.Z.L.)
| | - W. Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA; (C.T.L.); (S.S.); (O.A.A.)
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Oluwatobiloba A. Akingbade
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA; (C.T.L.); (S.S.); (O.A.A.)
| | - Catherine J. Karr
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; (A.L.F.); (C.J.K.)
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA; (C.T.L.); (S.S.); (O.A.A.)
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| |
Collapse
|