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Greig Custo MT, Lang MK, Barker WW, Gonzalez J, Vélez-Uribe I, Arruda F, Conniff J, Rodriguez MJ, Loewenstein DA, Duara R, Adjouadi M, Curiel RE, Rosselli M. The association of depression and apathy with Alzheimer's disease biomarkers in a cross-cultural sample. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:849-865. [PMID: 35764422 PMCID: PMC9930412 DOI: 10.1080/23279095.2022.2079414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Cross-cultural differences in the association between neuropsychiatric symptoms and Alzheimer's disease (AD) biomarkers are not well understood. This study aimed to (1) compare depressive symptoms and frequency of reported apathy across diagnostic groups of participants with normal cognition (CN), mild cognitive impairment (MCI), and dementia, as well as ethnic groups of Hispanic Americans (HA) and European Americans (EA); (2) evaluate the relationship between depression and apathy with Aβ deposition and brain atrophy. Statistical analyses included ANCOVAs, chi-squared, nonparametric tests, correlations, and logistic regressions. Higher scores on the Geriatric Depression Scale (GDS-15) were reported in the MCI and dementia cohorts, while older age corresponded with lower GDS-15 scores. The frequency of apathy differed across diagnoses within each ethnicity, but not when comparing ethnic groups. Reduced volume in the rostral anterior cingulate cortex (ACC) significantly correlated with and predicted apathy for the total sample after applying false discovery rate corrections (FDR), controlling for covariates. The EA group separately demonstrated a significant negative relationship between apathy and superior frontal volume, while for HA, there was a relationship between rostral ACC volume and apathy. Apathy corresponded with higher Aβ levels for the total sample and for the CN and HA groups.
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Affiliation(s)
- María T. Greig Custo
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
| | - Merike K. Lang
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Warren W. Barker
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
| | - Joanna Gonzalez
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Idaly Vélez-Uribe
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Fernanda Arruda
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Joshua Conniff
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | | | - David A. Loewenstein
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
| | - Malek Adjouadi
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
- Center for Advanced Technology and Education, College of Engineering, Florida International University, Miami, FL, USA
| | - Rosie E. Curiel
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Mónica Rosselli
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
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Perales-Puchalt J, Checa I, Espejo B, de la C Martín Carbonell M, Fracachán-Cabrera M, Baker C, Ramírez-Mantilla M, Mendez-Asaro P, Zimmer M, Williams K, Greiner KA, Zaudke J, Arreaza H, Velez-Uribe I, Moore H, Sepulveda-Rivera V, Meyer K, Benton D, Kittle K, Gillen L, Burns JM. Validation of dementia care-related scales among informal caregivers of Latinos with dementia or mild cognitive impairment. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.28.24312743. [PMID: 39252909 PMCID: PMC11383477 DOI: 10.1101/2024.08.28.24312743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
Objectives To test the psychometric properties of several dementia care-related scales among Latinos in the US. Design We leveraged secondary baseline data from a one-arm mHealth trial on dementia caregiver support. We included 100 responses for caregiver-focused scales and 88 responses for care recipient-focused scales. Scales included the Neuropsychiatric Inventory Questionnaire Severity and Distress scales, six-item Zarit Burden Inventory, Ten-item Center for Epidemiologic Studies Depression Scale, Geriatric Depression Inventory, Quality of Life in Alzheimer's Disease, and Single-item Satisfaction With Life Scale. We calculated concurrent validity using Pearson and Spearman correlations and expected correlations amongst all variables in line with the Stress Process Framework. We calculated internal consistency reliability using Cronbach's alpha. Results All concurrent validity correlations followed the expected directionality, with 19/21 inter-scale correlations in the total sample reaching statistical significance (p<0.05), and 17/21 reaching at least a low correlation (0.3). Cronbach's alpha ranged from 0.832 to 0.879 in all scales in the total sample. Conclusion The English and Spanish caregiver-administered scales tested in this manuscript have good psychometric properties. Clinical Implications The dementia care-related scales are now appropriately available for use among US Latinos in research and clinical contexts.
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Affiliation(s)
| | - Irene Checa
- Universitat de Valencia, Valencia, 46010; Spain
| | | | | | | | - Christina Baker
- University of Kansas Medical Center, Kansas City, KS 66160; USA
| | | | | | - Malissia Zimmer
- Alzheimer's Association, Central & Western Kansas; Wichita, KS 67213
| | | | - K Allen Greiner
- University of Kansas Medical Center, Kansas City, KS 66160; USA
| | | | - Hector Arreaza
- Clinica Sierra Vista, and Rio Bravo Family Medicine Residency Program, Bakersfield, CA 93306; USA
| | - Idaly Velez-Uribe
- Wien Center for Alzheimer's Disease and Memory Disorders, and Florida Alzheimer's Disease Research Center, Miami, FL 33140; USA
| | - Henry Moore
- University of Miami Miller School of Medicine; Miami, FL 33136; USA
| | | | - Kylie Meyer
- Case Western Reserve University, Cleveland, OH 44106; USA
| | - Donna Benton
- University of Southern California, Los Angeles, CA 90089; USA
| | - Krystal Kittle
- University of Massachusetts-Amherst, Amherst, MA 01003; USA
| | - Lindsey Gillen
- University of Kansas Alzheimer's Disease Research Center, Fairway, KS 66205
| | - Jeffrey M Burns
- University of Kansas Alzheimer's Disease Research Center, Fairway, KS 66205
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Medina V, Watts A, Fracachán-Cabrera M, Hazlewood C, Ramirez-Mantilla M, Vidoni ED, Perales-Puchalt J. Analysis of the intensity of engagement with CuidaTEXT, a text message intervention for dementia caregiver support among Latinos/as. ETHNICITY & HEALTH 2024:1-22. [PMID: 39107055 DOI: 10.1080/13557858.2024.2387111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 07/27/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVES To examine the associations between participant intensity of engagement with a text message intervention, CuidaTEXT, and socio-demographic factors, acceptability measures, and clinical outcomes among Latino/a caregivers of individuals with dementia. METHODS CuidaTEXT is a six-month, bilingual, and bidirectional intervention. We enrolled 24 Latino/a caregivers in a one-arm feasibility trial. Participants received approximately one automatic daily text message and could engage with the intervention by texting specific keywords (e.g. STRESS to receive messages about stress-coping), and by chat-texting with a live coach. We used metrics and psychometric scales to quantify variables. RESULTS Participants sent a total of 1847 messages to CuidaTEXT. Higher intensity of engagement was associated with higher intervention satisfaction (r = 0.6, p = 0.007), as were several other acceptability outcomes. We found no associations between intensity of engagement with CuidaTEXT and sociodemographic or clinical outcomes (p > 0.05). CONCLUSION Encouraging more intense engagement with CuidaTEXT might lead to higher levels of satisfaction with the intervention. However, it is possible that those who are highly satisfied, engage more intensely with CuidaTEXT. Future research should determine the directionality of these associations to optimize text message interventions. CLINICAL IMPLICATIONS Creating more opportunities to increase the intensity of text message engagement with caregiver support interventions may improve caregiver satisfaction with them.
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Affiliation(s)
- Valerie Medina
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Amber Watts
- Department of Psychology, University of Kansas, Lawrence, KS, USA
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
| | | | - Cameo Hazlewood
- Internal Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Eric D Vidoni
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
| | - Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
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Rodriguez MJ, Mendoza L, Garcia P, Duarte A, Padron D, Marsiske M, Fiala J, Gonzalez J, Duara R. Functional measures and AD biomarkers among Hispanic and White non-Hispanic older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12632. [PMID: 39130803 PMCID: PMC11316142 DOI: 10.1002/dad2.12632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 07/04/2024] [Accepted: 07/14/2024] [Indexed: 08/13/2024]
Abstract
INTRODUCTION Poorer baseline functioning is associated with long-term cognitive decline among Hispanic older adults, but little is known about associations of these factors with Alzheimer's disease (AD) neuroimaging biomarkers. METHODS A total of 461 Hispanic and White non-Hispanic (NHW) older adults who are cognitively normal (n = 76), had impaired cognition without mild cognitive impairment (MCI) (n = 41), or carried a diagnosis of MCI (n = 253) or dementia (n = 91) completed neuropsychological and functional assessment, genetic testing, and brain magnetic resonance imaging (MRI). Structural equation modeling (SEM) was used to examine predictive associations between functional and cognitive measures of AD neuroimaging biomarkers. RESULTS MRI volumes significantly predicted functional limitations in both groups. Sex and amyloid load significantly predicted functional limitations among the Hispanic group only. Years of education and MRI regional volume were the strongest predictors of cognition among both groups. DISCUSSION Results indicate that functional performance is associated with early AD biomarkers among Hispanic older adults. Clinical implications are discussed. Highlights The current study addresses health disparities in Alzheimer's disease (AD) and related dementia assessment among Hispanics by identifying measures sensitive to early AD biomarkers.Associations of functional measures with AD genetic and neuroimaging biomarkers revealed that similarities in these associations exist between Hispanic and White non-Hispanic individuals, but biological sex and amyloid load significantly predicted functional limitations among the Hispanic group only.These results have clinical implications for physicians who treat Hispanic AD patients and indicate that when compared to traditional diagnostic assessments, functional assessments may better aid in AD diagnostic precision among Hispanics.
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Affiliation(s)
- Miriam J. Rodriguez
- Albizu University‐Miami CampusDoralFloridaUSA
- Indiana University‐BloomingtonBloomingtonIndianaUSA
| | | | | | | | - Dilianna Padron
- Albizu University‐Miami CampusDoralFloridaUSA
- Central Virginia VA Healthcare SystemRichmondVirginiaUSA
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Graves LV, Conaway Z, Weberg M, Lozano J, Mercer E, Larry M, Vergonia L. Sex-based dyad differences on informant reports of participants' daily functioning. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-9. [PMID: 38842328 DOI: 10.1080/23279095.2024.2362744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Functional assessment in neurocognitive evaluation is often provided via informant reports. These subjective reports can vary based on the characteristics of informants and their relationships with participants, such as informant sex. However, whether informant sex intersects with participant sex to impact subjective ratings of participants' daily functioning, and whether such effects mirror observed patterns in neuropsychological performance, has not been adequately examined with ethnoracially diverse samples. We examined differences among participant-informant sex-based dyads on subjective informant reports of participants' daily functioning (assessed via the Functional Activities Questionnaire [FAQ]), and whether any observed differences on reported functioning corresponded to differences in objective participant performance on neuropsychological performance, among middle-aged and older Hispanic/Latino (n = 543), non-Hispanic Black (NHB; n = 1030), and non-Hispanic White (NHW; n = 5356) adults in the National Alzheimer's Coordinating Center cohort (n = 6929). Analysis of covariance (ANCOVA) tests revealed significant dyad differences on FAQ scores in the NHB (p<.001) and NHW subsamples (p<.05), but not in the Hispanic/Latino subsample (p>.05). For the Hispanic/Latino and NHB subsamples, ANCOVA tests revealed no significant effects of dyad on neuropsychological performance (ps>.01), whereas for the NHW subsample, ANCOVA tests revealed significant dyad differences on performance in multiple cognitive domains (ps<.01). Nevertheless, the pattern of dyad differences on neuropsychological performance did not mirror the pattern of observed differences on FAQ scores in the NHW subsample. Findings and their implications, including potential contributions of other informant characteristics on observed dyad differences on reported functioning, are discussed.
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Affiliation(s)
- Lisa V Graves
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Zachary Conaway
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Mathilde Weberg
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Jennifer Lozano
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Elizabeth Mercer
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Maiya Larry
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Lorraine Vergonia
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
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Vélez-Uribe I, Rosselli M, Newman D, Gonzalez J, Gonzalez Pineiro Y, Barker WW, Marsiske M, Fiala J, Lang MK, Conniff J, Ahne E, Goytizolo A, Loewenstein DA, Curiel RE, Duara R. Cross-cultural Diagnostic Validity of the Multilingual Naming Test (MINT) in a Sample of Older Adults. Arch Clin Neuropsychol 2024; 39:464-481. [PMID: 38123477 DOI: 10.1093/arclin/acad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/06/2023] [Accepted: 11/11/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE We aimed to evaluate the psychometric properties and diagnostic accuracy of the 32-item version of the Multilingual Naming Test (MINT) in participants from 2 ethnic groups (European Americans [EA; n = 106] and Hispanic Americans [HA; n = 175]) with 3 diagnostic groups (cognitively normal [CN], n = 94, mild cognitive impairment [MCI], n = 148, and dementia, n = 39). METHOD An Item Response Theory model was used to evaluate items across ethnicity and language groups (Spanish and English), resulting in a 24-item version. We analyzed the MINT discriminant and predictive validity across diagnostic groups. RESULTS A total of 8 items were differentially difficult between languages in the 32-item version of the MINT. EA scored significantly higher than HA, but the difference was not significant when removing those 8 items (controlling for Education). The Receiver Operating Characteristics showed that the MINT had poor accuracy when identifying CN participants and was acceptable in identifying dementia participants but unacceptable in classifying MCI participants. Finally, we tested the association between MINT scores and magnetic resonance imaging volumetric measures of language-related areas in the temporal and frontal lobes. The 32-item MINT in English and Spanish and the 24-item MINT in Spanish were significantly correlated with the bilateral middle temporal gyrus. The left fusiform gyrus correlated with MINT scores regardless of language and MINT version. We also found differential correlations depending on the language of administration. CONCLUSIONS Our results highlight the importance of analyzing cross-cultural samples when implementing clinical neuropsychological tests such as the MINT.
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Affiliation(s)
- Idaly Vélez-Uribe
- Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Mónica Rosselli
- Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - David Newman
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Joanna Gonzalez
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Yaimara Gonzalez Pineiro
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Warren W Barker
- Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Michael Marsiske
- Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Jacob Fiala
- Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Merike K Lang
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Joshua Conniff
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Emily Ahne
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Alicia Goytizolo
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - David A Loewenstein
- Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Rosie E Curiel
- Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjan Duara
- Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
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Conca F, Esposito V, Catricalà E, Manenti R, L'Abbate F, Quaranta D, Giuffrè GM, Rossetto F, Solca F, Orso B, Inguscio E, Crepaldi V, De Matteis M, Rotondo E, Manera M, Caruso G, Catania V, Canu E, Rundo F, Cotta Ramusino M, Filippi M, Fundarò C, Piras F, Arighi A, Tiraboschi P, Stanzani Maserati M, Pardini M, Poletti B, Silani V, Marra C, Di Tella S, Cotelli M, Lodi R, Tagliavini F, Cappa SF. Clinical validity of the Italian adaptation of the Uniform Data Set Neuropsychological Test Battery (I-UDSNB) in Mild Cognitive Impairment and Alzheimer's Disease. Alzheimers Res Ther 2024; 16:98. [PMID: 38704608 PMCID: PMC11069160 DOI: 10.1186/s13195-024-01465-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The identification and staging of Alzheimer's Disease (AD) represent a challenge, especially in the prodromal stage of Mild Cognitive Impairment (MCI), when cognitive changes can be subtle. Worldwide efforts were dedicated to select and harmonize available neuropsychological instruments. In Italy, the Italian Network of Neuroscience and Neuro-Rehabilitation has promoted the adaptation of the Uniform Data Set Neuropsychological Test Battery (I-UDSNB), collecting normative data from 433 healthy controls (HC). Here, we aimed to explore the ability of I-UDSNB to differentiate between a) MCI and HC, b) AD and HC, c) MCI and AD. METHODS One hundred thirty-seven patients (65 MCI, 72 AD) diagnosed after clinical-neuropsychological assessment, and 137 HC were included. We compared the I-UDSNB scores between a) MCI and HC, b) AD and HC, c) MCI and AD, with t-tests. To identify the test(s) most capable of differentiating between groups, significant scores were entered in binary logistic and in stepwise regressions, and then in Receiver Operating Characteristic curve analyses. RESULTS Two episodic memory tests (Craft Story and Five Words test) differentiated MCI from HC subjects; Five Words test, Semantic Fluency (vegetables), and TMT-part B differentiated AD from, respectively, HC and MCI. CONCLUSIONS Our findings indicate that the I-UDSNB is a suitable tool for the harmonized and concise assessment of patients with cognitive decline, showing high sensitivity and specificity for the diagnosis of MCI and AD.
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Affiliation(s)
- Francesca Conca
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, Pavia, Italy
| | | | - Eleonora Catricalà
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, Pavia, Italy.
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federica L'Abbate
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Davide Quaranta
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Guido Maria Giuffrè
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | | - Federica Solca
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | | | | | | | - Emanuela Rotondo
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marina Manera
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit Pavia-Montescano, Pavia Institute, Pavia, Italy
| | - Giulia Caruso
- Neuropsychiatric Laboratory, Clinical Neuroscience and Neurorehabilitation Department, IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, Neurophysiology Service, Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Cira Fundarò
- Istituti Clinici Scientifici Maugeri IRCCS, Neurophysiopatology Unit Pavia-Montescano, Pavia Institute, Pavia, Italy
| | - Federica Piras
- Neuropsychiatric Laboratory, Clinical Neuroscience and Neurorehabilitation Department, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Andrea Arighi
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- "Dino Ferrari" Center, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Camillo Marra
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Sonia Di Tella
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Stefano Francesco Cappa
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
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Graves LV, Beacham D, Sawitzky N, Lozano J, Weberg M, Reyes K, Vergonia L, Santana A, Hernandez E, Sarsar D, Conaway Z. Informant sex/gender moderates associations between reported functioning and memory performance in Mexican American adults. Clin Neuropsychol 2024; 38:715-737. [PMID: 37571992 DOI: 10.1080/13854046.2023.2246669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/05/2023] [Indexed: 08/14/2023]
Abstract
Objective: In neuropsychological evaluations, assessing cognitive functioning is often achieved using objective neuropsychological measures, whereas subjective informant reports are typically obtained to determine manifest daily functioning. Informant reports of participant functioning and their associations with objective participant performance on neuropsychological testing have been shown to vary based on informant characteristics. However, associations among informant characteristics, reported functioning, and neuropsychological performance have not been adequately examined with Mexican American or other Hispanic/Latino samples, despite these populations' disproportionately higher rates of dementia due to Alzheimer's disease and related disorders. Method: We examined associations of informant characteristics with informant reports of participant functioning (assessed via the Functional Activities Questionnaire [FAQ]), and potential moderating effects of these characteristics on associations between reported functioning and participant performance on neuropsychological testing, for Mexican American adult participants in the National Alzheimer's Coordinating Center cohort (n = 294). Results: Female informants reported significantly worse participant functioning compared to male informants (p = .035, r = .126). Moreover, significant associations between reported functioning and memory performance were observed for participants with female informants, but not for those with male informants (p = .024, r = .138). Higher levels of informant education were associated with significantly worse participant functioning (p = .011, r = .151). However, informant education did not moderate associations between reported functioning and neuropsychological performance (ps > .05). Conclusions: Compared to male informants, female informants may provide subjective reports of Mexican American participant functioning that more closely corroborate objective participant performance in memory.
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Affiliation(s)
- Lisa V Graves
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Dora Beacham
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Nicole Sawitzky
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Jennifer Lozano
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Mathilde Weberg
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Karissa Reyes
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Lorraine Vergonia
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Ashley Santana
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Ezekiel Hernandez
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Darya Sarsar
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Zachary Conaway
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
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Perales-Puchalt J, Ramírez-Mantilla M, Fracachán-Cabrera M, Vidoni ED, Ellerbeck EF, Ramírez AS, Watts A, Williams K, Burns J. A text message intervention to support latino dementia family caregivers (CuidaTEXT): feasibility study. Clin Gerontol 2024; 47:50-65. [PMID: 36268684 PMCID: PMC10119327 DOI: 10.1080/07317115.2022.2137449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To test the feasibility, acceptability, and preliminary efficacy of CuidaTEXT: a bidirectional text message intervention to support Latino dementia family caregivers. METHODS CuidaTEXT is a six-month, bilingual intervention tailored to caregiver needs (e.g., education, problem-solving, resources). We used convenience sampling and reached 31 potential participants via clinics, registries, community promotion, and online advertising. We enrolled 24 Latino caregivers in a one-arm trial and assessed feasibility, acceptability, and preliminary efficacy within six months. RESULTS None of the participants unsubscribed from CuidaTEXT and 83.3% completed the follow up survey. Most participants (85.7%) reported reading most text messages thoroughly. All participants reported being very or extremely satisfied with the intervention. Participants reported that CuidaTEXT helped a lot (vs not at all, a little, or somehow) in caring for their care recipient (71.4%; n = 15), for themselves (66.7%; n = 14), and understanding more about dementia (85.7%; n = 18). Compared to baseline, at six months caregiver behavioral symptom distress (0-60) decreased from 19.8 to 12.0 and depression (0-30) from 8.8 to 5.4 (p < .05). CONCLUSIONS CuidaTEXT demonstrated high levels of feasibility, acceptability, and preliminary efficacy among Latino caregivers. CLINICAL IMPLICATIONS CuidaTEXT's feasibility and potential for widespread implementation holds promise in supporting Latino caregivers of people with dementia.
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Affiliation(s)
- Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- Department of Population Health, University of Kansas Medical Center, Kansas, Kansas, USA
| | | | | | - Eric D Vidoni
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- Department of Population Health, University of Kansas Medical Center, Kansas, Kansas, USA
| | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas, Kansas, USA
| | - A Susana Ramírez
- Department of Public Health, University of California, Merced, California, USA
| | - Amber Watts
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Kristine Williams
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- School of Nursing, University of Kansas Medical Center, Kansas, Kansas, USA
| | - Jeffrey Burns
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- Department of Population Health, University of Kansas Medical Center, Kansas, Kansas, USA
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10
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Arruda F, Rosselli M, Mejia Kurasz A, Loewenstein DA, DeKosky ST, Lang MK, Conniff J, Vélez-Uribe I, Ahne E, Shihadeh L, Adjouadi M, Goytizolo A, Barker WW, Curiel RE, Smith GE, Duara R. Stability in cognitive classification as a function of severity of impairment and ethnicity: A longitudinal analysis. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-14. [PMID: 37395391 DOI: 10.1080/23279095.2023.2222861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE The interaction of ethnicity, progression of cognitive impairment, and neuroimaging biomarkers of Alzheimer's Disease remains unclear. We investigated the stability in cognitive status classification (cognitively normal [CN] and mild cognitive impairment [MCI]) of 209 participants (124 Hispanics/Latinos and 85 European Americans). METHODS Biomarkers (structural MRI and amyloid PET scans) were compared between Hispanic/Latino and European American individuals who presented a change in cognitive diagnosis during the second or third follow-up and those who remained stable over time. RESULTS There were no significant differences in biomarkers between ethnic groups in any of the diagnostic categories. The frequency of CN and MCI participants who were progressors (progressed to a more severe cognitive diagnosis at follow-up) and non-progressors (either stable through follow-ups or unstable [progressed but later reverted to a diagnosis of CN]) did not significantly differ across ethnic groups. Progressors had greater atrophy in the hippocampus (HP) and entorhinal cortex (ERC) at baseline compared to unstable non-progressors (reverters) for both ethnic groups, and more significant ERC atrophy was observed among progressors of the Hispanic/Latino group. For European Americans diagnosed with MCI, there were 60% more progressors than reverters (reverted from MCI to CN), while among Hispanics/Latinos with MCI, there were 7% more reverters than progressors. Binomial logistic regressions predicting progression, including brain biomarkers, MMSE, and ethnicity, demonstrated that only MMSE was a predictor for CN participants at baseline. However, for MCI participants at baseline, HP atrophy, ERC atrophy, and MMSE predicted progression.
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Affiliation(s)
- Fernanda Arruda
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Mónica Rosselli
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
| | - Andrea Mejia Kurasz
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - David A Loewenstein
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Steven T DeKosky
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Merike K Lang
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Joshua Conniff
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Idaly Vélez-Uribe
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Emily Ahne
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Layaly Shihadeh
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Malek Adjouadi
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Center for Advanced Technology and Education, College of Engineering, Florida International University, Miami, FL, USA
| | - Alicia Goytizolo
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Warren W Barker
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Rosie E Curiel
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Glenn E Smith
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - Ranjan Duara
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
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11
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Conca F, Esposito V, Rundo F, Quaranta D, Muscio C, Manenti R, Caruso G, Lucca U, Galbussera AA, Di Tella S, Baglio F, L'Abbate F, Canu E, Catania V, Filippi M, Mattavelli G, Poletti B, Silani V, Lodi R, De Matteis M, Stanzani Maserati M, Arighi A, Rotondo E, Tanzilli A, Pace A, Garramone F, Cavaliere C, Pardini M, Rizzetto C, Sorbi S, Perri R, Tiraboschi P, Canessa N, Cotelli M, Ferri R, Weintraub S, Marra C, Tagliavini F, Catricalà E, Cappa SF. Italian adaptation of the Uniform Data Set Neuropsychological Test Battery (I-UDSNB 1.0): development and normative data. Alzheimers Res Ther 2022; 14:113. [PMID: 35982477 PMCID: PMC9389755 DOI: 10.1186/s13195-022-01056-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neuropsychological testing plays a cardinal role in the diagnosis and monitoring of Alzheimer's disease. A major concern is represented by the heterogeneity of the neuropsychological batteries currently adopted in memory clinics and healthcare centers. The current study aimed to solve this issue. METHODS Following the initiative of the University of Washington's National Alzheimer's Coordinating Center (NACC), we presented the Italian adaptation of the Neuropsychological Test Battery of the Uniform Data Set (I-UDSNB). We collected data from 433 healthy Italian individuals and employed regression models to evaluate the impact of demographic variables on the performance, deriving the reference norms. RESULTS Higher education and lower age were associated with a better performance in the majority of tests, while sex affected only fluency tests and Digit Span Forward. CONCLUSIONS The I-UDSNB offers a valuable and harmonized tool for neuropsychological testing in Italy, to be used in clinical and research settings.
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Affiliation(s)
| | | | - Francesco Rundo
- Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
| | - Davide Quaranta
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Cristina Muscio
- Present address: ASST Bergamo Ovest, Treviglio, Italy
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Rosa Manenti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giulia Caruso
- Laboratory of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessia Antonella Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | | | - Federica L'Abbate
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valentina Catania
- Unit of Psychology I.C., Oasi Research Institute-IRCCS, Troina, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giulia Mattavelli
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli studi di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli studi di Milano, Milan, Italy
| | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | | | - Andrea Arighi
- Fondazione IRCSS ca' Granda, Ospedale Policlinico, Milan, Italy
| | | | - Antonio Tanzilli
- Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Pace
- Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Matteo Pardini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Cristiano Rizzetto
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy
| | - Roberta Perri
- Laboratory of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Nicola Canessa
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | - Maria Cotelli
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Raffaele Ferri
- Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease and Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Camillo Marra
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | | - Eleonora Catricalà
- IRCCS Mondino Foundation, Pavia, Italy
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100, Pavia, Italy
| | - Stefano Francesco Cappa
- IRCCS Mondino Foundation, Pavia, Italy.
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100, Pavia, Italy.
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Mendoza L, Garcia P, Duara R, Rosselli M, Loewenstein D, Greig-Custo MT, Barker W, Dahlin P, Rodriguez MJ. The effect of acculturation on cognitive performance among older Hispanics in the United States. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:163-171. [PMID: 32116033 DOI: 10.1080/23279095.2020.1725888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The effect of acculturation on cognition was examined among 142 older Hispanics: cognitively normal [CN; n = 70], Mild Cognitive Impairment, amnestic [aMCI; n = 27], and Dementia [D; n = 45]. Acculturation levels (high vs. low) were determined using the Short Acculturation Scale for Hispanics (SASH). ANCOVAs used a wide variety of neuropsychological tests as independent variables controlling for age and education. Among CN subjects, the highly acculturated group performed better on Logical Memory delayed recall (LM-II) [F(1, 56) = 9.26, p < .001, η p 2 = 0.14], Digit Span Forward [F(1, 56) = 4.37, p < .05, η p 2 = 0.07], Trail Making Test A [F(1, 56) = 7.74, p < .05, η p 2 = 0.12], and Trail Making Test B [F(1, 56) = 4.66, p = .03, η p 2 = 0.08], indicating that high acculturation was associated with a better performance on tests of episodic memory, auditory attention, working memory, cognitive flexibility, and processing speed among CN Hispanics. ANCOVA analyses were not significant among the other groups. In the absence of acculturation scales in clinical practice, caution should be exerted when interpreting neurocognitive results.
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Affiliation(s)
- Lisandra Mendoza
- Albizu University-Miami Campus, Psychology Doctoral Program, Miami, FL, USA
| | - Patricia Garcia
- Jackson Memorial Hospital, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Ranjan Duara
- Mount Sinai Medical Center, Wien Center for Alzheimer's Disease and Memory Disorders, Miami Beach, FL, USA
| | - Mónica Rosselli
- Department of Psychology, Charles E. Schmidt College of Medicine, Florida Atlantic University, Davie, FL, USA
| | - David Loewenstein
- Mount Sinai Medical Center, Wien Center for Alzheimer's Disease and Memory Disorders, Miami Beach, FL, USA
- University of Miami and Center on Aging, Miller School of Medicine, Miami, FL, USA
| | - Maria T Greig-Custo
- Mount Sinai Medical Center, Wien Center for Alzheimer's Disease and Memory Disorders, Miami Beach, FL, USA
| | - Warren Barker
- Mount Sinai Medical Center, Wien Center for Alzheimer's Disease and Memory Disorders, Miami Beach, FL, USA
| | - Pamela Dahlin
- Albizu University-Miami Campus, Psychology Doctoral Program, Miami, FL, USA
| | - Miriam J Rodriguez
- Albizu University-Miami Campus, Psychology Doctoral Program, Miami, FL, USA
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13
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Gullett JM, Albizu A, Fang R, Loewenstein DA, Duara R, Rosselli M, Armstrong MJ, Rundek T, Hausman HK, Dekosky ST, Woods AJ, Cohen RA. Baseline Neuroimaging Predicts Decline to Dementia From Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2021; 13:758298. [PMID: 34950021 PMCID: PMC8691733 DOI: 10.3389/fnagi.2021.758298] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/01/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Objectives: Prediction of decline to dementia using objective biomarkers in high-risk patients with amnestic mild cognitive impairment (aMCI) has immense utility. Our objective was to use multimodal MRI to (1) determine whether accurate and precise prediction of dementia conversion could be achieved using baseline data alone, and (2) generate a map of the brain regions implicated in longitudinal decline to dementia. Methods: Participants meeting criteria for aMCI at baseline (N = 55) were classified at follow-up as remaining stable/improved in their diagnosis (N = 41) or declined to dementia (N = 14). Baseline T1 structural MRI and resting-state fMRI (rsfMRI) were combined and a semi-supervised support vector machine (SVM) which separated stable participants from those who decline at follow-up with maximal margin. Cross-validated model performance metrics and MRI feature weights were calculated to include the strength of each brain voxel in its ability to distinguish the two groups. Results: Total model accuracy for predicting diagnostic change at follow-up was 92.7% using baseline T1 imaging alone, 83.5% using rsfMRI alone, and 94.5% when combining T1 and rsfMRI modalities. Feature weights that survived the p < 0.01 threshold for separation of the two groups revealed the strongest margin in the combined structural and functional regions underlying the medial temporal lobes in the limbic system. Discussion: An MRI-driven SVM model demonstrates accurate and precise prediction of later dementia conversion in aMCI patients. The multi-modal regions driving this prediction were the strongest in the medial temporal regions of the limbic system, consistent with literature on the progression of Alzheimer's disease.
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Affiliation(s)
- Joseph M. Gullett
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Alejandro Albizu
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Ruogu Fang
- Clayton J. Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - David A. Loewenstein
- Center for Cognitive Neuroscience and Aging, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ranjan Duara
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Monica Rosselli
- Department of Psychology, Florida Atlantic University, Davie, FL, United States
| | | | - Tatjana Rundek
- Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Hanna K. Hausman
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Steven T. Dekosky
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Adam J. Woods
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Ronald A. Cohen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
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Li L, Cheng GR, Liu D, Hu FF, Gan XG, Zhang B, An L, Chen C, Zou MJ, Xu L, Ou YM, Chen YS, Li JQ, Wei Z, Wu Q, Chen XX, Guo MQ, Wu QM, Wang R, Zeng Y. The Hubei Memory and Aging Cohort Study: Study Design, Baseline Characteristics, and Prevalence of Cognitive Impairments. J Alzheimers Dis 2021; 85:561-571. [PMID: 34842190 DOI: 10.3233/jad-215129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite the improved access to health services in China, inadequate diagnosis and management of dementia are common issues, especially in rural regions. OBJECTIVE The Hubei Memory & Aging Cohort Study was designed as a prospective study in Central China to determine the prevalence, incidence, and risk factors for dementia and mild cognitive impairment (MCI) among urban and rural older adults. METHODS From 2018-2020, participants aged ≥65 years were screened, and data regarding their life behaviors, families, socio-economic status, physical and mental health, social and psychological factors, and cognition were collected. Diagnoses of MCI and dementia were made via consensus diagnosis using the Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria. RESULTS Of 8,221 individuals who completed their baseline clinical evaluation, 4,449 (54.1%) were women and 3,164 (38.4%) were from remote rural areas (average age: 71.96 years; mean education period: 7.58 years). At baseline, 25.98%(95%confidence interval [CI]: 24.99-26.96) and 7.24%(95%CI: 6.68-7.80) of the participants were diagnosed with MCI and dementia, respectively. Prevalence showed a strong relationship with age. The substantial disparities between rural and urban regions in MCI and dementia prevalence and multiple dementia-related risk factors were revealed. Especially for dementia, the prevalence rate in rural areas was 2.65 times higher than that in urban regions. CONCLUSION Our results suggested that public health interventions are urgently needed to achieve equitable diagnosis and management for people living with dementia in the communities across urban and rural areas.
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Affiliation(s)
- Lin Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Gui-Rong Cheng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Dan Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Fei-Fei Hu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Xu-Guang Gan
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Bo Zhang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Lina An
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Cong Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Ming-Jun Zou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Lang Xu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yang-Ming Ou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Shan Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Jin-Quan Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Zhen Wei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Qiong Wu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Xing-Xing Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Man-Qing Guo
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Qing-Ming Wu
- Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Ru Wang
- China Resources and WISCO General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Yan Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
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15
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Santos OA, Rios-Rosales A, Pedraza O, Bergeron CD, Chandler M. Memory Support System in Spanish: A Pilot Study. Brain Sci 2021; 11:brainsci11111379. [PMID: 34827378 PMCID: PMC8615490 DOI: 10.3390/brainsci11111379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
Subjective cognitive decline (SCD) is prevalent in the general population, particularly among Hispanic adults. SCD increases the risk of mild cognitive impairment (MCI) and dementia. While non-pharmacologic interventions are recommended to mitigate cognitive decline and preserve daily function in SCD and MCI, such interventions are not readily available for Spanish-speaking Hispanic adults with SCD. This pilot study, preregistered at clinicialtrials.gov, aimed to develop a linguistically and culturally appropriate adaptation of an existing memory compensation intervention, the Memory Support System (MSS), from English to Spanish, and to gather data to assess its impact in this population. Twenty Spanish-speaking Hispanic adults with SCD and 16 support partners were recruited. Measures of treatment adherence, daily function, self-efficacy for memory, quality of life, mood, anxiety, and caregiver burden were assessed at baseline, treatment end, and 8-week follow-up. By treatment end, participants with SCD improved their general functional status, daily activities requiring organizational skills, and depression and anxiety symptoms. Partners reported improvement in anxiety by treatment end and in caregiver burden at follow-up. The MSS was successfully translated into Spanish and readily learned by participants with SCD and their partners. The MSS in Spanish may help with daily functioning and aspects of patient and family well-being.
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Affiliation(s)
- Octavio A. Santos
- Department of Psychology, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL 32224, USA; (A.R.-R.); (O.P.); (M.C.)
- Correspondence: ; Tel.: +1-613-798-5555 (ext. 13456)
| | - Anapaula Rios-Rosales
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL 32224, USA; (A.R.-R.); (O.P.); (M.C.)
| | - Otto Pedraza
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL 32224, USA; (A.R.-R.); (O.P.); (M.C.)
| | - Caroline D. Bergeron
- Division of Aging, Seniors and Dementia, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada;
- LIFE Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Melanie Chandler
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL 32224, USA; (A.R.-R.); (O.P.); (M.C.)
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Balbim GM, Aguiñaga S, Ajilore OA, Bustamante EE, Erickson KI, Lamar M, Marquez DX. The Effects of the BAILAMOS TM Dance Program on Physical Activity Levels and Cognition of Older Latino Adults: A Pilot Study. J Aging Health 2021; 34:25-40. [PMID: 34027686 DOI: 10.1177/08982643211020996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To investigate the effects of the BAILAMOSTM dance program on physical activity (PA), cardiorespiratory, and cognitive health. Methods: A parallel, two-armed pilot study was conducted with 57 older Latinos randomized to the BAILAMOSTM dance program (n = 28) or health education (HE) (n = 29). We conducted two- and three-way repeated-measures ANOVAs. Results: BAILAMOSTM participants increased participation in leisure moderate-to-vigorous PA (LMVPA) (F[1,53] = 3.17, p = .048, η2G = .01) and performance in global cognition relative to HE participants (F[1,52] = 4.19, p = .045, η2G = .01). Attendance moderated increases in moderate PA, MVPA, LMVPA, and total PA (p < .05). Participants of both groups with ≥75% attendance increased participation in PA. Among participants with <75% attendance, BAILAMOSTM participants increased PA relative to HE. Discussion: BAILAMOSTM positively impacted self-reported PA and global cognition in older Latinos. Even smaller doses of dance appear to impact self-reported PA levels.
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Affiliation(s)
- Guilherme M Balbim
- Department of Kinesiology and Nutrition, 315410University of Illinois at Chicago, Chicago, IL, United States
| | - Susan Aguiñaga
- Department of Kinesiology and Community Health, 115958University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Olusola A Ajilore
- Department of Psychiatry, 315334University of Illinois at Chicago, Chicago, IL, United States
| | - Eduardo E Bustamante
- Department of Kinesiology and Nutrition, 315410University of Illinois at Chicago, Chicago, IL, United States
| | - Kirk I Erickson
- Department of Psychology, 6614University of Pittsburgh, Pittsburgh, PA, United States
| | - Melissa Lamar
- Division of Behavioral Sciences, Rush University, Chicago, IL, United States
| | - David X Marquez
- Department of Kinesiology and Nutrition, 315410University of Illinois at Chicago, Chicago, IL, United States
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Balbim GM, Ajilore OA, Erickson KI, Lamar M, Aguiñaga S, Bustamante EE, Marquez DX. The Impact of the BAILAMOS™ Dance Program on Brain Functional Connectivity and Cognition in Older Latino Adults: A Pilot Study. JOURNAL OF COGNITIVE ENHANCEMENT 2021; 5:1-14. [PMID: 33748658 PMCID: PMC7968343 DOI: 10.1007/s41465-020-00185-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/17/2020] [Indexed: 12/12/2022]
Abstract
Dance is a culturally salient form of physical activity (PA) for older Latinos. Resting-state functional connectivity (FC) is a putative biomarker for age-related cognitive decline. We aimed to investigate the impact of the BAILAMOS™ dance program on FC in three brain functional networks (Default Mode [DMN], Frontoparietal [FPN], and Salience [SAL] networks), and cognition. Ten cognitively healthy older Latinos participated in the four-month BAILAMOS™ dance program. We assessed PA levels (self-reported and device-assessed) and estimated cardiorespiratory fitness, cognition, and resting-state FC via functional magnetic resonance imaging at baseline and post-intervention. We performed paired t-tests and Pearson correlations. Given the pilot nature of the study, significance levels were set at p < 0.05 and effect sizes are reported. We observed a significant increase in self-reported moderate leisure-time PA from pre- to post-intervention (t(9) = 3.16, p = 0.011, d = 0.66). FC within-FPN regions of interest (ROIs) significantly increased pre- to post-intervention (t(9) = 2.35, p = 0.043, d = 0.70). DMN ROIs showed an increase, with a moderate effect size, in the integration with other networks' ROIs (t(9) = 1.96, p = 0.081, d = 0.64) post-intervention. Increases in moderate leisure-time PA at post-intervention were associated with increases in the FC within-FPN (R = 0.79, p = 0.006). Our results suggest that dance might be a promising approach for improving age-related disruption of FC within- and between-networks commonly associated with cognitive decline.
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Affiliation(s)
- Guilherme M Balbim
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States
| | - Olusola A Ajilore
- University of Illinois at Chicago, Department of Psychiatry, Chicago, Illinois, United States
| | - Kirk I Erickson
- University of Pittsburgh, Department of Psychology, Pittsburgh, Pennsylvania, United States
| | - Melissa Lamar
- Rush University, Division of Behavioral Sciences, Chicago, Illinois, United States
| | - Susan Aguiñaga
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, Champaign, Illinois, United States
| | - Eduardo E Bustamante
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States
| | - David X Marquez
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States
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18
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Stickel AM, McKinnon AC, Matijevic S, Grilli MD, Ruiz J, Ryan L. Apolipoprotein E ε4 Allele-Based Differences in Brain Volumes Are Largely Uniform Across Late Middle Aged and Older Hispanic/Latino- and Non-Hispanic/Latino Whites Without Dementia. Front Aging Neurosci 2021; 13:627322. [PMID: 33716715 PMCID: PMC7952627 DOI: 10.3389/fnagi.2021.627322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/01/2021] [Indexed: 12/01/2022] Open
Abstract
Hispanics/Latinos are at an equal or a greater risk for Alzheimer's disease (AD), yet risk factors remain more poorly characterized as compared to non-Hispanic/Latino Whites. Among non-Hispanic/Latino White cohorts, the apolipoprotein E (APOE) ε4 allele is one of the strongest risk factors for AD with subtle declines in episodic memory and brain volumes detectable in the preclinical stages. We examined whether the APOE ε4 status had a differential impact on cognition and brain volumes among cognitively healthy and mild cognitively impaired Hispanics/Latinos (n = 86; ε4 n = 23) compared to a well-matched group of non-Hispanic/Latino Whites (n = 92; ε4 n = 29). Neither the APOE ε4 status nor the interaction between the ε4 status and ethnicity was associated with cognitive performance. The APOE ε4 status was associated with white matter and not with gray matter volumes. APOE ε4 carriers had a significantly smaller total brain white matter volumes, as well as smaller right middle temporal and left superior temporal volumes. The Hispanics/Latinos had significantly smaller left middle frontal gray matter volumes, yet marginally larger overall white matter volumes, than the non-Hispanic/Latino Whites. Exploratory analysis within the Hispanic/Latino sample found that those people whose primary language was Spanish had larger total brain white matter volumes compared primarily to the English speakers. Importantly, primary language differences only held for Hispanic/Latino ε4 carriers and did not differentiate Hispanic/Latino non-carriers, underscoring the need for further investigation into the impacts of language and acculturation on cognitive aging among the fastest growing ethnic minority group in the United States.
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Affiliation(s)
- Ariana M. Stickel
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Andrew C. McKinnon
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | | | - Matthew D. Grilli
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - John Ruiz
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Lee Ryan
- Department of Psychology, University of Arizona, Tucson, AZ, United States
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19
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Arruda F, Rosselli M, Greig MT, Loewenstein DA, Lang M, Torres VL, Vélez-Uribe I, Conniff J, Barker WW, Curiel RE, Adjouadi M, Duara R. The Association Between Functional Assessment and Structural Brain Biomarkers in an Ethnically Diverse Sample With Normal Cognition, Mild Cognitive Impairment, or Dementia. Arch Clin Neuropsychol 2021; 36:51-61. [PMID: 32890393 DOI: 10.1093/arclin/acaa065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/13/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the association between the functional activities questionnaire (FAQ) and brain biomarkers (bilateral hippocampal volume [HV], bilateral entorhinal volume [ERV], and entorhinal cortical thickness [ERT]) in cognitively normal (CN) individuals, mild cognitive impairment (MCI), or dementia. METHOD In total, 226 participants (137 females; mean age = 71.76, SD = 7.93; Hispanic Americans = 137; European Americans = 89) were assessed with a comprehensive clinical examination, a neuropsychological battery, a structural magnetic resonance imaging, and were classified as CN or diagnosed with MCI or dementia. Linear regression analyses examined the association between functional activities as measured by the FAQ on brain biomarkers, including HV, ERV, and ERT, controlling for age, education, global cognition, gender, and ethnicity. RESULTS The FAQ significantly predicted HV, ERV, and ERT for the entire sample. However, this association was not significant for ERV and ERT when excluding the dementia group. The FAQ score remained a significant predictor of HV for the non-dementia group. Age, education, gender, ethnicity, Montreal Cognitive Assessment score, and FAQ were also significant predictors of HV for the overall sample, suggesting that younger Hispanic females with fewer years of education, higher global mental status, and better functioning, were more likely to have larger HV. CONCLUSION FAQ scores were related to HV in older adults across clinical groups (CN, MCI, and dementia), but its association with the entorhinal cortex was driven by individuals with dementia. Demographic variables, including ethnicity, additionally influenced these associations.
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Affiliation(s)
- Fernanda Arruda
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Mónica Rosselli
- Department of Psychology, Florida Atlantic University, Davie, FL, USA.,1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA
| | - Maria T Greig
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - David A Loewenstein
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Department of Psychiatry and Behavioral Sciences, Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Merike Lang
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Valeria L Torres
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Idaly Vélez-Uribe
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Joshua Conniff
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Warren W Barker
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Rosie E Curiel
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Department of Psychiatry and Behavioral Sciences, Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Malek Adjouadi
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Engineering Center, Florida International University, Miami, FL, USA
| | - Ranjan Duara
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
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20
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Understanding the role of cultural factors in the risk of mild cognitive impairment in diverse populations. Int Psychogeriatr 2021; 33:11-13. [PMID: 33543695 DOI: 10.1017/s1041610220000435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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21
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Royall DR, Palmer RF. δ scores predict multiple neuropsychiatric symptoms. Int J Geriatr Psychiatry 2020; 35:1341-1348. [PMID: 32584472 DOI: 10.1002/gps.5371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/03/2020] [Accepted: 06/21/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Dementia severity is strongly related to Spearman's general intelligence factor "g", via the latent dementia phenotype "δ" and is distinct from domain-specific cognitive impairments arising from disease-specific regional pathologies. It is an empiric question whether behavioral and psychological symptoms of dementia (BPSD) are associated with δ or with domain-specific constructs. METHODS A recently developed δ homolog ("dDx") was tested as a predictor of 1 year prospective BPSD in n = 723 Mexican-American and non-Hispanic White participants in the Texas Alzheimer's Research and Care Consortium (TARCC). The informant-rated frequencies of 12 BPSD were rated by the neuropsychiatric inventory (NPI-Q). Baseline BPSD, demographic features, selected biomarkers, and treatment exposure to acetylcholinesterase inhibitors were used as covariates. Composite scores derived from orthogonal latent measures of domain-specific memory (MEM) and executive function (EF) were also tested as predictors. RESULTS "Functionally salient cognitive impairment (FSCI)" that is, categorical "dementia" as diagnosed by dDx was associated with increased prospective frequency of 11/12 BPSD, independently of baseline behavior and covariates. Age, depressive symptoms, and EF were associated with individual BPSD. MEM was not associated with any. Dementia severity, as measured by dDx, was also associated with a prospective increase in total NPI-Q scores. CONCLUSION δ is associated non-specifically with multiple BPSD. This suggests the existence of a dementia-specific behavioral profile, arising from insults to general intelligence, and unrelated to disease-specific regional pathology(ies).
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Affiliation(s)
- Donald R Royall
- Departments of Psychiatry, Medicine, Family and Community Medicine, and the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Disease, The University of Texas Health Science Center, San Antonio, Texas, USA
| | - Raymond F Palmer
- Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, Texas, USA
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22
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Stickel A, McKinnon A, Ruiz J, Grilli MD, Ryan L. The impact of cardiovascular risk factors on cognition in Hispanics and non-Hispanic whites. Learn Mem 2019; 26:235-244. [PMID: 31209118 PMCID: PMC6581002 DOI: 10.1101/lm.048470.118] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/10/2019] [Indexed: 11/25/2022]
Abstract
Among non-Hispanic whites, cardiovascular risk factors are associated with increased mortality and poorer cognition. Prevalence of cardiovascular risk factors among aging Hispanics is also high and Hispanics generally have poorer access to healthcare, yet they tend to have advantageous cardiovascular disease rates and outcomes and live longer than non-Hispanic whites, an epidemiological phenomenon commonly referred to as the Hispanic or Latino health paradox. Although robust data support these ethnic benefits on physical health and mortality, it is unknown if it extends to include cognition resilience advantages in older adulthood. The present study compared relationships between cardiovascular risk and cognition (executive functions and episodic memory) in late middle age and older Hispanics (n = 87) and non-Hispanic whites (n = 81). Participants were selected from the National Alzheimer's Coordinating Center and Alzheimer's Disease Neuroimaging Initiative databases. Hispanics and non-Hispanic white groups were matched on age (50-94 yr, mean age = 72 yr), education, gender, cognitive status (i.e., cognitively healthy versus mildly cognitively impaired), and apolipoprotein E4 status. History of hypertension and higher body mass index were both associated with poorer executive functions among Hispanics but not non-Hispanic whites. Our findings suggest greater vulnerability to impairments in executive functions among Hispanics with hypertension and obesity, contrary to the notion of a Hispanic health paradox for cognitive aging.
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Affiliation(s)
- Ariana Stickel
- Department of Psychology, University of Arizona, Tucson, Arizona 85721, USA
| | - Andrew McKinnon
- Brain and Mind Centre, University of Sydney, Camperdown, Sydney 2050, Australia
| | - John Ruiz
- Department of Psychology, University of Arizona, Tucson, Arizona 85721, USA
| | - Matthew D Grilli
- Department of Psychology, University of Arizona, Tucson, Arizona 85721, USA
| | - Lee Ryan
- Department of Psychology, University of Arizona, Tucson, Arizona 85721, USA
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23
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Duara R, Loewenstein DA, Lizarraga G, Adjouadi M, Barker WW, Greig-Custo MT, Rosselli M, Penate A, Shea YF, Behar R, Ollarves A, Robayo C, Hanson K, Marsiske M, Burke S, Ertekin-Taner N, Vaillancourt D, De Santi S, Golde T, St D. Effect of age, ethnicity, sex, cognitive status and APOE genotype on amyloid load and the threshold for amyloid positivity. NEUROIMAGE-CLINICAL 2019; 22:101800. [PMID: 30991618 PMCID: PMC6447735 DOI: 10.1016/j.nicl.2019.101800] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 02/08/2019] [Accepted: 03/26/2019] [Indexed: 11/30/2022]
Abstract
The threshold for amyloid positivity by visual assessment on PET has been validated by comparison to amyloid load measured histopathologically and biochemically at post mortem. As such, it is now feasible to use qualitative visual assessment of amyloid positivity as an in-vivo gold standard to determine those factors which can modify the quantitative threshold for amyloid positivity. We calculated quantitative amyloid load, measured as Standardized Uptake Value Ratios (SUVRs) using [18-F]florbetaben PET scans, for 159 Hispanic and non-Hispanic participants, who had been classified clinically as Cognitively Normal (CN), Mild Cognitive Impairment (MCI) or Dementia (DEM). PET scans were visually rated as amyloid positive (A+) or negative (A-), and these judgments were used as the gold standard with which to determine (using ROC analyses) the SUVR threshold for amyloid positivity considering factors such as age, ethnicity (Hispanic versus non-Hispanic), gender, cognitive status, and apolipoprotein E ε4 carrier status. Visually rated scans were A+ for 11% of CN, 39.0% of MCI and 70% of DEM participants. The optimal SUVR threshold for A+ among all participants was 1.42 (sensitivity = 94%; specificity = 92.5%), but this quantitative threshold was higher among E4 carriers (SUVR = 1.52) than non-carriers (SUVR = 1.31). While mean SUVRs did not differ between Hispanic and non-Hispanic participants;, a statistically significant interaction term indicated that the effect of E4 carrier status on amyloid load was greater among non-Hispanics than Hispanics. Visual assessment, as the gold standard for A+, facilitates determination of the effects of various factors on quantitative thresholds for amyloid positivity. A continuous relationship was found between amyloid load and global cognitive scores, suggesting that any calculated threshold for the whole group, or a subgroup, is artefactual and that the lowest calculated threshold may be optimal for the purposes of early diagnosis and intervention. Demographic factors did not affect the threshold for amyloid positivity. Cognitive status did not affect this threshold for amyloid positivity. APOE4 carriers had a higher threshold for amyloid positivity than non-carriers. Among APOE4 carriers, non-Hispanics had higher amyloid load than non- Hispanics. There was a continuous relationship between amyloid load and cognitive status.
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Affiliation(s)
- R Duara
- Florida ADRC, USA; Mount Sinai Medical Center, Miami Beach, USA; College of Engineering and Computing, Florida International University, Miami, FL, USA; University of Florida College of Medicine, Gainesville, FL, USA.
| | - D A Loewenstein
- Florida ADRC, USA; Mount Sinai Medical Center, Miami Beach, USA; Miller School of Medicine, University of Miami, Miami, FL, USA
| | - G Lizarraga
- Florida ADRC, USA; College of Engineering and Computing, Florida International University, Miami, FL, USA
| | - M Adjouadi
- Florida ADRC, USA; College of Engineering and Computing, Florida International University, Miami, FL, USA
| | - W W Barker
- Florida ADRC, USA; Mount Sinai Medical Center, Miami Beach, USA
| | - M T Greig-Custo
- Florida ADRC, USA; Mount Sinai Medical Center, Miami Beach, USA
| | - M Rosselli
- Florida ADRC, USA; Florida Atlantic University, USA
| | - A Penate
- Florida ADRC, USA; Mount Sinai Medical Center, Miami Beach, USA
| | - Y F Shea
- Mount Sinai Medical Center, Miami Beach, USA; Department of Medicine, University of Hong Kong, Hong Kong
| | - R Behar
- Florida ADRC, USA; Mount Sinai Medical Center, Miami Beach, USA
| | - A Ollarves
- Florida ADRC, USA; Mount Sinai Medical Center, Miami Beach, USA
| | - C Robayo
- Florida ADRC, USA; Mount Sinai Medical Center, Miami Beach, USA
| | - K Hanson
- Florida ADRC, USA; University of Florida College of Medicine, Gainesville, FL, USA
| | - M Marsiske
- Florida ADRC, USA; University of Florida College of Medicine, Gainesville, FL, USA; University of Florida, College of Public Health and Health Professions, USA
| | - S Burke
- Florida ADRC, USA; Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - N Ertekin-Taner
- Mayo Clinic Florida, Department of Neurology, Jacksonville, FL, USA; Mayo Clinic Florida, Department of Neuroscience, Jacksonville, FL, USA
| | - D Vaillancourt
- Florida ADRC, USA; University of Florida College of Medicine, Gainesville, FL, USA
| | | | - T Golde
- Florida ADRC, USA; University of Florida College of Medicine, Gainesville, FL, USA
| | - DeKosky St
- Florida ADRC, USA; University of Florida College of Medicine, Gainesville, FL, USA
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24
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Russo MJ, Cohen G, Campos J, Martin ME, Clarens MF, Sabe L, Barcelo E, Allegri RF. Usefulness of Discriminability and Response Bias Indices for the Evaluation of Recognition Memory in Mild Cognitive Impairment and Alzheimer Disease. Dement Geriatr Cogn Disord 2018; 43:1-14. [PMID: 27889770 DOI: 10.1159/000452255] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Most studies examining episodic memory in Alzheimer disease (AD) have focused on patients' impaired ability to remember information. This approach provides only a partial picture of memory deficits since other factors involved are not considered. OBJECTIVE To evaluate the recognition memory performance by using a yes/no procedure to examine the effect of discriminability and response bias measures in amnestic mild cognitive impairment (a-MCI), AD dementia, and normal-aging subjects. METHODS We included 43 controls and 45 a-MCI and 51 mild AD dementia patients. Based on the proportions of correct responses (hits) and false alarms from the Rey Auditory Verbal Learning Test (RAVLT), discriminability (d') and response bias (C) indices from signal detection theory (SDT) were calculated. RESULTS Results showed significant group differences for d' (F (2) = 83.26, p < 0.001), and C (F (2) = 6.05, p = 0.00). The best predictors of group membership were delayed recall and d' scores. The d' measure correctly classified subjects with 82.98% sensitivity and 91.11% specificity. CONCLUSIONS a-MCI and AD dementia subjects exhibit less discrimination accuracy and more liberal response bias than controls. Furthermore, combined indices of delayed recall and discriminability from the RAVLT are effective in defining early AD. SDT may help enhance diagnostic specificity.
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Affiliation(s)
- María Julieta Russo
- Department of Cognitive Neurology, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
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25
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Crocco EA, Loewenstein DA, Curiel RE, Alperin N, Czaja SJ, Harvey PD, Sun X, Lenchus J, Raffo A, Peñate A, Melo J, Sang L, Valdivia R, Cardenas K. A novel cognitive assessment paradigm to detect Pre-mild cognitive impairment (PreMCI) and the relationship to biological markers of Alzheimer's disease. J Psychiatr Res 2018; 96:33-38. [PMID: 28957712 PMCID: PMC6132245 DOI: 10.1016/j.jpsychires.2017.08.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/20/2017] [Accepted: 08/18/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A number of older adults obtain normal scores on formal cognitive tests, but present clinical concerns that raise suspicion of cognitive decline. Despite not meeting full criteria for Mild Cognitive Impairment (MCI), these PreMCI states confer risk for progression to Alzheimer's disease (AD). This investigation addressed a pressing need to identify cognitive measures that are sensitive to PreMCI and are associated with brain biomarkers of neurodegeneration. METHOD Participants included 49 older adults with a clinical history suggestive of cognitive decline but normal scores on an array of neuropsychological measures, thus not meeting formal criteria for MCI. The performance of these PreMCI participants were compared to 117 cognitively normal (CN) elders on the LASSI-L, a cognitive stress test that uniquely assesses the failure to recover from proactive semantic interference effects (frPSI). Finally, a subset of these individuals had volumetric analyses based on MRI scans. RESULTS PreMCI participants evidenced greater LASSI- L deficits, particularly with regards to frPSI and delayed recall, relative to the CN group. No differences on MRI measures were observed. Controlling for false discovery rate (FDR), frPSI was uniquely related to increased dilatation of the inferior lateral ventricle and decreased MRI volumes in the hippocampus, precuneus, superior parietal region, and other AD prone areas. In contrast, other LASSI-L indices and standard memory tests were not related to volumetric findings. CONCLUSIONS Despite equivalent performance on traditional memory measures, the frPSI distinguished between PreMCI and CN elders and was associated with reductions in brain volume in numerous AD-relevant brain regions.
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Affiliation(s)
- Elizabeth A Crocco
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, United States
| | - David A Loewenstein
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, United States.
| | - Rosie E Curiel
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, United States
| | - Noam Alperin
- Department of Neurology, Miller School of Medicine, University of Miami, United States
| | - Sara J Czaja
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, United States
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, United States; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, United States
| | - Xiaoyan Sun
- Department of Neurology, Miller School of Medicine, University of Miami, United States
| | - Joshua Lenchus
- Department of Medicine, Miller School of Medicine, University of Miami, United States
| | - Arlene Raffo
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, United States
| | - Ailyn Peñate
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, United States
| | - Jose Melo
- Department of Psychiatry and Behavioral Sciences, Center on Aging, Miller School of Medicine, University of Miami, United States
| | - Lee Sang
- Department of Radiology, Miller School of Medicine, University of Miami, United States
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26
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Regular Latin Dancing and Health Education May Improve Cognition of Late Middle-Aged and Older Latinos. J Aging Phys Act 2017; 25:482-489. [PMID: 28095105 DOI: 10.1123/japa.2016-0049] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Disparities exist between Latinos and non-Latino Whites in cognitive function. Dance is culturally appropriate and challenges individuals physically and cognitively, yet the impact of regular dancing on cognitive function in older Latinos has not been examined. A two-group pilot trial was employed among inactive, older Latinos. Participants (N = 57) participated in the BAILAMOS© dance program or a health education program. Cognitive test scores were converted to z-scores and measures of global cognition and specific domains (executive function, episodic memory, working memory) were derived. Results revealed a group × time interaction for episodic memory (p < .05), such that the dance group showed greater improvement in episodic memory than the health education group. A main effect for time for global cognition (p < .05) was also demonstrated, with participants in both groups improving. Structured Latin dance programs can positively influence episodic memory, and participation in structured programs may improve overall cognition among older Latinos.
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Ownby RL, Acevedo A, Waldrop-Valverde D, Caballero J, Simonson M, Davenport R, Kondwani K, Jacobs RJ. A Mobile App for Chronic Disease Self-Management: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e53. [PMID: 28381395 PMCID: PMC5399224 DOI: 10.2196/resprot.7272] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/05/2017] [Accepted: 02/08/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Health literacy is a critically important skill that helps people become active participants in their health care. Multiple studies in the United States and across the world have documented the association of health literacy with multiple health outcomes. In particular, the elderly and many members of minority groups have been shown to have low levels of health literacy; the same groups are disproportionately affected by chronic illnesses. These twin burdens affect the people most in need of the skills and knowledge required for coping with chronic illnesses. Chronic disease self-management (CDSM) is a logical target for a general health literacy intervention. In an approach that spans across specific diseases, CDSM targets problems and skills needed to cope with issues such as fatigue, pain, stress, depression, sleep disturbance, and treatment adherence. In a previous study, we showed that a computer-delivered tailored information intervention targeting health literacy could improve treatment and adherence and be cost effective, but it is not clear that this same strategy will be effective in persons with low health literacy and multiple chronic conditions. OBJECTIVE The purpose of this study is to develop a computer-delivered mobile intervention that will provide individuals with chronic conditions the necessary information to cope with their conditions. METHODS In this project, we will complete a qualitative study on the status and needs of individuals with more than one chronic condition. Results of this study will be used to develop a mobile tailored information app that will address self-management challenges in the areas of pain, sleep, fatigue, depression, anger, stress, memory problems, and treatment adherence. The impact of the intervention on patient quality of life, patient-provider relationships, health literacy, and patient activation will be assessed. We will also explore the extent to which health literacy mediates important outcomes, such as health-related quality of life and health service utilization. RESULTS We are currently completing the preliminary qualitative and usability studies that will inform the content and design of the intervention. We anticipate that the intervention will be complete in 2017, and the clinical trial of its efficacy will also commence in 2017. CONCLUSIONS Results will provide evidence on the usefulness of a mobile tailored information app for improving health literacy, patient activation, health-related quality of life, and self-reported health in patients with multiple chronic conditions. TRIAL REGISTRATION Clinicaltrials.gov NCT02922439; https://clinicaltrials.gov/ct2/show/NCT02922439 (Archived by WebCite at http://www.webcitation.org/6pTiqDAyN).
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Affiliation(s)
- Raymond L Ownby
- Nova Southeastern University, Department of Psychiatry and Behavioral Medicine, Fort Lauderdale, FL, United States
| | - Amarilis Acevedo
- Nova Southeastern University, College of Psychology, Fort Lauderdale, FL, United States
| | | | - Joshua Caballero
- Larkin Health Sciences Institute, Department of Clinical and Administrative Sciences, College of Pharmacy, Miami, FL, United States
| | - Michael Simonson
- Department of Instructional Design and Technology, Fischler College of Education, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Rosemary Davenport
- Nova Southeastern University, Department of Psychiatry and Behavioral Medicine, Fort Lauderdale, FL, United States
| | - Kofi Kondwani
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, United States
| | - Robin J Jacobs
- Baylor College of Medicine, Department of Family and Community Medicine--Research Programs, Houston, TX, United States
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Bateman RJ, Benzinger TL, Berry S, Clifford DB, Duggan C, Fagan AM, Fanning K, Farlow MR, Hassenstab J, McDade EM, Mills S, Paumier K, Quintana M, Salloway SP, Santacruz A, Schneider LS, Wang G, Xiong C. The DIAN-TU Next Generation Alzheimer's prevention trial: Adaptive design and disease progression model. Alzheimers Dement 2017; 13:8-19. [PMID: 27583651 PMCID: PMC5218895 DOI: 10.1016/j.jalz.2016.07.005] [Citation(s) in RCA: 196] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/09/2016] [Accepted: 07/19/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The Dominantly Inherited Alzheimer Network Trials Unit (DIAN-TU) trial is an adaptive platform trial testing multiple drugs to slow or prevent the progression of Alzheimer's disease in autosomal dominant Alzheimer's disease (ADAD) families. With completion of enrollment of the first two drug arms, the DIAN-TU now plans to add new drugs to the platform, designated as the Next Generation (NexGen) prevention trial. METHODS In collaboration with ADAD families, philanthropic organizations, academic leaders, the DIAN-TU Pharma Consortium, the National Institutes of Health, and regulatory colleagues, the DIAN-TU developed innovative clinical study designs for the DIAN-TU NexGen prevention trial. RESULTS Our expanded trial toolbox consists of a disease progression model for ADAD, primary end point DIAN-TU cognitive performance composite, biomarker development, self-administered cognitive assessments, adaptive dose adjustments, and blinded data collection through the last participant completion. CONCLUSION These steps represent elements to improve efficacy of the adaptive platform trial and a continued effort to optimize prevention and treatment trials in ADAD.
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Affiliation(s)
- Randall J Bateman
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA.
| | - Tammie L Benzinger
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | | | - David B Clifford
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Cynthia Duggan
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Kathleen Fanning
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Martin R Farlow
- Indiana Alzheimer Disease Center, Indiana University, Indianapolis, IN, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Eric M McDade
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Susan Mills
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Katrina Paumier
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | | | - Stephen P Salloway
- Memory and Aging Program, Butler Hospital, Brown Medical School, Providence, RI, USA
| | - Anna Santacruz
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Lon S Schneider
- Alzheimer's Disease Research Center, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Guoqiao Wang
- Department of Biostatistics, Washington University in St Louis, St Louis, MO, USA
| | - Chengjie Xiong
- Department of Biostatistics, Washington University in St Louis, St Louis, MO, USA
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Siqueira LDS, Gonçalves HA, Hübner LC, Fonseca RP. Development of the Brazilian version of the Child Hayling Test. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2016; 38:164-174. [DOI: 10.1590/2237-6089-2016-0019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/09/2016] [Indexed: 11/21/2022]
Abstract
Abstract Introduction: The Hayling Test assesses the components of initiation, inhibition, cognitive flexibility and verbal speed by means of a sentence completion task. This study presents the process of developing the Brazilian version of the Child Hayling Test (CHT) and reports evidence of its content validity. Methods: 139 people took part in the study. The adaptation was performed by seven translators and 12 specialist judges. An initial sample of 92 healthy children was recruited to test a selection of sentences adapted from previous adult and pediatric versions of the instrument, and a sample of 28 healthy children was recruited for pilot testing of the final version. The instrument was developed in seven stages: 1) translation, 2) back-translation, 3) comparison of translated versions, 4) preparation of new stimuli, 5) data collection with healthy children to analyze comprehension of the stimuli and analyses by the authors against the psycholinguistic criteria adopted, 6) analyses conducted by judges who are specialists in neuropsychology or linguistics, and 7) the pilot study. Results: Twenty-four of the 72 sentences constructed were selected on the basis of 70-100% agreement between judges evaluating what they assessed and level of comprehensibility. The pilot study revealed better performance by older children, providing evidence of the instrument's sensitivity to developmental factors. Conclusions: Future studies employing this version of CHT with clinical pediatric populations who have frontal lesions and dysfunctions and in related areas are needed to test functional and differential diagnoses of preserved or impaired executive functions.
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Funes CM, Hernandez Rodriguez J, Lopez SR. Norm comparisons of the Spanish-language and English-language WAIS-III: Implications for clinical assessment and test adaptation. Psychol Assess 2016; 28:1709-1715. [PMID: 26950442 DOI: 10.1037/pas0000302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study provides a systematic comparison of the norms of 3 Spanish-language Wechsler Adult Intelligence Scales (WAIS-III) batteries from Mexico, Spain, and Puerto Rico, and the U.S. English-language WAIS-III battery. Specifically, we examined the performance of the 4 normative samples on 2 identical subtests (Digit Span and Digit Symbol-Coding) and 1 nearly identical subtest (Block Design). We found that across most age groups the means associated with the Spanish-language versions of the 3 subtests were lower than the means of the U.S. English-language version. In addition, we found that for most age ranges the Mexican subsamples scored lower than the Spanish subsamples. Lower educational levels of Mexicans and Spaniards compared to U.S. residents are consistent with the general pattern of findings. These results suggest that because of the different norms, applying any of the 3 Spanish-language versions of the WAIS-III generally risks underestimating deficits, and that applying the English-language WAIS-III norms risks overestimating deficits of Spanish-speaking adults. There were a few exceptions to these general patterns. For example, the Mexican subsample ages 70 years and above performed significantly better on the Digit Symbol and Block Design than did the U.S. and Spanish subsamples. Implications for the clinical assessment of U.S. Spanish-speaking Latinos and test adaptation are discussed with an eye toward improving the clinical care for this community. (PsycINFO Database Record
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Cardoso CDO, Zimmermann N, Paraná CB, Gindri G, de Pereira APA, Fonseca RP. Brazilian adaptation of the Hotel Task: A tool for the ecological assessment of executive functions. Dement Neuropsychol 2015; 9:156-164. [PMID: 29213957 PMCID: PMC5619354 DOI: 10.1590/1980-57642015dn92000010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Over recent years, neuropsychological research has been increasingly concerned
with the need to develop more ecologically valid instruments for the assessment
of executive functions. The Hotel Task is one of the most widely used ecological
measures of executive functioning, and provides an assessment of planning,
organization, self-monitoring and cognitive flexibility.
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Affiliation(s)
| | - Nicolle Zimmermann
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brazil
| | | | - Gigiane Gindri
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brazil
| | | | - Rochele Paz Fonseca
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brazil
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Jacobs RJ, Caballero J, Ownby RL, Kane MN. Development of a culturally appropriate computer-delivered tailored Internet-based health literacy intervention for Spanish-dominant Hispanics living with HIV. BMC Med Inform Decis Mak 2014; 14:103. [PMID: 25433489 PMCID: PMC4260191 DOI: 10.1186/s12911-014-0103-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 10/30/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Low health literacy is associated with poor medication adherence in persons with human immunodeficiency virus (HIV), which can lead to poor health outcomes. As linguistic minorities, Spanish-dominant Hispanics (SDH) face challenges such as difficulties in obtaining and understanding accurate information about HIV and its treatment. Traditional health educational methods (e.g., pamphlets, talking) may not be as effective as delivering through alternate venues. Technology-based health information interventions have the potential for being readily available on desktop computers or over the Internet. The purpose of this research was to adapt a theoretically-based computer application (initially developed for English-speaking HIV-positive persons) that will provide linguistically and culturally appropriate tailored health education to Spanish-dominant Hispanics with HIV (HIV + SDH). METHODS A mixed methods approach using quantitative and qualitative interviews with 25 HIV + SDH and 5 key informants guided by the Information-Motivation-Behavioral (IMB) Skills model was used to investigate cultural factors influencing medication adherence in HIV + SDH. We used a triangulation approach to identify major themes within cultural contexts relevant to understanding factors related to motivation to adhere to treatment. From this data we adapted an automated computer-based health literacy intervention to be delivered in Spanish. RESULTS Culture-specific motivational factors for treatment adherence in HIV + SDH persons that emerged from the data were stigma, familismo (family), mood, and social support. Using this data, we developed a culturally and linguistically adapted a tailored intervention that provides information about HIV infection, treatment, and medication related problem solving skills (proven effective in English-speaking populations) that can be delivered using touch-screen computers, tablets, and smartphones to be tested in a future study. CONCLUSION Using a theoretically-grounded Internet-based eHealth education intervention that builds on knowledge and also targets core cultural determinants of adherence may prove a highly effective approach to improve health literacy and medication decision-making in this group.
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Affiliation(s)
- Robin J Jacobs
- />Biomedical Informatics/Psychiatry and Behavioral Medicine College of Osteopathic Medicine Nova Southeastern University 3200 S, University Drive Terry Building HPD/OST, Fort Lauderdale, FL 33328 USA
| | - Joshua Caballero
- />College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL 33328 USA
| | - Raymond L Ownby
- />Psychiatry and Behavioral, Medicine College of Osteopathic Medicine Nova Southeastern University, Fort Lauderdale, FL 33328 USA
| | - Michael N Kane
- />College for Design & Social Inquiry School of Social Work Florida, Atlantic University, Glades road, Boca Raton, FL 33431 777 USA
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Benson G, de Felipe J, Xiaodong, Sano M. Performance of Spanish-speaking community-dwelling elders in the United States on the Uniform Data Set. Alzheimers Dement 2014; 10:S338-43. [PMID: 24418057 PMCID: PMC4092047 DOI: 10.1016/j.jalz.2013.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 08/30/2013] [Accepted: 09/03/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Spanish is the second-most common language spoken in the United States, and Spanish speakers represent one third of the aging population. The National Alzheimer's Coordinating Center's Uniform Data Set implemented a Spanish neuropsychological battery. Previous work described the neuropsychological performance for English speakers. Here we describe performance on the Spanish version. METHODS Data from 276 Spanish speakers with normal cognition were summarized, with descriptive tables of performance on individual cognitive tests. Regression techniques were used to evaluate the effect of demographics on cognitive performance. RESULTS Spanish speakers were younger (70.0 vs 74.0 years) and less educated (10.7 vs 15.7 years) with more females (76% vs 63% female) than the previously described English speakers. Higher education and lower age were associated with better performance. CONCLUSION This national cohort of well-characterized Spanish-speaking elders provides descriptive data on cognitive performance, an important tool for clinical and research efforts.
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Affiliation(s)
- Gloria Benson
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Jesús de Felipe
- Department of Psychiatry, Fundación Jiménez Díaz Hospital, Madrid, Spain; Universidad Camilo José Cela, Villanueva de la Cañada, Spain
| | - Xiaodong
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Mary Sano
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA.
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Marquez DX, Wilbur J, Hughes SL, Berbaum ML, Wilson RS, Buchner DM, McAuley E. B.A.I.L.A. - a Latin dance randomized controlled trial for older Spanish-speaking Latinos: rationale, design, and methods. Contemp Clin Trials 2014; 38:397-408. [PMID: 24969395 DOI: 10.1016/j.cct.2014.06.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/13/2014] [Accepted: 06/15/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Physical activity (PA) has documented health benefits, but older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance holds a promise as a culturally appropriate form of PA that challenges individuals physically and cognitively. This paper describes a randomized controlled trial that will test the efficacy of BAILAMOS, a 4-month Latin dance program followed by a 4-month maintenance program, for improving lifestyle PA and health outcomes. METHODS Older adults (n=332), aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels, and at risk for disability will be randomized to one of two programs, a dance program or health education control group. BAILAMOS is a 4-month program that meets two times per week for one 1h per session. Dance sessions focus on instruction, including four styles of dance, and couples dancing. Bi-monthly Fiestas de Baile (dance parties) are also included, in which participants dance and practice what they have learned. Monthly 1-hour discussion sessions utilize a Social Cognitive framework and focus on knowledge, social support, and self-efficacy to increase lifestyle PA. The health education control group will meet one time per week for two 2h per session. OUTCOMES Primary outcomes including PA changes and secondary outcomes including self-efficacy, physical function, cognitive function, and disability will be assessed at baseline, 4, and 8 months. It is hypothesized that PA, self-efficacy, physical function, cognitive function, and functional limitations and disability scores will be significantly better in the BAILAMOS group at 4 and 8 months compared to the control group.
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Affiliation(s)
- David X Marquez
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 W. Taylor Street, Chicago, IL 60612, United States; University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 1747 West Roosevelt Road, Chicago, IL 60608, United States.
| | - JoEllen Wilbur
- Rush University, College of Nursing, 600 S. Paulina, 1062B, Chicago, IL 60612, United States
| | - Susan L Hughes
- University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Michael L Berbaum
- University of Illinois at Chicago, Institute for Health Research and Policy, Methodology Research Core, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Robert S Wilson
- Rush University Medical Center, Departments of Neurological Sciences and Behavioral Sciences, Rush Alzheimer's Disease Center, 600 South Paulina Street, Suite 1038, Chicago, IL 60612, United States
| | - David M Buchner
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 S. Goodwin Ave., Urbana, IL 61801, United States
| | - Edward McAuley
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 S. Goodwin Ave., Urbana, IL 61801, United States
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Which language declines more? longitudinal versus cross-sectional decline of picture naming in bilinguals with Alzheimer's disease. J Int Neuropsychol Soc 2014; 20:534-46. [PMID: 24725624 PMCID: PMC4209950 DOI: 10.1017/s1355617714000228] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In this study, we investigated dual-language decline in non-balanced bilinguals with probable Alzheimer's disease (AD) both longitudinally and cross-sectionally. We examined patients' naming accuracy on the Boston Naming Test (BNT: Kaplan et al., 1983) over three testing sessions (longitudinal analysis) and compared their performance to that of matched controls (cross-sectional analysis). We found different longitudinal and cross-sectional patterns of decline: Longitudinally, the non-dominant language seemed to decline more steeply than the dominant language, but, cross-sectionally, differences between patients and controls were larger for the dominant than for the non-dominant language, especially at the initial testing session. This differential pattern of results for cross-sectional versus longitudinal decline was supported by correlations between decline measures and BNT item characteristics. Further studies will be needed to better characterize the nature of linguistic decline in bilinguals with AD; however, these results suggest that representational robustness of individual lexical representations, rather than language membership, might determine the time course of decline for naming in bilinguals with AD.
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Hu WT, Watts K, Grossman M, Glass J, Lah JJ, Hales C, Shelnutt M, Van Deerlin V, Trojanowski JQ, Levey AI. Reduced CSF p-Tau181 to Tau ratio is a biomarker for FTLD-TDP. Neurology 2013; 81:1945-52. [PMID: 24174584 PMCID: PMC3843382 DOI: 10.1212/01.wnl.0000436625.63650.27] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 08/26/2013] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To validate the ability of candidate CSF biomarkers to distinguish between the 2 main forms of frontotemporal lobar degeneration (FTLD), FTLD with TAR DNA-binding protein 43 (TDP-43) inclusions (FTLD-TDP) and FTLD with Tau inclusions (FTLD-Tau). METHODS Antemortem CSF samples were collected from 30 patients with FTLD in a single-center validation cohort, and CSF levels of 5 putative FTLD-TDP biomarkers as well as levels of total Tau (t-Tau) and Tau phosphorylated at threonine 181 (p-Tau181) were measured using independent assays. Biomarkers most associated with FTLD-TDP were then tested in a separate 2-center validation cohort composed of subjects with FTLD-TDP, FTLD-Tau, Alzheimer disease (AD), and cognitively normal subjects. The sensitivity and specificity of FTLD-TDP biomarkers were determined. RESULTS In the first validation cohort, FTLD-TDP cases had decreased levels of p-Tau181 and interleukin-23, and increased Fas. Reduced ratio of p-Tau181 to t-Tau (p/t-Tau) was the strongest predictor of FTLD-TDP pathology. Analysis in the second validation cohort showed CSF p/t-Tau ratio <0.37 to distinguish FTLD-TDP from FTLD-Tau, AD, and healthy seniors with 82% sensitivity and 82% specificity. CONCLUSION A reduced CSF p/t-Tau ratio represents a reproducible, validated biomarker for FTLD-TDP with performance approaching well-established CSF AD biomarkers. Introducing this biomarker into research and the clinical arena can significantly increase the power of clinical trials targeting abnormal accumulations of TDP-43 or Tau, and select the appropriate patients for target-specific therapies. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that the CSF p/t-Tau ratio distinguishes FTLD-TDP from FTLD-Tau.
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Affiliation(s)
- William T Hu
- From the Department of Neurology (W.T.H., K.W., J.G., J.J.L., C.H., M.S., A.I.L.), Center for Neurodegenerative Diseases Research (W.T.H., K.W., J.G., J.J.L., C.H., A.I.L.), Alzheimer's Disease Research Center (W.T.H., J.G., J.J.L., C.H., A.I.L.), Emory University School of Medicine, Atlanta, GA; and Departments of Neurology (M.G.) and Laboratory Medicine and Pathology (V.V.D., J.Q.T.), University of Pennsylvania, Philadelphia
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Alegret M, Espinosa A, Valero S, Vinyes-Junqué G, Ruiz A, Hernández I, Rosende-Roca M, Mauleón A, Becker JT, Tárraga L, Boada M. Cut-off scores of a brief neuropsychological battery (NBACE) for Spanish individual adults older than 44 years old. PLoS One 2013; 8:e76436. [PMID: 24146868 PMCID: PMC3797837 DOI: 10.1371/journal.pone.0076436] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 08/27/2013] [Indexed: 11/18/2022] Open
Abstract
The neuropsychological battery used in Fundació ACE (NBACE) is a relatively brief, and easy to administer, test battery that was designed to detect cognitive impairment in the adulthood. The NBACE includes measures of cognitive information processing speed, orientation, attention, verbal learning and memory, language, visuoperception, praxis and executive functions. The aim of the present study was to establish the cut-off scores for impairment for different levels of age and education that could be useful in the cognitive assessment of Spanish subjects who are at risk for cognitive impairment, especially dementia. Data from 1018 patients with a mild dementia syndrome, and 512 cognitively healthy subjects, older than 44 years, from the Memory Clinic of Fundació ACE (Barcelona, Spain) were analyzed. In the whole sample, cut-off scores and sensitivity/specificity values were calculated for six conditions after combining 3 age ranges (44 to 64; 65 to 74; and older than 74 years old) by 2 educational levels (until Elementary school; and more than Elementary school). Moreover, general cut-offs are reported for Catalan and Spanish speakers. The results showed that most of NBACE tests reached good sensitivity and specificity values, except for Ideomotor praxis, Repetition and Verbal Comprehension tests, which had a ceiling effect. Word List Learning from the Wechsler Memory Scale-III and Semantic Verbal Fluency were the most useful tests to discriminate between cognitively healthy and demented subjects. The NBACE has been shown to be a useful tool able to detect cognitive impairment, especially dementia, in older than 44 years Spanish persons.
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Affiliation(s)
- Montserrat Alegret
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
- * E-mail:
| | - Ana Espinosa
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Sergi Valero
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Georgina Vinyes-Junqué
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Agustín Ruiz
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Isabel Hernández
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Maitee Rosende-Roca
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Ana Mauleón
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - James T. Becker
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Psychology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Lluís Tárraga
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Mercè Boada
- Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
- Hospital Universitari Vall d’Hebron -Institut de Recerca, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain
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Ownby RL, Acevedo A, Waldrop-Valverde D, Jacobs RJ, Caballero J, Davenport R, Homs AM, Czaja SJ, Loewenstein D. Development and initial validation of a computer-administered health literacy assessment in Spanish and English: FLIGHT/VIDAS. PATIENT-RELATED OUTCOME MEASURES 2013; 4:21-35. [PMID: 23990736 PMCID: PMC3753170 DOI: 10.2147/prom.s48384] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Current measures of health literacy have been criticized on a number of grounds, including use of a limited range of content, development on small and atypical patient groups, and poor psychometric characteristics. In this paper, we report the development and preliminary validation of a new computer-administered and -scored health literacy measure addressing these limitations. Items in the measure reflect a wide range of content related to health promotion and maintenance as well as care for diseases. The development process has focused on creating a measure that will be useful in both Spanish and English, while not requiring substantial time for clinician training and individual administration and scoring. The items incorporate several formats, including questions based on brief videos, which allow for the assessment of listening comprehension and the skills related to obtaining information on the Internet. In this paper, we report the interim analyses detailing the initial development and pilot testing of the items (phase 1 of the project) in groups of Spanish and English speakers. We then describe phase 2, which included a second round of testing of the items, in new groups of Spanish and English speakers, and evaluation of the new measure’s reliability and validity in relation to other measures. Data are presented that show that four scales (general health literacy, numeracy, conceptual knowledge, and listening comprehension), developed through a process of item and factor analyses, have significant relations to existing measures of health literacy.
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Affiliation(s)
- Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
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Salles JFD, Fonseca RP, Cruz-Rodrigues C, Mello CB, Barbosa T, Miranda MC. Desenvolvimento do Instrumento de Avaliação Neuropsicológica Breve Infantil NEUPSILIN-INF. PSICO-USF 2011. [DOI: 10.1590/s1413-82712011000300006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo é apresentar o processo de desenvolvimento e validação de conteúdo do Instrumento de Avaliação Neuropsicológica Breve Infantil NEUPSILIN-INF, que avalia, de modo breve, componentes de oito funções neuropsicológicas em crianças em idade escolar: orientação, atenção, percepção visual, memória, habilidades aritméticas, linguagem, habilidades visuoconstrutivas e funções executivas. O processo envolveu: 1) análise do instrumento original NEUPSILIN e definição das funções e tarefas a serem adaptadas para avaliação neuropsicológica infantil; 2) desenvolvimento de novas tarefas consideradas fundamentais para a avaliação na infância; 3) estudo piloto 1 com a versão preliminar do instrumento; 4) análise de juízes especialistas; 5) estudos piloto 2 e 3, nova reformulação de tarefas do instrumento e elaboração de sua versão final. O instrumento apresentou adequada validade aparente e de conteúdo.
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Jefferson AL, Gibbons LE, Rentz DM, Carvalho JO, Manly J, Bennett DA, Jones RN. A life course model of cognitive activities, socioeconomic status, education, reading ability, and cognition. J Am Geriatr Soc 2011; 59:1403-11. [PMID: 21797830 DOI: 10.1111/j.1532-5415.2011.03499.x] [Citation(s) in RCA: 164] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To cross-sectionally quantify the contribution of proxy measures of cognitive reserve reflective of the lifespan, such as education, socioeconomic status (SES), reading ability, and cognitive activities, in explaining late-life cognition. DESIGN Prospective observational cohort study of aging. SETTING Retirement communities across the Chicago metropolitan area. PARTICIPANTS Nine hundred fifty-one older adults free of clinical dementia in the Rush Memory and Aging Project (aged 79 ± 8, 74% female). MEASUREMENTS Baseline data on multiple life course factors included early-, mid-, and late-life participation in cognitive activities; early-life and adult SES; education; and reading ability (National Adult Reading Test; NART). Path analysis quantified direct and indirect standardized effects of life course factors on global cognition and five cognitive domains (episodic memory, semantic memory, working memory, visuospatial ability, perceptual speed). RESULTS Adjusting for age, sex, and race, education had the strongest association with global cognition, episodic memory, semantic memory, and visuospatial ability, whereas NART (followed by education) had the strongest association with working memory. Late-life cognitive activities had the strongest association with perceptual speed, followed by education. CONCLUSIONS These cross-sectional findings suggest that education and reading ability are the most-robust proxy measures of cognitive reserve in relation to late-life cognition. Additional research leveraging path analysis is warranted to better understand how these life course factors, reflecting the latent construct of cognitive reserve, affect abnormal cognitive aging.
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Affiliation(s)
- Angela L Jefferson
- Alzheimer's Disease Center, School of Medicine, Boston University, Boston, Massachusetts, USA.
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Gollan TH, Salmon DP, Montoya RI, da Pena E. Accessibility of the nondominant language in picture naming: a counterintuitive effect of dementia on bilingual language production. Neuropsychologia 2010; 48:1356-66. [PMID: 20036679 PMCID: PMC2843816 DOI: 10.1016/j.neuropsychologia.2009.12.038] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Revised: 12/01/2009] [Accepted: 12/22/2009] [Indexed: 11/24/2022]
Abstract
The current study tested the assumption that bilinguals with dementia regress to using primarily the dominant language. Spanish-English bilinguals with probable Alzheimer's disease (AD; n=29), and matched bilingual controls (n=42) named Boston Naming Test pictures in their dominant and nondominant languages. Surprisingly, differences between patients and controls were larger using dominant-language than nondominant-language naming scores, and bilinguals with AD were either more likely than controls (in English-dominant bilinguals), or equally likely (in Spanish-dominant bilinguals), to name some pictures in the nondominant language that they could not produce in their dominant language. These findings suggest that dominant language testing may provide the best assessment of language deficits in bilingual AD, and argue against the common notion that the nondominant language is particularly susceptible to dementia. The greater vulnerability of the dominant language may reflect the increased probability of AD affecting richer semantic representations associated with dominant compared to nondominant language names.
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Affiliation(s)
- Tamar H Gollan
- Department of Psychiatry, University of California, San Diego, CA 92093-0949, USA.
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