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Sunderaraman P, De Anda‐Duran I, Karjadi C, Peterson J, Ding H, Devine SA, Shih LC, Popp Z, Low S, Hwang PH, Goyal K, Hathaway L, Monteverde J, Lin H, Kolachalama VB, Au R. Design and Feasibility Analysis of a Smartphone-Based Digital Cognitive Assessment Study in the Framingham Heart Study. J Am Heart Assoc 2024; 13:e031348. [PMID: 38226510 PMCID: PMC10926817 DOI: 10.1161/jaha.123.031348] [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: 06/26/2023] [Accepted: 11/09/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Smartphone-based digital technology is increasingly being recognized as a cost-effective, scalable, and noninvasive method of collecting longitudinal cognitive and behavioral data. Accordingly, a state-of-the-art 3-year longitudinal project focused on collecting multimodal digital data for early detection of cognitive impairment was developed. METHODS AND RESULTS A smartphone application collected 2 modalities of cognitive data, digital voice and screen-based behaviors, from the FHS (Framingham Heart Study) multigenerational Generation 2 (Gen 2) and Generation 3 (Gen 3) cohorts. To understand the feasibility of conducting a smartphone-based study, participants completed a series of questions about their smartphone and app use, as well as sensory and environmental factors that they encountered while completing the tasks on the app. Baseline data collected to date were from 537 participants (mean age=66.6 years, SD=7.0; 58.47% female). Across the younger participants from the Gen 3 cohort (n=455; mean age=60.8 years, SD=8.2; 59.12% female) and older participants from the Gen 2 cohort (n=82; mean age=74.2 years, SD=5.8; 54.88% female), an average of 76% participants agreed or strongly agreed that they felt confident about using the app, 77% on average agreed or strongly agreed that they were able to use the app on their own, and 81% on average rated the app as easy to use. CONCLUSIONS Based on participant ratings, the study findings are promising. At baseline, the majority of participants are able to complete the app-related tasks, follow the instructions, and encounter minimal barriers to completing the tasks independently. These data provide evidence that designing and collecting smartphone application data in an unsupervised, remote, and naturalistic setting in a large, community-based population is feasible.
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Affiliation(s)
- Preeti Sunderaraman
- Department of NeurologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research CenterBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Ileana De Anda‐Duran
- Department of EpidemiologyTulane University School of Public Health & Tropical MedicineNew OrleansLAUSA
| | - Cody Karjadi
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Julia Peterson
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Huitong Ding
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Sherral A. Devine
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Ludy C. Shih
- Department of NeurologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Zachary Popp
- Boston University Alzheimer’s Disease Research CenterBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Spencer Low
- Boston University Alzheimer’s Disease Research CenterBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Phillip H. Hwang
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Kriti Goyal
- Department of NeurologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Lindsay Hathaway
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Jose Monteverde
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
| | - Honghuang Lin
- Department of MedicineUniversity of Massachusetts Chan Medical SchoolWorcesterMAUSA
| | - Vijaya B. Kolachalama
- Boston University Alzheimer’s Disease Research CenterBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of MedicineBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of Computer Science and Faculty of Computing & Data SciencesBoston UniversityBostonMAUSA
| | - Rhoda Au
- Department of NeurologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research CenterBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of Anatomy & NeurobiologyBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
- Department of MedicineBoston University Chobanian & Avedisian School of Medicine School of MedicineBostonMAUSA
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2
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Kang M, Ang TFA, Devine SA, Sherva R, Mukherjee S, Trittschuh EH, Gibbons LE, Scollard P, Lee M, Choi SE, Klinedinst B, Nakano C, Dumitrescu LC, Durant A, Hohman TJ, Cuccaro ML, Saykin AJ, Kukull WA, Bennett DA, Wang LS, Mayeux RP, Haines JL, Pericak-Vance MA, Schellenberg GD, Crane PK, Au R, Lunetta KL, Mez JB, Farrer LA. A genome-wide search for pleiotropy in more than 100,000 harmonized longitudinal cognitive domain scores. Mol Neurodegener 2023; 18:40. [PMID: 37349795 PMCID: PMC10286470 DOI: 10.1186/s13024-023-00633-4] [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: 02/17/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND More than 75 common variant loci account for only a portion of the heritability for Alzheimer's disease (AD). A more complete understanding of the genetic basis of AD can be deduced by exploring associations with AD-related endophenotypes. METHODS We conducted genome-wide scans for cognitive domain performance using harmonized and co-calibrated scores derived by confirmatory factor analyses for executive function, language, and memory. We analyzed 103,796 longitudinal observations from 23,066 members of community-based (FHS, ACT, and ROSMAP) and clinic-based (ADRCs and ADNI) cohorts using generalized linear mixed models including terms for SNP, age, SNP × age interaction, sex, education, and five ancestry principal components. Significance was determined based on a joint test of the SNP's main effect and interaction with age. Results across datasets were combined using inverse-variance meta-analysis. Genome-wide tests of pleiotropy for each domain pair as the outcome were performed using PLACO software. RESULTS Individual domain and pleiotropy analyses revealed genome-wide significant (GWS) associations with five established loci for AD and AD-related disorders (BIN1, CR1, GRN, MS4A6A, and APOE) and eight novel loci. ULK2 was associated with executive function in the community-based cohorts (rs157405, P = 2.19 × 10-9). GWS associations for language were identified with CDK14 in the clinic-based cohorts (rs705353, P = 1.73 × 10-8) and LINC02712 in the total sample (rs145012974, P = 3.66 × 10-8). GRN (rs5848, P = 4.21 × 10-8) and PURG (rs117523305, P = 1.73 × 10-8) were associated with memory in the total and community-based cohorts, respectively. GWS pleiotropy was observed for language and memory with LOC107984373 (rs73005629, P = 3.12 × 10-8) in the clinic-based cohorts, and with NCALD (rs56162098, P = 1.23 × 10-9) and PTPRD (rs145989094, P = 8.34 × 10-9) in the community-based cohorts. GWS pleiotropy was also found for executive function and memory with OSGIN1 (rs12447050, P = 4.09 × 10-8) and PTPRD (rs145989094, P = 3.85 × 10-8) in the community-based cohorts. Functional studies have previously linked AD to ULK2, NCALD, and PTPRD. CONCLUSION Our results provide some insight into biological pathways underlying processes leading to domain-specific cognitive impairment and AD, as well as a conduit toward a syndrome-specific precision medicine approach to AD. Increasing the number of participants with harmonized cognitive domain scores will enhance the discovery of additional genetic factors of cognitive decline leading to AD and related dementias.
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Affiliation(s)
- Moonil Kang
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street E200, Boston, MA 02118 USA
| | - Ting Fang Alvin Ang
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | - Sherral A. Devine
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | - Richard Sherva
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street E200, Boston, MA 02118 USA
| | - Shubhabrata Mukherjee
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Emily H. Trittschuh
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA USA
| | - Laura E. Gibbons
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Phoebe Scollard
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Michael Lee
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Seo-Eun Choi
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Brandon Klinedinst
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Connie Nakano
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Logan C. Dumitrescu
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN USA
| | - Alaina Durant
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN USA
| | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, Miami, FL USA
| | - Andrew J. Saykin
- Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA
- Department of Radiology and Imaging Services, Indiana University School of Medicine, Indianapolis, IN USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN USA
| | - Walter A. Kukull
- Department of Epidemiology, University of Washington, Seattle, WA USA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL USA
| | - Li-San Wang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Richard P. Mayeux
- Department of Neurology, Columbia University School of Medicine, New York, NY USA
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH USA
| | | | - Gerard D. Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Paul K. Crane
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA USA
| | - Kathryn L. Lunetta
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Jesse B. Mez
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street E200, Boston, MA 02118 USA
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
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Liu C, Li Y, Ang TFA, Liu Y, Devine SA, Au R, Doraiswamy PM. Sex‐specific Biomarkers in Alzheimer's Disease Progression: Framingham Heart Study. Alzheimers Dement 2022. [DOI: 10.1002/alz.060884] [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: 12/24/2022]
Affiliation(s)
- Chunyu Liu
- Framingham Heart Study Framingham MA USA
- Boston University School of Public Health Boston MA USA
| | - Yi Li
- Boston University Boston MA USA
| | | | - Yulin Liu
- Boston University School of Medicine Boston MA USA
| | | | - Rhoda Au
- Boston University School of Medicine Boston MA USA
- The Framingham Heart Study, Boston University School of Medicine; Boston University School of Public Health Boston MA USA
| | - P. Murali Doraiswamy
- Duke Institute for Brain Sciences Durham NC USA
- Duke University Medical Center Durham NC USA
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4
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Hwang PH, Ang TFA, Liu X, Liu Y, Gurnani AS, Mez JB, Auerbach SH, Joshi PS, Yuan J, Devine SA, Au R, Liu C. Modifying adult life course dementia risk: results from the Framingham Heart Study. Alzheimers Dement 2022. [DOI: 10.1002/alz.059081] [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: 12/24/2022]
Affiliation(s)
| | - Ting Fang Alvin Ang
- Boston University School of Medicine Boston MA USA
- Framingham Heart Study Framingham MA USA
- Boston University School of Public Health Boston MA USA
| | - Xue Liu
- Boston University School of Medicine Boston MA USA
| | - Yulin Liu
- Boston University School of Medicine Boston MA USA
| | | | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
- Boston University Alzheimer’s Disease Research Center Boston MA USA
| | | | | | - Jing Yuan
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing China
- Peking Union Medical College Hospital Beijing China
| | | | - Rhoda Au
- Boston University School of Medicine Boston MA USA
- The Framingham Heart Study, Boston University School of Medicine; Boston University School of Public Health Boston MA USA
- Boston University Alzheimer’s Disease Center, Boston University Boston MA USA
| | - Chunyu Liu
- Framingham Heart Study Framingham MA USA
- Boston University School of Public Health Boston MA USA
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5
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Kang M, Mez JB, Ang TFA, Devine SA, Mukherjee S, Trittschuh EH, Saykin AJ, Crane PK, Au R, Lunetta KL, Farrer LA. A Genome‐Wide Search for Pleiotropy in Cognitive Domain Scores. Alzheimers Dement 2022. [DOI: 10.1002/alz.066834] [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: 12/24/2022]
Affiliation(s)
- Moonil Kang
- Department of Medicine, Boston University School of Medicine Boston MA USA
| | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
| | - Ting Fang Alvin Ang
- Department of Anatomy and Neurobiology, Boston University School of Medicine Boston MA USA
- Framingham Heart Study, Boston University School of Medicine Boston MA USA
- Slone Epidemiology Center, Boston University School of Medicine Boston MA USA
| | - Sherral A. Devine
- Department of Anatomy and Neurobiology, Boston University School of Medicine Boston MA USA
- Framingham Heart Study, Boston University School of Medicine Boston MA USA
| | - Shubhabrata Mukherjee
- Department of General Internal Medicine, University of Washington School of Medicine Seattle WA USA
| | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine Seattle WA USA
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System Seattle WA USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University School of Medicine Indianapolis IN USA
- Indiana University School of Medicine Indianapolis IN USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine Indianapolis IN USA
| | - Paul K. Crane
- Department of General Internal Medicine, University of Washington School of Medicine Seattle WA USA
- University of Washington Alzheimer’s Disease Research Center, University of Washington School of Medicine Seattle WA USA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine Boston MA USA
- Framingham Heart Study, Boston University School of Medicine Boston MA USA
- Slone Epidemiology Center, Boston University School of Medicine Boston MA USA
- Department of Neurology, Boston University School of Medicine Boston MA USA
- Department of Epidemiology, Boston University School of Public Health Boston MA USA
| | - Kathryn L. Lunetta
- Department of Biostatistics, Boston University School of Public Health Boston MA USA
| | - Lindsay A. Farrer
- Department of Neurology, Boston University School of Medicine Boston MA USA
- Department of Epidemiology, Boston University School of Public Health Boston MA USA
- Department of Biostatistics, Boston University School of Public Health Boston MA USA
- Boston University School of Medicine, Department of Medicine, Biomedical Genetics Boston MA USA
- Department of Ophthalmology, Boston University School of Medicine Boston MA USA
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6
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Yuan J, Liu X, Liu C, Ang AF, Massaro J, Devine SA, Auerbach SH, Blusztajn JK, Au R, Jacques PF. Is dietary choline intake related to dementia and Alzheimer's disease risks? Results from the Framingham Heart Study. Am J Clin Nutr 2022; 116:1201-1207. [PMID: 37208066 PMCID: PMC9630864 DOI: 10.1093/ajcn/nqac193] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/27/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The positive association of choline for cognition has been reported in both animal and human studies, yet the associations of choline with the risks of incident dementia or Alzheimer's disease (AD) in humans is unclear. OBJECTIVES Our objective was to test the hypothesis that lower or higher dietary choline intake is associated with increased or decreased, respectively, risks of incident dementia and AD. METHODS Data from the Framingham Heart Study Offspring Cohort exam 5 to exam 9 were used. Participants were free of dementia and stroke, with a valid self-reported 126-item Harvard FFQ at exam 5. The intakes of total choline, its contributing compounds, and betaine were estimated based on a published nutrient database. The intakes were updated at each exam to represent the cumulative average intake across the 5 exams. The associations between dietary choline intakes and incident dementia and AD were examined in mixed-effect Cox proportional hazard models, adjusting for covariates. RESULTS A total of 3224 participants (53.8% female; mean ± SD age, 54.5 ± 9.7 y) were followed up for a mean ± SD of 16.1 ± 5.1 y (1991-2011). There were 247 incident dementia cases, of which 177 were AD. Dietary choline intake showed nonlinear relationships with incident dementia and AD. After adjusting for covariates, low choline intake (defined as ≤ 219 and ≤ 215 mg/d for dementia and AD, respectively) was significantly associated with incident dementia and incident AD. CONCLUSIONS Low choline intake was associated with increased risks of incident dementia and AD.
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Affiliation(s)
- Jing Yuan
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Xue Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Chunyu Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Alvin Fa Ang
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA; Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA; Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA
| | - Joseph Massaro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA; Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA
| | - Sherral A Devine
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA; Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA
| | - Sanford H Auerbach
- Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | | | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA; Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA; Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA; Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA USA.
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7
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Wong CG, Thomas KR, Edmonds EC, Weigand AJ, Bangen KJ, Eppig JS, Jak AJ, Devine SA, Delano-Wood L, Libon DJ, Edland SD, Au R, Bondi MW. Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study's Old-Old. Dement Geriatr Cogn Disord 2018; 46:253-265. [PMID: 30391953 PMCID: PMC9049857 DOI: 10.1159/000493541] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 06/28/2018] [Accepted: 09/06/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Mild cognitive impairment (MCI) lacks a "gold standard" operational definition. The Jak/Bondi actuarial neuropsychological criteria for MCI are associated with improved diagnostic stability and prediction of progression to dementia compared to conventional MCI diagnostic approaches, although its utility in diagnosing MCI in old-old individuals (age 75+) is unknown. Therefore, we investigated the applicability of neuropsychological MCI criteria among old-old from the Framingham Heart Study. METHODS A total of 347 adults (ages 79-102) were classified as cognitively normal or MCI via Jak/Bondi and conventional Petersen/Winblad criteria, which differ on cutoffs for cognitive impairment and number of impaired scores required for a diagnosis. Cox models examined MCI status in predicting risk of progression to dementia. RESULTS MCI diagnosed by both the Jak/Bondi and Petersen/Winblad criteria was associated with incident dementia; however, when both criteria were included in the regression model together, only the Jak/Bondi criteria remained statistically significant. At follow-up, the Jak/Bondi criteria had a lower MCI-to-normal reversion rate than the Petersen/Winblad criteria. CONCLUSIONS Our findings are consistent with previous research on the Jak/Bondi criteria and support the use of a comprehensive neuropsychological diagnostic approach for MCI among old-old individuals.
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Affiliation(s)
- Christina G. Wong
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA,Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kelsey R. Thomas
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA,Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Emily C. Edmonds
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA,Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Alexandra J. Weigand
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA,Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Katherine J. Bangen
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA,Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Joel S. Eppig
- San Diego State University/University of California, San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Amy J. Jak
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA,Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Sherral A. Devine
- The Framingham Heart Study, Framingham, MA, USA,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Lisa Delano-Wood
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA,Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - David J. Libon
- Department of Geriatrics and Gerontology and the Department of Psychology, School of Osteopathic Medicine, New Jersey Institute for Successful Aging, Rowan University, Glassboro, NJ, USA
| | - Steven D. Edland
- Department of Biostatistics, University of California, San Diego, La Jolla, CA, USA,Department of Family and Preventative Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Rhoda Au
- The Framingham Heart Study, Framingham, MA, USA,Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Mark W. Bondi
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA,Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
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Hankee LD, Preis SR, Piers RJ, Beiser AS, Devine SA, Liu Y, Seshadri S, Wolf PA, Au R. Population Normative Data for the CERAD Word List and Victoria Stroop Test in Younger- and Middle-Aged Adults: Cross-Sectional Analyses from the Framingham Heart Study. Exp Aging Res 2017; 42:315-28. [PMID: 27410241 DOI: 10.1080/0361073x.2016.1191838] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND/STUDY CONTEXT To provide baseline normative data on tests of verbal memory and executive function for nondemented younger- and middle-aged adults. METHODS The Consortium to Establish a Registry for Alzheimer's Disease word list memory task (CERAD-WL) and Victoria Stroop Test (VST) were administered to 3362 Framingham Heart Study (FHS) volunteer participants aged 24-78 years. Analyses of the effects of age, gender, and education were conducted. Normative data on traditional measures and error responses are reported for each test. RESULTS Traditional measures were significantly associated with both age and education in this cohort. Error responses also evidenced significant age and education effects. CONCLUSION These data provide a normative comparison for assessment of verbal memory and executive functioning capabilities in younger- and middle-aged adults and may be utilized as a tool for preclinical studies of disease in this population.
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Affiliation(s)
- Lisa D Hankee
- a Boston University School of Medicine , Boston , Massachusetts , USA.,b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA
| | - Sarah R Preis
- b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA.,c Boston University School of Public Health , Boston , Massachusetts , USA
| | - Ryan J Piers
- a Boston University School of Medicine , Boston , Massachusetts , USA.,b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA
| | - Alexa S Beiser
- a Boston University School of Medicine , Boston , Massachusetts , USA.,b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA.,c Boston University School of Public Health , Boston , Massachusetts , USA
| | - Sherral A Devine
- a Boston University School of Medicine , Boston , Massachusetts , USA.,b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA
| | - Yulin Liu
- a Boston University School of Medicine , Boston , Massachusetts , USA.,b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA
| | - Sudha Seshadri
- a Boston University School of Medicine , Boston , Massachusetts , USA.,b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA
| | - Philip A Wolf
- a Boston University School of Medicine , Boston , Massachusetts , USA.,b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA
| | - Rhoda Au
- a Boston University School of Medicine , Boston , Massachusetts , USA.,b Framingham Heart Study/National Heart Lung and Blood Institute , Framingham , Massachusetts , USA
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Hankee LD, Preis SR, Beiser AS, Devine SA, Liu Y, Seshadri S, Wolf PA, Au R. Qualitative neuropsychological measures: normative data on executive functioning tests from the Framingham offspring study. Exp Aging Res 2014; 39:515-35. [PMID: 24151914 DOI: 10.1080/0361073x.2013.839029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: Studies have found that executive functioning is affected early in the pathophysiological processes associated with Alzheimer's disease and vascular dementia. There also exists a range of functioning on executive tasks during normal aging. Although qualitative data are commonly utilized in clinical practice for evaluating subtle changes in cognitive functioning and diagnostic discernment, it is not clear whether error responses used in clinical practice are also evident as normative behavior. METHODS As part of an extensive battery of neuropsychological tests, executive functioning measures (i.e., Trail Making Test Part B, Similarities and Verbal Fluency tests) were administered via standardized administration prescript. Regression analyses were used to determine associations between vascular aging indices and qualitative performance measures. Descriptive statistics are included for 1907 cognitively normal individuals. RESULTS Results suggest that although qualitative errors do occur, they are relatively infrequent within a presumably cognitively normal sample. Error commission rates on executive functioning tests are significantly associated with both age and education. CONCLUSION Provided is a baseline profile of errors committed on tests of executive function across a range of age and educational levels. The normative data sets are included, stratified by age and educational achievement, for which to compare qualitative test performance of clinical and research populations.
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Affiliation(s)
- Lisa D Hankee
- a Boston University School of Medicine , Boston , Massachusetts , USA
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Nyborn JA, Himali JJ, Beiser AS, Devine SA, Du Y, Kaplan E, O'Connor MK, Rinn WE, Denison HS, Seshadri S, Wolf PA, Au R. The Framingham Heart Study clock drawing performance: normative data from the offspring cohort. Exp Aging Res 2013; 39:80-108. [PMID: 23316738 DOI: 10.1080/0361073x.2013.741996] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: Although the Clock Drawing Test (CDT) is a popular tool used to assess cognitive function, limited normative data on CDT performance exist. The objective of the current study was to provide normative data on an expanded version of previous CDT scoring protocols from a large community-based sample of middle to older adults (aged 43 to 91) from the Framingham Heart Study. METHODS The CDT was administered to 1476 Framingham Heart Study Offspring Cohort participants using a scoring protocol that assigned error scores to drawn features. Total error scores were computed, as well as for subscales pertaining to outline, numeral placement, time-setting, center, and "other." RESULTS Higher levels of education were significantly associated with fewer errors for time-setting (Command: p < .001; Copy: p = .003), numerals (Command: p < .001), and "other" (Command: p < .001) subscales. Older age was significantly associated with more errors for time-setting (Command: p < .001; Copy: p = .003), numerals (Command: p < .001), and "other" (Command: p < .001) subscales. Significant differences were also found between education groups on the Command condition for all but the oldest age group (75+). CONCLUSION Results provide normative data on CDT performance within a community-based cohort. Errors appear to be more prevalent in older compared with younger individuals, and may be less prevalent in individuals who completed at least some college compared with those who did not. Future studies are needed to determine whether this expanded scoring system allows detection of preclinical symptoms of future risk for dementia.
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Affiliation(s)
- Justin A Nyborn
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
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Devine SA, Kirkley SM, Palumbo CL, White RF. MRI and neuropsychological correlates of carbon monoxide exposure: a case report. Environ Health Perspect 2002; 110:1051-5. [PMID: 12361932 PMCID: PMC1241033 DOI: 10.1289/ehp.021101051] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
A 45-year-old woman experienced long-term, chronic exposure to carbon monoxide in the restaurant kitchen where she was employed as a cook. After returning to the restaurant after 5 days off work, she noticed that her symptoms returned immediately; she then aired out the room and called the gas company. Approximately 6 hr after a leak was detected, the patient went to the hospital, where her carboxyhemoglobin was found to be within normal limits and results of a neurologic examination were described as normal. Based on her symptoms, the patient believed she had been exposed to CO for at least 1 year before the leak was discovered. Initially, she experienced flu-like symptoms, which eventually resolved. At the time of her first neuropsychological evaluation (17 months after the exposure was identified), her persisting complaints included difficulties in reading, writing, speaking and word retrieval. The test results were consistent with secondary frontal lobe dysfunction associated with subcortical disorders such as those seen after CO exposure. Results of a subsequent neuropsychological examination (29 months postexposure) showed slight improvement in performance, but her performance was still consistent with mild frontal/subcortical dysfunction. Although the initial screening of a brain magnetic resonance image (MRI) performed 15 months after the exposure was interpreted as being within normal limits, two subsequent blind reviews of the same scans identified multiple bilateral lesions in the basal ganglia, which were consistent with chronic CO exposure. We present this case as an example of the utility of MRI and neuropsychological examinations in detecting central nervous system dysfunction secondary to CO exposure.
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Affiliation(s)
- Sherral A Devine
- Boston University Neurology Associates, Boston University Medical Campus and Boston Environmental Hazards Center and Psychology Service, VA Boston Healthcare System, Boston, Massachusetts 02130, USA
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