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Crane PK, Groot C, Ossenkoppele R, Mukherjee S, Choi S, Lee M, Scollard P, Gibbons LE, Sanders RE, Trittschuh E, Saykin AJ, Mez J, Nakano C, Donald CM, Sohi H, Risacher S. Cognitively defined Alzheimer's dementia subgroups have distinct atrophy patterns. Alzheimers Dement 2024; 20:1739-1752. [PMID: 38093529 PMCID: PMC10984445 DOI: 10.1002/alz.13567] [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: 07/03/2023] [Revised: 10/16/2023] [Accepted: 11/03/2023] [Indexed: 03/03/2024]
Abstract
INTRODUCTION We sought to determine structural magnetic resonance imaging (MRI) characteristics across subgroups defined based on relative cognitive domain impairments using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and to compare cognitively defined to imaging-defined subgroups. METHODS We used data from 584 people with Alzheimer's disease (AD) (461 amyloid positive, 123 unknown amyloid status) and 118 amyloid-negative controls. We used voxel-based morphometry to compare gray matter volume (GMV) for each group compared to controls and to AD-Memory. RESULTS There was pronounced bilateral lower medial temporal lobe atrophy with relative cortical sparing for AD-Memory, lower left hemisphere GMV for AD-Language, anterior lower GMV for AD-Executive, and posterior lower GMV for AD-Visuospatial. Formal asymmetry comparisons showed substantially more asymmetry in the AD-Language group than any other group (p = 1.15 × 10-10 ). For overlap between imaging-defined and cognitively defined subgroups, AD-Memory matched up with an imaging-defined limbic predominant group. DISCUSSION MRI findings differ across cognitively defined AD subgroups.
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Affiliation(s)
- Paul K. Crane
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Colin Groot
- Clinical Memory Research UnitLund UniversityLundSweden
- Alzheimer centerAmsterdam UMC ‐ VU Medical CenterAmsterdamNetherlands
| | - Rik Ossenkoppele
- Clinical Memory Research UnitLund UniversityLundSweden
- Alzheimer centerAmsterdam UMC ‐ VU Medical CenterAmsterdamNetherlands
| | | | - Seo‐Eun Choi
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Michael Lee
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Phoebe Scollard
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Laura E. Gibbons
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Emily Trittschuh
- Department of Psychiatry and Behavioral SciencesUniversity of Washington, and Geriatrics ResearchEducation, and Clinical CenterVA Puget Sound Health Care SystemSeattleUSA
| | - Andrew J. Saykin
- Indiana Alzheimer's Disease Research CenterIndiana University School of MedicineIndianapolisUSA
- Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisUSA
| | - Jesse Mez
- Department of NeurologyBoston UniversityBostonMassachusettsUSA
| | - Connie Nakano
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Harkirat Sohi
- Department of Biomedical Informatics and Medical EducationUniversity of WashingtonSeattleUSA
- Now Pacific Northwest National LaboratoryRichlandUSA
| | | | - Shannon Risacher
- Indiana Alzheimer's Disease Research CenterIndiana University School of MedicineIndianapolisUSA
- Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisUSA
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Cholerton B, Latimer CS, Crane PK, Corrada MM, Gibbons LE, Larson EB, Kawas CH, Keene CD, Montine TJ. Neuropathologic Burden and Dementia in Nonagenarians and Centenarians: Comparison of 2 Community-Based Cohorts. Neurology 2024; 102:e208060. [PMID: 38175995 PMCID: PMC11097771 DOI: 10.1212/wnl.0000000000208060] [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: 07/03/2023] [Accepted: 10/10/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to compare 2 large clinicopathologic cohorts of participants aged 90+ and to determine whether the association between neuropathologic burden and dementia in these older groups differs substantially from those seen in younger-old adults. METHODS Autopsied participants from The 90+ Study and Adult Changes in Thought (ACT) Study community-based cohort studies were evaluated for dementia-associated neuropathologic changes. Associations between neuropathologic variables and dementia were assessed using logistic or linear regression, and the weighted population attributable fraction (PAF) per type of neuropathologic change was estimated. RESULTS The 90+ Study participants (n = 414) were older (mean age at death = 97.7 years) and had higher amyloid/tau burden than ACT <90 (n = 418) (mean age at death = 83.5 years) and ACT 90+ (n = 401) (mean age at death = 94.2 years) participants. The ACT 90+ cohort had significantly higher rates of limbic-predominant age-related TDP-43 encephalopathy (LATE-NC), microvascular brain injury (μVBI), and total neuropathologic burden. Independent associations between individual neuropathologic lesions and odds of dementia were similar between all 3 groups, with the exception of μVBI, which was associated with increased dementia risk in the ACT <90 group only (odds ratio 1.5, 95% CI 1.2-1.8, p < 0.001). Weighted PAF scores indicated that eliminating μVBI, although more prevalent in ACT 90+ participants, would have little effect on dementia. Conversely, eliminating μVBI in ACT <90 could theoretically reduce dementia at a similar rate to that of AD neuropathologic change (weighted PAF = 6.1%, 95% CI 3.8-8.4, p = 0.001). Furthermore, reducing LATE-NC in The 90+ Study could potentially reduce dementia to a greater degree (weighted PAF = 5.1%, 95% CI 3.0-7.3, p = 0.001) than either ACT cohort (weighted PAFs = 1.69, 95% CI 0.4-2.7). DISCUSSION Our results suggest that specific neuropathologic features may differ in their effect on dementia among nonagenarians and centenarians from cohorts with different selection criteria and study design. Furthermore, microvascular lesions seem to have a more significant effect on dementia in younger compared with older participants. The results from this study demonstrate that different populations may require distinct dementia interventions, underscoring the need for disease-specific biomarkers.
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Affiliation(s)
- Brenna Cholerton
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
| | - Caitlin S Latimer
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
| | - Paul K Crane
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
| | - Maria M Corrada
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
| | - Laura E Gibbons
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
| | - Eric B Larson
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
| | - Claudia H Kawas
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
| | - C Dirk Keene
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
| | - Thomas J Montine
- From the Department of Pathology (B.C., T.J.M.), Stanford University School of Medicine, CA; Departments of Laboratory Medicine and Pathology (C.S.L., C.D.K.), Medicine (P.K.C.), and General Internal Medicine (L.E.G., E.B.L.), University of Washington, Seattle; Departments of Neurology (M.M.C., C.H.K.), Epidemiology (M.M.C.), and Neurobiology & Behavior (C.H.K.), University of California, Irvine; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle
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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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4
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Scollard P, Choi SE, Lee ML, Mukherjee S, Trittschuh EH, Sanders RE, Gibbons LE, Joshi P, Devine S, Au R, Dams-O’Connor K, Saykin AJ, Seshadri S, Beiser A, Aparicio HJ, Salinas J, Gonzales MM, Pase MP, Ghosh S, Finney R, Mez J, Crane PK. Ceiling effects and differential measurement precision across calibrated cognitive scores in the Framingham Study. Neuropsychology 2023; 37:383-397. [PMID: 37276135 PMCID: PMC10247160 DOI: 10.1037/neu0000828] [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] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVE To calibrate cognitive assessment data across multiple waves of the Framingham Heart Study (FHS), addressing study design considerations, ceiling effects, and measurement precision. METHOD FHS participants completed several cognitive assessments including screening instruments and more comprehensive batteries at different study visits. We used expert opinion to assign each cognitive test item to a single domain-memory, executive function, language, visuospatial abilities, or none of the above. As part of a larger cross-study harmonization effort, we calibrated each domain separately using bifactor confirmatory factor analysis (CFA) models, incorporating item parameters for anchor items previously calibrated from other studies and freely estimating item parameters for FHS-specific items. We obtained scores and standard errors (SEs) for each participant at each study visit. We addressed psychometric considerations of ceiling effects and measurement precision. RESULTS Overall, memory domain scores were the most precisely estimated. Scores for all domains from visits where the Mini-Mental State Examination (MMSE) was the only test administered were imprecisely estimated and suffered from ceiling effects. Scores from visits with a more extensive battery were estimated more precisely and better differentiated between ability levels. CONCLUSIONS The harmonized and calibrated cognitive data from the FHS should prove useful for future analyses examining cognition and cognitive decline. They will be of particular interest when combining FHS with other studies that have been similarly calibrated. Researchers should be aware of varying levels of measurement precision and the possibility of ceiling effects in their planned analyses of data from the FHS and similar studies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Phoebe Scollard
- Department of Medicine, University of Washington, Seattle, WA USA
| | - Seo-Eun Choi
- Department of Medicine, University of Washington, Seattle, WA USA
| | - Michael L. Lee
- Department of Medicine, University of Washington, Seattle, WA USA
| | | | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
- VA Puget Sound, Geriatric Research Education and Clinical Center
| | | | - Laura E. Gibbons
- Department of Medicine, University of Washington, Seattle, WA USA
| | - Prajakta Joshi
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA USA
- Department of General Dentistry, Boston University School of Dentistry, Boston, MA USA
| | - Sherral Devine
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY U.S.A
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY U.S.A
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University, Indianapolis, IN USA
- Indiana Alzheimer’s Disease Research Center, Indiana University, Indianapolis, IN USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
| | - Alexa Beiser
- Department of Neurology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Hugo J. Aparicio
- Department of Neurology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Joel Salinas
- Department of Neurology, New York University Grossman School of Medicine, New York, NY USA
| | - Mitzi M. Gonzales
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
| | - Matthew P. Pase
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC AUS
- Harvard T.H. Chan School of public health, Boston, MA USA
| | - Saptaparni Ghosh
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Rebecca Finney
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Jesse Mez
- Department of Neurology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Paul K. Crane
- Department of Medicine, University of Washington, Seattle, WA USA
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5
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Crane PK, Choi SE, Lee M, Scollard P, Sanders RE, Klinedinst B, Nakano C, Trittschuh EH, Mez J, Saykin AJ, Gibbons LE, Wang C, Mungas D, Zhu R, Foldi NS, Lamar M, Jutten R, Sikkes SA, Grandoit E, Rabin LA, Jones RN, Tommet D. Measurement precision across cognitive domains in the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set. Neuropsychology 2023; 37:373-382. [PMID: 37276134 PMCID: PMC10247161 DOI: 10.1037/neu0000901] [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] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVE To demonstrate measurement precision of cognitive domains in the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set. METHOD Participants with normal cognition (NC), mild cognitive impairment (MCI), and Alzheimer's disease (AD) were included from all ADNI waves. We used data from each person's last study visit to calibrate scores for memory, executive function, language, and visuospatial functioning. We extracted item information functions for each domain and used these to calculate standard errors of measurement. We derived scores for each domain for each diagnostic group and plotted standard errors of measurement for the observed range of scores. RESULTS Across all waves, there were 961 people with NC, 825 people with MCI, and 694 people with AD at their most recent study visit (data pulled February 25, 2019). Across ADNI's battery there were 34 memory items, 18 executive function items, 20 language items, and seven visuospatial items. Scores for each domain were highest on average for people with NC, intermediate for people with MCI, and lowest for people with AD, with most scores across all groups in the range of -1 to +1. Standard error of measurement in the range from -1 to +1 was highest for memory, intermediate for language and executive functioning, and lowest for visuospatial. CONCLUSION Modern psychometric approaches provide tools to help understand measurement precision of the scales used in studies. In ADNI, there are important differences in measurement precision across cognitive domains. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Paul K. Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Seo-Eun Choi
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Michael Lee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Phoebe Scollard
- Department of Medicine, University of Washington, Seattle, WA, USA
| | | | | | - Connie Nakano
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington, and VA Puget Sound Health Care System, Geriatrics Research, Education, and Clinical Core (GRECC), both in Seattle, WA, USA
| | - Jesse Mez
- Department of Neurology, Boston University, Boston, MA, USA
| | | | - Laura E. Gibbons
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Chun Wang
- College of Education, University of Washington, Seattle, WA, USA
| | - Dan Mungas
- Department of Neurology, University of California at Davis, Sacramento, CA, USA
| | - Ruoyi Zhu
- College of Education, University of Washington, Seattle, WA, USA
| | - Nancy S. Foldi
- Department of Psychology, Queens College and The Graduate Center, City University of New York & Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY
| | - Melissa Lamar
- Rush University Alzheimer’s Center and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Roos Jutten
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location, VUmc & Amsterdam Neuroscience, Neurodegeneration & Department of Clinical, Neuro, and Developmental Psychology, Vrije Universitiet Amsterdam, Amsterdam, NL
| | - Evan Grandoit
- Department of Psychology, Northwestern University, Chicago, IL, USA
| | - Laura A. Rabin
- Department of Psychology, Brooklyn College and the Graduate Center, City University of New York, Brooklyn, NY, USA
| | | | - Doug Tommet
- Department of Psychiatry, Brown University, Providence, RI, USA
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6
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Hampton OL, Mukherjee S, Properzi MJ, Schultz AP, Crane PK, Gibbons LE, Hohman TJ, Maruff P, Lim YY, Amariglio RE, Papp KV, Johnson KA, Rentz DM, Sperling RA, Buckley RF. Harmonizing the preclinical Alzheimer cognitive composite for multicohort studies. Neuropsychology 2023; 37:436-449. [PMID: 35862098 PMCID: PMC9859944 DOI: 10.1037/neu0000833] [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] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Studies are increasingly examining research questions across multiple cohorts using data from the preclinical Alzheimer cognitive composite (PACC). Our objective was to use modern psychometric approaches to develop a harmonized PACC. METHOD We used longitudinal data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), Harvard Aging Brain Study (HABS), and Australian Imaging, Biomarker and Lifestyle Study of Ageing (AIBL) cohorts (n = 2,712). We further demonstrated our method with the Anti-Amyloid Treatment of Asymptomatic Alzheimer's Disease (A4) Study prerandomized data (n = 4,492). For the harmonization method, we used confirmatory factor analysis (CFA) on the final visit of the longitudinal cohorts to determine parameters to generate latent PACC (lPACC) scores. Overlapping tests across studies were set as "anchors" that tied cohorts together, while parameters from unique tests were freely estimated. We performed validation analyses to assess the performance of lPACC versus the common standardized PACC (zPACC). RESULTS Baseline (BL) scores for the zPACC were centered on zero, by definition. The harmonized lPACC did not define a common mean of zero and demonstrated differences in baseline ability levels across the cohorts. Baseline lPACC slightly outperformed zPACC in the prediction of progression to dementia. Longitudinal change in the lPACC was more constrained and less variable relative to the zPACC. In combined-cohort analyses, longitudinal lPACC slightly outperformed longitudinal zPACC in its association with baseline β-amyloid status. CONCLUSIONS This study proposes procedures for harmonizing the PACC that make fewer strong assumptions than the zPACC, facilitating robust multicohort analyses. This implementation of item response theory lends itself to adapting across future cohorts with similar composites. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Olivia L. Hampton
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Shubhabrata Mukherjee
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Michael J. Properzi
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Aaron P. Schultz
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Paul K. Crane
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Laura E. Gibbons
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Timothy J. Hohman
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Paul Maruff
- Cogstate Ltd., Melbourne, Victoria, Australia
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Rebecca E. Amariglio
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Kathryn V. Papp
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Keith A. Johnson
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Dorene M. Rentz
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Reisa A. Sperling
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Rachel F. Buckley
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
- Melbourne School of Psychological Science, University of Melbourne
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7
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Mukherjee S, Choi SE, Lee ML, Scollard P, Trittschuh EH, Mez J, Saykin AJ, Gibbons LE, Sanders RE, Zaman AF, Teylan MA, Kukull WA, Barnes LL, Bennett DA, Lacroix AZ, Larson EB, Cuccaro M, Mercado S, Dumitrescu L, Hohman TJ, Crane PK. Cognitive domain harmonization and cocalibration in studies of older adults. Neuropsychology 2023; 37:409-423. [PMID: 35925737 PMCID: PMC9898463 DOI: 10.1037/neu0000835] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [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: 02/06/2023] Open
Abstract
OBJECTIVE Studies use different instruments to measure cognitirating cognitive tests permit direct comparisons of individuals across studies and pooling data for joint analyses. METHOD We began our legacy item bank with data from the Adult Changes in Thought study (n = 5,546), the Alzheimer's Disease Neuroimaging Initiative (n = 3,016), the Rush Memory and Aging Project (n = 2,163), and the Religious on such as the Mini-Mental State Examination, the Alzheimer's Disease Assessment Scale-Cognitive Subscale, the Wechsler Memory Scale, and the Boston Naming Test. CocalibOrders Study (n = 1,456). Our workflow begins with categorizing items administered in each study as indicators of memory, executive functioning, language, visuospatial functioning, or none of these domains. We use confirmatory factor analysis models with data from the most recent visit on the pooled sample across these four studies for cocalibration and derive item parameters for all items. Using these item parameters, we then estimate factor scores along with corresponding standard errors for each domain for each study. We added additional studies to our pipeline as available and focused on thorough consideration of candidate anchor items with identical content and administration methods across studies. RESULTS Prestatistical harmonization steps such qualitative and quantitative assessment of granular cognitive items and evaluating factor structure are important steps when trying to cocalibrate cognitive scores across studies. We have cocalibrated cognitive data and derived scores for four domains for 76,723 individuals across 10 studies. CONCLUSIONS We have implemented a large-scale effort to harmonize and cocalibrate cognitive domain scores across multiple studies of cognitive aging. Scores on the same metric facilitate meta-analyses of cognitive outcomes across studies or the joint analysis of individual data across studies. Our systematic approach allows for cocalibration of additional studies as they become available and our growing item bank enables robust investigation of cognition in the context of aging and dementia. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Seo-Eun Choi
- Department of Medicine, The University of Washington
| | | | | | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, The University of Washington
- VA Puget Sound Health Care System, Seattle, Washington, United States
| | - Jesse Mez
- Department of Neurology, Boston University School of Medicine
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana Alzheimer’s Disease Research Center, Indiana University
| | | | | | - Andrew F. Zaman
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine
| | - Merilee A. Teylan
- National Alzheimer’s Coordinating Center, Department of Epidemiology, University of Washington
| | - Walter A. Kukull
- National Alzheimer’s Coordinating Center, Department of Epidemiology, University of Washington
- Department of Epidemiology, The University of Washington
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, United States
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, United States
| | | | - Eric B. Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, United States
| | - Michael Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine
| | - Shannon Mercado
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Timothy J. Hohman
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Paul K. Crane
- Department of Medicine, The University of Washington
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8
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Power MC, Parthasarathy V, Gianattasio KZ, Walker RL, Crane PK, Larson EB, Gibbons LE, Kumar RG, Dams O'Connor K. Investigation of the association of military employment and Parkinson's disease with a validated Parkinson's disease case-finding strategy. Brain Inj 2023; 37:383-387. [PMID: 36524738 PMCID: PMC10033361 DOI: 10.1080/02699052.2022.2158234] [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: 05/05/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Persons with military involvement may be more likely to have Parkinson's disease (PD) risk factors. As PD is rare, case finding remains a challenge, contributing to our limited understanding of PD risk factors. Here, we explore the validity of case-finding strategies and whether military employment is associated with PD. MATERIALS AND METHODS We identified Adult Changes in Thought (ACT) study participants reporting military employment as their longest or second longest occupation. We used self-report and prescription fills to identify PD cases and validated this case-finding approach against medical record review. RESULTS At enrollment, 6% of 5,125 eligible participants had military employment and 1.8% had prevalent PD; an additional 3.5% developed PD over follow-up (mean: 8.3 years). Sensitivity of our case-finding approach was higher for incident (80%) than prevalent cases (54%). Specificity was high (>97%) for both. Military employment was not associated with prevalent PD. Among nonsmokers, point estimates suggested an increased risk of incident PD with military employment, but the result was non-significant and based on a small number of cases. CONCLUSIONS Self-report and prescription medications can accurately identify incident PD cases relative to the reference method of medical record review. We found no association between military employment and PD.
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Affiliation(s)
- Melinda C Power
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Varsha Parthasarathy
- Department of Medicine, The George Washington School of Medicine and Health Sciences, Washington, Washington, USA
| | - Kan Z Gianattasio
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Rod L Walker
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Laura E Gibbons
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Raj G Kumar
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, NY, New York, USA
| | - Kristen Dams O'Connor
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, NY, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, NY, New York, USA
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9
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Smith JR, Gibbons LE, Crane PK, Mungas DM, Glymour MM, Manly JJ, Zahodne LB, Rose Mayeda E, Jones RN, Gross AL. Shifting of Cognitive Assessments Between Face-to-Face and Telephone Administration: Measurement Considerations. J Gerontol B Psychol Sci Soc Sci 2023; 78:191-200. [PMID: 36099407 PMCID: PMC9938920 DOI: 10.1093/geronb/gbac135] [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: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Telephone-administered cognitive assessments are a cost-effective and sometimes necessary alternative to face-to-face assessments. There is limited information in large studies concerning mode effects, or differences in cognition attributable to the assessment method, as a potential measurement threat. We evaluated mode effects on cognitive scores using a population-based sample of community-living older adults. METHODS We used data from participants aged 65-79 in the 2014 Health and Retirement Study for whom the interview mode was randomized (n = 6,825). We assessed mode differences in test means, whether mode modifies associations of cognition with criterion variables, and formal measurement invariance testing. RESULTS Relative to face-to-face assessment, telephone assessment was associated with higher scores for memory and calculation (0.06 to 0.013 standard deviations [SD]) and lower scores for nonmemory items (-0.09 to -0.01 SD). Cognition was significantly differentially related to instrumental activities of daily living difficulty depending on assessment mode. Measurement invariance testing identified evidence of mode differences in certain tests as a function of mode: adjusting for underlying cognition, the largest mode differences in memory and attention: immediate noun recall, delayed word recall, and serial-7s scores were higher given telephone administration. DISCUSSION Differences by mode of administration are apparent in cognitive measurement in older adults, albeit to a small degree in our study, and most pronounced for tests of memory and attention. The importance of accounting for mode differences ultimately depends on one's research question and study sample: not all associations may be affected by mode differences, and such modification may only be apparent among those with lower cognitive functioning.
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Affiliation(s)
- Jason R Smith
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura E Gibbons
- General Internal Medicine, University of Washington, Seattle, Washington, USA
| | - Paul K Crane
- General Internal Medicine, University of Washington, Seattle, Washington, USA
| | - Dan M Mungas
- Department of Neurology, University of California, Davis, California, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California, USA
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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10
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Gibbons LE, Power MC, Walker RL, Kumar RG, Murphy A, Latimer CS, Nolan AL, Melief EJ, Beller A, Bogdani M, Keene CD, Larson EB, Crane PK, Dams-O'Connor K. Association of Traumatic Brain Injury with Late Life Neuropathological Outcomes in a Community-Based Cohort. J Alzheimers Dis 2023; 93:949-961. [PMID: 37125552 DOI: 10.3233/jad-221224] [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] [Indexed: 05/02/2023]
Abstract
BACKGROUND Prior studies into the association of head trauma with neuropathology have been limited by incomplete lifetime neurotrauma exposure characterization. OBJECTIVE To investigate the neuropathological sequelae of traumatic brain injury (TBI) in an autopsy sample using three sources of TBI ascertainment, weighting findings to reflect associations in the larger, community-based cohort. METHODS Self-reported head trauma with loss of consciousness (LOC) exposure was collected in biennial clinic visits from 780 older adults from the Adult Changes in Thought study who later died and donated their brain for research. Self-report data were supplemented with medical record abstraction, and, for 244 people, structured interviews on lifetime head trauma. Neuropathology outcomes included Braak stage, CERAD neuritic plaque density, Lewy body distribution, vascular pathology, hippocampal sclerosis, and cerebral/cortical atrophy. Exposures were TBI with or without LOC. Modified Poisson regressions adjusting for age, sex, education, and APOE ɛ4 genotype were weighted back to the full cohort of 5,546 participants. RESULTS TBI with LOC was associated with the presence of cerebral cortical atrophy (Relative Risk 1.22, 95% CI 1.02, 1.42). None of the other outcomes was associated with TBI with or without LOC. CONCLUSION TBI with LOC was associated with increased risk of cerebral cortical atrophy. Despite our enhanced TBI ascertainment, we found no association with the Alzheimer's disease-related neuropathologic outcomes among people who survived to at least age 65 without dementia. This suggests the pathophysiological processes underlying post-traumatic neurodegeneration are distinct from the hallmark pathologies of Alzheimer's disease.
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Affiliation(s)
- Laura E Gibbons
- General Internal Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Melinda C Power
- George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Rod L Walker
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Raj G Kumar
- Department of Rehabilitation and Human Performance, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alia Murphy
- George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Caitlin S Latimer
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Amber L Nolan
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erica J Melief
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Allison Beller
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Marika Bogdani
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - C Dirk Keene
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Eric B Larson
- General Internal Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Paul K Crane
- General Internal Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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11
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Mukherjee S, Ariza J, Gibbons LE, Rachleff VM, Travaglini KJ, Latimer CS, Melief EJ, Campos JS, Gabitto M, Miller JA, Ding Y, Levi B, Long B, Kaplan ES, Hodge RD, Larson EB, Crane PK, Lein ES, Keene CD. Rate of memory decline is associated with neuronal nuclear protein (NeuN) positive cells count in middle temporal gyrus in the Adult Changes in Thought (ACT) autopsy cohort. Alzheimers Dement 2022. [DOI: 10.1002/alz.063401] [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)
| | | | | | | | | | | | - Erica J Melief
- University of Washington School of Medicine Seattle WA USA
| | | | | | | | - Yi Ding
- Allen Institute for Brain Science Seattle WA USA
| | - Boaz Levi
- Allen Institute for Brain Science Seattle WA USA
| | - Brian Long
- Allen Institute for Brain Science Seattle WA USA
| | | | | | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
| | | | - Ed S Lein
- Allen Institute for Brain Science Seattle WA USA
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12
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Lao PJ, Young CB, Andrews RM, Gibbons LE, Kraal A, Turney IC, Deters KD, Trelle AN, Fox‐Fuller JT, Minto L, Seblova D, Mukherjee S, Dotson VM, Manly JJ, Zahodne LB. Loneliness predicts stronger negative associations between cerebrovascular, but not Alzheimer’s, pathology and cognition. Alzheimers Dement 2022. [DOI: 10.1002/alz.066983] [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)
- Patrick J. Lao
- Columbia University Irving Medical Center New York NY USA
| | | | | | | | - A.Zarina Kraal
- Columbia University Irving Medical Center New York NY USA
| | | | | | | | | | - Lex Minto
- Georgia State University Atlanta GA USA
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13
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Crane PK, Trittschuh EH, Mez JB, Saykin AJ, Sanders RE, Gibbons LE, Lee ML, Scollard P, Choi S, Rainey‐Smith S, Chooi CK, Gavett BE, Maruff P, Ames D, Culhane JE, Gauthreaux K, Chan KCG, Biber S, Stephens K, Kukull WA, Dumitrescu L, Hohman TJ, Mukherjee S. Development of harmonized and co‐calibrated scores for memory, executive functioning, language, and visuospatial in the AIBL Study, ADNI, and NACC datasets. Alzheimers Dement 2022. [DOI: 10.1002/alz.064534] [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)
| | - Emily H. Trittschuh
- UW School of Medicine Seattle WA USA
- VA Puget Sound Health Care System, Seattle Division Seattle WA USA
| | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
- Boston University Alzheimer’s Disease Research Center Boston MA USA
| | | | | | | | | | | | | | - Stephanie Rainey‐Smith
- Centre of Excellence for Alzheimer’s Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup Western Australia Australia
- Murdoch University, Murdoch Western Australia Australia
- Edith Cowan University, Joondalup Western Australia Australia
| | - Cheyenne K Chooi
- University of Western Australia, Perth Western Australia Australia
| | - Brandon E Gavett
- University of Western Australia, Perth Western Australia Australia
| | - Paul Maruff
- University of Melbourne Melbourne VIC Australia
| | - David Ames
- The University of Melbourne Melbourne VIC Australia
| | - Jessica E. Culhane
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Kathryn Gauthreaux
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Kwun Chuen Gary Chan
- University of Washington Seattle WA USA
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Sarah Biber
- University of Washington Seattle WA USA
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Kari Stephens
- University of Washington Seattle WA USA
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Walter A. Kukull
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Logan Dumitrescu
- Department of Neurology, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | - Timothy J. Hohman
- Department of Neurology, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt University Nashville TN USA
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14
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Choi S, Mukherjee S, Gibbons LE, Trittschuh EH, Lee ML, Scollard P, Sanders RE, Snitz BE, Sweet R, Lopez OL, Mez JB, Saykin AJ, Hohman TJ, Crane PK. Beyond the Uniform Data Set (UDS): Benefits of incorporating additional items for the measurement of memory, executive functioning, and language from the University of Pittsburgh Alzheimer’s Disease Research Center. Alzheimers Dement 2022. [DOI: 10.1002/alz.067975] [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)
| | - 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
- VA Puget Sound Health Care System, Seattle Division Seattle WA USA
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System Seattle WA USA
| | | | | | | | - Beth E Snitz
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer’s Disease Research Center Pittsburgh PA USA
| | - Robert Sweet
- University of Pittsburgh Pittsburgh PA USA
- VA Pittsburgh Healthcare System Pittsburgh PA USA
| | - Oscar L. Lopez
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer’s Disease Research Center Pittsburgh PA USA
| | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
- Boston University Alzheimer’s Disease Research Center Boston MA USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University School of Medicine Indianapolis IN USA
- Indiana University Indianapolis IN USA
- Indiana University School of Medicine Indianapolis IN USA
| | - Timothy J. Hohman
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | - Paul K. Crane
- University of Washington Seattle WA USA
- Department of General Internal Medicine, University of Washington School of Medicine Seattle WA USA
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15
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Lee CS, Gibbons LE, Lee AY, Yanagihara RT, Blazes MS, Lee ML, McCurry SM, Bowen JD, McCormick WC, Crane PK, Larson EB. Association Between Cataract Extraction and Development of Dementia. JAMA Intern Med 2022; 182:134-141. [PMID: 34870676 PMCID: PMC8649913 DOI: 10.1001/jamainternmed.2021.6990] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
IMPORTANCE Visual function is important for older adults. Interventions to preserve vision, such as cataract extraction, may modify dementia risk. OBJECTIVE To determine whether cataract extraction is associated with reduced risk of dementia among older adults. DESIGN, SETTING, AND PARTICIPANTS This prospective, longitudinal cohort study analyzed data from the Adult Changes in Thought study, an ongoing, population-based cohort of randomly selected, cognitively normal members of Kaiser Permanente Washington. Study participants were 65 years of age or older and dementia free at enrollment and were followed up biennially until incident dementia (all-cause, Alzheimer disease, or Alzheimer disease and related dementia). Only participants who had a diagnosis of cataract or glaucoma before enrollment or during follow-up were included in the analyses (ie, a total of 3038 participants). Data used in the analyses were collected from 1994 through September 30, 2018, and all data were analyzed from April 6, 2019, to September 15, 2021. EXPOSURES The primary exposure of interest was cataract extraction. Data on diagnosis of cataract or glaucoma and exposure to surgery were extracted from electronic medical records. Extensive lists of dementia-related risk factors and health-related variables were obtained from study visit data and electronic medical records. MAIN OUTCOMES AND MEASURES The primary outcome was dementia as defined by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Multivariate Cox proportional hazards regression analyses were conducted with the primary outcome. To address potential healthy patient bias, weighted marginal structural models incorporating the probability of surgery were used and the association of dementia with glaucoma surgery, which does not restore vision, was evaluated. RESULTS In total, 3038 participants were included (mean [SD] age at first cataract diagnosis, 74.4 (6.2) years; 1800 women (59%) and 1238 men (41%); and 2752 (91%) self-reported White race). Based on 23 554 person-years of follow-up, cataract extraction was associated with significantly reduced risk (hazard ratio, 0.71; 95% CI, 0.62-0.83; P < .001) of dementia compared with participants without surgery after controlling for years of education, self-reported White race, and smoking history and stratifying by apolipoprotein E genotype, sex, and age group at cataract diagnosis. Similar results were obtained in marginal structural models after adjusting for an extensive list of potential confounders. Glaucoma surgery did not have a significant association with dementia risk (hazard ratio, 1.08; 95% CI, 0.75-1.56; P = .68). Similar results were found with the development of Alzheimer disease dementia. CONCLUSIONS AND RELEVANCE This cohort study found that cataract extraction was significantly associated with lower risk of dementia development. If validated in future studies, cataract surgery may have clinical relevance in older adults at risk of developing dementia.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle.,Roger and Angie Karalis Johnson Retina Center, Seattle, Washington
| | - Laura E Gibbons
- Department of General Internal Medicine, University of Washington, Seattle
| | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle.,Roger and Angie Karalis Johnson Retina Center, Seattle, Washington
| | | | - Marian S Blazes
- Department of Ophthalmology, University of Washington, Seattle
| | - Michael L Lee
- Department of General Internal Medicine, University of Washington, Seattle
| | | | - James D Bowen
- Department of Neurology, Swedish Medical Center, Seattle, Washington
| | - Wayne C McCormick
- Department of General Internal Medicine, University of Washington, Seattle
| | - Paul K Crane
- Department of General Internal Medicine, University of Washington, Seattle
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
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16
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Crane PK, Choi S, Gibbons LE, Mukherjee S, Zhu R, Scollard P, Lee ML, Trittschuh EH, Saykin AJ, Mez J, Mungas DM, Wang C. Cognitive assessments in ADNI: Lessons learned from the ADNI psychometrics project. Alzheimers Dement 2021. [DOI: 10.1002/alz.056474] [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: 11/11/2022]
Affiliation(s)
| | | | | | | | - Ryoui Zhu
- University of Washington Seattle WA USA
| | | | | | - Emily H. Trittschuh
- UW School of Medicine Seattle WA USA
- VA Puget Sound Health Care System, Seattle Division Seattle WA USA
| | - Andrew J. Saykin
- Indiana Alzheimer's Disease Research Center Indianapolis IN USA
- Indiana University School of Medicine Indianapolis IN USA
- Department of Radiology and Imaging Sciences Indiana University School of Medicine Indianapolis IN USA
| | - Jesse Mez
- Department of Neurology Boston University School of Medicine Boston MA USA
- Boston University Alzheimer’s Disease Research Center Boston MA USA
- Boston University School of Medicine Boston MA USA
| | - Dan M. Mungas
- University of California, Davis School of Medicine Sacramento CA USA
| | - Chun Wang
- University of Washington Seattle WA USA
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Kobayashi LC, Gross AL, Gibbons LE, Tommet D, Sanders RE, Choi SE, Mukherjee S, Glymour M, Manly JJ, Berkman LF, Crane PK, Mungas DM, Jones RN. You Say Tomato, I Say Radish: Can Brief Cognitive Assessments in the U.S. Health Retirement Study Be Harmonized With Its International Partner Studies? J Gerontol B Psychol Sci Soc Sci 2021; 76:1767-1776. [PMID: 33249448 DOI: 10.1093/geronb/gbaa205] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 06/10/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To characterize the extent to which brief cognitive assessments administered in the population-representative U.S. Health and Retirement Study (HRS) and its International Partner Studies can be considered to be measuring a single, unidimensional latent cognitive function construct. METHODS Cognitive function assessments were administered in face-to-face interviews in 12 studies in 26 countries (N = 155,690), including the U.S. HRS and selected International Partner Studies. We used the time point of the first cognitive assessment for each study to minimize differential practice effects across studies and documented cognitive test item coverage across studies. Using confirmatory factor analysis models, we estimated single-factor general cognitive function models and bifactor models representing memory-specific and nonmemory-specific cognitive domains for each study. We evaluated model fits and factor loadings across studies. RESULTS Despite relatively sparse and inconsistent cognitive item coverage across studies, all studies had some cognitive test items in common with other studies. In all studies, the bifactor models with a memory-specific domain fit better than single-factor general cognitive function models. The data fit the models at reasonable thresholds for single-factor models in 6 of the 12 studies and for the bifactor models in all 12 of the 12 studies. DISCUSSION The cognitive assessments in the U.S. HRS and its International Partner Studies reflect comparable underlying cognitive constructs. We discuss the assumptions underlying our methods, present alternatives, and future directions for cross-national harmonization of cognitive aging data.
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Affiliation(s)
- Lindsay C Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.,Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins University Center on Aging and Health, Baltimore, Maryland
| | - Laura E Gibbons
- Department of Medicine, School of Medicine, University of Washington, Seattle
| | - Doug Tommet
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - R Elizabeth Sanders
- Department of Medicine, School of Medicine, University of Washington, Seattle
| | - Seo-Eun Choi
- Department of Medicine, School of Medicine, University of Washington, Seattle
| | | | - Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Jennifer J Manly
- Department of Neurology and the Taubman Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York
| | - Lisa F Berkman
- Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts
| | - Paul K Crane
- Department of Medicine, School of Medicine, University of Washington, Seattle
| | - Dan M Mungas
- Department of Neurology, University of California, Davis, Sacramento
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
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Mohammed A, Gibbons LE, Gates G, Anderson ML, McCurry SM, McCormick W, Bowen JD, Grabowski TJ, Crane PK, Larson EB. Association of Performance on Dichotic Auditory Tests With Risk for Incident Dementia and Alzheimer Dementia. JAMA Otolaryngol Head Neck Surg 2021; 148:20-27. [PMID: 34647974 DOI: 10.1001/jamaoto.2021.2716] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Importance Age-related hearing difficulties can include problems with signal audibility and central auditory processing. Studies have demonstrated associations between audibility and dementia risk. To our knowledge, limited data exist to determine whether audibility, central processing, or both drive these associations. Objective To determine the associations between signal sensitivity, central auditory processing, and dementia and Alzheimer dementia (AD) risk. Design, Setting, and Participants This follow-up observational study of a sample from the prospective Adult Changes in Thought study of dementia risk was conducted at Kaiser Permanente Washington, a western Washington health care delivery system, and included 280 volunteer participants without dementia who were evaluated from October 2003 to February 2006 with follow-up through September 2018. Analyses began in 2019 and continued through 2021. Exposures Hearing tests included pure tone signal audibility, a monaural word recognition test, and 2 dichotic tests: the Dichotic Sentence Identification (DSI) test and the Dichotic Digits test (DDT). Main Outcomes and Measures Cognition was assessed biennially with the Cognitive Abilities Screening Instrument (range, 1-100; higher scores are better), and scores of less than 86 prompted clinical and neuropsychological evaluations. All data were reviewed at multidisciplinary consensus conferences, and standardized criteria were used to define incident cases of dementia and probable or possible AD. Cox proportional hazard models were used to determine associations with hearing test performance. Results A total of 280 participants (177 women [63%]; mean [SD] age, 79.5 [5.2] years). As of September 2018, there were 2196 person-years of follow-up (mean, 7.8 years) and 89 incident cases of dementia (66 not previously analyzed), of which 84 (94.4%) were AD (63 not previously analyzed). Compared with people with DSI scores of more than 80, the dementia adjusted hazard ratio (aHR) for DSI scores of less than 50 was 4.18 (95% CI, 2.37-7.38; P < .001); for a DSI score of 50 to 80, it was 1.82 (95% CI, 1.10-3.04; P = .02). Compared with people with DDT scores of more than 80, the dementia aHR for DDT scores of less than 50 was 2.66 (95% CI, 1.31-5.42; P = .01); for a DDT score of 50 to 80, it was 2.40 (95% CI, 1.45-3.98; P = .001). The AD results were similar. Pure tone averages were weakly and insignificantly associated with dementia and AD, and associations were null when controlling for DSI scores. Conclusions and Relevance In this cohort study, abnormal central auditory processing as measured by dichotic tests was independently associated with dementia and AD risk.
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Affiliation(s)
- Adeeb Mohammed
- The College of Arts and Sciences, University of Washington, Seattle
| | - Laura E Gibbons
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle
| | - George Gates
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
| | | | | | - Wayne McCormick
- Division of Geriatrics, Department of Medicine, University of Washington, Seattle
| | - James D Bowen
- Department of Neurology, Swedish Medical Center, Seattle, Washington
| | - Thomas J Grabowski
- Departments of Radiology and Neurology, University of Washington, Seattle
| | - Paul K Crane
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle
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19
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Power MC, Murphy AE, Gianattasio KZ, Zhang YI, Walker RL, Crane PK, Larson EB, Gibbons LE, Kumar RG, Dams-O'Connor K. Association of Military Employment With Late-Life Cognitive Decline and Dementia: A Population-Based Prospective Cohort Study. Mil Med 2021; 188:e1132-e1139. [PMID: 34626181 PMCID: PMC10390078 DOI: 10.1093/milmed/usab413] [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: 05/27/2021] [Revised: 08/06/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION As the number of U.S. veterans over age 65 has increased, interest in whether military service affects late-life health outcomes has grown. Whether military employment is associated with increased risk of cognitive decline and dementia remains unclear. MATERIALS AND METHODS We used data from 4,370 participants of the longitudinal Adult Changes in Thought (ACT) cohort study, enrolled at age 65 or older, to examine whether military employment was associated with greater cognitive decline or higher risk of incident dementia in late life. We classified persons as having military employment if their first or second-longest occupation was with the military. Cognitive status was assessed at each biennial Adult Changes in Thought study visit using the Cognitive Abilities Screening Instrument, scored using item response theory (CASI-IRT). Participants meeting screening criteria were referred for dementia ascertainment involving clinical examination and additional cognitive testing. Primary analyses were adjusted for sociodemographic characteristics and APOE genotype. Secondary analyses additionally adjusted for indicators of early-life socioeconomic status and considered effect modification by age, gender, and prior traumatic brain injury with loss of consciousness TBI with LOC. RESULTS Overall, 6% of participants had military employment; of these, 76% were males. Military employment was not significantly associated with cognitive change (difference in modeled 10-year cognitive change in CASI-IRT scores in SD units (95% confidence interval [CI]): -0.042 (-0.19, 0.11), risk of dementia (hazard ratio [HR] [95% CI]: 0.92 [0.71, 1.18]), or risk of Alzheimer's disease dementia (HR [95% CI]: 0.93 [0.70, 1.23]). These results were robust to additional adjustment and sensitivity analyses. There was no evidence of effect modification by age, gender, or traumatic brain injury with loss of consciousness. CONCLUSIONS Among members of the Adult Changes in Thought cohort, military employment was not associated with increased risk of cognitive decline or dementia. Nevertheless, military veterans face the same high risks for cognitive decline and dementia as other aging adults.
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Affiliation(s)
- Melinda C Power
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC 20052, USA
| | - Alia E Murphy
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC 20052, USA
| | - Kan Z Gianattasio
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC 20052, USA
| | - Y I Zhang
- Department of Statistics, George Washington University Columbian College of Arts and Sciences, Washington, DC 20052, USA
| | - Rod L Walker
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA 98195-6420, USA
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA 98195-6420, USA
| | - Laura E Gibbons
- Department of Medicine, University of Washington, Seattle, WA 98195-6420, USA
| | - Raj G Kumar
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Kristen Dams-O'Connor
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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20
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Uretsky M, Gibbons LE, Mukherjee S, Trittschuh EH, Fardo DW, Boyle PA, Keene CD, Saykin AJ, Crane PK, Schneider JA, Mez J. Longitudinal cognitive performance of Alzheimer's disease neuropathological subtypes. Alzheimers Dement (N Y) 2021; 7:e12201. [PMID: 34604500 PMCID: PMC8474122 DOI: 10.1002/trc2.12201] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/03/2021] [Accepted: 06/17/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Alzheimer's disease (AD) neuropathological subtypes (limbic predominant [lpAD], hippocampal sparing [HpSpAD], and typical [tAD]), defined by relative neurofibrillary tangle (NFT) burden in limbic and cortical regions, have not been studied in prospectively characterized epidemiological cohorts with robust cognitive assessments. METHODS Two hundred ninety-two participants with neuropathologically confirmed AD from the Religious Orders Study and Memory and Aging Project were categorized by neuropathological subtype based on previously specified diagnostic criteria using quantitative regional NFT counts. Rates of cognitive decline were compared across subtypes using linear mixed-effects models that included subtype, time, and a subtype-time interaction as predictors and four cognitive domain factor scores (memory, executive function, language, visuospatial) and a global score as outcomes. To assess if memory was relatively preserved in HpSpAD, non-memory factor scores were included as covariates in the mixed-effects model with memory as the outcome. RESULTS There were 57 (20%) with lpAD, 22 (8%) with HpSpAD and 213 (73%) with tAD. LpAD died significantly later than the participants with tAD (2.4 years, P = .01) and with HpSpAD (3.8 years, P = .03). Compared to tAD, HpSpAD, but not lpAD, performed significantly worse in all cognitive domains at the time of initial impairment and declined significantly faster in memory, language, and globally. HpSpAD did not have relatively preserved memory performance at any time point. CONCLUSION The relative frequencies of AD neuropathological subtypes in an epidemiological sample were consistent with a previous report in a convenience sample. People with HpSpAD decline rapidly, but may not have a memory-sparing clinical syndrome. Cohort-specific differences in regional tau burden and comorbid neuropathology may explain the lack of clinicopathological correlation.
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Affiliation(s)
- Madeline Uretsky
- Boston University Alzheimer's Disease and CTE CentersBoston University School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
| | - Laura E. Gibbons
- Department of General Internal MedicineUniversity of Washington School of Medicine, University of WashingtonSeattleWashingtonUSA
| | - Shubhabrata Mukherjee
- Department of General Internal MedicineUniversity of Washington School of Medicine, University of WashingtonSeattleWashingtonUSA
| | - Emily H. Trittschuh
- Geriatric Research, Education, and Clinical CenterPuget Sound Veterans Affairs Health Care SystemSeattleWashingtonUSA
- Department of Psychiatry and Behavioral SciencesUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - David W. Fardo
- Sanders‐Brown Center on AgingUniversity of Kentucky College of MedicineLexingtonKentuckyUSA
- College of Public Health and Department of BiostatisticsUniversity of KentuckyLexingtonKentuckyUSA
| | - Patricia A. Boyle
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Division of Behavioral SciencesRush Medical CollegeChicagoIllinoisUSA
| | - C. Dirk Keene
- University of Washington Alzheimer's Disease Research CenterUniversity of Washington School of MedicineSeattleWashingtonUSA
- Department of Laboratory Medicine and PathologyUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - Andrew J. Saykin
- Indiana Alzheimer's Disease Research CenterIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Radiology and Imaging ServicesIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Paul K. Crane
- Department of General Internal MedicineUniversity of Washington School of Medicine, University of WashingtonSeattleWashingtonUSA
- University of Washington Alzheimer's Disease Research CenterUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - Julie A. Schneider
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of PathologyRush Medical College, ChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Jesse Mez
- Boston University Alzheimer's Disease and CTE CentersBoston University School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
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21
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Barthold D, Gibbons LE, Marcum ZA, Gray SL, Dirk Keene C, Grabowski TJ, Postupna N, Larson EB, Crane PK. Alzheimer's Disease-Related Neuropathology Among Patients with Medication Treated Type 2 Diabetes in a Community-Based Autopsy Cohort. J Alzheimers Dis 2021; 83:1303-1312. [PMID: 34420950 DOI: 10.3233/jad-210059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/18/2023]
Abstract
BACKGROUND Diabetes is a risk factor for Alzheimer's disease and related dementias (ADRD). Epidemiologic evidence shows an association between diabetes medications and ADRD risk; cell and mouse models show diabetes medication association with AD-related neuropathologic change (ADNC). OBJECTIVE This hypothesis-generating analysis aimed to describe autopsy-measured ADNC for individuals who used diabetes medications. METHODS Descriptive analysis of ADNC for Adult Changes in Thought (ACT) Study autopsy cohort who used diabetes medications, including sulfonylureas, insulin, and biguanides; total N = 118. ADNC included amyloid plaque distribution (Thal phasing), neurofibrillary tangle (NFT) distribution (Braak stage), and cortical neuritic plaque density (CERAD score). We also examined quantitative measures of ADNC using the means of standardized Histelide measures of cortical PHF-tau and Aβ1-42. Adjusted analyses control for age at death, sex, education, APOE genotype, and diabetes complication severity index. RESULTS Adjusted analyses showed no significant association between any drug class and traditional neuropathologic measures compared to nonusers of that class. In adjusted Histelide analyses, any insulin use was associated with lower mean levels of Aβ1-42 (-0.57 (CI: -1.12, -0.02)) compared to nonusers. Five years of sulfonylureas and of biguanides use was associated with lower levels of Aβ1-42 compared to nonusers (-0.15 (CI: -0.28, -0.02), -0.31 (CI: -0.54, -0.07), respectively). CONCLUSION Some evidence exists that diabetes medications are associated with lower levels of Aβ1-42, but not traditional measures of neuropathology. Future studies are needed in larger samples to build understanding of the mechanisms between diabetes, its medications, and ADRD, and to potentially repurpose existing medications for prevention or delay of ADRD.
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Affiliation(s)
- Douglas Barthold
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Department of Pharmacy, University of Washington, Seattle, WA, USA.,The Plein Center for Geriatric Pharmacy Research, Education, and Outreach, School of Pharmacy, University of Washington, Seattle, WA, USA
| | - Laura E Gibbons
- General Internal Medicine, Data Management and Statistics Core, Alzheimer's Disease Research Center, University of Washington, Seattle, WA, USA.,Department of Medicine, UW School of Medicine, University of Washington, Seattle, WA, USA
| | - Zachary A Marcum
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Department of Pharmacy, University of Washington, Seattle, WA, USA.,The Plein Center for Geriatric Pharmacy Research, Education, and Outreach, School of Pharmacy, University of Washington, Seattle, WA, USA
| | - Shelly L Gray
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Department of Pharmacy, University of Washington, Seattle, WA, USA.,The Plein Center for Geriatric Pharmacy Research, Education, and Outreach, School of Pharmacy, University of Washington, Seattle, WA, USA
| | - C Dirk Keene
- Laboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Thomas J Grabowski
- Departments of Radiology and Neurology, UW School of Medicine, Alzheimer's Disease Research Center, University of Washington, Seattle, WA, USA
| | - Nadia Postupna
- Laboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.,Department of Medicine, UW School of Medicine, University of Washington, Seattle, WA, USA
| | - Paul K Crane
- Department of Medicine, UW School of Medicine, University of Washington, Seattle, WA, USA
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22
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Webster JM, Grabowski TJ, Madhyastha TM, Gibbons LE, Keene CD, Latimer CS. Leveraging Neuroimaging Tools to Assess Precision and Accuracy in an Alzheimer's Disease Neuropathologic Sampling Protocol. Front Neurosci 2021; 15:693242. [PMID: 34483821 PMCID: PMC8416420 DOI: 10.3389/fnins.2021.693242] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/29/2021] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION The study of Alzheimer's disease investigates topographic patterns of degeneration in the context of connected networks comprised of functionally distinct domains using increasingly sophisticated molecular techniques. Therefore, obtaining high precision and accuracy of neuropathologic tissue sampling will enhance the reliability of molecular studies and contribute to the understanding of Alzheimer's disease pathology. Neuroimaging tools can help assess these aspects of current sampling protocols as well as contribute directly to their improvement. METHODS Using a virtual sampling method on magnetic resonance images (MRIs) from 35 participants (21 women), we compared the precision and accuracy of traditional neuropathologic vs. neuroimaging-guided sampling. The impact of the resulting differences was assessed by evaluating the functional connectivity pattern of regions selected by each approach. RESULTS Virtual sampling using the traditional neuropathologic approach had low neuroanatomical precision and accuracy for all cortical regions tested. Neuroimaging-guided strategies narrowed these gaps. Discrepancies in the location of traditional and neuroimaging-guided samples corresponded to differences in fMRI measures of functional connectivity. DISCUSSION Integrating neuroimaging tools with the neuropathologic assessment will improve neuropathologic-neuroimaging correlations by helping to ensure specific functional domains are accurately sampled for quantitative molecular neuropathologic applications. Our neuroimaging-based simulation of current sampling practices provides a benchmark of precision and accuracy against which to measure improvements when using novel tissue sampling approaches. Our results suggest that relying on gross landmarks alone to select samples at autopsy leads to significant variability, even when sampled by the same neuropathologist. Further, this exercise highlights how sampling precision could be enhanced if neuroimaging were integrated with the standard neuropathologic assessment. More accurate targeting and improved biological homogeneity of sampled brain tissue will facilitate the interpretation of neuropathological analyses in AD and the downstream research applications of brain tissue from biorepositories.
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Affiliation(s)
- Jason M. Webster
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Thomas J. Grabowski
- Department of Radiology, University of Washington, Seattle, WA, United States,Department of Neurology, University of Washington, Seattle, WA, United States
| | - Tara M. Madhyastha
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Laura E. Gibbons
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - C. Dirk Keene
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States
| | - Caitlin S. Latimer
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States,*Correspondence: Caitlin S. Latimer,
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23
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Lee CS, Lee ML, Gibbons LE, Yanagihara RT, Blazes M, Kam JP, McCurry SM, Bowen JD, McCormick WC, Lee AY, Larson EB, Crane PK. Associations Between Retinal Artery/Vein Occlusions and Risk of Vascular Dementia. J Alzheimers Dis 2021; 81:245-253. [PMID: 33749651 DOI: 10.3233/jad-201492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/15/2022]
Abstract
BACKGROUND Vascular disease is a risk factor for Alzheimer's disease (AD) and related dementia in older adults. Retinal artery/vein occlusion (RAVO) is an ophthalmic complication of systemic vascular pathology. Whether there are associations between RAVO and dementia risk is unknown. OBJECTIVE To determine whether RAVOs are associated with an increased risk of developing vascular dementia or AD. METHODS Data from Adult Changes in Thought (ACT) study participants were analyzed. This prospective, population-based cohort study followed older adults (age ≥65 years) who were dementia-free at enrollment for development of vascular dementia or AD based on research criteria. RAVO diagnoses were extracted from electronic medical records. Cox-regression survival analyses were stratified by APOEɛ4 genotype and adjusted for demographic and clinical factors. RESULTS On review of 41,216 person-years (4,743 participants), 266 (5.6%) experienced RAVO. APOEɛ4 carriers who developed RAVO had greater than four-fold higher risk for developing vascular dementia (Hazard Ratio [HR] 4.54, 95% Confidence Interval [CI] 1.86, 11.10, p = 0.001). When including other cerebrovascular disease (history of carotid endarterectomy or transient ischemic attack) in the model, the risk was three-fold higher (HR 3.06, 95% CI 1.23, 7.62). No other conditions evaluated in the secondary analyses were found to confound this relationship. There was no effect in non-APOEɛ4 carriers (HR 1.03, 95% CI 0.37, 2.80). There were no significant associations between RAVO and AD in either APOE group. CONCLUSION Older dementia-free patients who present with RAVO and carry the APOEɛ4 allele appear to be at higher risk for vascular dementia.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Michael L Lee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Laura E Gibbons
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ryan T Yanagihara
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Marian Blazes
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Jason P Kam
- Kaiser Permanente Washington, Seattle, WA, USA
| | - Susan M McCurry
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - James D Bowen
- Department of Neurology, Swedish Medical Center, Seattle, WA, USA
| | | | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
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24
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Postupna N, Rose SE, Gibbons LE, Coleman NM, Hellstern LL, Ritchie K, Wilson AM, Cudaback E, Li X, Melief EJ, Beller AE, Miller JA, Nolan AL, Marshall DA, Walker R, Montine TJ, Larson EB, Crane PK, Ellenbogen RG, Lein ES, Dams-O'Connor K, Keene CD. The Delayed Neuropathological Consequences of Traumatic Brain Injury in a Community-Based Sample. Front Neurol 2021; 12:624696. [PMID: 33796061 PMCID: PMC8008107 DOI: 10.3389/fneur.2021.624696] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/12/2021] [Indexed: 12/14/2022] Open
Abstract
The late neuropathological effects of traumatic brain injury have yet to be fully elucidated, particularly with respect to community-based cohorts. To contribute to this critical gap in knowledge, we designed a multimodal neuropathological study, integrating traditional and quantitative approaches to detect pathologic changes in 532 consecutive brain autopsies from participants in the Adult Changes in Thought (ACT) study. Diagnostic evaluation including assessment for chronic traumatic encephalopathy (CTE) and quantitative immunoassay-based methods were deployed to examine levels of pathological (hyperphosphorylated) tau (pTau) and amyloid (A) β in brains from ACT participants with (n = 107) and without (n = 425) history of remote TBI with loss of consciousness (w/LOC). Further neuropathological assessments included immunohistochemistry for α-synuclein and phospho-TDP-43 pathology and astro- (GFAP) and micro- (Iba1) gliosis, mass spectrometry analysis of free radical injury, and gene expression evaluation (RNA sequencing) in a smaller sub-cohort of matched samples (49 cases with TBI and 49 non-exposed matched controls). Out of 532 cases, only 3 (0.6%-none with TBI w/LOC history) showed evidence of the neuropathologic signature of chronic traumatic encephalopathy (CTE). Across the entire cohort, the levels of pTau and Aβ showed expected differences for brain region (higher levels in temporal cortex), neuropathological diagnosis (higher in participants with Alzheimer's disease), and APOE genotype (higher in participants with one or more APOE ε4 allele). However, no differences in PHF-tau or Aβ1-42 were identified by Histelide with respect to the history of TBI w/LOC. In a subset of TBI cases with more carefully matched control samples and more extensive analysis, those with TBI w/LOC history had higher levels of hippocampal pTau but no significant differences in Aβ, α-synuclein, pTDP-43, GFAP, Iba1, or free radical injury. RNA-sequencing also did not reveal significant gene expression associated with any measure of TBI exposure. Combined, these findings suggest long term neuropathological changes associated with TBI w/LOC may be subtle, involve non-traditional pathways of neurotoxicity and neurodegeneration, and/or differ from those in autopsy cohorts specifically selected for neurotrauma exposure.
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Affiliation(s)
- Nadia Postupna
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Shannon E. Rose
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Laura E. Gibbons
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Natalie M. Coleman
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Leanne L. Hellstern
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Kayla Ritchie
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Angela M. Wilson
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Eiron Cudaback
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Xianwu Li
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Erica J. Melief
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Allison E. Beller
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | | | - Amber L. Nolan
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Desiree A. Marshall
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Rod Walker
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Thomas J. Montine
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Eric B. Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Paul K. Crane
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Richard G. Ellenbogen
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States
| | - Edward S. Lein
- Allen Institute for Brain Science, Seattle, WA, United States
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States
| | - Kristen Dams-O'Connor
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - C. Dirk Keene
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States
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25
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Kumar RG, Jayasinghe N, Walker RL, Gibbons LE, Power MC, Larson EB, Crane PK, Dams-O’Connor K. Association of remote traumatic brain injury and military employment with late-life trajectories of depressive symptom severity. J Affect Disord 2021; 281:376-383. [PMID: 33348181 PMCID: PMC8887889 DOI: 10.1016/j.jad.2020.12.003] [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: 08/04/2020] [Revised: 11/13/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) and military service are common lifetime exposures among current older adults that may affect late-life mental health. The objective of the present study was to evaluate the association between TBI with loss of consciousness (LOC) and military employment and late-life depressive symptom severity trajectory. METHODS 1445 males and 2096 females adults at least 65 years old without dementia or recent TBI were enrolled and followed biennially for up to 10 years in the Adult Changes in Thought study from Kaiser Permanente Washington in Seattle, Washington. RESULTS Using group-based trajectory modeling, we documented four distinct depressive symptom severity trajectories that followed a similar course in males and females (Minimal, Decreasing, Increasing, and Persistent). In multinomial regression analyses, TBI with LOC in males was associated with greater likelihood of Persistent versus Minimal depressive symptom severity compared to individuals without TBI (OR = 1.51, 95% CI: 1.01, 2.27; p=0.046). Males reporting past military employment had greater likelihood of Decreasing versus Minimal depressive symptom severity compared to individuals without past military employment (OR = 1.54, 95% CI: 1.03, 2.31; p=0.035). There was no association between TBI or military employment and depression trajectories in females, and no evidence of effect modification by age or between exposures. LIMITATIONS Lifetime history of TBI was ascertained retrospectively and may be subject to recall bias. Also, past military employment does not presuppose combat exposure. CONCLUSIONS Remote TBI and past military employment are relevant to late-life trajectories of depressive symptom severity in dementia-free older males.
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Affiliation(s)
- Raj G. Kumar
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai
| | - Nimali Jayasinghe
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai,Department of Psychiatry, Weill Cornell Medicine
| | - Rod L. Walker
- Kaiser Permanente Washington Health Research Institute
| | | | - Melinda C. Power
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University
| | - Eric B. Larson
- Department of Medicine, University of Washington,Kaiser Permanente Washington Health Research Institute
| | | | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai,Department of Neurology, Icahn School of Medicine at Mount Sinai,Corresponding author: Kristen Dams-O’Connor, PhD, One Gustave L. Levy Place, Box 1163, New York, NY 10029, (212) 241-0137, kristen.dams-o’
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26
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Adams LM, Gell NM, Hoffman EV, Gibbons LE, Phelan EA, Sturgeon JA, Turk DC, Patel KV. Impact of COVID-19 'Stay Home, Stay Healthy' Orders on Function among Older Adults Participating in a Community-Based, Behavioral Intervention Study. J Aging Health 2021; 33:458-468. [PMID: 33555230 PMCID: PMC8238828 DOI: 10.1177/0898264321991314] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background: Early mitigation orders for COVID-19 halted participation in community-based programs. We examined the early impact of “Stay Home, Stay Healthy” orders on functioning in older adults participating in a behavioral intervention study involving community-based exercise. Methods: A quasi-natural experiment, using mixed methods (n = 39). Participants completed interviews and questionnaires after 3–4 weeks of the Stay Home, Stay Healthy directive. PROMIS-29 outcomes were compared to pre-COVID-19 responses. Results: Participants had a mean age of 74.1 (6.5) years, 79.5% were women, and 20.5% were racial/ethnic minorities. Compared to pre-COVID-19, there was a significant increase in anxiety and decrease in fatigue and social participation. Thematic analysis revealed five main themes related to disruption of daily life, the emotional and physical impact of stay-at-home orders, unexpected positive outcomes, and perspectives on messaging surrounding the pandemic. Conclusions: Efforts to curb the spread of COVID-19 have substantially impacted the lives of older adults participating in community-based exercise.
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Affiliation(s)
- Leah M Adams
- 3298Departments of Psychology and Women & Gender Studies, George Mason University, Fairfax, VA, USA
| | - Nancy M Gell
- 2092Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Elise V Hoffman
- 7284Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Laura E Gibbons
- Division of General Internal Medicine, 7284University of Washington, Seattle, WA, USA
| | - Elizabeth A Phelan
- Division of Gerontology and Geriatric Medicine, 7284University of Washington, Seattle, WA, USA.,7284Department of Health Services, University of Washington, Seattle, WA, USA
| | - John A Sturgeon
- 7284Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Dennis C Turk
- 7284Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Kushang V Patel
- 7284Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.,Division of Gerontology and Geriatric Medicine, 7284University of Washington, Seattle, WA, USA
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27
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Fredericksen RJ, Gibbons LE, Fitzsimmons E, Nance RM, Schafer KR, Batey DS, Loo S, Dougherty S, Mathews WC, Christopoulos K, Mayer KH, Mugavero MJ, Kitahata MM, Crane PK, Crane HM. Impact and correlates of sub-optimal social support among patients in HIV care. AIDS Care 2021; 33:1178-1188. [PMID: 33443445 DOI: 10.1080/09540121.2020.1853660] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Social support (SS) predicts health outcomes among patients living with HIV. We administered a brief, validated measure of SS, the Multifactoral Assessment of Perceived Social Support, within a patient-reported outcomes assessment of health domains in HIV care at 4 U.S. clinics in English and Spanish (n = 708). In univariate analysis, low SS was associated with poorer engagement in care, antiretroviral adherence, and health-related quality of life; current methamphetamine/crystal use, depression, anxiety, and HIV stigma (all p < 0.001); any use of either methamphetamines/crystal, illicit opioids, or cocaine/crack (p = 0.001), current marijuana use (p = 0.012), nicotine use (p = 0.005), and concern for sexually transmitted infection exposure (p = 0.001). High SS was associated with undetectable viral load (p = 0.031). Multivariate analyses found low SS independently associated with depression (risk ratio (RR) 3.72, 95% CI 2.93-4.72), lower adherence (RR 0.76, 95% CI 0.64-0.89), poor engagement in care (RR 2.05, 95% CI 1.44-2.96), and having more symptoms (RR 2.29, 95% CI 1.92-2.75). Medium SS was independently associated with depression (RR 2.59, 95% CI 2.00-3.36), poor engagement in care (RR 1.62, 95% CI 1.15-2.29) and having more symptoms (RR 1.75, 95% CI 1.44-2.13). SS assessment may help identify patients at risk for these outcomes.
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Affiliation(s)
| | - L E Gibbons
- Medicine, University of Washington, Seattle, WA, USA
| | - E Fitzsimmons
- Medicine, University of Washington, Seattle, WA, USA
| | - R M Nance
- Medicine, University of Washington, Seattle, WA, USA
| | - K R Schafer
- Internal Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - D S Batey
- Medicine, University of Alabama, Birmingham, AL, USA
| | - S Loo
- Fenway Community Health, Boston, MA, USA
| | - S Dougherty
- Medicine, University of Alabama, Birmingham, AL, USA
| | - W C Mathews
- Medicine, University of California, San Diego, CA, USA
| | | | - K H Mayer
- Fenway Community Health, Boston, MA, USA
| | - M J Mugavero
- Medicine, University of Alabama, Birmingham, AL, USA
| | - M M Kitahata
- Medicine, University of Washington, Seattle, WA, USA
| | - P K Crane
- Medicine, University of Washington, Seattle, WA, USA
| | - H M Crane
- Medicine, University of Washington, Seattle, WA, USA
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28
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Choi S, Mukherjee S, Gibbons LE, Sanders RE, Jones RN, Tommet D, Mez J, Trittschuh EH, Saykin A, Lamar M, Rabin L, Foldi NS, Sikkes S, Jutten RJ, Grandoit E, Mac Donald C, Risacher S, Groot C, Ossenkoppele R, Crane PK. Development and validation of language and visuospatial composite scores in ADNI. Alzheimers Dement (N Y) 2020; 6:e12072. [PMID: 33313380 PMCID: PMC7718716 DOI: 10.1002/trc2.12072] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Composite scores may be useful to summarize overall language or visuospatial functioning in studies of older adults. METHODS We used item response theory to derive composite measures for language (ADNI-Lan) and visuospatial functioning (ADNI-VS) from the cognitive battery administered in the Alzheimer's Disease Neuroimaging Initiative (ADNI). We evaluated the scores among groups of people with normal cognition, mild cognitive impairment (MCI), and Alzheimer's disease (AD) in terms of responsiveness to change, association with imaging findings, and ability to differentiate between MCI participants who progressed to AD dementia and those who did not progress. RESULTS ADNI-Lan and ADNI-VS were able to detect change over time and predict conversion from MCI to AD. They were associated with most of the pre-specified magnetic resonance imaging measures. ADNI-Lan had strong associations with a cerebrospinal fluid biomarker pattern. DISCUSSION ADNI-Lan and ADNI-VS may be useful composites for language and visuospatial functioning in ADNI.
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Affiliation(s)
- Seo‐Eun Choi
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Laura E. Gibbons
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Richard N. Jones
- Department of NeurologyBrown UniversityProvidenceRhode IslandUSA
| | - Douglas Tommet
- Department of NeurologyBrown UniversityProvidenceRhode IslandUSA
| | - Jesse Mez
- Department of NeurologyBoston UniversityBostonMassachusettsUSA
| | - Emily H. Trittschuh
- Department of PsychiatryUniversity of WashingtonSeattleWashingtonUSA
- Puget Sound Veterans AdministrationGeriatric Research Education and Clinical CenterVA Puget Sound Health Care SystemSeattleWashingtonUSA
| | - Andrew Saykin
- Department of Radiology and Alzheimer's Research CenterIndiana UniversityIndianapolisIndianaUSA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center and Department of Behavioral Sciences and PsychiatryRush University Medical CenterChicagoIllinoisUSA
| | - Laura Rabin
- Department of PsychologyCity University of New York–BrooklynNew YorkUSA
| | - Nancy S. Foldi
- Department of PsychologyCity University of New York–Queens CollegeNew YorkUSA
| | - Sietske Sikkes
- Alzheimer CenterAmsterdam UMC ‐ VU University Medical CenterAmsterdamthe Netherlands
| | - Roos J. Jutten
- Alzheimer CenterAmsterdam UMC ‐ VU University Medical CenterAmsterdamthe Netherlands
| | - Evan Grandoit
- Department of PsychologyNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Shannon Risacher
- Department of Radiology and Alzheimer's Research CenterIndiana UniversityIndianapolisIndianaUSA
| | - Colin Groot
- Alzheimer CenterAmsterdam UMC ‐ VU University Medical CenterAmsterdamthe Netherlands
| | - Rik Ossenkoppele
- Alzheimer CenterAmsterdam UMC ‐ VU University Medical CenterAmsterdamthe Netherlands
- Clinical Memory Research UnitLund UniversityLundSweden
| | | | - Paul K. Crane
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
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29
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Gibbons LE, Power MC, Walker RL, Kumar RG, Murphy A, Latimer CS, Melief EJ, Beller AE, Keene CD, Larson EB, Crane PK, Dams‐O'Connor K. Association of traumatic brain injury with late life neuropathological outcomes in a community‐based cohort. Alzheimers Dement 2020. [DOI: 10.1002/alz.041939] [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)
| | | | - Rod L Walker
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
| | - Raj G Kumar
- Icahn School of Medicine at Mount Sinai New York NY USA
| | - Alia Murphy
- George Washington University Milken Institute School of Public Health Washington DC USA
| | | | - Erica J Melief
- University of Washington School of Medicine Seattle WA USA
| | | | | | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
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30
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Choi S, Mukherjee S, Gibbons LE, Sanders RE, Jones RN, Tommet D, Mez J, Trittschuh EH, Saykin AJ, Lamar M, Rabin L, Foldi N, Sikkes SA, Jutten RJ, Grandoit E, MacDonald C, Risacher SL, Groot C, Ossenkoppele R, Crane PK. Development and validation of composite scores for language and visuospatial functioning in ADNI. Alzheimers Dement 2020. [DOI: 10.1002/alz.045508] [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: 11/08/2022]
Affiliation(s)
| | | | | | | | - Richard N. Jones
- Warren Alpert Medical School of Brown University Providence RI USA
| | - Douglas Tommet
- Warren Alpert Medical School Brown University Providence RI USA
| | - Jesse Mez
- Boston University Alzheimer's Disease Center Boston MA USA
| | | | | | | | - Laura Rabin
- Brooklyn College of the City, University of New York Brooklyn NY USA
| | | | | | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | | | - Colin Groot
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience VU University Medical Center Amsterdam Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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31
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Tommet D, Choi S, Rabin L, Sikkes SA, Jutten RJ, Grandoit E, Foldi N, Jones RN, Lamar M, Gibbons LE, Mukherjee S, Lee ML, Sanders RE, Saykin AJ, Trittschuh EH, Mez J, Risacher SL, Crane PK. Six‐month decline in language, but not other cognitive domains, identifies increased risk of conversion from MCI to AD in ADNI. Alzheimers Dement 2020. [DOI: 10.1002/alz.045357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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)
- Douglas Tommet
- Warren Alpert Medical School Brown University Providence RI USA
| | | | - Laura Rabin
- Brooklyn College of the City University of New York New York NY USA
| | | | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | - Richard N. Jones
- Warren Alpert Medical School of Brown University Providence RI USA
| | | | | | | | | | | | | | | | - Jesse Mez
- Boston University Alzheimer's Disease Center Boston MA USA
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32
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Lee CS, Lee ML, Gibbons LE, Larson EB, Crane PK. Retinal vascular occlusions are associated with increased risk for vascular dementia in
APOE
ε4 carriers in a community‐based cohort. Alzheimers Dement 2020. [DOI: 10.1002/alz.045563] [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)
| | | | | | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
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33
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Mukherjee S, Mez J, Trittschuh EH, Saykin AJ, Gibbons LE, Sanders RE, Fardo DW, Crane PK. Protein‐protein interaction networks of genes associated with different cognitively defined subtypes of late‐onset Alzheimer's disease in five white populations identify novel candidate genes. Alzheimers Dement 2020. [DOI: 10.1002/alz.045014] [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)
| | - Jesse Mez
- Boston University Alzheimer's Disease Center Boston MA USA
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34
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Lee CS, Gibbons LE, Lee ML, Lee AY, Yanagihara RT, Crane PK, Larson EB. Cataract surgery is associated with reduced risk for Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.044940] [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)
| | | | | | | | | | | | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
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35
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Mukherjee S, Fardo DW, Gibbons LE, Larson EB, Schneider JA, Montine TJ, Keene CD, De Jager PL, Bennett DA, Crane PK, Thornton TA. Genome‐wide association analysis of neurofibrillary tangle burden identifies novel risk loci in the adult changes of thought (ACT) and the religious orders study and memory and aging project (ROSMAP) autopsy cohorts. Alzheimers Dement 2020. [DOI: 10.1002/alz.043573] [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]
Affiliation(s)
| | | | | | - Eric B. Larson
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
| | - Julie A. Schneider
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA
| | | | | | | | - David A. Bennett
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA
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36
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Lee CS, Larson EB, Gibbons LE, Latimer CS, Rose SE, Hellstern LL, Keene CD, Crane PK. Ophthalmology-Based Neuropathology Risk Factors: Diabetic Retinopathy is Associated with Deep Microinfarcts in a Community-Based Autopsy Study. J Alzheimers Dis 2020; 68:647-655. [PMID: 30883356 DOI: 10.3233/jad-181087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 02/02/2023]
Abstract
BACKGROUND The aging eye offers unique opportunities to study and understand the aging brain, in particular related to Alzheimer's disease (AD) and dementia. However, little is known about relationships between eye diseases and dementia-related neurodegeneration. OBJECTIVE To determine the potential association between three age-related eye diseases and AD and dementia-related neuropathology. METHODS We reviewed autopsy data from the prospective longitudinal Adult Changes in Thought (ACT) cohort. ICD-9 codes were used to identify diagnoses of diabetic retinopathy, glaucoma, and age-related macular degeneration. Multivariate regression models were used to determine odds ratios (OR) of neuropathology features associated with dementia, including Braak stage, Consortium to Establish a Registry for AD (CERAD score), Lewy bodies, hippocampal sclerosis, and microvascular brain injury, in addition to quantitative paired helical filament (PHF)-tau levels for people with and without each eye condition. We also evaluated interactions between eye conditions and dementia related neuropathologic findings were evaluated. RESULTS 676 autopsies were included. Diabetic retinopathy was significantly associated with increased risk of deep cerebral microinfarcts (OR = 1.91 [95% confidence interval (CI) 1.11, 3.27], p = 0.02). No other significant association or interaction between eye diseases and neuropathology was found. When PHF-tau quantity was evaluated in 124 decedents, the OR for the association between PHF-tau in the occipital cortex and glaucoma was 1.36 (95% CI 0.91, 2.03, p = 0.13). No statistical correction was made for multiple comparisons. CONCLUSION Increased risk of deep cerebral microinfarcts was found in participants diagnosed with diabetic retinopathy. Eye diseases such as glaucoma may increase susceptibility to neurofibrillary tangles in the occipital cortex.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Laura E Gibbons
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Caitlin S Latimer
- Department of Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Shannon E Rose
- Department of Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Leanne L Hellstern
- Department of Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - C Dirk Keene
- Department of Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Paul K Crane
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Suemoto CK, Gibbons LE, Thacker EL, Jackson JD, Satizabal CL, Bettcher BM, Launer L, Phillips C, White LR, Power MC. Incident prolonged QT interval in midlife and late-life cognitive performance. PLoS One 2020; 15:e0229519. [PMID: 32097438 PMCID: PMC7041789 DOI: 10.1371/journal.pone.0229519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 02/08/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Measures of cardiac ventricular electrophysiology have been associated with cognitive performance in cross-sectional studies. We sought to evaluate the association of worsening ventricular repolarization in midlife, as measured by incident prolonged QT interval, with cognitive decline in late life. METHODS Midlife QT interval was assessed by electrocardiography during three study visits from 1965/68 to 1971/74 in a cohort of Japanese American men aged 46-68 at Exam 1 from the Honolulu Heart Study. We defined incident prolonged QT as the QT interval in the upper quartile at Exam 2 or 3 after QT interval in lower three quartiles at Exam 1. Cognitive performance was assessed at least once using the Cognitive Abilities Screening Instrument (CASI), scored using item response theory (CASI-IRT), during four subsequent visits from 1991/93 to 1999/2000 among 2,511 of the 4,737 men in the Honolulu-Asia Aging Study otherwise eligible for inclusion in analyses. We used marginal structural modeling to determine the association of incident prolonged QT with cognitive decline, using weighting to account for confounding and attrition. RESULTS Incident prolonged QT interval in midlife was not associated with late-life CASI-IRT at cognitive baseline (estimated difference in CASI-IRT: 0.04; 95% CI: -0.28, 0.35; p = 0.81), or change in CASI-IRT over time (estimated difference in annual change in CASI-IRT: -0.002; 95%CI: -0.013, 0.010; p = 0.79). Findings were consistent across sensitivity analyses. CONCLUSIONS Although many midlife cardiovascular risk factors and cardiac structure and function measures are associated with late-life cognitive decline, incident prolonged QT interval in midlife was not associated with late-life cognitive performance or cognitive decline.
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Affiliation(s)
- Claudia K. Suemoto
- Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
| | - Laura E. Gibbons
- Harborview Medical Center, University of Washington, Seattle, Washington, United States of America
| | - Evan L. Thacker
- Department of Public Health, Brigham Young University, Provo, Utah, United States of America
| | - Jonathan D. Jackson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Claudia L. Satizabal
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- UT Health San Antonio, San Antonio, Texas, United States of America
| | - Brianne M. Bettcher
- Departments of Neurosurgery and Neurology, Rocky Mountain Alzheimer’s Disease Center, University of Colorado Anschutz School of Medicine, Aurora, Colorado, United States of America
| | - Lenore Launer
- National Institute on Aging, Bethesda, Maryland, United States of America
| | - Caroline Phillips
- National Institute on Aging, Bethesda, Maryland, United States of America
| | - Lon R. White
- Departments of Medicine and Geriatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, United States of America
| | - Melinda C. Power
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute of Public Health, Washington, DC, United States of America
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Mukherjee S, Mez J, Trittschuh EH, Saykin AJ, Gibbons LE, Fardo DW, Wessels M, Bauman J, Moore M, Choi SE, Gross AL, Rich J, Louden DKN, Sanders RE, Grabowski TJ, Bird TD, McCurry SM, Snitz BE, Kamboh MI, Lopez OL, De Jager PL, Bennett DA, Keene CD, Larson EB, Crane PK. Correction: Genetic data and cognitively defined late-onset Alzheimer's disease subgroups. Mol Psychiatry 2020; 25:3100. [PMID: 30647434 PMCID: PMC7962581 DOI: 10.1038/s41380-019-0348-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article was originally published under standard licence, but has now been made available under a [CC BY 4.0] license. The PDF and HTML versions of the paper have been modified accordingly.
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Affiliation(s)
- Shubhabrata Mukherjee
- grid.34477.330000000122986657Department of Medicine, School of Medicine, University of Washington, Seattle, WA USA
| | - Jesse Mez
- grid.189504.10000 0004 1936 7558Department of Neurology, Boston University School of Medicine, Boston, MA USA
| | - Emily H. Trittschuh
- grid.34477.330000000122986657Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA USA ,grid.413919.70000 0004 0420 6540VA Puget Sound Health Care System, Seattle, WA USA
| | - Andrew J. Saykin
- grid.257413.60000 0001 2287 3919Department of Radiology, Indiana University, Indianapolis, IN USA
| | - Laura E. Gibbons
- grid.34477.330000000122986657Department of Medicine, School of Medicine, University of Washington, Seattle, WA USA
| | - David W. Fardo
- grid.266539.d0000 0004 1936 8438Department of Biostatistics, University of Kentucky, Lexington, KY USA
| | - Madeline Wessels
- grid.34477.330000000122986657College of Arts and Sciences, School of Nursing, University of Washington, Seattle, WA USA
| | - Julianna Bauman
- grid.34477.330000000122986657College of Arts and Sciences, School of Nursing, University of Washington, Seattle, WA USA
| | - Mackenzie Moore
- grid.34477.330000000122986657College of Arts and Sciences, School of Nursing, University of Washington, Seattle, WA USA
| | - Seo-Eun Choi
- grid.34477.330000000122986657Department of Medicine, School of Medicine, University of Washington, Seattle, WA USA
| | - Alden L. Gross
- grid.21107.350000 0001 2171 9311Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Joanne Rich
- grid.34477.330000000122986657Health Sciences Library, University Libraries, University of Washington, Seattle, WA USA
| | - Diana K. N. Louden
- grid.34477.330000000122986657Health Sciences Library, University Libraries, University of Washington, Seattle, WA USA
| | - R. Elizabeth Sanders
- grid.34477.330000000122986657Department of Medicine, School of Medicine, University of Washington, Seattle, WA USA
| | - Thomas J. Grabowski
- grid.34477.330000000122986657Department of Neurology, School of Medicine, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Radiology, School of Medicine, University of Washington, Seattle, WA USA
| | - Thomas D. Bird
- grid.413919.70000 0004 0420 6540VA Puget Sound Health Care System, Seattle, WA USA ,grid.34477.330000000122986657Department of Neurology, School of Medicine, University of Washington, Seattle, WA USA
| | - Susan M. McCurry
- grid.34477.330000000122986657Department of Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA USA
| | - Beth E. Snitz
- grid.21925.3d0000 0004 1936 9000Department of Neurology, University of Pittsburgh, Pittsburgh, PA USA
| | - M. Ilyas Kamboh
- grid.21925.3d0000 0004 1936 9000Departments of Human Genetics, University of Pittsburgh, Pittsburgh, PA USA
| | - Oscar L. Lopez
- grid.21925.3d0000 0004 1936 9000Department of Neurology, University of Pittsburgh, Pittsburgh, PA USA ,grid.21925.3d0000 0004 1936 9000Departments of Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
| | - Philip L. De Jager
- grid.239585.00000 0001 2285 2675Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Medical Center, New York, NY USA
| | - David A. Bennett
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL USA
| | - C. Dirk Keene
- grid.34477.330000000122986657Department of Pathology, School of Medicine, The University of Washington, Seattle, WA USA
| | - Eric B. Larson
- grid.34477.330000000122986657Department of Medicine, School of Medicine, University of Washington, Seattle, WA USA ,grid.488833.c0000 0004 0615 7519Kaiser Permanente Washington Health Research Institute, Seattle, WA USA
| | | | | | | | | | | | | | - Paul K. Crane
- grid.34477.330000000122986657Department of Medicine, School of Medicine, University of Washington, Seattle, WA USA
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Abstract
STUDY DESIGN A systematic search and review OBJECTIVE.: The aim of this study was to investigate the term, degenerative disc disease, to elucidate its current usage and inform clinical, research, and policy recommendations. SUMMARY OF BACKGROUND DATA Degenerative disc disease has long been a dominant concept in common, painful spinal disorders. Yet, despite its pervasiveness and important clinical consequences and controversies, there has not been a systematic examination of its use and meaning in the scientific literature. METHODS We conducted a systematic search of publications using the term degenerative disc disease from 2007 through 2016 in Ovid MEDLINE (R), Embase, CINAHL, and Scopus. Two investigators independently reviewed all publications in the primary sample. Publication and author identifiers, and qualitative study descriptors were extracted. Finally, the definition of degenerative disc disease was placed in one of eight categories. Data were summarized using descriptive statistics. RESULTS Degenerative disc disease appeared in the titles of 402 publications in the primary sample and increased in frequency by 189% from the first to the last 3 years of the decade. No single definition was used in the majority of publications, and most frequently, the term was used without any definition provided (30.1%). In other cases, degenerative disc disease specifically included radiculopathy or myelopathy (14.4%), or only back or neck pain (5.5%), or was equated with disc degeneration regardless of the presence of symptoms (15.4%), or with discogenic pain or disc degeneration as a presumed cause of axial pain (12.7%). Another 7.2% comprised a mix of broad ranging findings and diagnoses. The most notable differences in definitions occurred between surgeons and other disciplines, and when applied to cervical versus lumbar regions. CONCLUSION Despite longstanding use and important consequences, degenerative disc disease represents an underdeveloped concept, with greatly varying, disparate definitions documented. Such inconsistencies challenge clear, accurate communication in medicine and science, create confusion and misconceptions among clinicians, patients and others, and hinder the advancement of related knowledge. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Michele C Battié
- Faculty of Health Sciences & Western's Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Anand B Joshi
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC
| | - Laura E Gibbons
- Department of General Internal Medicine, University of Washington, Seattle, WA
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Bauman J, Gibbons LE, Moore M, Mukherjee S, McCurry SM, McCormick W, Bowen JD, Trittschuh E, Glymour M, Mez J, Saykin AJ, Dams-O’Conner K, Bennett DA, Larson EB, Crane PK. Associations Between Depression, Traumatic Brain Injury, and Cognitively-Defined Late-Onset Alzheimer’s Disease Subgroups. J Alzheimers Dis 2019; 70:611-619. [DOI: 10.3233/jad-181212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Julianna Bauman
- College of Arts and Sciences, University of Washington, Seattle, WA, USA
| | - Laura E. Gibbons
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Mackenzie Moore
- College of Arts and Sciences, University of Washington, Seattle, WA, USA
| | | | - Susan M. McCurry
- Department of Psychosocial and Community Health, University of Washington, Seattle, WA, USA
| | - Wayne McCormick
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - James D. Bowen
- Department of Neurology, Swedish Medical Center, Seattle, WA, USA
| | - Emily Trittschuh
- VA Puget Sound Health Care System, Geriatric Research Education and Clinical Center, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - Maria Glymour
- Department of Epidemiology and Biostatistics, University of San Francisco, San Francisco, CA, USA
| | - Jesse Mez
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences and the Indiana Alzheimer’s Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kristen Dams-O’Conner
- Department of Rehabilitation Medicine, Mt. Sinai Icahn School of Medicine, New York, NY, USA
| | | | - Eric B. Larson
- Kaiser Permenente Washington Health Research Institute, Seattle, WA, USA
| | - Paul K. Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
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Glymour MM, Gibbons LE, Gilsanz P, Gross AL, Mez J, Brewster PW, Marden J, Zahodne LB, Nho K, Hamilton J, Li G, Larson EB, Crane PK. Initiation of antidepressant medication and risk of incident stroke: using the Adult Changes in Thought cohort to address time-varying confounding. Ann Epidemiol 2019; 35:42-47.e1. [PMID: 31200987 PMCID: PMC8074509 DOI: 10.1016/j.annepidem.2019.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/02/2019] [Revised: 04/08/2019] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Depression strongly predicts stroke incidence, suggesting that treating depression may reduce stroke risk. Antidepressant medications, however, may increase stroke risk via direct pathways. Previous evidence on antidepressant medication and stroke incidence is mixed. We evaluated associations between antidepressant use and incident stroke. METHODS For 2302 Adult Changes in Thought cohort participants with no stroke at study entry, we characterized antidepressant use from pharmacy records, biennial depressive symptoms with a 10-item Centers for Epidemiologic Study-Depression scale, and incident strokes from ICD codes. We used discrete-time survival models with inverse probability weighting to compare stroke risk associated with filling antidepressant prescriptions and by medication category: tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors, or other. RESULTS Over an average 8.4-year follow-up, 441 incident strokes occurred. Filling antidepressant medications 3+ times versus 0-2 times predicted 35% increased odds of stroke (OR = 1.35; 95% CI: 0.98, 1.66). Use of TCAs was associated with stroke onset (OR per 10 fills = 1.28; CI: 1.04, 1.57), but use of selective serotonin reuptake inhibitors (OR = 0.98; CI: 0.80, 1.20) or other antidepressants (OR = 0.99; CI: 0.67, 1.45) was not. CONCLUSIONS Although patients who received antidepressant medication were at higher risk of stroke, this association appeared specific to TCA prescriptions.
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Affiliation(s)
- M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
| | - Laura E Gibbons
- Department of Medicine, University of Washington, Seattle, WA
| | | | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins University Center on Aging and Health, Baltimore, MD
| | - Jesse Mez
- Alzheimer's Disease and Chronic Traumatic Encephalopathy Center, Boston University School of Medicine, Boston, MA
| | - Paul W Brewster
- Institute on Aging & Lifelong Health and Department of Psychology, University of Victoria, Victoria BC
| | | | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI
| | - Kwangsik Nho
- Center for Neuroimaging, Center for Computational Biology and Bioinformatics, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN
| | - Jamie Hamilton
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY
| | - Gail Li
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA; Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA
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Sohi H, Gennari J, Madhyastha T, Lee BE, Risacher SL, MacDonald C, Groot C, Ossenkoppele R, Mez J, Trittschuh EH, Saykin AJ, Mukherjee S, Gibbons LE, Sanders RE, Choi SE, Crane PK. P1-361: REGIONAL DIFFERENCES IN CORTICAL THICKNESS ACROSS COGNITIVELY DEFINED ALZHEIMER'S DISEASE SUBGROUPS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.916] [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: 10/25/2022]
Affiliation(s)
| | | | | | - Briana E. Lee
- University of Washington Medical Center; Seattle WA USA
| | | | | | - Colin Groot
- Amsterdam Neuroscience, VU University Medical Center; Amsterdam UMC; Amsterdam Netherlands
| | | | - Jesse Mez
- Boston University School of Medicine; Boston MA USA
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Tremblay KL, Larson EB, Gibbons LE, Crane PK, Mohammed AB, Gates GA, Anderson ML, McCurry SM, Grabowski TJ. P3-580: CENTRAL AUDITORY DYSFUNCTION IS A STRONG PREDICTOR OF ALZHEIMER'S DISEASE: ADDITIONAL DATA FROM A PROSPECTIVE COHORT STUDY WITH EXTENSIVE FOLLOW-UP. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3617] [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: 11/28/2022]
Affiliation(s)
| | - Eric B.B. Larson
- Kaiser Permanente Washington Health Research Institute; Seattle WA USA
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Groot C, Risacher SL, Chen JQA, Saykin AJ, MacDonald C, Mez J, Trittschuh EH, Mukherjee S, Gibbons LE, Choi SE, Sanders RE, Dicks E, Barkhof F, Scheltens P, van der Flier WM, Crane PK, Ossenkoppele R. P3-422: FDG-PET REVEALS DISTINCT HYPOMETABOLIC TRAJECTORIES IN COGNITIVELY DEFINED SUBGROUPS OF ALZHEIMER'S DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3456] [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: 10/25/2022]
Affiliation(s)
- Colin Groot
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Netherlands
| | - Shannon L. Risacher
- Indiana Alzheimer Disease Center; Indianapolis IN USA
- Indiana University School of Medicine; Indianapolis IN USA
| | | | - Andrew J. Saykin
- Indiana Alzheimer Disease Center; Indianapolis IN USA
- Indiana University School of Medicine; Indianapolis IN USA
| | | | - Jesse Mez
- Boston University School of Medicine; Boston MA USA
| | - Emily H. Trittschuh
- University of Washington; Seattle WA USA
- VA Puget Sound Health Care System; Seattle WA USA
| | | | | | | | | | - Ellen Dicks
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Frederik Barkhof
- Institutes of Neurology and Healthcare Engineering; University College London; London United Kingdom
- Department of Radiology and Nuclear Medicine Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience; VU University Medical Center, Amsterdam UMC; Amsterdam Netherlands
- Department of Epidemiology and Biostatistics; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
- Department of Clinical Memory Research; Lund University; Lund Sweden
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Fredericksen RJ, Fitzsimmons E, Gibbons LE, Dougherty S, Loo S, Shurbaji S, Batey DS, Avendano-Soto S, Mathews WC, Christopoulos K, Mayer KH, Mugavero MJ, Crane PK, Crane HM. Development and content validation of the Multifactoral assessment of perceived social support (MAPSS), a brief, patient-reported measure of social support for use in HIV care. AIDS Care 2019; 31:1-9. [PMID: 31189333 DOI: 10.1080/09540121.2019.1612005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/26/2022]
Abstract
Low perceived social support (SS) negatively impacts health outcomes. We developed a measure of perceived SS for use in HIV care. We sought and categorized legacy items, selecting strongest items within categories. We elicited SS concepts from patients in English/Spanish, coded transcripts to match item pool content, and developed new items for salient unrepresented content. In focus groups, patients prioritized highly-matched items. We conducted cognitive interviews on high-priority items, and validity testing on final items against two legacy measures. From interviews (n = 32), we matched the following concepts: sense of belonging/inclusion; communication; emotional support; feeling accepted by others as a person; companionship; and practical support. We identified a new concept: support from friends/family in remaining healthy. Focus groups (n = 23) prioritized emotional support, communication, and support to remain healthy. Cognitive interviews (n = 30) found items were well-understood. The final 8-item measure performed well with patients (n = 708), with good construct validity. We used an Item Response Theory program to create a 3-item Short Form version of the measure, which captures 96% of patients indicating low social support. We developed the Multifactoral Assessment of Perceived Social Support (MAPSS) and Short Form (MAPSS-SF); brief, clinically relevant, sufficiently unidimensional measures of SS for use in HIV care.
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Affiliation(s)
| | | | - Laura E Gibbons
- Department of General Internal Medicine, University of Washington, Seattle, USA
| | | | | | - Sally Shurbaji
- 1917 Clinic, University of Alabama-Birmingham, Seattle, USA
| | - David S Batey
- Department of Social Work, University of Alabama-Birmingham, Seattle, USA
| | | | - William C Mathews
- Department of Medicine, University of California-San Diego, Seattle, USA
| | | | | | | | - Paul K Crane
- Department of General Internal Medicine, University of Washington, Seattle, USA
| | - Heidi M Crane
- Department of Medicine, University of Washington, Seattle, USA
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Latimer CS, Burke BT, Liachko NF, Currey HN, Kilgore MD, Gibbons LE, Henriksen J, Darvas M, Domoto-Reilly K, Jayadev S, Grabowski TJ, Crane PK, Larson EB, Kraemer BC, Bird TD, Keene CD. Resistance and resilience to Alzheimer's disease pathology are associated with reduced cortical pTau and absence of limbic-predominant age-related TDP-43 encephalopathy in a community-based cohort. Acta Neuropathol Commun 2019; 7:91. [PMID: 31174609 PMCID: PMC6556006 DOI: 10.1186/s40478-019-0743-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 02/07/2023] Open
Abstract
Alzheimer's disease neuropathologic change (ADNC) is defined by progressive accumulation of β-amyloid plaques and hyperphosphorylated tau (pTau) neurofibrillary tangles across diverse regions of brain. Non-demented individuals who reach advanced age without significant ADNC are considered to be resistant to AD, while those burdened with ADNC are considered to be resilient. Understanding mechanisms underlying ADNC resistance and resilience may provide important clues to treating and/or preventing AD associated dementia. ADNC criteria for resistance and resilience are not well-defined, so we developed stringent pathologic cutoffs for non-demented subjects to eliminate cases of borderline pathology. We identified 14 resistant (85+ years old, non-demented, Braak stage ≤ III, CERAD absent) and 7 resilient (non-demented, Braak stage VI, CERAD frequent) individuals out of 684 autopsies from the Adult Changes in Thought study, a long-standing community-based cohort. We matched each resistant or resilient subject to a subject with dementia and severe ADNC (Braak stage VI, CERAD frequent) by age, sex, year of death, and post-mortem interval. We expanded the neuropathologic evaluation to include quantitative approaches to assess neuropathology and found that resilient participants had lower neocortical pTau burden despite fulfilling criteria for Braak stage VI. Moreover, limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) was robustly associated with clinical dementia and was more prevalent in cases with high pTau burden, supporting the notion that resilience to ADNC may depend, in part, on resistance to pTDP-43 pathology. To probe for interactions between tau and TDP-43, we developed a C. elegans model of combined human (h) Tau and TDP-43 proteotoxicity, which exhibited a severe degenerative phenotype most compatible with a synergistic, rather than simply additive, interaction between hTau and hTDP-43 neurodegeneration. Pathways that underlie this synergy may present novel therapeutic targets for the prevention and treatment of AD.
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Verney SP, Gibbons LE, Dmitrieva NO, Kueider AM, Williams MW, Meyer OL, Manly JJ, Sisco SM, Marsiske M. Health literacy, sociodemographic factors, and cognitive training in the active study of older adults. Int J Geriatr Psychiatry 2019; 34:563-570. [PMID: 30548889 PMCID: PMC6557659 DOI: 10.1002/gps.5051] [Citation(s) in RCA: 20] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 12/09/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Health literacy is critical for understanding information from health-care providers and correct use of medications and includes the capacity to filter other information in navigating health care systems. Older adults with low health literacy exhibit more chronic health conditions, worse physical functioning, and poorer mental health. This study examined the relationship between sociodemographic variables and health literacy, and the impact of cognitive training on change in health literacy over 10 years in older adults. METHODS Participants (N = 2,802) aged 65 years and older completed assessments, including reading and numeracy health literacy items, as part of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. We evaluated baseline sociodemographic variables and change in health literacy over a 10-year period in individuals exposed to cognitive training in reasoning, processing speed, memory, or a no-contact control condition. RESULTS Age, sex, race, education level, and general cognitive functioning at baseline were all associated with baseline health literacy in older adults. Predictors of change in health literacy over the 10-year follow-up were age, race, education level, general cognitive functioning, and neighborhood income; disparities in health literacy because of race attenuated over time, while the effect of age increased over time. Health literacy was generally stable across the ACTIVE intervention groups over 10 years. CONCLUSIONS The present study showed important disparities in health literacy level and change over 10 years. Cognitive training did not significantly impact health literacy, suggesting that alternative approaches are needed to reduce the disparities.
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Affiliation(s)
- Steven P Verney
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Laura E Gibbons
- University of Washington, UW Medicine Memory and Brain Wellness Center Harborview Medical Center, Seattle, WA, USA
| | - Natalia O Dmitrieva
- Northern Arizona University, College of Social and Behavioral Sciences, Flagstaff, AZ, USA
| | - Alexandra M Kueider
- Department of Psychiatry and Behavioral Sciences, Duke University, Duke Institute for Brain Sciences, Durham, NC, USA
| | - Michael W Williams
- Johns Hopkins University School of Medicine, Department of Physical Medicine and Rehabilitation, Baltimore, MD, USA
| | - Oanh L Meyer
- Alzheimer's Disease Center Department of Neurology, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | | | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Abstract
A 49-year-old Caucasian woman presented with subacute headache and right eye pain associated with scotoma, blurred vision and photophobia. MRI was suggestive of optic neuritis of the right optic nerve and she was treated with steroids. Due to persistent symptoms, a lumbar puncture was performed and cerebrospinal fluid analysis was positive for venereal disease research laboratory and rapid plasma reagin titres. On further history, she recalled experiencing an illness associated with diffuse rash, likely secondary syphilis, 1-2 months prior. She tested negative for HIV. She was treated with intravenous penicillin for 2 weeks following which she experienced improvement in symptoms.
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Affiliation(s)
- Nathanial S Nolan
- Internal Medicine, University of Missouri Columbia School of Medicine, Columbia, Missouri, USA
| | - Laura E Gibbons
- Internal Medicine-Pediatrics, University of Missouri Columbia School of Medicine, Columbia, Missouri, USA
| | - Madihah A Hepburn
- Department of Neurology, University of Missouri Columbia School of Medicine, Columbia, Missouri, USA
| | - Ahmed Elkeeb
- Department of Ophthalmology, University of Missouri Columbia, Columbia, Missouri, USA
| | - Hariharan Regunath
- Department of Medicine, Divisions of Pulmonary, Critical Care Medicine and Infectious Diseases, Columbia, Missouri, USA
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49
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Fredericksen RJ, Yang FM, Gibbons LE, Edwards TC, Brown S, Fitzsimmons E, Alperovitz-Bichell K, Godfrey M, Wang A, Church A, Gutierrez C, Paez E, Dant L, Loo S, Walcott M, Mugavero MJ, Mayer KH, Mathews WC, Patrick DL, Crane PK, Crane HM. Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care. Res Social Adm Pharm 2018; 15:1168-1176. [PMID: 30327183 DOI: 10.1016/j.sapharm.2018.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 03/26/2018] [Revised: 09/26/2018] [Accepted: 10/04/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Providers are often unaware of poor adherence to prescribed medications for their patients with chronic diseases. OBJECTIVE To develop brief, computer-administered patient-reported measures in English and Spanish assessing adherence behaviors and barriers. Design, Participants, and Main Measures: Item pools were constructed from existing measures of medication adherence behaviors and barriers, which informed development of a patient concept elicitation interview guide to identify medication adherence behavior and barrier-related concepts. Two hundred six patients either living with HIV (PLWH) or without were interviewed. Interviews were coded, concepts matched to item pool content, and new items were developed for novel concepts. A provider/investigator team highlighted clinically relevant items. Cognitive interviews were conducted with patients on final candidate items (n = 37). The instruments were administered to 2081 PLWH. KEY RESULTS Behavioral themes from concept elicitation interviews included routines incorporating time of day, placement, visual cues, and intentionality to miss or skip doses. Barrier themes included health-related (e.g. depressed mood, feeling ill), attitudes/beliefs (e.g., need for medication), access (e.g., cost/insurance problems), and circumstantial barriers (e.g., lack of privacy, disruption of daily routine). The final instruments included 6 behavior items, and 1 barrier item with up to 23 response options. PLWH endorsed a mean (SD) of 3.5 (1.1) behaviors. The 201 PLWH who missed ≥2 doses in the previous week endorsed a mean (SD) of 3.1 (2.5) barriers. The intraclass correlation coefficient (ICC) for the numbers of behaviors endorsed in 61 PLWH after 4-16 days was 0.54 and for the number of barriers for the 20 PLWH with ≥2 missed doses the ICC was 0.89, representing fair and excellent test-retest reliability. CONCLUSION Measures of medication adherence behaviors and barriers were developed for use with patients living with chronic diseases focusing on clinical relevance, brevity, and content validity for use in clinical care.
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Affiliation(s)
- R J Fredericksen
- University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA.
| | - F M Yang
- Augusta University, 1120 15th Street Augusta, GA, 30912, USA
| | - L E Gibbons
- University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA
| | - T C Edwards
- University of Washington, Quality of Life Group, Box 359455, Seattle, WA, 98195, USA
| | - S Brown
- University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA
| | - E Fitzsimmons
- University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA
| | | | - M Godfrey
- Beaufort Jasper Hampton Comprehensive Health Services, 1520 Grays Highway, Ridgeland, SC, 29936, USA
| | - A Wang
- Chase Brexton Health Care, 5500 Knoll N Dr #370, Columbia, MD, 21045, USA
| | - A Church
- University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA
| | - C Gutierrez
- Fenway Community Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - E Paez
- University of California-San Diego, The Owen Clinic, 4168 Front Street, San Diego, CA, 92103, USA
| | - L Dant
- Fenway Community Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - S Loo
- Fenway Community Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - M Walcott
- University of Alabama-Birmingham, 1917 Clinic, Community Care Building, 908 South 20th Street, Birmingham, AL, 35294, USA
| | - M J Mugavero
- University of Alabama-Birmingham, 1917 Clinic, Community Care Building, 908 South 20th Street, Birmingham, AL, 35294, USA
| | - K H Mayer
- Fenway Community Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - W C Mathews
- University of California-San Diego, The Owen Clinic, 4168 Front Street, San Diego, CA, 92103, USA
| | - D L Patrick
- University of Washington, Quality of Life Group, Box 359455, Seattle, WA, 98195, USA
| | - P K Crane
- University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA
| | - H M Crane
- University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA
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50
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Fredericksen RJ, Mayer KH, Gibbons LE, Edwards TC, Yang FM, Walcott M, Brown S, Dant L, Loo S, Gutierrez C, Paez E, Fitzsimmons E, Wu AW, Mugavero MJ, Mathews WC, Lober WB, Kitahata MM, Patrick DL, Crane PK, Crane HM. Development and Content Validation of a Patient-Reported Sexual Risk Measure for Use in Primary Care. J Gen Intern Med 2018; 33:1661-1668. [PMID: 29845470 PMCID: PMC6153230 DOI: 10.1007/s11606-018-4496-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 10/09/2017] [Revised: 02/21/2018] [Accepted: 05/11/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patient-provider sexual risk behavior discussions occur infrequently but may be facilitated by high-quality sexual risk screening tools. OBJECTIVE To develop the Sexual Risk Behavior Inventory (SRBI), a brief computer-administered patient-reported measure. DESIGN Qualitative item development/quantitative instrument validation. PARTICIPANTS We developed SRBI items based on patient interviews (n = 128) at four geographically diverse US primary care clinics. Patients were diverse in gender identity, sex, sexual orientation, age, race/ethnicity, and HIV status. We compared sexual risk behavior identified by the SRBI and the Risk Assessment Battery (RAB) among patients (n = 422). APPROACH We constructed an item pool based on validated measures of sexual risk, developed an in-depth interview guide based on pool content, and used interviews to elicit new sexual risk concepts. We coded concepts, matched them to item pool content, and developed new content where needed. A provider team evaluated item clinical relevance. We conducted cognitive interviews to assess item comprehensibility. We administered the SRBI and the RAB to patients. KEY RESULTS Common, clinically relevant concepts in the SRBI included number of sex partners; partner HIV status; partner use of antiretroviral medication (ART)/pre-exposure prophylaxis (PrEP); and recent sex without barrier protection, direction of anal sex, and concern regarding HIV/STI exposure. While 90% reported inconsistent condom use on the RAB, same-day SRBI administration revealed that for over one third, all their partners were on ART/PrEP. CONCLUSION The SRBI is a brief, skip-patterned, clinically relevant measure that ascertains sexual risk behavior across sex, sexual orientation, gender identity, partner HIV serostatus, and partner treatment status, furnishing providers with context to determine gradations of risk for HIV/STI.
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Affiliation(s)
| | | | - Laura E Gibbons
- Center for AIDS Research, University of Washington, Seattle, WA, USA
| | - Todd C Edwards
- Center for AIDS Research, University of Washington, Seattle, WA, USA
| | | | | | - Sharon Brown
- Center for AIDS Research, University of Washington, Seattle, WA, USA
| | - Lydia Dant
- Fenway Community Health, Boston, MA, USA
| | | | | | - Edgar Paez
- University of California, San Diego, CA, USA
| | - Emma Fitzsimmons
- Center for AIDS Research, University of Washington, Seattle, WA, USA
| | - Albert W Wu
- Johns Hopkins University, Baltimore, MD, USA
| | | | | | - William B Lober
- Center for AIDS Research, University of Washington, Seattle, WA, USA
| | - Mari M Kitahata
- Center for AIDS Research, University of Washington, Seattle, WA, USA
| | - Donald L Patrick
- Center for AIDS Research, University of Washington, Seattle, WA, USA
| | - Paul K Crane
- Center for AIDS Research, University of Washington, Seattle, WA, USA
| | - Heidi M Crane
- Center for AIDS Research, University of Washington, Seattle, WA, USA
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