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Gerstenecker A, Kennedy R, Zhang Y, Martin RC, Mackin RS, Weiner MW, Howell T, Petersen RC, Roberson ED, Marson DC. Item Response Analysis of the Financial Capacity Instrument-Short Form. Arch Clin Neuropsychol 2023; 38:739-758. [PMID: 36644855 PMCID: PMC10369359 DOI: 10.1093/arclin/acac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE The Financial Capacity Instrument-Short Form (FCI-SF) is a performance-based measure of everyday financial skills that takes 15 min to administer. Although the FCI-SF has demonstrated excellent psychometric properties, advanced psychometric methods such as item response theory (IRT) can provide important information on the performance of individual test items in measuring financial capacity and in distinguishing between healthy and cognitively impaired individuals. METHOD Participants were 272 older adults diagnosed with mild cognitive impairment (MCI) and 1,344 cognitively healthy controls recruited from the Mayo Clinic Study of Aging at the Mayo Clinic in Rochester, Minnesota and also from the Cognitive Observations in Seniors study at the University of Alabama at Birmingham. Participants in each study were administered the FCI-SF, which evaluates coin/currency calculation, financial conceptual knowledge, use of a checkbook/register, and use of a bank statement. RESULTS A unidimensional two-parameter logistic model best fit the 37 FCI-SF Test items, and most FCI-SF items fit the unidimensional two-parameter model well. The results indicated that all FCI-SF items robustly distinguished cognitively healthy controls from persons with MCI. CONCLUSIONS The study results showed that the FCI-SF performed well under IRT analysis, further highlighted the psychometric properties of the FCI-SF as a valid and reliable measure of financial capacity, and demonstrated the clinical utility of the FCI-SF in distinguishing between cognitively normal and cognitively impaired individuals.
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Affiliation(s)
- Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, San Francisco, CA, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
| | - Richard Kennedy
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, San Francisco, CA, USA
- Interdisciplinary Center for Aging Research, University of Alabama at Birmingham, San Francisco, CA, USA
| | - Yue Zhang
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, San Francisco, CA, USA
| | - Roy C Martin
- Department of Neurology, University of Alabama at Birmingham, San Francisco, CA, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
| | - R Scott Mackin
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Michael W Weiner
- San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Taylor Howell
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, San Francisco, CA, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
- Interdisciplinary Center for Aging Research, University of Alabama at Birmingham, San Francisco, CA, USA
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, San Francisco, CA, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
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Rajabli F, Benchek P, Tosto G, Kushch N, Sha J, Bazemore K, Zhu C, Lee WP, Haut J, Hamilton-Nelson KL, Wheeler NR, Zhao Y, Farrell JJ, Grunin MA, Leung YY, Kuksa PP, Li D, Lucio da Fonseca E, Mez JB, Palmer EL, Pillai J, Sherva RM, Song YE, Zhang X, Iqbal T, Pathak O, Valladares O, Kuzma AB, Abner E, Adams PM, Aguirre A, Albert MS, Albin RL, Allen M, Alvarez L, Apostolova LG, Arnold SE, Asthana S, Atwood CS, Ayres G, Baldwin CT, Barber RC, Barnes LL, Barral S, Beach TG, Becker JT, Beecham GW, Beekly D, Benitez BA, Bennett D, Bertelson J, Bird TD, Blacker D, Boeve BF, Bowen JD, Boxer A, Brewer J, Burke JR, Burns JM, Buxbaum JD, Cairns NJ, Cantwell LB, Cao C, Carlson CS, Carlsson CM, Carney RM, Carrasquillo MM, Chasse S, Chesselet MF, Chin NA, Chui HC, Chung J, Craft S, Crane PK, Cribbs DH, Crocco EA, Cruchaga C, Cuccaro ML, Cullum M, Darby E, Davis B, De Jager PL, DeCarli C, DeToledo J, Dick M, Dickson DW, Dombroski BA, Doody RS, Duara R, Ertekin-Taner NI, Evans DA, Faber KM, Fairchild TJ, Fallon KB, Fardo DW, Farlow MR, Fernandez-Hernandez V, Ferris S, Foroud TM, Frosch MP, Fulton-Howard B, Galasko DR, Gamboa A, Gearing M, Geschwind DH, Ghetti B, Gilbert JR, Goate AM, Grabowski TJ, Graff-Radford NR, Green RC, Growdon JH, Hakonarson H, Hall J, Hamilton RL, Harari O, Hardy J, Harrell LE, Head E, Henderson VW, Hernandez M, Hohman T, Honig LS, Huebinger RM, Huentelman MJ, Hulette CM, Hyman BT, Hynan LS, Ibanez L, Jarvik GP, Jayadev S, Jin LW, Johnson K, Johnson L, Kamboh MI, Karydas AM, Katz MJ, Kauwe JS, Kaye JA, Keene CD, Khaleeq A, Kim R, Knebl J, Kowall NW, Kramer JH, Kukull WA, LaFerla FM, Lah JJ, Larson EB, Lerner A, Leverenz JB, Levey AI, Lieberman AP, Lipton RB, Logue M, Lopez OL, Lunetta KL, Lyketsos CG, Mains D, Margaret FE, Marson DC, Martin ERR, Martiniuk F, Mash DC, Masliah E, Massman P, Masurkar A, McCormick WC, McCurry SM, McDavid AN, McDonough S, McKee AC, Mesulam M, Miller BL, Miller CA, Miller JW, Montine TJ, Monuki ES, Morris JC, Mukherjee S, Myers AJ, Nguyen T, O'Bryant S, Olichney JM, Ory M, Palmer R, Parisi JE, Paulson HL, Pavlik V, Paydarfar D, Perez V, Peskind E, Petersen RC, Pierce A, Polk M, Poon WW, Potter H, Qu L, Quiceno M, Quinn JF, Raj A, Raskind M, Reiman EM, Reisberg B, Reisch JS, Ringman JM, Roberson ED, Rodriguear M, Rogaeva E, Rosen HJ, Rosenberg RN, Royall DR, Sager MA, Sano M, Saykin AJ, Schneider JA, Schneider LS, Seeley WW, Slifer SH, Small S, Smith AG, Smith JP, Sonnen JA, Spina S, St George-Hyslop P, Stern RA, Stevens AB, Strittmatter SM, Sultzer D, Swerdlow RH, Tanzi RE, Tilson JL, Trojanowski JQ, Troncoso JC, Tsuang DW, Van Deerlin VM, van Eldik LJ, Vance JM, Vardarajan BN, Vassar R, Vinters HV, Vonsattel JP, Weintraub S, Welsh-Bohmer KA, Whitehead PL, Wijsman EM, Wilhelmsen KC, Williams B, Williamson J, Wilms H, Wingo TS, Wisniewski T, Woltjer RL, Woon M, Wright CB, Wu CK, Younkin SG, Yu CE, Yu L, Zhu X, Kunkle BW, Bush WS, Wang LS, Farrer LA, Haines JL, Mayeux R, Pericak-Vance MA, Schellenberg GD, Jun GR, Reitz C, Naj AC. Multi-ancestry genome-wide meta-analysis of 56,241 individuals identifies LRRC4C, LHX5-AS1 and nominates ancestry-specific loci PTPRK , GRB14 , and KIAA0825 as novel risk loci for Alzheimer's disease: the Alzheimer's Disease Genetics Consortium. medRxiv 2023:2023.07.06.23292311. [PMID: 37461624 PMCID: PMC10350126 DOI: 10.1101/2023.07.06.23292311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Limited ancestral diversity has impaired our ability to detect risk variants more prevalent in non-European ancestry groups in genome-wide association studies (GWAS). We constructed and analyzed a multi-ancestry GWAS dataset in the Alzheimer's Disease (AD) Genetics Consortium (ADGC) to test for novel shared and ancestry-specific AD susceptibility loci and evaluate underlying genetic architecture in 37,382 non-Hispanic White (NHW), 6,728 African American, 8,899 Hispanic (HIS), and 3,232 East Asian individuals, performing within-ancestry fixed-effects meta-analysis followed by a cross-ancestry random-effects meta-analysis. We identified 13 loci with cross-ancestry associations including known loci at/near CR1 , BIN1 , TREM2 , CD2AP , PTK2B , CLU , SHARPIN , MS4A6A , PICALM , ABCA7 , APOE and two novel loci not previously reported at 11p12 ( LRRC4C ) and 12q24.13 ( LHX5-AS1 ). Reflecting the power of diverse ancestry in GWAS, we observed the SHARPIN locus using 7.1% the sample size of the original discovering single-ancestry GWAS (n=788,989). We additionally identified three GWS ancestry-specific loci at/near ( PTPRK ( P =2.4×10 -8 ) and GRB14 ( P =1.7×10 -8 ) in HIS), and KIAA0825 ( P =2.9×10 -8 in NHW). Pathway analysis implicated multiple amyloid regulation pathways (strongest with P adjusted =1.6×10 -4 ) and the classical complement pathway ( P adjusted =1.3×10 -3 ). Genes at/near our novel loci have known roles in neuronal development ( LRRC4C, LHX5-AS1 , and PTPRK ) and insulin receptor activity regulation ( GRB14 ). These findings provide compelling support for using traditionally-underrepresented populations for gene discovery, even with smaller sample sizes.
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Gerstenecker A, Martin RC, Hebert K, Triebel K, Marson DC. Cognitive Correlates of Impaired Testamentary Capacity in Alzheimer's Dementia. Arch Clin Neuropsychol 2022; 37:1148-1157. [PMID: 35731016 DOI: 10.1093/arclin/acac034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Testamentary capacity (TC) is a legal construct about the ability to make or change a will. Although studies of financial and medical capacities have noted a strong association between capacity and cognition, no study has examined the cognitive correlates of TC in Alzheimer's disease (ad). METHODS Study participants were 22 cognitively healthy controls and 20 persons with mild to moderate ad who were administered a neuropsychological battery and the Testamentary Capacity Instrument (TCI), a new performance-based measure of TC. Both TCI Element and TCI Total scores were calculated. TCI Total scores were calculated for the purposes of expanding correlational analyses (i.e., Pearson's product-moment) and are not intended for forensic TC evaluations. Final predictors were identified using linear and logistic regression modeling. RESULTS All ad participants but one obtained TCI Totals that fell >2.5 standard deviations below the control group mean. Initial cognitive correlates of TCI performance were measures of general cognition, language, verbal memory, executive function, and processing speed. The four cognitive variables showing the highest t values and correlating with TCI Total score > 0.7 were entered into logistic and linear regression models. Final predictor models consisted of measures of verbal memory, executive function, and semantic knowledge and demonstrated shared variance of 0.71 (linear) and 0.82 (logistic). CONCLUSIONS A diagnosis of ad dementia is associated with clinical impairment in TC and associated cognitive abilities and indicates that a legal assessment of TC is warranted. Second, the results offer insight into the cognitive basis of TC in persons with Alzheimer's dementia.
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Affiliation(s)
- Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.,Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA.,Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Roy C Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.,Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA.,Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Katina Hebert
- Tuscaloosa Veteran's Administration, Tuscaloosa, AL, USA
| | - Kristen Triebel
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.,Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA.,Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.,Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA.,Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
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Vassilaki M, Aakre JA, Kremers WK, Mielke MM, Geda YE, Machulda MM, Knopman DS, Vemuri P, Lowe VJ, Jack CR, Roberson ED, Gerstenecker A, Martin RC, Kennedy RE, Marson DC, Petersen RC. Association of Performance on the Financial Capacity Instrument–Short Form With Brain Amyloid Load and Cortical Thickness in Older Adults. Neurol Clin Pract 2022; 12:113-124. [PMID: 35747890 PMCID: PMC9208409 DOI: 10.1212/cpj.0000000000001157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractObjective:To investigate the association of the Financial Capacity Instrument–Short Form (FCI-SF) performance and timing total scores with brain β-amyloid and cortical thickness in cognitively unimpaired (CU) at baseline older adults.Methods:309 participants (≥70 years old) of the Mayo Clinic Study of Aging underwent 11C Pittsburgh compound B PET amyloid imaging, MR imaging, and completed the FCI-SF. Abnormal amyloid PET was defined as standardized uptake value ratio ≥1.48 in an Alzheimer's disease (AD)-related region of interest and reduced AD signature cortical thickness as ≤2.68mm (neurodegeneration). A cohort of 218 (of the 309) participants had follow-up visits (every 15 months) with FCI-SF data for longitudinal analysis (number of visits including baseline, median (range): 2 (2-4)). In analysis, we used linear regression and mixed-effects models adjusted for age, sex, education, apolipoprotein ε4 allele status, global cognitive z-score, and prior FCI-SF testing.Results:Participants’ mean age (SD) was 80.2 (±4.8) years (56.3% males). In cross-sectional analysis, abnormal amyloid PET (vs. normal) was associated with a lower FCI-SF Total score and slower Total Composite Time. In longitudinal analysis, FCI-SF Total Score declined faster (difference in annualized rate of change, beta coefficient (β) (95%CI) = -1.123 (-2.086, -0.161)) and FCI-SF Total Composite Time increased faster (difference in annualized rate of change, β (95%CI) = 16.274 (5.951, 26.597) for participants with neurodegeneration at baseline (vs. those without). Participants who had both abnormal amyloid PET and neurodegeneration at baseline had a greater increase in Total Composite Time compared to the group without abnormal amyloid and without neurodegeneration (difference in annualized rate of change, β (95%CI) = 16.750 (3.193, 30.307)).Conclusions:Performance and processing speed on the FCI-SF were associated with imaging biomarkers of AD pathophysiology in CU at baseline older adults. Higher burdens of imaging biomarkers were associated with longitudinal worsening on FCI-SF performance. Additional research is needed to delineate further these associations and their predictive utility at the individual person level.
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Affiliation(s)
- Maria Vassilaki
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Jeremiah A Aakre
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Walter K Kremers
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Michelle M Mielke
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Yonas E Geda
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Mary M Machulda
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - David S Knopman
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Prashanthi Vemuri
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Val J Lowe
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Clifford R Jack
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Erik D Roberson
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Adam Gerstenecker
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Roy C Martin
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Richard E Kennedy
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Daniel C Marson
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
| | - Ronald C Petersen
- Department of Quantitative Health Sciences (MV, JAA, WKK, M.M. Mielke, RCP), and Department of Neurology (M.M. Mielke, DSK, RCP), Mayo Clinic, Rochester, MN; Department of Neurology (YEG), Barrow Neurological Institute, Phoenix, AZ; Department of Psychiatry and Psychology (M.M. Machulda), and Department of Radiology (PV, VJL, CRJ), Mayo Clinic, Rochester, MN; Department of Neurology (EDR, AG, RCM, DCM), Department of Medicine (REK), and Alzheimer's Disease Center (DCM), University of Alabama at Birmingham
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Wadley VG, Bull TP, Zhang Y, Barba C, Bryan RN, Crowe M, Desiderio L, Deutsch G, Erus G, Geldmacher DS, Go R, Lassen-Greene CL, Mamaeva OA, Marson DC, McLaughlin M, Nasrallah IM, Owsley C, Passler J, Perry RT, Pilonieta G, Steward KA, Kennedy RE. Cognitive Processing Speed Is Strongly Related to Driving Skills, Financial Abilities, and Other Instrumental Activities of Daily Living in Persons With Mild Cognitive Impairment and Mild Dementia. J Gerontol A Biol Sci Med Sci 2020; 76:1829-1838. [PMID: 33313639 DOI: 10.1093/gerona/glaa312] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cognitive processing speed is important for performing everyday activities in persons with mild cognitive impairment (MCI). However, its role in daily function has not been examined while simultaneously accounting for contributions of Alzheimer's disease (AD) risk biomarkers. We examine the relationships of processing speed and genetic and neuroimaging biomarkers to composites of daily function, mobility, and driving. METHOD We used baseline data from 103 participants on the MCI/mild dementia spectrum from the Applying Programs to Preserve Skills trial. Linear regression models examined relationships of processing speed, structural magnetic resonance imaging (MRI), and genetic risk alleles for AD to composites of performance-based instrumental activities of daily living (IADLs), community mobility, and on-road driving evaluations. RESULTS In multivariable models, processing speed and the brain MRI neurodegeneration biomarker Spatial Pattern of Abnormality for Recognition of Early Alzheimer's disease (SPARE-AD) were significantly associated with functional and mobility composite performance. Better processing speed and younger age were associated with on-road driving ratings. Genetic risk markers, left hippocampal atrophy, and white matter lesion volumes were not significant correlates of these abilities. Processing speed had a strong positive association with IADL function (p < .001), mobility (p < .001), and driving (p = .002). CONCLUSIONS Cognitive processing speed is strongly and consistently associated with critical daily functions in persons with MCI in models including genetic and neuroimaging biomarkers of AD risk. SPARE-AD scores also significantly correlate with IADL performance and mobility. Results highlight the central role of processing speed in everyday task performance among persons with MCI/mild dementia.
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Affiliation(s)
- Virginia G Wadley
- Department of Medicine, University of Alabama at Birmingham.,Department of Psychology, University of Alabama at Birmingham.,Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham
| | - Tyler P Bull
- Department of Psychology, University of Alabama at Birmingham
| | - Yue Zhang
- Department of Medicine, University of Alabama at Birmingham
| | - Cheyanne Barba
- Department of Psychology, University of Alabama at Birmingham
| | - R Nick Bryan
- Department of Diagnostic Medicine, Dell Medical School, The University of Texas at Austin
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham
| | - Lisa Desiderio
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Georg Deutsch
- Department of Radiology, University of Alabama at Birmingham
| | - Guray Erus
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - David S Geldmacher
- Department of Neurobiology, University of Alabama at Birmingham.,Department of Neurology, University of Alabama at Birmingham
| | - Rodney Go
- Department of Epidemiology, University of Alabama at Birmingham
| | - Caroline L Lassen-Greene
- Department of Psychology, University of Alabama at Birmingham.,Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center, Nashville
| | - Olga A Mamaeva
- Department of Epidemiology, University of Alabama at Birmingham
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham
| | - Marianne McLaughlin
- Department of Medicine, University of Alabama at Birmingham.,Department of Neurology, University of Alabama at Birmingham
| | - Ilya M Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham
| | - Jesse Passler
- Department of Psychology, University of Alabama at Birmingham.,Department of Rehabilitation, Psychology and Neuropsychology, Baylor College of Medicine/TIRR Memorial Hermann, Houston, Texas
| | - Rodney T Perry
- Department of Epidemiology, University of Alabama at Birmingham
| | | | - Kayla A Steward
- Department of Psychology, University of Alabama at Birmingham.,Department of Mental Health and Behavioral Sciences, James A. Haley Veterans' Hospital, Tampa, Florida
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Dodge HH, Goldstein FC, Wakim NI, Gefen T, Teylan M, Kukull WA, Barnes LL, Giordani B, Hughes TM, Kramer JH, Loewenstein DA, Marson DC, Mungas DM, Sachs B, Salmon DP, Steenland K, Parker MW, Welsh‐Bohmer KA, Morris JC, Weintraub S. Differentiating among stages of cognitive impairment: Comparisons of versions two and three of the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS) neuropsychological test battery. Alzheimers Dement 2020. [DOI: 10.1002/alz.040648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Hiroko H Dodge
- Layton Aging & Alzheimer's Disease Center Oregon Health & Science University Portland OR USA
| | | | | | | | - Merilee Teylan
- National Alzheimer's Coordinating Center University of Washington Seattle WA USA
| | | | - Lisa L Barnes
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA
| | | | | | - Joel H Kramer
- UMemory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | | | | | - Dan M Mungas
- University of California, Davis Sacramento CA USA
| | - Bonnie Sachs
- Wake Forest School of Medicine Winston‐Salem NC USA
| | | | | | | | | | - John C Morris
- Washington University School of Medicine St. Louis MO USA
- Hope Center for Neurological Disorders St. Louis MO USA
- Knight Alzheimer Disease Research Center St. Louis MO USA
- Washington University in St. Louis School of Medicine St. Louis MO USA
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7
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Dodge HH, Goldstein FC, Wakim NI, Gefen T, Teylan M, Chan KC, Kukull WA, Barnes LL, Giordani B, Hughes TM, Kramer JH, Loewenstein DA, Marson DC, Mungas DM, Mattek N, Sachs BC, Salmon DP, Willis‐Parker M, Welsh‐Bohmer KA, Wild KV, Morris JC, Weintraub S. Differentiating among stages of cognitive impairment in aging: Version 3 of the Uniform Data Set (UDS) neuropsychological test battery and MoCA index scores. Alzheimers Dement (N Y) 2020; 6:e12103. [PMID: 33283037 PMCID: PMC7683960 DOI: 10.1002/trc2.12103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Federally funded Alzheimer's Disease Centers in the United States have been using a standardized neuropsychological test battery as part of the National Alzheimer's Coordinating Center Uniform Data Set (UDS) since 2005. Version 3 (V3) of the UDS replaced the previous version (V2) in 2015. We compared V2 and V3 neuropsychological tests with respect to their ability to distinguish among the Clinical Dementia Rating (CDR) global scores of 0, 0.5, and 1. METHODS First, we matched participants receiving V2 tests (V2 cohort) and V3 tests (V3 cohort) in their cognitive functions using tests common to both versions. Then, we compared receiver-operating characteristic (ROC) area under the curve in differentiating CDRs for the remaining tests. RESULTS Some V3 tests performed better than V2 tests in differentiating between CDR 0.5 and 0, but the improvement was limited to Caucasian participants. DISCUSSION Further efforts to improve the ability for early identification of cognitive decline among diverse racial groups are required.
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Affiliation(s)
- Hiroko H. Dodge
- Layton Aging and Alzheimer's Disease CenterOregon Health & Science UniversityPortlandOregonUSA
| | - Felicia C. Goldstein
- Goizueta Alzheimer's Disease Research CenterEmory University School of MedicineAtlantaGeorgiaUSA
| | - Nicole I Wakim
- Department of BiostatisticsUniversity of MichiganAnn ArborMichiganUSA
| | - Tamar Gefen
- The Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Merilee Teylan
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWashingtonUSA
| | - Kwun C.G. Chan
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWashingtonUSA
| | - Walter A. Kukull
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWashingtonUSA
- Department of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Lisa L. Barnes
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Bruno Giordani
- Michigan Alzheimer's Disease CenterUniversity of MichiganAnn ArborMichiganUSA
| | - Timothy M. Hughes
- The Wake Forest Alzheimer's Disease Research Center, Wake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Joel H. Kramer
- Memory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - David A. Loewenstein
- Center for Cognitive Neuroscience and AgingUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Daniel C. Marson
- Alzheimer's Disease CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Dan M. Mungas
- The UC Davis Alzheimer's Disease Research CenterUniversity of California, DavisSacramentoCaliforniaUSA
| | - Nora Mattek
- Layton Aging and Alzheimer's Disease CenterOregon Health & Science UniversityPortlandOregonUSA
| | - Bonnie C. Sachs
- The Wake Forest Alzheimer's Disease Research Center, Wake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - David P. Salmon
- The Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Monica Willis‐Parker
- Goizueta Alzheimer's Disease Research CenterEmory University School of MedicineAtlantaGeorgiaUSA
| | | | - Katherine V. Wild
- Layton Aging and Alzheimer's Disease CenterOregon Health & Science UniversityPortlandOregonUSA
| | - John C. Morris
- Knight Alzheimer Disease Research CenterWashington University School of MedicineSt. LouisMissouriUSA
| | - Sandra Weintraub
- The Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
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8
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Gerstenecker A, Martin RC, Triebel KL, Marson DC. Anosognosia of financial ability in mild cognitive impairment. Int J Geriatr Psychiatry 2019; 34:1200-1207. [PMID: 30968462 DOI: 10.1002/gps.5118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 04/08/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Although financial ability has been well-studied in mild cognitive impairment (MCI) and Alzheimer's disease (AD) using performance-based financial capacity assessment instruments, research is limited investigating everyday financial problems and declines in persons with AD and MCI and the insight of people with MCI to recognize that financial capacity declines are occurring. To address this gap in the research, we investigated everyday financial activities and skills in a sample of older adults representing the dementia spectrum. METHODS Participants were 186 older adults in three diagnostic classifications: cognitively healthy, MCI likely due to AD, and mild AD dementia. Everyday financial ability was assessed using the Current Financial Activities Report (CFAR). The CFAR is a standardized report-based measure which elicits participant and study partner ratings about a participant's everyday financial abilities. RESULTS Results showed that both CFAR self- and study partner-report distinguished diagnostic groups on key financial capacity variables in a pattern consistent with level of clinical pathology. Study partner-report indicated higher levels of financial skill difficulties in study participants than did the self-report of the same study participants. Study partner-ratings were more highly correlated with participant scores on a performance-based measure of financial capacity than were participant self-ratings. Results also showed that loss of awareness of financial decline is emerging at the MCI stage of AD. CONCLUSIONS People with MCI represent a group of older adults at particular risk for financial missteps and-similar to people with AD-are in need of supervision of their financial skills and activities.
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Affiliation(s)
- Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL.,Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL
| | - Roy C Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL.,Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL
| | - Kristen L Triebel
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL.,Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL.,Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL
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9
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Kunkle BW, Grenier-Boley B, Sims R, Bis JC, Damotte V, Naj AC, Boland A, Vronskaya M, van der Lee SJ, Amlie-Wolf A, Bellenguez C, Frizatti A, Chouraki V, Martin ER, Sleegers K, Badarinarayan N, Jakobsdottir J, Hamilton-Nelson KL, Moreno-Grau S, Olaso R, Raybould R, Chen Y, Kuzma AB, Hiltunen M, Morgan T, Ahmad S, Vardarajan BN, Epelbaum J, Hoffmann P, Boada M, Beecham GW, Garnier JG, Harold D, Fitzpatrick AL, Valladares O, Moutet ML, Gerrish A, Smith AV, Qu L, Bacq D, Denning N, Jian X, Zhao Y, Del Zompo M, Fox NC, Choi SH, Mateo I, Hughes JT, Adams HH, Malamon J, Sanchez-Garcia F, Patel Y, Brody JA, Dombroski BA, Naranjo MCD, Daniilidou M, Eiriksdottir G, Mukherjee S, Wallon D, Uphill J, Aspelund T, Cantwell LB, Garzia F, Galimberti D, Hofer E, Butkiewicz M, Fin B, Scarpini E, Sarnowski C, Bush WS, Meslage S, Kornhuber J, White CC, Song Y, Barber RC, Engelborghs S, Sordon S, Voijnovic D, Adams PM, Vandenberghe R, Mayhaus M, Cupples LA, Albert MS, De Deyn PP, Gu W, Himali JJ, Beekly D, Squassina A, Hartmann AM, Orellana A, Blacker D, Rodriguez-Rodriguez E, Lovestone S, Garcia ME, Doody RS, Munoz-Fernadez C, Sussams R, Lin H, Fairchild TJ, Benito YA, Holmes C, Karamujić-Čomić H, Frosch MP, Thonberg H, Maier W, Roshchupkin G, Ghetti B, Giedraitis V, Kawalia A, Li S, Huebinger RM, Kilander L, Moebus S, Hernández I, Kamboh MI, Brundin R, Turton J, Yang Q, Katz MJ, Concari L, Lord J, Beiser AS, Keene CD, Helisalmi S, Kloszewska I, Kukull WA, Koivisto AM, Lynch A, Tarraga L, Larson EB, Haapasalo A, Lawlor B, Mosley TH, Lipton RB, Solfrizzi V, Gill M, Longstreth WT, Montine TJ, Frisardi V, Diez-Fairen M, Rivadeneira F, Petersen RC, Deramecourt V, Alvarez I, Salani F, Ciaramella A, Boerwinkle E, Reiman EM, Fievet N, Rotter JI, Reisch JS, Hanon O, Cupidi C, Andre Uitterlinden AG, Royall DR, Dufouil C, Maletta RG, de Rojas I, Sano M, Brice A, Cecchetti R, George-Hyslop PS, Ritchie K, Tsolaki M, Tsuang DW, Dubois B, Craig D, Wu CK, Soininen H, Avramidou D, Albin RL, Fratiglioni L, Germanou A, Apostolova LG, Keller L, Koutroumani M, Arnold SE, Panza F, Gkatzima O, Asthana S, Hannequin D, Whitehead P, Atwood CS, Caffarra P, Hampel H, Quintela I, Carracedo Á, Lannfelt L, Rubinsztein DC, Barnes LL, Pasquier F, Frölich L, Barral S, McGuinness B, Beach TG, Johnston JA, Becker JT, Passmore P, Bigio EH, Schott JM, Bird TD, Warren JD, Boeve BF, Lupton MK, Bowen JD, Proitsi P, Boxer A, Powell JF, Burke JR, Kauwe JSK, Burns JM, Mancuso M, Buxbaum JD, Bonuccelli U, Cairns NJ, McQuillin A, Cao C, Livingston G, Carlson CS, Bass NJ, Carlsson CM, Hardy J, Carney RM, Bras J, Carrasquillo MM, Guerreiro R, Allen M, Chui HC, Fisher E, Masullo C, Crocco EA, DeCarli C, Bisceglio G, Dick M, Ma L, Duara R, Graff-Radford NR, Evans DA, Hodges A, Faber KM, Scherer M, Fallon KB, Riemenschneider M, Fardo DW, Heun R, Farlow MR, Kölsch H, Ferris S, Leber M, Foroud TM, Heuser I, Galasko DR, Giegling I, Gearing M, Hüll M, Geschwind DH, Gilbert JR, Morris J, Green RC, Mayo K, Growdon JH, Feulner T, Hamilton RL, Harrell LE, Drichel D, Honig LS, Cushion TD, Huentelman MJ, Hollingworth P, Hulette CM, Hyman BT, Marshall R, Jarvik GP, Meggy A, Abner E, Menzies GE, Jin LW, Leonenko G, Real LM, Jun GR, Baldwin CT, Grozeva D, Karydas A, Russo G, Kaye JA, Kim R, Jessen F, Kowall NW, Vellas B, Kramer JH, Vardy E, LaFerla FM, Jöckel KH, Lah JJ, Dichgans M, Leverenz JB, Mann D, Levey AI, Pickering-Brown S, Lieberman AP, Klopp N, Lunetta KL, Wichmann HE, Lyketsos CG, Morgan K, Marson DC, Brown K, Martiniuk F, Medway C, Mash DC, Nöthen MM, Masliah E, Hooper NM, McCormick WC, Daniele A, McCurry SM, Bayer A, McDavid AN, Gallacher J, McKee AC, van den Bussche H, Mesulam M, Brayne C, Miller BL, Riedel-Heller S, Miller CA, Miller JW, Al-Chalabi A, Morris JC, Shaw CE, Myers AJ, Wiltfang J, O'Bryant S, Olichney JM, Alvarez V, Parisi JE, Singleton AB, Paulson HL, Collinge J, Perry WR, Mead S, Peskind E, Cribbs DH, Rossor M, Pierce A, Ryan NS, Poon WW, Nacmias B, Potter H, Sorbi S, Quinn JF, Sacchinelli E, Raj A, Spalletta G, Raskind M, Caltagirone C, Bossù P, Orfei MD, Reisberg B, Clarke R, Reitz C, Smith AD, Ringman JM, Warden D, Roberson ED, Wilcock G, Rogaeva E, Bruni AC, Rosen HJ, Gallo M, Rosenberg RN, Ben-Shlomo Y, Sager MA, Mecocci P, Saykin AJ, Pastor P, Cuccaro ML, Vance JM, Schneider JA, Schneider LS, Slifer S, Seeley WW, Smith AG, Sonnen JA, Spina S, Stern RA, Swerdlow RH, Tang M, Tanzi RE, Trojanowski JQ, Troncoso JC, Van Deerlin VM, Van Eldik LJ, Vinters HV, Vonsattel JP, Weintraub S, Welsh-Bohmer KA, Wilhelmsen KC, Williamson J, Wingo TS, Woltjer RL, Wright CB, Yu CE, Yu L, Saba Y, Pilotto A, Bullido MJ, Peters O, Crane PK, Bennett D, Bosco P, Coto E, Boccardi V, De Jager PL, Lleo A, Warner N, Lopez OL, Ingelsson M, Deloukas P, Cruchaga C, Graff C, Gwilliam R, Fornage M, Goate AM, Sanchez-Juan P, Kehoe PG, Amin N, Ertekin-Taner N, Berr C, Debette S, Love S, Launer LJ, Younkin SG, Dartigues JF, Corcoran C, Ikram MA, Dickson DW, Nicolas G, Campion D, Tschanz J, Schmidt H, Hakonarson H, Clarimon J, Munger R, Schmidt R, Farrer LA, Van Broeckhoven C, C O'Donovan M, DeStefano AL, Jones L, Haines JL, Deleuze JF, Owen MJ, Gudnason V, Mayeux R, Escott-Price V, Psaty BM, Ramirez A, Wang LS, Ruiz A, van Duijn CM, Holmans PA, Seshadri S, Williams J, Amouyel P, Schellenberg GD, Lambert JC, Pericak-Vance MA. Genetic meta-analysis of diagnosed Alzheimer's disease identifies new risk loci and implicates Aβ, tau, immunity and lipid processing. Nat Genet 2019; 51:414-430. [PMID: 30820047 PMCID: PMC6463297 DOI: 10.1038/s41588-019-0358-2] [Citation(s) in RCA: 1541] [Impact Index Per Article: 308.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 01/22/2019] [Indexed: 02/08/2023]
Abstract
Risk for late-onset Alzheimer's disease (LOAD), the most prevalent dementia, is partially driven by genetics. To identify LOAD risk loci, we performed a large genome-wide association meta-analysis of clinically diagnosed LOAD (94,437 individuals). We confirm 20 previous LOAD risk loci and identify five new genome-wide loci (IQCK, ACE, ADAM10, ADAMTS1, and WWOX), two of which (ADAM10, ACE) were identified in a recent genome-wide association (GWAS)-by-familial-proxy of Alzheimer's or dementia. Fine-mapping of the human leukocyte antigen (HLA) region confirms the neurological and immune-mediated disease haplotype HLA-DR15 as a risk factor for LOAD. Pathway analysis implicates immunity, lipid metabolism, tau binding proteins, and amyloid precursor protein (APP) metabolism, showing that genetic variants affecting APP and Aβ processing are associated not only with early-onset autosomal dominant Alzheimer's disease but also with LOAD. Analyses of risk genes and pathways show enrichment for rare variants (P = 1.32 × 10-7), indicating that additional rare variants remain to be identified. We also identify important genetic correlations between LOAD and traits such as family history of dementia and education.
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Affiliation(s)
- Brian W Kunkle
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Benjamin Grenier-Boley
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Rebecca Sims
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Vincent Damotte
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Adam C Naj
- Department of Biostatistics and Epidemiology/Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Maria Vronskaya
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Sven J van der Lee
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Alexandre Amlie-Wolf
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Céline Bellenguez
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Aura Frizatti
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Vincent Chouraki
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Eden R Martin
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kristel Sleegers
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium
- Laboratory for Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Nandini Badarinarayan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Kara L Hamilton-Nelson
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sonia Moreno-Grau
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Robert Olaso
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Rachel Raybould
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Yuning Chen
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Amanda B Kuzma
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mikko Hiltunen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Taniesha Morgan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Badri N Vardarajan
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Jacques Epelbaum
- UMR 894, Center for Psychiatry and Neuroscience, Inserm, Université Paris Descartes, Paris, France
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Division of Medical Genetics, University Hospital and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Merce Boada
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Gary W Beecham
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jean-Guillaume Garnier
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Denise Harold
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Otto Valladares
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marie-Laure Moutet
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Amy Gerrish
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Albert V Smith
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Liming Qu
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Delphine Bacq
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Nicola Denning
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Yi Zhao
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Maria Del Zompo
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Seung-Hoan Choi
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ignacio Mateo
- Neurology Service and CIBERNED, 'Marqués de Valdecilla' University Hospital (University of Cantabria and IDIVAL), Santander, Spain
| | - Joseph T Hughes
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hieab H Adams
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - John Malamon
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Yogen Patel
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Beth A Dombroski
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Makrina Daniilidou
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - David Wallon
- Normandie University, UNIROUEN, Inserm U1245, and Rouen University Hospital, Department of Neurology, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - James Uphill
- Department of Neurodegenerative Disease, MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- Centre for Public Health, University of Iceland, Reykjavik, Iceland
| | - Laura B Cantwell
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Fabienne Garzia
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Daniela Galimberti
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy
- University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Mariusz Butkiewicz
- Institute for Computational Biology, Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Bertrand Fin
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Elio Scarpini
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy
- University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Chloe Sarnowski
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Will S Bush
- Institute for Computational Biology, Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Stéphane Meslage
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Charles C White
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Yuenjoo Song
- Institute for Computational Biology, Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Robert C Barber
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Sebastiaan Engelborghs
- Laboratory for Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp, Antwerp, Belgium
| | - Sabrina Sordon
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Dina Voijnovic
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Perrie M Adams
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurology, University Hospital and University of Leuven, Leuven, Belgium
| | - Manuel Mayhaus
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - L Adrienne Cupples
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Peter P De Deyn
- Laboratory for Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp, Antwerp, Belgium
| | - Wei Gu
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Jayanadra J Himali
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Duane Beekly
- National Alzheimer's Coordinating Center, University of Washington, Seattle, WA, USA
| | - Alessio Squassina
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Annette M Hartmann
- Department of Psychiatry, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Adelina Orellana
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
| | - Deborah Blacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Eloy Rodriguez-Rodriguez
- Neurology Service and CIBERNED, 'Marqués de Valdecilla' University Hospital (University of Cantabria and IDIVAL), Santander, Spain
| | | | - Melissa E Garcia
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Rachelle S Doody
- Alzheimer's Disease and Memory Disorders Center, Baylor College of Medicine, Houston, TX, USA
| | - Carmen Munoz-Fernadez
- Department of Immunology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Rebecca Sussams
- Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Thomas J Fairchild
- Office of Strategy and Measurement, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Yolanda A Benito
- Department of Immunology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Clive Holmes
- Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK
| | | | - Matthew P Frosch
- C.S. Kubik Laboratory for Neuropathology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Hakan Thonberg
- Theme Aging, Unit for Hereditary Dementias, Karolinska University Hospital-Solna, Stockholm, Sweden
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Alzheimer Research Center, Division of Neurogeriatrics, Solna, Sweden
| | - Wolfgang Maier
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Gennady Roshchupkin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Vilmantas Giedraitis
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Amit Kawalia
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Shuo Li
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Ryan M Huebinger
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Isabel Hernández
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - M Ilyas Kamboh
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - RoseMarie Brundin
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - James Turton
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Mindy J Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Letizia Concari
- Section of Neuroscience, DIMEC-University of Parma, Parma, Italy
- FERB-Alzheimer Center, Gazzaniga (Bergamo), Italy
| | - Jenny Lord
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Alexa S Beiser
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Seppo Helisalmi
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Iwona Kloszewska
- Elderly and Psychiatric Disorders Department, Medical University of Lodz, Lodz, Poland
| | - Walter A Kukull
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Anne Maria Koivisto
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Aoibhinn Lynch
- Mercer's Institute for Research on Aging, St. James's Hospital and Trinity College, Dublin, Ireland
- St. James's Hospital and Trinity College, Dublin, Ireland
| | - Lluís Tarraga
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Annakaisa Haapasalo
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Brian Lawlor
- Mercer's Institute for Research on Aging, St. James's Hospital and Trinity College, Dublin, Ireland
- St. James's Hospital and Trinity College, Dublin, Ireland
| | - Thomas H Mosley
- Departments of Medicine, Geriatrics, Gerontology and Neurology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Vincenzo Solfrizzi
- Interdisciplinary Department of Medicine, Geriatric Medicine and Memory Unity, University of Bari, Bari, Italy
| | - Michael Gill
- Mercer's Institute for Research on Aging, St. James's Hospital and Trinity College, Dublin, Ireland
- St. James's Hospital and Trinity College, Dublin, Ireland
| | - W T Longstreth
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Thomas J Montine
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Vincenza Frisardi
- Department of Geriatrics, Center for Aging Brain, University of Bari, Bari, Italy
| | - Monica Diez-Fairen
- Fundació per la Recerca Biomèdica i Social Mútua Terrassa, Terrassa, Barcelona, Spain
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdamt, the Netherlands
- Netherlands Consortium on Health Aging and National Genomics Initiative, Leiden, the Netherlands
| | | | - Vincent Deramecourt
- CHU Lille, Memory Center of Lille (Centre Mémoire de Ressources et de Recherche), Lille, France
| | - Ignacio Alvarez
- Fundació per la Recerca Biomèdica i Social Mútua Terrassa, Terrassa, Barcelona, Spain
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - Francesca Salani
- Department of Clinical and Behavioral Neurology, Experimental Neuropsychobiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Antonio Ciaramella
- Department of Clinical and Behavioral Neurology, Experimental Neuropsychobiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Eric Boerwinkle
- School of Public Health, Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Eric M Reiman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
- Banner Alzheimer's Institute, Phoenix, AZ, USA
- Department of Psychiatry, University of Arizona, Phoenix, AZ, USA
| | - Nathalie Fievet
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Joan S Reisch
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Olivier Hanon
- University Paris Descartes, EA 4468, AP-HP, Geriatrics Department, Hôpital Broca, Paris, France
| | - Chiara Cupidi
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - A G Andre Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdamt, the Netherlands
- Netherlands Consortium on Health Aging and National Genomics Initiative, Leiden, the Netherlands
| | - Donald R Royall
- Departments of Psychiatry, Medicine, Family & Community Medicine, South Texas Veterans Health Administration Geriatric Research Education & Clinical Center (GRECC), UT Health Science Center at San Antonio, San Antonio, TX, USA
| | - Carole Dufouil
- University of Bordeaux, Inserm 1219, Bordeaux, France
- Department of Neurology, Bordeaux University Hospital / CHU de Bordeaux, Bordeaux, France
| | | | - Itziar de Rojas
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Mary Sano
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexis Brice
- Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Université Paris 06, UMRS 1127, Institut du Cerveau et de la Moelle Épinière, Paris, France
- AP-HP, Department of Genetics, Pitié-Salpêtrière Hospital, Paris, France
| | - Roberta Cecchetti
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Peter St George-Hyslop
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
| | - Karen Ritchie
- Inserm U1061 Neuropsychiatry, La Colombière Hospital, Montpellier, France
- Montpellier University, Montpellier, France
- Department of Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Magda Tsolaki
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Debby W Tsuang
- VA Puget Sound Health Care System/>GRECC, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d'Alzheimer and Institut du Cerveau et de la Moelle Épinière, Département de Neurologie, Hôpital de la Pitié-Salpêtrière, Paris, France
- Institut des Neurosciences Translationnelles de Paris, Institut du Cerveau et de la Moelle Épinière, Paris, France
- Inserm, CNRS, UMR-S975, Institut du Cerveau et de la Moelle Epinière, Paris, France
- Sorbonne Universités, Université Pierre et Marie Curie, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
| | - David Craig
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Chuang-Kuo Wu
- Departments of Neurology, Pharmacology & Neuroscience, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Hilkka Soininen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Despoina Avramidou
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Geriatric Research, Education and Clinical Center (GRECC), VA Ann Arbor Healthcare System (VAAAHS), Ann Arbor, MI, USA
- Michigan Alzheimer Disease Center, Ann Arbor, MI, USA
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Antonia Germanou
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Liana G Apostolova
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN, USA
| | - Lina Keller
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Maria Koutroumani
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Steven E Arnold
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Francesco Panza
- Department of Geriatrics, Center for Aging Brain, University of Bari, Bari, Italy
| | - Olymbia Gkatzima
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sanjay Asthana
- Geriatric Research, Education and Clinical Center (GRECC), University of Wisconsin, Madison, WI, USA
- Department of Medicine, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Didier Hannequin
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Patrice Whitehead
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Craig S Atwood
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN, USA
| | - Paolo Caffarra
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Harald Hampel
- AXA Research Fund & Sorbonne University Chair, Paris, France
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Brain & Spine Institute, Inserm U 1127, CNRS UMR 7225, Paris, France
- Institute of Memory and Alzheimer's Disease, Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Inés Quintela
- Grupo de Medicina Xenomica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado, Centro de Investigación Biomédica en Red de Enfermedades Raras, Santiago de Compostela, Spain
| | - Ángel Carracedo
- Grupo de Medicina Xenomica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado, Centro de Investigación Biomédica en Red de Enfermedades Raras, Santiago de Compostela, Spain
| | - Lars Lannfelt
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - David C Rubinsztein
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
- UK Dementia Research Institute, University of Cambridge, Cambridge, UK
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Florence Pasquier
- CHU Lille, Memory Center of Lille (Centre Mémoire de Ressources et de Recherche), Lille, France
| | - Lutz Frölich
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Sandra Barral
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Bernadette McGuinness
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | - Janet A Johnston
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter Passmore
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Eileen H Bigio
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Thomas D Bird
- Department of Neurology, University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System/>GRECC, Seattle, WA, USA
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | | | - Michelle K Lupton
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | | | - Petra Proitsi
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adam Boxer
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - John F Powell
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James R Burke
- Department of Neurology, Duke University, Durham, NC, USA
| | - John S K Kauwe
- Departments of Biology, Brigham Young University, Provo, UT, USA
| | - Jeffrey M Burns
- University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Michelangelo Mancuso
- Department of Experimental and Clinical Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ubaldo Bonuccelli
- Department of Experimental and Clinical Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Nigel J Cairns
- Department of Pathology and Immunology, Washington University, St. Louis, MO, USA
| | | | - Chuanhai Cao
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
| | - Chris S Carlson
- Department of Medicine, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Nicholas J Bass
- Division of Psychiatry, University College London, London, UK
| | | | - John Hardy
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - Regina M Carney
- Mental Health & Behavioral Science Service, Bruce W. Carter VA Medical Center, Miami, FL, USA
| | - Jose Bras
- UK Dementia Research Institute at UCL, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | | | - Rita Guerreiro
- UK Dementia Research Institute at UCL, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Mariet Allen
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Helena C Chui
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth Fisher
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Carlo Masullo
- Department of Neurology, Catholic University of Rome, Rome, Italy
| | - Elizabeth A Crocco
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Charles DeCarli
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Gina Bisceglio
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Malcolm Dick
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Li Ma
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Ranjan Duara
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | | | - Denis A Evans
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Angela Hodges
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kelley M Faber
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kenneth B Fallon
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - David W Fardo
- Sanders-Brown Center on Aging, Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - Reinhard Heun
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Martin R Farlow
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - Heike Kölsch
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Steven Ferris
- Department of Psychiatry, New York University, New York, NY, USA
| | - Markus Leber
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Tatiana M Foroud
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Isabella Heuser
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
| | - Douglas R Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Ina Giegling
- Department of Psychiatry, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Marla Gearing
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
- Emory Alzheimer's Disease Center, Emory University, Atlanta, GA, USA
| | - Michael Hüll
- Department of Psychiatry, University of Freiburg, Freiburg, Germany
| | - Daniel H Geschwind
- Neurogenetics Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - John R Gilbert
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - John Morris
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St. Louis, MO, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine and Partners Center for Personalized Genetic Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kevin Mayo
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University, St. Louis, MO, USA
- Department of Genetics, Washington University, St. Louis, MO, USA
| | - John H Growdon
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Thomas Feulner
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Ronald L Hamilton
- Department of Pathology (Neuropathology), University of Pittsburgh, Pittsburgh, PA, USA
| | - Lindy E Harrell
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dmitriy Drichel
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Lawrence S Honig
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
| | - Thomas D Cushion
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Matthew J Huentelman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Paul Hollingworth
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Rachel Marshall
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Gail P Jarvik
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA, USA
| | - Alun Meggy
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Erin Abner
- Sanders-Brown Center on Aging, College of Public Health, Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Georgina E Menzies
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Lee-Way Jin
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain
| | - Ganna Leonenko
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Luis M Real
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain
| | - Gyungah R Jun
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Clinton T Baldwin
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Detelina Grozeva
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Giancarlo Russo
- Functional Genomics Center Zurich, ETH/University of Zurich, Zurich, Switzerland
| | - Jeffrey A Kaye
- Department of Neurology, Oregon Health &Science University, Portland, OR, USA
- Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - Ronald Kim
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Frank Jessen
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Neil W Kowall
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Pathology, Boston University School of Medicine, Boston University, Boston, MA, USA
| | - Bruno Vellas
- Inserm U558, University of Toulouse, Toulouse, France
| | - Joel H Kramer
- Department of Neuropsychology, University of California San Francisco, San Francisco, CA, USA
| | - Emma Vardy
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
| | - Frank M LaFerla
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - James J Lah
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
| | - James B Leverenz
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
| | - David Mann
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Allan I Levey
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Stuart Pickering-Brown
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Norman Klopp
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Munich, Germany
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - H-Erich Wichmann
- Helmholtz Center Munich, Institute of Epidemiology, Neuherberg, Munich, Germany
- Ludwig-Maximilians University Chair of Epidemiology, Munich, Germany
- Joint Biobank Munich and KORA Biobank, Baltimore, MD, USA
| | | | - Kevin Morgan
- Human Genetics, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristelle Brown
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Frank Martiniuk
- Department of Medicine-Pulmonary, New York University, New York, NY, USA
| | - Christopher Medway
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Deborah C Mash
- Department of Neurology, University of Miami, Miami, FL, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Eliezer Masliah
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Department of Pathology, University of California, San Diego, La Jolla, CA, USA
| | - Nigel M Hooper
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Hearth, Rome, Italy
| | - Susan M McCurry
- School of Nursing Northwest Research Group on Aging, University of Washington, Seattle, WA, USA
| | - Anthony Bayer
- Institute of Primary Care and Public Health, Cardiff University, University Hospital of Wales, Cardiff, UK
| | - Andrew N McDavid
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ann C McKee
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Pathology, Boston University School of Medicine, Boston University, Boston, MA, USA
| | - Hendrik van den Bussche
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Bruce L Miller
- Weill Institute for Neurosciences, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Carol A Miller
- Department of Pathology, University of Southern California, Los Angeles, CA, USA
| | - Joshua W Miller
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, USA
| | - Ammar Al-Chalabi
- Institute of Psychiatry, Psychology and Neuroscienceó, King's College London, London, UK
| | - John C Morris
- Department of Pathology and Immunology, Washington University, St. Louis, MO, USA
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Christopher E Shaw
- Institute of Psychiatry, Psychology and Neuroscienceó, King's College London, London, UK
- UK Dementia Research Institute, King's College London, London, UK
| | - Amanda J Myers
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
- German Center for Neurodegenerative Diseases, Goettingen, Germany
- IBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Sid O'Bryant
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - John M Olichney
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Victoria Alvarez
- Molecular Genetics Laboratory-Hospital, University of Central Asturias, Oviedo, Spain
| | - Joseph E Parisi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Andrew B Singleton
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Henry L Paulson
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer Disease Center, Ann Arbor, MI, USA
| | - John Collinge
- Department of Neurodegenerative Disease, MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK
| | - William R Perry
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Simon Mead
- Department of Neurodegenerative Disease, MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK
| | - Elaine Peskind
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - David H Cribbs
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
| | - Martin Rossor
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Aimee Pierce
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
| | - Natalie S Ryan
- Department of Neurodegenerative Disease, MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK
| | - Wayne W Poon
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- Centro di Ricerca, Trasferimento e Alta Formazione DENOTHE, University of Florence, Florence, Italy
| | - Huntington Potter
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Joseph F Quinn
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eleonora Sacchinelli
- Department of Clinical and Behavioral Neurology, Experimental Neuropsychobiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ashok Raj
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Murray Raskind
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Carlo Caltagirone
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Paola Bossù
- Department of Clinical and Behavioral Neurology, Experimental Neuropsychobiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Maria Donata Orfei
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Barry Reisberg
- Department of Psychiatry, New York University, New York, NY, USA
- Alzheimer's Disease Center, New York University, New York, NY, USA
| | - Robert Clarke
- Oxford Healthy Aging Project, Clinical Trial Service Unit, University of Oxford, Oxford, UK
| | - Christiane Reitz
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - A David Smith
- Oxford Project to Investigate Memory and Ageing, University of Oxford, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - John M Ringman
- Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, Los Angeles, CA, USA
| | - Donald Warden
- Oxford Project to Investigate Memory and Ageing, University of Oxford, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gordon Wilcock
- Oxford Project to Investigate Memory and Ageing, University of Oxford, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
| | | | - Howard J Rosen
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Maura Gallo
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - Roger N Rosenberg
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mark A Sager
- Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Patrizia Mecocci
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Andrew J Saykin
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - Pau Pastor
- Fundació per la Recerca Biomèdica i Social Mútua Terrassa, Terrassa, Barcelona, Spain
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - Michael L Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jeffery M Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Julie A Schneider
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, IL, USA
| | - Lori S Schneider
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
- Department of Psychiatry, University of Southern California, Los Angeles, CA, USA
| | - Susan Slifer
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Amanda G Smith
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - Joshua A Sonnen
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Salvatore Spina
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Robert A Stern
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Russell H Swerdlow
- University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mitchell Tang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rudolph E Tanzi
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Juan C Troncoso
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Linda J Van Eldik
- Sanders-Brown Center on Aging, Department of Neuroscience, University of Kentucky, Lexington, KY, USA
| | - Harry V Vinters
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jean Paul Vonsattel
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Pathology, Columbia University, New York, NY, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathleen A Welsh-Bohmer
- Department of Neurology, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Kirk C Wilhelmsen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Williamson
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
| | - Thomas S Wingo
- Department of Neurology, Emory University, Atlanta, GA, USA
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Randall L Woltjer
- Department of Pathology, Oregon Health & Science University, Portland, OR, USA
| | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Chang-En Yu
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Lei Yu
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Yasaman Saba
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Division of Molecular Biology and Biochemistry, Medical University Graz, Graz, Austria
| | - Alberto Pilotto
- Gerontology and Geriatrics Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- Department Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genova, Italy
| | - Maria J Bullido
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
- IdiPAZ, Instituto de Investigación Sanitaria la Paz, Madrid, Spain
- Centro de Biologia Molecular Severo Ochoa (CSIC-UAM), Madrid, Spain
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
- German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - David Bennett
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Paola Bosco
- Instituto di Ricovero e Cura a Carattere Scientifico, Associazione Oasi Maria Santissima Srl, Troina, Italy
| | - Eliecer Coto
- Molecular Genetics Laboratory-Hospital, University of Central Asturias, Oviedo, Spain
| | - Virginia Boccardi
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Phil L De Jager
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Alberto Lleo
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Autonomous University Barcelona, Barcelona, Spain
| | - Nick Warner
- Somerset Partnership NHS Trust, Somerset, UK
| | - Oscar L Lopez
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martin Ingelsson
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | | | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St. Louis, MO, USA
| | - Caroline Graff
- Theme Aging, Unit for Hereditary Dementias, Karolinska University Hospital-Solna, Stockholm, Sweden
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Alzheimer Research Center, Division of Neurogeriatrics, Solna, Sweden
| | - Rhian Gwilliam
- The Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Alison M Goate
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pascual Sanchez-Juan
- Neurology Service and CIBERNED, 'Marqués de Valdecilla' University Hospital (University of Cantabria and IDIVAL), Santander, Spain
| | - Patrick G Kehoe
- University of Bristol Medical School, Learning & Research level 2, Southmead Hospital, Bristol, UK
| | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Nilifur Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Claudine Berr
- Inserm U1061 Neuropsychiatry, La Colombière Hospital, Montpellier, France
- Montpellier University, Montpellier, France
| | - Stéphanie Debette
- Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Université Paris 06, UMRS 1127, Institut du Cerveau et de la Moelle Épinière, Paris, France
- AP-HP, Department of Genetics, Pitié-Salpêtrière Hospital, Paris, France
| | - Seth Love
- University of Bristol Medical School, Learning & Research level 2, Southmead Hospital, Bristol, UK
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Steven G Younkin
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Departments of Radiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | | | - Gael Nicolas
- Normandie University, UNIROUEN, Inserm U1245, and Rouen University Hospital, Department of Neurology, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Dominique Campion
- Normandie University, UNIROUEN, Inserm U1245, and Rouen University Hospital, Department of Neurology, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
- Department of Research Rouvray Psychiatric Hospital, Sotteville-lès-Rouen, France
| | | | - Helena Schmidt
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Division of Molecular Biology and Biochemistry, Medical University Graz, Graz, Austria
- Department of Neurology, Medical University Graz, Graz, Austria
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Human Genetics, Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jordi Clarimon
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Autonomous University Barcelona, Barcelona, Spain
| | | | - Reinhold Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University Graz, Graz, Austria
| | - Lindsay A Farrer
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
- Department of Ophthalmology, Boston University School of Medicine, Boston University, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium
- Laboratory for Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Michael C O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Anita L DeStefano
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Lesley Jones
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Jonathan L Haines
- Institute for Computational Biology, Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Jean-Francois Deleuze
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Michael J Owen
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Richard Mayeux
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Valentina Escott-Price
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
- Kaiser Permanente, Washington Health Research Institute, Seattle, WA, USA
| | - Alfredo Ramirez
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Li-San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Agustin Ruiz
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Peter A Holmans
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Julie Williams
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Phillippe Amouyel
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
- Centre Hospitalier Universitaire de Lille, Lille, France
| | - Gerard D Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jean-Charles Lambert
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France.
- Institut Pasteur de Lille, Lille, France.
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France.
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.
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10
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Gerstenecker A, Hoagey DA, Marson DC, Kennedy KM. White Matter Degradation is Associated with Reduced Financial Capacity in Mild Cognitive Impairment and Alzheimer's Disease. J Alzheimers Dis 2018; 60:537-547. [PMID: 28826185 DOI: 10.3233/jad-170341] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Financial capacity (FC) is a cognitively complex activity of daily living that declines in mild cognitive impairment (MCI) and Alzheimer's disease (AD), limiting an individual's ability to manage one's finances and function independently. The neural underpinnings of this decline in function are poorly understood but likely involve age-related and disease-related degradation across structural networks. The purpose of the current study was to determine if altered white matter integrity is associated with declining FC in persons with MCI and AD compared to older controls. Individuals with MCI due to AD (n = 31), mild dementia (n = 39), and cognitively healthy older adults (n = 60) were administered a neuropsychological battery including the FC Instrument, a performance-based measure of FC. All 130 participants also underwent diffusion tensor imaging (DTI) upon which tract-based spatial statistics were performed. Both FC and white matter integrity decreased in accordance with disease severity with little to no effect in healthy elderly, significant effects in MCI, and greater effects in AD. Regional white matter degradation (increased diffusivities and decreased fractional anisotropy) was associated with reduced FC in both MCI and AD groups even after controlling for age, education, and gender. Specifically, in MCI, decreased fractional anisotropy, but not increased diffusivities, was associated with poorer FC in widespread cingulo-parietal-frontal and temporo-occipital areas. In AD, rather than anisotropy, increased mean and axial diffusivities in anterior cingulate, callosum, and frontal areas associated with poorer FC. These findings suggest a severity gradient of white matter degradation across DTI metrics and AD stages that predict declining financial skill and knowledge.
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Affiliation(s)
- Adam Gerstenecker
- Division of Neuropsychology, Department of Neurology, The University of Alabama at Birmingham, Birmingham, AL, USA.,Alzheimer's Disease Center, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - David A Hoagey
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, Center for Vital Longevity, Dallas, TX, USA
| | - Daniel C Marson
- Division of Neuropsychology, Department of Neurology, The University of Alabama at Birmingham, Birmingham, AL, USA.,Alzheimer's Disease Center, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristen M Kennedy
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, Center for Vital Longevity, Dallas, TX, USA
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11
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Martin RC, Gerstenecker A, Triebel KL, Falola M, McPherson T, Cutter G, Marson DC. Declining Financial Capacity in Mild Cognitive Impairment: A Six-Year Longitudinal Study. Arch Clin Neuropsychol 2018; 34:152-161. [DOI: 10.1093/arclin/acy030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 03/14/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Roy C Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristen L Triebel
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael Falola
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tarrant McPherson
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
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12
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Sims R, van der Lee SJ, Naj AC, Bellenguez C, Badarinarayan N, Jakobsdottir J, Kunkle BW, Boland A, Raybould R, Bis JC, Martin ER, Grenier-Boley B, Heilmann-Heimbach S, Chouraki V, Kuzma AB, Sleegers K, Vronskaya M, Ruiz A, Graham RR, Olaso R, Hoffmann P, Grove ML, Vardarajan BN, Hiltunen M, Nöthen MM, White CC, Hamilton-Nelson KL, Epelbaum J, Maier W, Choi SH, Beecham GW, Dulary C, Herms S, Smith AV, Funk CC, Derbois C, Forstner AJ, Ahmad S, Li H, Bacq D, Harold D, Satizabal CL, Valladares O, Squassina A, Thomas R, Brody JA, Qu L, Sánchez-Juan P, Morgan T, Wolters FJ, Zhao Y, Garcia FS, Denning N, Fornage M, Malamon J, Naranjo MCD, Majounie E, Mosley TH, Dombroski B, Wallon D, Lupton MK, Dupuis J, Whitehead P, Fratiglioni L, Medway C, Jian X, Mukherjee S, Keller L, Brown K, Lin H, Cantwell LB, Panza F, McGuinness B, Moreno-Grau S, Burgess JD, Solfrizzi V, Proitsi P, Adams HH, Allen M, Seripa D, Pastor P, Cupples LA, Price ND, Hannequin D, Frank-García A, Levy D, Chakrabarty P, Caffarra P, Giegling I, Beiser AS, Giedraitis V, Hampel H, Garcia ME, Wang X, Lannfelt L, Mecocci P, Eiriksdottir G, Crane PK, Pasquier F, Boccardi V, Henández I, Barber RC, Scherer M, Tarraga L, Adams PM, Leber M, Chen Y, Albert MS, Riedel-Heller S, Emilsson V, Beekly D, Braae A, Schmidt R, Blacker D, Masullo C, Schmidt H, Doody RS, Spalletta G, Longstreth WT, Fairchild TJ, Bossù P, Lopez OL, Frosch MP, Sacchinelli E, Ghetti B, Yang Q, Huebinger RM, Jessen F, Li S, Kamboh MI, Morris J, Sotolongo-Grau O, Katz MJ, Corcoran C, Dunstan M, Braddel A, Thomas C, Meggy A, Marshall R, Gerrish A, Chapman J, Aguilar M, Taylor S, Hill M, Fairén MD, Hodges A, Vellas B, Soininen H, Kloszewska I, Daniilidou M, Uphill J, Patel Y, Hughes JT, Lord J, Turton J, Hartmann AM, Cecchetti R, Fenoglio C, Serpente M, Arcaro M, Caltagirone C, Orfei MD, Ciaramella A, Pichler S, Mayhaus M, Gu W, Lleó A, Fortea J, Blesa R, Barber IS, Brookes K, Cupidi C, Maletta RG, Carrell D, Sorbi S, Moebus S, Urbano M, Pilotto A, Kornhuber J, Bosco P, Todd S, Craig D, Johnston J, Gill M, Lawlor B, Lynch A, Fox NC, Hardy J, Albin RL, Apostolova LG, Arnold SE, Asthana S, Atwood CS, Baldwin CT, Barnes LL, Barral S, Beach TG, Becker JT, Bigio EH, Bird TD, Boeve BF, Bowen JD, Boxer A, Burke JR, Burns JM, Buxbaum JD, Cairns NJ, Cao C, Carlson CS, Carlsson CM, Carney RM, Carrasquillo MM, Carroll SL, Diaz CC, Chui HC, Clark DG, Cribbs DH, Crocco EA, DeCarli C, Dick M, Duara R, Evans DA, Faber KM, Fallon KB, Fardo DW, Farlow MR, Ferris S, Foroud TM, Galasko DR, Gearing M, Geschwind DH, Gilbert JR, Graff-Radford NR, Green RC, Growdon JH, Hamilton RL, Harrell LE, Honig LS, Huentelman MJ, Hulette CM, Hyman BT, Jarvik GP, Abner E, Jin LW, Jun G, Karydas A, Kaye JA, Kim R, Kowall NW, Kramer JH, LaFerla FM, Lah JJ, Leverenz JB, Levey AI, Li G, Lieberman AP, Lunetta KL, Lyketsos CG, Marson DC, Martiniuk F, Mash DC, Masliah E, McCormick WC, McCurry SM, McDavid AN, McKee AC, Mesulam M, Miller BL, Miller CA, Miller JW, Morris JC, Murrell JR, Myers AJ, O'Bryant S, Olichney JM, Pankratz VS, Parisi JE, Paulson HL, Perry W, Peskind E, Pierce A, Poon WW, Potter H, Quinn JF, Raj A, Raskind M, Reisberg B, Reitz C, Ringman JM, Roberson ED, Rogaeva E, Rosen HJ, Rosenberg RN, Sager MA, Saykin AJ, Schneider JA, Schneider LS, Seeley WW, Smith AG, Sonnen JA, Spina S, Stern RA, Swerdlow RH, Tanzi RE, Thornton-Wells TA, Trojanowski JQ, Troncoso JC, Van Deerlin VM, Van Eldik LJ, Vinters HV, Vonsattel JP, Weintraub S, Welsh-Bohmer KA, Wilhelmsen KC, Williamson J, Wingo TS, Woltjer RL, Wright CB, Yu CE, Yu L, Garzia F, Golamaully F, Septier G, Engelborghs S, Vandenberghe R, De Deyn PP, Fernadez CM, Benito YA, Thonberg H, Forsell C, Lilius L, Kinhult-Stählbom A, Kilander L, Brundin R, Concari L, Helisalmi S, Koivisto AM, Haapasalo A, Dermecourt V, Fievet N, Hanon O, Dufouil C, Brice A, Ritchie K, Dubois B, Himali JJ, Keene CD, Tschanz J, Fitzpatrick AL, Kukull WA, Norton M, Aspelund T, Larson EB, Munger R, Rotter JI, Lipton RB, Bullido MJ, Hofman A, Montine TJ, Coto E, Boerwinkle E, Petersen RC, Alvarez V, Rivadeneira F, Reiman EM, Gallo M, O'Donnell CJ, Reisch JS, Bruni AC, Royall DR, Dichgans M, Sano M, Galimberti D, St George-Hyslop P, Scarpini E, Tsuang DW, Mancuso M, Bonuccelli U, Winslow AR, Daniele A, Wu CK, Peters O, Nacmias B, Riemenschneider M, Heun R, Brayne C, Rubinsztein DC, Bras J, Guerreiro R, Al-Chalabi A, Shaw CE, Collinge J, Mann D, Tsolaki M, Clarimón J, Sussams R, Lovestone S, O'Donovan MC, Owen MJ, Behrens TW, Mead S, Goate AM, Uitterlinden AG, Holmes C, Cruchaga C, Ingelsson M, Bennett DA, Powell J, Golde TE, Graff C, De Jager PL, Morgan K, Ertekin-Taner N, Combarros O, Psaty BM, Passmore P, Younkin SG, Berr C, Gudnason V, Rujescu D, Dickson DW, Dartigues JF, DeStefano AL, Ortega-Cubero S, Hakonarson H, Campion D, Boada M, Kauwe JK, Farrer LA, Van Broeckhoven C, Ikram MA, Jones L, Haines JL, Tzourio C, Launer LJ, Escott-Price V, Mayeux R, Deleuze JF, Amin N, Holmans PA, Pericak-Vance MA, Amouyel P, van Duijn CM, Ramirez A, Wang LS, Lambert JC, Seshadri S, Williams J, Schellenberg GD. Rare coding variants in PLCG2, ABI3, and TREM2 implicate microglial-mediated innate immunity in Alzheimer's disease. Nat Genet 2017; 49:1373-1384. [PMID: 28714976 PMCID: PMC5669039 DOI: 10.1038/ng.3916] [Citation(s) in RCA: 601] [Impact Index Per Article: 85.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 06/16/2017] [Indexed: 02/02/2023]
Abstract
We identified rare coding variants associated with Alzheimer's disease in a three-stage case-control study of 85,133 subjects. In stage 1, we genotyped 34,174 samples using a whole-exome microarray. In stage 2, we tested associated variants (P < 1 × 10-4) in 35,962 independent samples using de novo genotyping and imputed genotypes. In stage 3, we used an additional 14,997 samples to test the most significant stage 2 associations (P < 5 × 10-8) using imputed genotypes. We observed three new genome-wide significant nonsynonymous variants associated with Alzheimer's disease: a protective variant in PLCG2 (rs72824905: p.Pro522Arg, P = 5.38 × 10-10, odds ratio (OR) = 0.68, minor allele frequency (MAF)cases = 0.0059, MAFcontrols = 0.0093), a risk variant in ABI3 (rs616338: p.Ser209Phe, P = 4.56 × 10-10, OR = 1.43, MAFcases = 0.011, MAFcontrols = 0.008), and a new genome-wide significant variant in TREM2 (rs143332484: p.Arg62His, P = 1.55 × 10-14, OR = 1.67, MAFcases = 0.0143, MAFcontrols = 0.0089), a known susceptibility gene for Alzheimer's disease. These protein-altering changes are in genes highly expressed in microglia and highlight an immune-related protein-protein interaction network enriched for previously identified risk genes in Alzheimer's disease. These genetic findings provide additional evidence that the microglia-mediated innate immune response contributes directly to the development of Alzheimer's disease.
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Affiliation(s)
- Rebecca Sims
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Sven J van der Lee
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Adam C Naj
- Department of Biostatistics and Epidemiology/Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Céline Bellenguez
- INSERM, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- University Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Nandini Badarinarayan
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Brian W Kunkle
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida, USA
| | - Anne Boland
- CEA/Institut de Génomique, Centre National de Génotypage, Evry, France
| | - Rachel Raybould
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Eden R Martin
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida, USA
- Dr. John T. Macdonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida, USA
| | - Benjamin Grenier-Boley
- INSERM, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- University Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life &Brain Center, University of Bonn, Bonn, Germany
| | - Vincent Chouraki
- Boston University School of Medicine, Boston, Massachusetts, USA
- Framingham Heart Study, Framingham, Massachusetts, USA
| | - Amanda B Kuzma
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kristel Sleegers
- Neurodegenerative Brain Diseases Group, Department of Molecular Genetics, VIB, Antwerp, Belgium
- Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Maria Vronskaya
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Agustin Ruiz
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Robert R Graham
- Immunology Biomarkers Group, Genentech, South San Francisco, California, USA
| | - Robert Olaso
- CEA/Institut de Génomique, Centre National de Génotypage, Evry, France
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life &Brain Center, University of Bonn, Bonn, Germany
- Division of Medical Genetics, University Hospital and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Megan L Grove
- School of Public Health, Human Genetics Center, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Badri N Vardarajan
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
- Department of Neurology, Columbia University, New York, New York, USA
| | - Mikko Hiltunen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life &Brain Center, University of Bonn, Bonn, Germany
| | - Charles C White
- Program in Translational NeuroPsychiatric Genomics, Institute for the Neurosciences, Departments of Neurology and Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Jacques Epelbaum
- UMR 894, Center for Psychiatry and Neuroscience, INSERM, Université Paris Descartes, Paris, France
| | - Wolfgang Maier
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Seung-Hoan Choi
- Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Gary W Beecham
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida, USA
- Dr. John T. Macdonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida, USA
| | - Cécile Dulary
- CEA/Institut de Génomique, Centre National de Génotypage, Evry, France
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life &Brain Center, University of Bonn, Bonn, Germany
- Division of Medical Genetics, University Hospital and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Cory C Funk
- Institute for Systems Biology, Seattle, Washington, USA
| | - Céline Derbois
- CEA/Institut de Génomique, Centre National de Génotypage, Evry, France
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life &Brain Center, University of Bonn, Bonn, Germany
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Hongdong Li
- Institute for Systems Biology, Seattle, Washington, USA
| | - Delphine Bacq
- CEA/Institut de Génomique, Centre National de Génotypage, Evry, France
| | - Denise Harold
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | - Claudia L Satizabal
- Boston University School of Medicine, Boston, Massachusetts, USA
- Framingham Heart Study, Framingham, Massachusetts, USA
| | - Otto Valladares
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alessio Squassina
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Rhodri Thomas
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Liming Qu
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Pascual Sánchez-Juan
- Neurology Service and CIBERNED, 'Marqués de Valdecilla' University Hospital (University of Cantabria and IFIMAV), Santander, Spain
| | - Taniesha Morgan
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Frank J Wolters
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Yi Zhao
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Nicola Denning
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - John Malamon
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Elisa Majounie
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Thomas H Mosley
- Departments of Medicine, Geriatrics, Gerontology and Neurology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Beth Dombroski
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David Wallon
- Centre Hospitalier du Rouvray, Sotteville les Rouen, France
- INSERM U1079, Rouen University, IRIB, Normandy University, Rouen, France
| | - Michelle K Lupton
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Patrice Whitehead
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida, USA
| | - Laura Fratiglioni
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Christopher Medway
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | | | - Lina Keller
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Kristelle Brown
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Laura B Cantwell
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Bernadette McGuinness
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - Sonia Moreno-Grau
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Jeremy D Burgess
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Petra Proitsi
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hieab H Adams
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Mariet Allen
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Davide Seripa
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Pau Pastor
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - L Adrienne Cupples
- Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Didier Hannequin
- INSERM U1079, Rouen University, IRIB, Normandy University, Rouen, France
- Department of Neurology, Rouen University Hospital, Rouen, France
| | - Ana Frank-García
- Department of Neurology, University Hospital La Paz, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital la Paz (IdiPAZ), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Levy
- Boston University School of Medicine, Boston, Massachusetts, USA
- Framingham Heart Study, Framingham, Massachusetts, USA
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Paramita Chakrabarty
- Center for Translational Research in Neurodegenerative Disease, Department of Neuroscience, University of Florida, Gainesville, Florida, USA
| | - Paolo Caffarra
- Department of Neuroscience, University of Parma, Parma, Italy
- Center for Cognitive Disorders AUSL, Parma, Italy
| | - Ina Giegling
- Department of Psychiatry, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Alexa S Beiser
- Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Harald Hampel
- AXA Research Fund and UPMC Chair, Paris, France
- Sorbonne Universités, Université Pierre et Marie Curie, Paris, France
- Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle Épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Melissa E Garcia
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland, USA
| | - Xue Wang
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Lars Lannfelt
- Department of Public Health/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Patrizia Mecocci
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | | | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Florence Pasquier
- Centre Hospitalier Universitaire de Lille, Epidemiology and Public Health Department, Lille, France
- INSERM UMRS 1171, CNR-Maj, Lille, France
| | - Virginia Boccardi
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Isabel Henández
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Robert C Barber
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Lluis Tarraga
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Perrie M Adams
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Markus Leber
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Yuning Chen
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Valur Emilsson
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland
| | - Duane Beekly
- National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington, USA
| | - Anne Braae
- Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Reinhold Schmidt
- Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria
| | - Deborah Blacker
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Carlo Masullo
- Department of Neurology, Catholic University of Rome, Rome, Italy
| | - Helena Schmidt
- Institute of Molecular Biology and Biochemistry, Medical University Graz, Graz, Austria
| | - Rachelle S Doody
- Alzheimer's Disease and Memory Disorders Center, Baylor College of Medicine, Houston, Texas, USA
| | - Gianfranco Spalletta
- Experimental Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Rome, Italy
| | - W T Longstreth
- Department of Neurology, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Thomas J Fairchild
- Office of Strategy and Measurement, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Paola Bossù
- Experimental Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Rome, Italy
| | - Oscar L Lopez
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Matthew P Frosch
- C.S. Kubik Laboratory for Neuropathology, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Eleonora Sacchinelli
- Experimental Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Rome, Italy
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ryan M Huebinger
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Shuo Li
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - M Ilyas Kamboh
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John Morris
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Oscar Sotolongo-Grau
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Mindy J Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Chris Corcoran
- Department of Mathematics and Statistics, Utah State University, Logan, Utah, USA
| | - Melanie Dunstan
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Amy Braddel
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Charlene Thomas
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Alun Meggy
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Rachel Marshall
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Amy Gerrish
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jade Chapman
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Miquel Aguilar
- Fundació per la Recerca Biomèdica i Social Mútua Terrassa, Terrassa, Barcelona, Spain
- Memory Unit, Department of Neurology, Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Sarah Taylor
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Matt Hill
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mònica Díez Fairén
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Fundació per la Recerca Biomèdica i Social Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Angela Hodges
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bruno Vellas
- INSERM U558, University of Toulouse, Toulouse, France
| | - Hilkka Soininen
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Iwona Kloszewska
- Elderly and Psychiatric Disorders Department, Medical University of Lodz, Lodz, Poland
| | - Makrina Daniilidou
- Department of Health Sciences, Psychiatry for the Elderly, University of Leicester, Leicester, UK
| | - James Uphill
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Yogen Patel
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph T Hughes
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jenny Lord
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - James Turton
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Annette M Hartmann
- Department of Psychiatry, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Roberta Cecchetti
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Chiara Fenoglio
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Maria Serpente
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Marina Arcaro
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Carlo Caltagirone
- Experimental Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Rome, Italy
| | - Maria Donata Orfei
- Experimental Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Rome, Italy
| | - Antonio Ciaramella
- Experimental Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Rome, Italy
| | - Sabrina Pichler
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Manuel Mayhaus
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Wei Gu
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Alberto Lleó
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Juan Fortea
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Rafael Blesa
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Imelda S Barber
- Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Keeley Brookes
- Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Chiara Cupidi
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | | | - David Carrell
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Sandro Sorbi
- NEUROFARBA (Department of Neuroscience, Psychology, Drug Research and Child Health), University of Florence, Florence, Italy
- IRCCS 'Don Carlo Gnocchi', Florence, Italy
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Maria Urbano
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Alberto Pilotto
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Paolo Bosco
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Associazione Oasi Maria Santissima Srl, Troina, Italy
| | - Stephen Todd
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - David Craig
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - Janet Johnston
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - Michael Gill
- Mercers Institute for Research on Aging, St. James Hospital and Trinity College, Dublin, Ireland
| | - Brian Lawlor
- Mercers Institute for Research on Aging, St. James Hospital and Trinity College, Dublin, Ireland
| | - Aoibhinn Lynch
- Mercers Institute for Research on Aging, St. James Hospital and Trinity College, Dublin, Ireland
| | - Nick C Fox
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - John Hardy
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- Geriatric Research, Education and Clinical Center (GRECC), VA Ann Arbor Healthcare System (VAAAHS), Ann Arbor, Michigan, USA
- Michigan Alzheimer Disease Center, Ann Arbor, Michigan, USA
| | - Liana G Apostolova
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, Indiana, USA
- Department of Neurology, Indiana University, Indianapolis, Indiana, USA
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, Indiana, USA
| | - Steven E Arnold
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sanjay Asthana
- Geriatric Research, Education and Clinical Center (GRECC), University of Wisconsin, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA
| | - Craig S Atwood
- Geriatric Research, Education and Clinical Center (GRECC), University of Wisconsin, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA
| | - Clinton T Baldwin
- Department of Medicine (Genetics Program), Boston University, Boston, Massachusetts, USA
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Sandra Barral
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
- Department of Neurology, Columbia University, New York, New York, USA
| | - Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, Arizona, USA
| | - James T Becker
- Departments of Psychiatry, Neurology, and Psychology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Eileen H Bigio
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Thomas D Bird
- Department of Neurology, University of Washington, Seattle, Washington, USA
- VA Puget Sound Health Care System/GRECC, Seattle, Washington, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Adam Boxer
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - James R Burke
- Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Jeffrey M Burns
- University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Joseph D Buxbaum
- Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, New York, USA
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York, USA
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, USA
| | - Nigel J Cairns
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri, USA
| | - Chuanhai Cao
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, Florida, USA
| | - Chris S Carlson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Cynthia M Carlsson
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA
| | - Regina M Carney
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | - Steven L Carroll
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Carolina Ceballos Diaz
- Center for Translational Research in Neurodegenerative Disease, Department of Neuroscience, University of Florida, Gainesville, Florida, USA
| | - Helena C Chui
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - David G Clark
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Neurology, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
| | - David H Cribbs
- Department of Neurology, University of California, Irvine, Irvine, California, USA
| | - Elizabeth A Crocco
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Charles DeCarli
- Department of Neurology, University of California, Davis, Sacramento, California, USA
| | - Malcolm Dick
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, California, USA
| | - Ranjan Duara
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, Florida, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kelley M Faber
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, Indiana, USA
| | - Kenneth B Fallon
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David W Fardo
- Sanders-Brown Center on Aging, Department of Biostatistics, University of Kentucky, Lexington, Kentucky, USA
| | - Martin R Farlow
- Department of Neurology, Indiana University, Indianapolis, Indiana, USA
| | - Steven Ferris
- Department of Psychiatry, New York University, New York, New York, USA
| | - Tatiana M Foroud
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, Indiana, USA
| | - Douglas R Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
| | - Marla Gearing
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
- Emory Alzheimer's Disease Center, Emory University, Atlanta, Georgia, USA
| | - Daniel H Geschwind
- Neurogenetics Program, University of California, Los Angeles, Los Angeles, California, USA
| | - John R Gilbert
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida, USA
- Dr. John T. Macdonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida, USA
| | - Neill R Graff-Radford
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine and Partners Center for Personalized Genetic Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - John H Growdon
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Ronald L Hamilton
- Department of Pathology (Neuropathology), University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lindy E Harrell
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lawrence S Honig
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, New York, USA
| | - Matthew J Huentelman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | | | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Gail P Jarvik
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
- Department of Medicine (Medical Genetics), University of Washington, Seattle, Washington, USA
| | - Erin Abner
- Sanders-Brown Center on Aging, College of Public Health, Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA
| | - Lee-Way Jin
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, California, USA
| | - Gyungah Jun
- Department of Medicine (Genetics Program), Boston University, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University, Boston, Massachusetts, USA
- Department of Ophthalmology, Boston University, Boston, Massachusetts, USA
| | - Anna Karydas
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Jeffrey A Kaye
- Department of Neurology, Oregon Health &Science University, Portland, Oregon, USA
- Department of Neurology, Portland Veterans Affairs Medical Center, Portland, Oregon, USA
| | - Ronald Kim
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, California, USA
| | - Neil W Kowall
- Department of Neurology, Boston University, Boston, Massachusetts, USA
- Department of Pathology, Boston University, Boston, Massachusetts, USA
| | - Joel H Kramer
- Department of Neuropsychology, University of California, San Francisco, San Francisco, California, USA
| | - Frank M LaFerla
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California, USA
| | - James J Lah
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - James B Leverenz
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, Ohio, USA
| | - Allan I Levey
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Ge Li
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
- VA Puget Sound Health Care System/GRECC, Seattle, Washington, USA
| | - Andrew P Lieberman
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University, Boston, Massachusetts, USA
| | | | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Frank Martiniuk
- Department of Medicine-Pulmonary, New York University, New York, New York, USA
| | - Deborah C Mash
- Department of Neurology, University of Miami, Miami, Florida, USA
| | - Eliezer Masliah
- Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Wayne C McCormick
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Susan M McCurry
- School of Nursing Northwest Research Group on Aging, University of Washington, Seattle, Washington, USA
| | - Andrew N McDavid
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Ann C McKee
- Department of Neurology, Boston University, Boston, Massachusetts, USA
- Department of Pathology, Boston University, Boston, Massachusetts, USA
| | - Marsel Mesulam
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Carol A Miller
- Department of Pathology, University of Southern California, Los Angeles, California, USA
| | - Joshua W Miller
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, California, USA
| | - John C Morris
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Jill R Murrell
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, Indiana, USA
| | - Amanda J Myers
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sid O'Bryant
- Internal Medicine, Division of Geriatrics, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - John M Olichney
- Department of Neurology, University of California, Davis, Sacramento, California, USA
| | - Vernon S Pankratz
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Joseph E Parisi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Henry L Paulson
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- Michigan Alzheimer Disease Center, Ann Arbor, Michigan, USA
| | - William Perry
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida, USA
| | - Elaine Peskind
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Aimee Pierce
- Department of Neurology, University of California, Irvine, Irvine, California, USA
| | - Wayne W Poon
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, California, USA
| | - Huntington Potter
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Joseph F Quinn
- Department of Neurology, Oregon Health &Science University, Portland, Oregon, USA
- Department of Neurology, Portland Veterans Affairs Medical Center, Portland, Oregon, USA
| | - Ashok Raj
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, Florida, USA
| | - Murray Raskind
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Barry Reisberg
- Department of Psychiatry, New York University, New York, New York, USA
- Alzheimer's Disease Center, New York University, New York, New York, USA
| | - Christiane Reitz
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
- Department of Neurology, Columbia University, New York, New York, USA
- Department of Epidemiology, Columbia University, New York, New York, USA
| | - John M Ringman
- Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
| | - Howard J Rosen
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Roger N Rosenberg
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Mark A Sager
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Andrew J Saykin
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, Indiana, USA
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, Indiana, USA
| | - Julie A Schneider
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, Illinois, USA
| | - Lon S Schneider
- Department of Neurology, University of Southern California, Los Angeles, California, USA
- Department of Psychiatry, University of Southern California, Los Angeles, California, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Amanda G Smith
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, Florida, USA
| | - Joshua A Sonnen
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - Salvatore Spina
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Robert A Stern
- Department of Neurology, Boston University, Boston, Massachusetts, USA
| | - Russell H Swerdlow
- University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Rudolph E Tanzi
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Tricia A Thornton-Wells
- Translational Medicine, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Juan C Troncoso
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Linda J Van Eldik
- Sanders-Brown Center on Aging, Department of Anatomy and Neurobiology, University of Kentucky, Lexington, Kentucky, USA
| | - Harry V Vinters
- Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Jean Paul Vonsattel
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Pathology, Columbia University, New York, New York, USA
| | - Sandra Weintraub
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kathleen A Welsh-Bohmer
- Department of Medicine, Duke University, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Kirk C Wilhelmsen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer Williamson
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, New York, USA
| | - Thomas S Wingo
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Randall L Woltjer
- Department of Pathology, Oregon Health &Science University, Portland, Oregon, USA
| | - Clinton B Wright
- Evelyn F. McKnight Brain Institute, Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Chang-En Yu
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Lei Yu
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Fabienne Garzia
- CEA/Institut de Génomique, Centre National de Génotypage, Evry, France
| | - Feroze Golamaully
- CEA/Institut de Génomique, Centre National de Génotypage, Evry, France
| | - Gislain Septier
- CEA/Institut de Génomique, Centre National de Génotypage, Evry, France
| | - Sebastien Engelborghs
- Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp, Antwerp, Belgium
| | - Rik Vandenberghe
- Department of Neurology and Memory Clinic, Hospital Network Antwerp, Antwerp, Belgium
- Laboratory for Cognitive Neurology, Department of Neurology, University of Leuven, Leuven, Belgium
| | - Peter P De Deyn
- Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp, Antwerp, Belgium
| | - Carmen Muñoz Fernadez
- Department of Immunology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Yoland Aladro Benito
- Department of Immunology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Hakan Thonberg
- Department of Geriatric Medicine, Genetics Unit, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, KIADRC, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Forsell
- Department of Geriatric Medicine, Genetics Unit, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, KIADRC, Karolinska Institutet, Stockholm, Sweden
| | - Lena Lilius
- Department of Geriatric Medicine, Genetics Unit, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, KIADRC, Karolinska Institutet, Stockholm, Sweden
| | - Anne Kinhult-Stählbom
- Department of Geriatric Medicine, Genetics Unit, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, KIADRC, Karolinska Institutet, Stockholm, Sweden
| | - Lena Kilander
- Department of Public Health/Geriatrics, Uppsala University, Uppsala, Sweden
| | - RoseMarie Brundin
- Department of Public Health/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Letizia Concari
- Department of Neuroscience, University of Parma, Parma, Italy
- Center for Cognitive Disorders AUSL, Parma, Italy
| | - Seppo Helisalmi
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
| | - Anne Maria Koivisto
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
| | - Annakaisa Haapasalo
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
| | - Vincent Dermecourt
- CHU Lille, Memory Center of Lille (Centre Mémoire de Ressources et de Recherche), Lille, France
| | - Nathalie Fievet
- INSERM, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- University Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
- University Paris Descartes, EA 4468, AP-HP, Hôpital Broca, Geriatrics Department, Paris, France
| | - Olivier Hanon
- University Paris Descartes, EA 4468, AP-HP, Hôpital Broca, Geriatrics Department, Paris, France
| | - Carole Dufouil
- University of Bordeaux, Neuroepidemiology, Bordeaux, France
- INSERM, Neuroepidemiology, UMR 897, Bordeaux, France
| | - Alexis Brice
- INSERM U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Université Paris 06, UMRS 1127, Institut du Cerveau et de la Moelle Épinière, Paris, France
- AP-HP, Department of Genetics, Pitié-Salpêtrière Hospital, Paris, France
| | - Karen Ritchie
- INSERM U1061, La Colombière Hospital, Montpellier, France
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Département de Neurologie, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
- Institut des Neurosciences Translationnelles de Paris (IHU-A-ICM), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
- INSERM, CNRS, UMRS 975, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
- Sorbonne Universités, Université Pierre et Marie Curie, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
| | | | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - JoAnn Tschanz
- Department of Mathematics and Statistics, Utah State University, Logan, Utah, USA
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
| | - Walter A Kukull
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Maria Norton
- Department of Mathematics and Statistics, Utah State University, Logan, Utah, USA
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- Centre for Public Health, University of Iceland, Reykjavik, Iceland
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Group Health Research Institute, Group Health, Seattle, Washington, USA
| | - Ron Munger
- Department of Mathematics and Statistics, Utah State University, Logan, Utah, USA
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - María J Bullido
- Instituto de Investigación Sanitaria Hospital la Paz (IdiPAZ), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Madrid, Spain
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Thomas J Montine
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - Eliecer Coto
- Molecular Genetics Laboratory-Hospital, University of Central Asturias, Oviedo, Spain
| | - Eric Boerwinkle
- School of Public Health, Human Genetics Center, University of Texas Health Science Center at Houston, Houston, Texas, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Victoria Alvarez
- Molecular Genetics Laboratory-Hospital, University of Central Asturias, Oviedo, Spain
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium on Health Aging and National Genomics Initiative, Leiden, the Netherlands
| | - Eric M Reiman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Arizona Alzheimer's Consortium, Phoenix, Arizona, USA
- Banner Alzheimer's Institute, Phoenix, Arizona, USA
- Department of Psychiatry, University of Arizona, Phoenix, Arizona, USA
| | - Maura Gallo
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | | | - Joan S Reisch
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Donald R Royall
- Departments of Psychiatry, Medicine, and Family and Community Medicine and South Texas Veterans Health Administration Geriatric Research Education and Clinical Center (GRECC), University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Mary Sano
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, USA
| | - Daniela Galimberti
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Peter St George-Hyslop
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - Elio Scarpini
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Debby W Tsuang
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
- VA Puget Sound Health Care System/GRECC, Seattle, Washington, USA
| | - Michelangelo Mancuso
- Department of Experimental and Clinical Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Experimental and Clinical Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Ashley R Winslow
- PharmaTherapeutics Clinical Research, Pfizer Worldwide Research and Development, Cambridge, Massachusetts, USA
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Hearth, Rome, Italy
| | - Chuang-Kuo Wu
- Departments of Neurology, Pharmacology, and Neuroscience, Texas Tech University Health Science Center, Lubbock, Texas, USA
| | - Oliver Peters
- Department of Psychiatry, Charité University Medicine, Berlin, Germany
| | - Benedetta Nacmias
- NEUROFARBA (Department of Neuroscience, Psychology, Drug Research and Child Health), University of Florence, Florence, Italy
- IRCCS 'Don Carlo Gnocchi', Florence, Italy
| | | | - Reinhard Heun
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Carol Brayne
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - David C Rubinsztein
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - Jose Bras
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Rita Guerreiro
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Ammar Al-Chalabi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christopher E Shaw
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - John Collinge
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - David Mann
- Institute of Brain, Behaviour and Mental Health, Clinical and Cognitive Neuroscience Research Group, University of Manchester, Manchester, UK
| | - Magda Tsolaki
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Jordi Clarimón
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Rebecca Sussams
- Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK
| | | | - Michael C O'Donovan
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Michael J Owen
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Timothy W Behrens
- Immunology Biomarkers Group, Genentech, South San Francisco, California, USA
| | - Simon Mead
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Alison M Goate
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York, USA
| | - Andre G Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Clive Holmes
- VA Puget Sound Health Care System/GRECC, Seattle, Washington, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Martin Ingelsson
- Department of Public Health/Geriatrics, Uppsala University, Uppsala, Sweden
| | - David A Bennett
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - John Powell
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Todd E Golde
- Center for Translational Research in Neurodegenerative Disease, Department of Neuroscience, University of Florida, Gainesville, Florida, USA
- Florida Alzheimer's Disease Research Center, Gainesville, Florida, USA
| | - Caroline Graff
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, KIADRC, Karolinska Institutet, Stockholm, Sweden
| | - Philip L De Jager
- Center for Translational and Systems Neuroimmunology, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Kevin Morgan
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Nilufer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Onofre Combarros
- Neurology Service and CIBERNED, 'Marqués de Valdecilla' University Hospital (University of Cantabria and IFIMAV), Santander, Spain
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, USA
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - Peter Passmore
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | - Steven G Younkin
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Claudine Berr
- Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Département de Neurologie, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
- Memory Research and Resources Center, CMRR of Montpellier, Department of Neurology, Hospital Gui de Chauliac, Montpellier, France
- Department of Neurology, Montpellier University, Montpellier, France
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Dan Rujescu
- Department of Psychiatry, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Anita L DeStefano
- Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sara Ortega-Cubero
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Neurogenetics Laboratory, Division of Neurosciences, Centre for Applied Medical Research, University of Navarra School of Medicine, Pamplona, Spain
- Department of Neurology, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Dominique Campion
- Centre Hospitalier du Rouvray, Sotteville les Rouen, France
- INSERM U1079, Rouen University, IRIB, Normandy University, Rouen, France
| | - Merce Boada
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - John Keoni Kauwe
- Departments of Biology and Neuroscience, Brigham Young University, Provo, Utah, USA
| | - Lindsay A Farrer
- Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Medicine (Genetics Program), Boston University, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University, Boston, Massachusetts, USA
- Department of Ophthalmology, Boston University, Boston, Massachusetts, USA
- Department of Neurology, Boston University, Boston, Massachusetts, USA
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases Group, Department of Molecular Genetics, VIB, Antwerp, Belgium
- Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Lesley Jones
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jonathan L Haines
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA
| | - Christophe Tzourio
- INSERM U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Université Paris 06, UMRS 1127, Institut du Cerveau et de la Moelle Épinière, Paris, France
- University of Bordeaux, Neuroepidemiology, UMR 897, Bordeaux, France
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland, USA
| | - Valentina Escott-Price
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Richard Mayeux
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
- Department of Neurology, Columbia University, New York, New York, USA
| | | | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Peter A Holmans
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida, USA
- Dr. John T. Macdonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida, USA
| | - Philippe Amouyel
- INSERM, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- University Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
- Centre Hospitalier Universitaire de Lille, Epidemiology and Public Health Department, Lille, France
| | | | - Alfredo Ramirez
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Li-San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jean-Charles Lambert
- INSERM, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- University Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Sudha Seshadri
- Boston University School of Medicine, Boston, Massachusetts, USA
- Framingham Heart Study, Framingham, Massachusetts, USA
| | - Julie Williams
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Gerard D Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Lassen-Greene CL, Steward K, Okonkwo O, Porter E, Crowe M, Vance DE, Griffith HR, Ball K, Marson DC, Wadley VG. Mild Cognitive Impairment and Changes in Everyday Function Over Time: The Importance of Evaluating Both Speed and Accuracy. J Geriatr Psychiatry Neurol 2017; 30:220-227. [PMID: 28639877 PMCID: PMC5812285 DOI: 10.1177/0891988717711807] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Research estimates that a significant percentage of individuals with mild cognitive impairment (MCI) experience functional difficulties. In addition to reduced accuracy on measures of everyday function, cross-sectional research has demonstrated that speed of performing instrumental activities of daily living (IADLs) is slowed in individuals with MCI. The present study investigated whether baseline and longitudinal changes in speed and accuracy of IADL performance differed between persons with MCI and cognitively normal peers. DESIGN Linear mixed models were used to estimate the group differences in longitudinal performance on measures of IADLs. SETTING Assessments were conducted at university and medical research centers. PARTICIPANTS The sample consisted of 80 participants with MCI and 80 control participants who were enrolled in the Alzheimer's Disease Research Center's Measuring Independent Living in the Elderly Study. MEASUREMENTS Instrumental activities of daily living speed and accuracy were directly assessed using selected domains of the Financial Capacity Instrument, the Timed IADL assessment, and driving-related assessments (Useful Field of View, Road Sign Test). RESULTS Individuals with MCI performed worse on speed and accuracy measures of IADLs in comparison to cognitively normal peers and demonstrated significantly steeper rates of decline over three years in either speed or accuracy in all domains assessed. CONCLUSION Both speed and accuracy of performance on measures of IADL are valuable indices for early detection of functional change in MCI. The performance pattern may reflect a trade-off between speed and accuracy that can guide clinical recommendations for maintaining patient independence.
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Affiliation(s)
| | - Kayla Steward
- Department of Psychology, University of Alabama at Birmingham (UAB)
| | | | | | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham (UAB)
| | | | | | - Karlene Ball
- Department of Psychology, University of Alabama at Birmingham (UAB)
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Swanson CJ, Marson DC, McPherson T, Gerstenecker A, Logovinsky V. [P1–070]: THE FINANCIAL CAPACITY INSTRUMENT–SHORT FORM IS A NOVEL, PERFORMANCE‐BASED MEASURE THAT MAY HELP DIFFERENTIATE MILD COGNITIVE IMPAIRMENT AND MILD DEMENTIA DUE TO ALZHEIMER's DISEASE POPULATIONS IN CLINICAL TRIALS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Gerstenecker A, Lowry K, Myers T, Bashir K, Triebel KL, Martin RC, Marson DC. Medical decision-making capacity and its cognitive predictors in progressive MS: Preliminary evidence. J Neurol Sci 2017; 380:38-43. [PMID: 28870585 DOI: 10.1016/j.jns.2017.06.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/01/2017] [Accepted: 06/28/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Medical decision-making capacity (MDC) refers to the ability to make informed decisions about treatment and declines in cognition are associated with declines in MDC across multiple disease entities. However, although it is well known that cognitive impairment is prevalent in multiple sclerosis (MS), little is known about MDC in the disease. METHODS Data from 22 persons with progressive MS and 18 healthy controls were analyzed. All diagnoses were made by a board-certified neurologist with experience in MS. All study participants were administered a vignette-based measure of MDC and also a neuropsychological battery. RESULTS Performance on three MDC consent standards (i.e., Appreciation, Reasoning, Understanding) was significantly lower for people with progressive MS as compared to healthy controls. In the progressive MS group, verbal fluency was the primary cognitive predictor for both Reasoning and Understanding consent standards. Verbal learning and memory was the primary cognitive predictor for Appreciation. MS severity was not significantly correlated with any MDC variable. CONCLUSION MDC is a complex and cognitively mediated functional ability that is impaired in many people with progressive MS. Verbal measures of fluency and memory are strongly associated with MDC performances in the current sample of people with MS and could potentially be utilized to quickly screen for MDC impairment in MS.
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Affiliation(s)
- Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kathleen Lowry
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Terina Myers
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Khurram Bashir
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kristen L Triebel
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Roy C Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States.
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Gerstenecker A, Myers T, Lowry K, Martin RC, Triebel KL, Bashir K, Marson DC. Financial Capacity and its Cognitive Predictors in Progressive Multiple Sclerosis. Arch Clin Neuropsychol 2017; 32:943-950. [DOI: 10.1093/arclin/acx039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 04/03/2017] [Indexed: 11/12/2022] Open
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17
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Niccolai LM, Triebel KL, Gerstenecker A, McPherson TO, Cutter GR, Martin RC, Marson DC. Neurocognitive Predictors of Declining Financial Capacity in Persons with Mild Cognitive Impairment. Clin Gerontol 2017; 40:14-23. [PMID: 28452629 PMCID: PMC5412082 DOI: 10.1080/07317115.2016.1228022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To identify cognitive predictors of declining financial capacity (FC) in persons with mild cognitive impairment (MCI). METHODS Participants were 66 cognitively normal older adults and 49 persons with MCI who completed neuropsychological testing and a performance measure of financial capacity (Financial Capacity Instrument; FCI) at baseline and two-year follow-up. We calculated two-year change scores for neuropsychological tests and FCI total score. We examined bivariate correlations between demographic/clinical variables and FCI change score, and between neuropsychological and FCI change scores. The five strongest bivariate correlates were entered into a linear regression analysis to identify longitudinal predictors of financial decline within group. RESULTS Persons with MCI showed significant decline on the FCI and most cognitive variables, while controls demonstrated relatively stable performance. For persons with MCI, education correlated with FCI change score. The top four cognitive variable-FCI change score correlations were written arithmetic, confrontation naming, immediate visual memory, and visual attention. In the regression model, written arithmetic was the primary predictor and visual memory and visual attention were secondary predictors of two-year FCI change scores. CONCLUSION Semantic arithmetic knowledge, and to a lesser extent visual memory and attention, are key longitudinal cognitive predictors of financial skill decline in individuals with MCI. CLINICAL IMPLICATIONS Clinicians should consider neurocognitive abilities of written arithmetic, visual memory, and processing speed in their assessments of financial capacity in person with MCI.
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Affiliation(s)
| | | | | | | | - Gary R Cutter
- a University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Roy C Martin
- a University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Daniel C Marson
- a University of Alabama at Birmingham , Birmingham , Alabama , USA
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Steward KA, Novack TA, Kennedy R, Crowe M, Marson DC, Triebel KL. The Wechsler Test of Adult Reading as a Measure of Premorbid Intelligence Following Traumatic Brain Injury. Arch Clin Neuropsychol 2016; 32:98-103. [PMID: 27799224 DOI: 10.1093/arclin/acw081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2016] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The current study sought to determine whether the Wechsler Test of Adult Reading (WTAR) provides a stable estimate of premorbid intellectual ability in acutely injured patients recovering from traumatic brain injury (TBI). METHOD A total of 135 participants (43 mild TBI [mTBI], 40 moderate/severe TBI [msevTBI], 52 healthy controls) were administered the WTAR at 1 and 12 months post-injury. RESULTS Despite similar demographic profiles, participants with msevTBI performed significantly worse than controls on the WTAR at both time points. Moreover, the msevTBI group had a significant improvement in WTAR performance over the 1-year period. In contrast, those participants with mTBI did not significantly differ from healthy controls and both the mTBI and control groups demonstrated stability on the WTAR over time. CONCLUSIONS Results indicate that word-reading tests may underestimate premorbid intelligence during the immediate recovery period for patients with msevTBI. Clinicians should consider alternative estimation measures in this TBI subpopulation.
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Affiliation(s)
- Kayla A Steward
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Thomas A Novack
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Richard Kennedy
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristen L Triebel
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
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Spreng RN, Karlawish J, Marson DC. Cognitive, social, and neural determinants of diminished decision-making and financial exploitation risk in aging and dementia: A review and new model. J Elder Abuse Negl 2016; 28:320-344. [PMID: 27644698 DOI: 10.1080/08946566.2016.1237918] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In this article we will briefly review how changes in brain and in cognitive and social functioning, across the spectrum from normal to pathological aging, can lead to decision-making impairments that increase abuse risk in many life domains (e.g., health care, social engagement, financial management). The review will specifically focus on emerging research identifying neural, cognitive, and social markers of declining financial decision-making capacity in older adults. We will highlight how these findings are opening avenues for early detection and new interventions to reduce exploitation risk.
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Affiliation(s)
- R Nathan Spreng
- a Laboratory of Brain and Cognition, Human Neuroscience Institute, Department of Human Development , Cornell University , Ithaca , New York , USA
| | - Jason Karlawish
- b Center for Neuroscience and Society, Alzheimer's Disease Center, Center for Bioethics, Departments of Medicine and Medical Ethics , University of Pennsylvania , Philadelphia , Pennsylvania , USA
| | - Daniel C Marson
- c Department of Neurology and Alzheimer's Disease Center , University of Alabama at Birmingham , Birmingham , Alabama , USA
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Steward KA, Gerstenecker A, Triebel KL, Kennedy R, Novack TA, Dreer LE, Marson DC. Twelve-month recovery of medical decision-making capacity following traumatic brain injury. Neurology 2016; 87:1052-9. [PMID: 27511180 DOI: 10.1212/wnl.0000000000003079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/20/2016] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To investigate recovery of medical decision-making capacity (MDC) over the first year following traumatic brain injury (TBI). METHODS A total of 177 participants (111 persons with TBI and 66 healthy controls) were recruited from an inpatient/outpatient TBI rehabilitation unit and outpatient neurology department. Participants with TBI were classified by injury severity into subgroups: mild TBI (mTBI; n = 28), complicated mild TBI (cmTBI; n = 23), and moderate/severe TBI (msevTBI; n = 60). Control and TBI groups were compared at 1 month (t1), 6 months (t2), and 12 months (t3) postinjury using the Capacity to Consent to Treatment Instrument (CCTI), which evaluates MDC using 5 consent standards: expressing choice, reasonable choice, appreciation, reasoning, and understanding. RESULTS Relative to controls, no TBI group displayed impairment on CCTI expressing choice or reasonable choice at any timepoint. Those with mTBI had reduced appreciation and understanding at t1, which resolved by t2. The cmTBI and msevTBI groups were impaired on all 3 complex consent standards at t1. While patients with cmTBI improved to a level similar to controls by t3, those with msevTBI remained impaired on reasoning and understanding. Across all TBI groups, notable MDC improvement only occurred over the first 6 months postinjury. CONCLUSIONS Over 1 year, most individuals with mTBI or cmTBI regain MDC, while many individuals with msevTBI have lingering deficits in reasoning and comprehension of treatment information. Clinical recovery of MDC occurs primarily during the first 6 months post-TBI regardless of injury severity. Clinicians can therefore identify MDC outcomes in TBI at 6 months postinjury.
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Affiliation(s)
- Kayla A Steward
- From the Departments of Psychology (K.A.S.), Neurology (A.G., K.L.T., D.C.M.), Medicine (R.K.), Physical Medicine and Rehabilitation (T.A.N.), and Ophthalmology (L.E.D.), University of Alabama at Birmingham
| | - Adam Gerstenecker
- From the Departments of Psychology (K.A.S.), Neurology (A.G., K.L.T., D.C.M.), Medicine (R.K.), Physical Medicine and Rehabilitation (T.A.N.), and Ophthalmology (L.E.D.), University of Alabama at Birmingham
| | - Kristen L Triebel
- From the Departments of Psychology (K.A.S.), Neurology (A.G., K.L.T., D.C.M.), Medicine (R.K.), Physical Medicine and Rehabilitation (T.A.N.), and Ophthalmology (L.E.D.), University of Alabama at Birmingham
| | - Richard Kennedy
- From the Departments of Psychology (K.A.S.), Neurology (A.G., K.L.T., D.C.M.), Medicine (R.K.), Physical Medicine and Rehabilitation (T.A.N.), and Ophthalmology (L.E.D.), University of Alabama at Birmingham
| | - Thomas A Novack
- From the Departments of Psychology (K.A.S.), Neurology (A.G., K.L.T., D.C.M.), Medicine (R.K.), Physical Medicine and Rehabilitation (T.A.N.), and Ophthalmology (L.E.D.), University of Alabama at Birmingham
| | - Laura E Dreer
- From the Departments of Psychology (K.A.S.), Neurology (A.G., K.L.T., D.C.M.), Medicine (R.K.), Physical Medicine and Rehabilitation (T.A.N.), and Ophthalmology (L.E.D.), University of Alabama at Birmingham
| | - Daniel C Marson
- From the Departments of Psychology (K.A.S.), Neurology (A.G., K.L.T., D.C.M.), Medicine (R.K.), Physical Medicine and Rehabilitation (T.A.N.), and Ophthalmology (L.E.D.), University of Alabama at Birmingham.
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Abstract
INTRODUCTION Cognitive impairment often occurs in people with multiple sclerosis (MS), and dysfunction involving executive function, new learning, and working memory is especially common. Compromised activities of daily living are linked to this cognitive impairment, and people with MS are apt to be unemployed and struggle to manage domestic responsibilities. Financial decision making is an important activity of daily living, and no study has examined whether it is compromised by neuropsychological dysfunction in people with MS. METHOD A battery of neuropsychological tests and a measure of financial decision making (Financial Capacity Instrument, FCI: Marson, D. C. 2001. Loss of financial capacity in dementia: Conceptual and empirical approaches. Aging, Neuropsychology, and Cognition, 8, 164-181) were administered to 50 participants (34 patients with MS and 16 cognitively healthy adults). Based on the neuropsychological test results, 14 patients were classified as having cognitive impairment, and 20 had no significant impairment. RESULTS The impaired MS patients performed significantly worse than unimpaired patients and the healthy comparison group on most financial tasks. The impaired group retained abilities to count money and display adequate financial judgment. Regression analyses showed that measures of mental flexibility and working memory correlated most strongly with performance on the FCI domains across groups. CONCLUSIONS Cognitively impaired patients with MS have degraded financial skills, which are linked to executive function and working memory deficits.
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Affiliation(s)
- Victoria L Tracy
- a Department of Psychology , University of Tulsa , Tulsa , OK , USA
| | - Michael R Basso
- a Department of Psychology , University of Tulsa , Tulsa , OK , USA
| | - Daniel C Marson
- b University of Alabama School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA
| | - Dennis R Combs
- c Department of Psychology , University of Texas at Tyler , Tyler , TX , USA
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Marson DC, Gerstenecker A, Triebel K, Martin R, Christianson TJ, Swenson-Dravis D, Pankratz VS, Petersen RC. F5‐05‐03: Detecting Functional Impairment in Preclinical Alzheimer’s Disease using a Brief Performance Measure of Financial Skills. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Roy Martin
- University of Alabama at BirminghamBirminghamAL USA
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Gerstenecker A, Martin R, Marson DC, Bashir K, Triebel KL. Introducing demographic corrections for the 10/36 Spatial Recall Test. Int J Geriatr Psychiatry 2016; 31:406-11. [PMID: 26270773 PMCID: PMC4752917 DOI: 10.1002/gps.4346] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/09/2015] [Accepted: 07/21/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The 10/36 Spatial Recall Test is a measure of visuospatial memory and has been recommended for inclusion when administering a brief cognitive assessment to patients with multiple sclerosis by multiple groups. However, a notable limitation of the measure includes a lack of normative data with demographic corrections. Thus, the primary objective of the current study was to examine demographic influences on the 10/36 Spatial Recall Test and to introduce demographically corrected normative data for the instrument. METHODS Data were collected from 116 participants over the age of 50 years. All study participants were free of any neurologic disease or disorder and classified as cognitively intact by a consensus conference team that was comprised of neurologists and neuropsychologists. All study participants were administered a neuropsychological evaluation that included the 10/36 Spatial Recall Test Version A at the baseline visit. RESULTS 10/36 Spatial Recall Test scores were affected by age, education, and race. Gender effects were not observed. Given these effects, regression equations were used to correct for the effects of demographic variables. The z-scores obtained from these corrections were not significantly influenced by demographical variables. CONCLUSION The demographic corrections introduced in this paper offer the possibility to enhance the clinical utility of the 10/36 Spatial Recall Test.
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Affiliation(s)
- Adam Gerstenecker
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, USA
| | - Roy Martin
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, USA
| | - Daniel C. Marson
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, USA
| | - Khurram Bashir
- Department of Neurology, Division of Neuroimmunology and Multiple Sclerosis, University of Alabama at Birmingham, USA
| | - Kristen L. Triebel
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, USA
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Triebel KL, Gerstenecker A, Meneses K, Fiveash JB, Meyers CA, Cutter G, Marson DC, Martin RC, Eakin A, Watts O, Nabors LB. Capacity of patients with brain metastases to make treatment decisions. Psychooncology 2015; 24:1448-55. [PMID: 25613039 PMCID: PMC4512930 DOI: 10.1002/pon.3753] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 11/21/2014] [Accepted: 12/18/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to investigate medical decision-making capacity (MDC) in patients with brain metastases. METHODS Participants were 41 adults with brain metastases with Karnofsky Performance Status scores of ≥70 who were recruited from an academic medical center and 41 demographically matched controls recruited from the community. We evaluated MDC using the Capacity to Consent to Treatment Instrument and its four clinically relevant consent standards (expressing a treatment choice, appreciation, reasoning, and understanding). Capacity impairment ratings (no impairment, mild/moderate impairment, and severe impairment) on the consent standards were also assigned to each participant with brain metastasis using cutoff scores derived statistically from the performance of the control group. RESULTS The brain metastasis patient group performed significantly below controls on consent standards of understanding and reasoning. Capacity compromise was defined as performance ≤1.5 standard deviations below the control group mean. Using this definition, approximately 60% of the participants with brain metastases demonstrated capacity compromise on at least one MDC standard. CONCLUSION When defining capacity compromise as performance ≤1.5 standard deviation below the control group mean, over half of patients with brain metastases have reduced capacity to make treatment decisions. This impairment is demonstrated shortly after initial diagnosis of brain metastases and highlights the importance of routine clinical assessment of MDC following diagnosis of brain metastasis. These results also indicate a need for the development and investigation of interventions to support or improve MDC in this patient population.
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Affiliation(s)
- Kristen L. Triebel
- Department of Neurology, UAB, Birmingham, AL
- Comprehensive Cancer Center, UAB, Birmingham, AL
| | | | - Karen Meneses
- Comprehensive Cancer Center, UAB, Birmingham, AL
- School of Nursing, UAB, Birmingham, AL
| | - John B. Fiveash
- Comprehensive Cancer Center, UAB, Birmingham, AL
- Department of Radiation Oncology, UAB, Birmingham, AL
| | - Christina A. Meyers
- Department of Neuro-Oncology, M.D. Anderson Cancer Center, Houston, TX (retired)
| | - Gary Cutter
- Department of Biostatistics, School of Public Health, UAB, Birmingham, AL
| | | | | | | | - Olivia Watts
- Department of Psychology, Boston University, Boston, MA
| | - Louis B. Nabors
- Department of Neurology, UAB, Birmingham, AL
- Comprehensive Cancer Center, UAB, Birmingham, AL
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Martin RC, Gerstenecker A, Nabors LB, Marson DC, Triebel KL. Impairment of medical decisional capacity in relation to Karnofsky Performance Status in adults with malignant brain tumor. Neurooncol Pract 2015; 2:13-19. [PMID: 26034637 DOI: 10.1093/nop/npu030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We aimed to investigate the relationship between medical decisional capacity (MDC) and Karnofsky Performance Status (KPS) in adults with malignant brain tumors. METHODS Participants were 71 adults with primary (n = 26) or metastatic (n = 45) brain tumors. Testing to determine KPS scores and MDC was performed as close together as possible for each patient. Participants were administered a standardized measure of medical decision-making capacity (Capacity to Consent to Treatment Instrument [CCTI]) to assess 3 treatment consent abilities (ie, appreciation, reasoning, and understanding). Capacity classifications (ie, capable, marginally capable, and incapable) were established using cut scores previously derived from healthy control CCTI performance. RESULTS The majority of participants had KPS scores of 90-100 (n = 39), with the remainder divided between KPS scores of 70-80 (n = 26) and 50-60 (n = 6). Comparisons between persons with KPS scores of 90-100 or 70-80 revealed significant differences on the CCTI consent standards of understanding and appreciation. Participants with KPS ratings of 90-100 achieved 46% capable classifications across all CCTI standards, in contrast with 23% of participants with KPS ratings of 70-80, and 0% of participants with KPS ratings of 50-60. CONCLUSIONS A substantial portion of brain-tumor patients with KPS scores reflecting only minimal disability nonetheless demonstrated impairments on standardized measures of MDC. Clinicians working with this adult population should carefully screen for capacity to make clinical treatment decisions regardless of functional/performance status.
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Affiliation(s)
- Roy C Martin
- Department of Neurology , Division of Neuropsychology, University of Alabama at Birmingham , Birmingham, Alabama (R.C.M., A.G., D.C.M., K.L.T.); Comprehensive Cancer Center, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.); Department of Neurology , Division of Neuro-Oncology, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.)
| | - Adam Gerstenecker
- Department of Neurology , Division of Neuropsychology, University of Alabama at Birmingham , Birmingham, Alabama (R.C.M., A.G., D.C.M., K.L.T.); Comprehensive Cancer Center, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.); Department of Neurology , Division of Neuro-Oncology, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.)
| | - Louis B Nabors
- Department of Neurology , Division of Neuropsychology, University of Alabama at Birmingham , Birmingham, Alabama (R.C.M., A.G., D.C.M., K.L.T.); Comprehensive Cancer Center, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.); Department of Neurology , Division of Neuro-Oncology, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.)
| | - Daniel C Marson
- Department of Neurology , Division of Neuropsychology, University of Alabama at Birmingham , Birmingham, Alabama (R.C.M., A.G., D.C.M., K.L.T.); Comprehensive Cancer Center, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.); Department of Neurology , Division of Neuro-Oncology, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.)
| | - Kristen L Triebel
- Department of Neurology , Division of Neuropsychology, University of Alabama at Birmingham , Birmingham, Alabama (R.C.M., A.G., D.C.M., K.L.T.); Comprehensive Cancer Center, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.); Department of Neurology , Division of Neuro-Oncology, University of Alabama at Birmingham , Birmingham, Alabama (L.B.N.)
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Wang LS, Naj AC, Graham RR, Crane PK, Kunkle BW, Cruchaga C, Murcia JDG, Cannon-Albright L, Baldwin CT, Zetterberg H, Blennow K, Kukull WA, Faber KM, Schupf N, Norton MC, Tschanz JT, Munger RG, Corcoran CD, Rogaeva E, Lin CF, Dombroski BA, Cantwell LB, Partch A, Valladares O, Hakonarson H, St George-Hyslop P, Green RC, Goate AM, Foroud TM, Carney RM, Larson EB, Behrens TW, Kauwe JSK, Haines JL, Farrer LA, Pericak-Vance MA, Mayeux R, Schellenberg GD, Albert MS, Albin RL, Apostolova LG, Arnold SE, Barber R, Barmada M, Barnes LL, Beach TG, Becker JT, Beecham GW, Beekly D, Bennett DA, Bigio EH, Bird TD, Blacker D, Boeve BF, Bowen JD, Boxer A, Burke JR, Buxbaum JD, Cairns NJ, Cao C, Carlson CS, Carroll SL, Chui HC, Clark DG, Cribbs DH, Crocco EA, DeCarli C, DeKosky ST, Demirci FY, Dick M, Dickson DW, Duara R, Ertekin-Taner N, Fallon KB, Farlow MR, Ferris S, Frosch MP, Galasko DR, Ganguli M, Gearing M, Geschwind DH, Ghetti B, Gilbert JR, Glass JD, Graff-Radford NR, Growdon JH, Hamilton RL, Hamilton-Nelson KL, Harrell LE, Head E, Honig LS, Hulette CM, Hyman BT, Jarvik GP, Jicha GA, Jin LW, Jun G, Jun G, Kamboh MI, Karydas A, Kaye JA, Kim R, Koo EH, Kowall NW, Kramer JH, LaFerla FM, Lah JJ, Leverenz JB, Levey AI, Li G, Lieberman AP, Lopez OL, Lunetta KL, Lyketsos CG, Mack WJ, Marson DC, Martin ER, Martiniuk F, Mash DC, Masliah E, McCormick WC, McCurry SM, McDavid AN, McKee AC, Mesulam WM, Miller BL, Miller CA, Miller JW, Montine TJ, Morris JC, Murrell JR, Olichney JM, Parisi JE, Perry W, Peskind E, Petersen RC, Pierce A, Poon WW, Potter H, Quinn JF, Raj A, Raskind M, Reiman EM, Reisberg B, Reitz C, Ringman JM, Roberson ED, Rosen HJ, Rosenberg RN, Sano M, Saykin AJ, Schneider JA, Schneider LS, Seeley WW, Smith AG, Sonnen JA, Spina S, Stern RA, Tanzi RE, Thornton-Wells TA, Trojanowski JQ, Troncoso JC, Tsuang DW, Van Deerlin VM, Van Eldik LJ, Vardarajan BN, Vinters HV, Vonsattel JP, Weintraub S, Welsh-Bohmer KA, Williamson J, Wishnek S, Woltjer RL, Wright CB, Younkin SG, Yu CE, Yu L. Rarity of the Alzheimer disease-protective APP A673T variant in the United States. JAMA Neurol 2015; 72:209-16. [PMID: 25531812 DOI: 10.1001/jamaneurol.2014.2157] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Recently, a rare variant in the amyloid precursor protein gene (APP) was described in a population from Iceland. This variant, in which alanine is replaced by threonine at position 673 (A673T), appears to protect against late-onset Alzheimer disease (AD). We evaluated the frequency of this variant in AD cases and cognitively normal controls to determine whether this variant will significantly contribute to risk assessment in individuals in the United States. OBJECTIVE To determine the frequency of the APP A673T variant in a large group of elderly cognitively normal controls and AD cases from the United States and in 2 case-control cohorts from Sweden. DESIGN, SETTING, AND PARTICIPANTS Case-control association analysis of variant APP A673T in US and Swedish white individuals comparing AD cases with cognitively intact elderly controls. Participants were ascertained at multiple university-associated medical centers and clinics across the United States and Sweden by study-specific sampling methods. They were from case-control studies, community-based prospective cohort studies, and studies that ascertained multiplex families from multiple sources. MAIN OUTCOMES AND MEASURES Genotypes for the APP A673T variant were determined using the Infinium HumanExome V1 Beadchip (Illumina, Inc) and by TaqMan genotyping (Life Technologies). RESULTS The A673T variant genotypes were evaluated in 8943 US AD cases, 10 480 US cognitively normal controls, 862 Swedish AD cases, and 707 Swedish cognitively normal controls. We identified 3 US individuals heterozygous for A673T, including 1 AD case (age at onset, 89 years) and 2 controls (age at last examination, 82 and 77 years). The remaining US samples were homozygous for the alanine (A673) allele. In the Swedish samples, 3 controls were heterozygous for A673T and all AD cases were homozygous for the A673 allele. We also genotyped a US family previously reported to harbor the A673T variant and found a mother-daughter pair, both cognitively normal at ages 72 and 84 years, respectively, who were both heterozygous for A673T; however, all individuals with AD in the family were homozygous for A673. CONCLUSIONS AND RELEVANCE The A673T variant is extremely rare in US cohorts and does not play a substantial role in risk for AD in this population. This variant may be primarily restricted to Icelandic and Scandinavian populations.
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Affiliation(s)
- Li-San Wang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Adam C Naj
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Robert R Graham
- Department of Human Genetics, Genentech Inc, South San Francisco, California
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle
| | - Brian W Kunkle
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri7Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St Louis, Missouri
| | | | - Lisa Cannon-Albright
- Division of Genetic Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City10George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Clinton T Baldwin
- Biomedical Genetics, Department of Medicine, Boston University, Boston, Massachusetts
| | - Henrik Zetterberg
- Institute of Neurology, University College London, London, England13Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska Uni
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Walter A Kukull
- Department of Epidemiology, University of Washington, Seattle
| | - Kelley M Faber
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis
| | - Nicole Schupf
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York17Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York18Gertrude H. Sergievsky Center, Columbia
| | - Maria C Norton
- Department of Family, Consumer, and Human Development, Utah State University, Logan20Department of Psychology, Utah State University, Logan
| | | | - Ronald G Munger
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan
| | | | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
| | | | - Chiao-Feng Lin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Beth A Dombroski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Laura B Cantwell
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Amanda Partch
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Otto Valladares
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Hakon Hakonarson
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Peter St George-Hyslop
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada25Cambridge Institute for Medical Research, Department of Clinical Neurosciences, University of Cambridge, Cambridge, England
| | - Robert C Green
- Division of Genetics, Department of Medicine and Partners Center for Personalized Genetic Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Alison M Goate
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri7Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St Louis, Missouri
| | - Tatiana M Foroud
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis
| | - Regina M Carney
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle28Group Health Research Institute, Seattle, Washington
| | - Timothy W Behrens
- Department of Human Genetics, Genentech Inc, South San Francisco, California
| | - John S K Kauwe
- Department of Biology, Brigham Young University, Provo, Utah
| | - Jonathan L Haines
- Center for Human Genetics and Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee
| | - Lindsay A Farrer
- Department of Biology, Brigham Young University, Provo, Utah30Department of Biostatistics, Boston University, Boston, Massachusetts31Department of Ophthalmology, Boston University, Boston, Massachusetts32Department of Neurology, Boston University, Boston
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida34Dr John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, Florida
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York18Gertrude H. Sergievsky Center, Columbia University, New York, New York35Department of Neurology, Columbia University, New York, New York
| | - Gerard D Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
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Gerstenecker A, Meneses K, Duff K, Fiveash JB, Marson DC, Triebel KL. Cognitive predictors of understanding treatment decisions in patients with newly diagnosed brain metastasis. Cancer 2015; 121:2013-9. [PMID: 25735262 DOI: 10.1002/cncr.29326] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 02/02/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Medical decision-making capacity is a higher-order functional skill that refers to a patient's ability to make informed, sound decisions related to care and treatment. In a medical context, understanding is the most cognitively demanding consent standard and refers to a patient's ability to comprehend information to the extent that informed decisions can be made. METHODS The association between reasoning and cognition was examined using data from 41 patients with diagnosed brain metastasis. All diagnoses were made by a board-certified radiation oncologist and were verified histologically. In total, 41 demographically matched, cognitively healthy controls were also included to aid in classifying patients with brain metastasis according to reasoning status (ie, intact or impaired). RESULTS Results indicate that measures of simple attention, verbal fluency, verbal memory, processing speed, and executive functioning were all associated with understanding, and that verbal memory and phonemic fluency were the primary cognitive predictors. Using these two primary predictors, equations can be constructed to predict the ability to understand treatment decisions in patients with brain metastasis. CONCLUSIONS Although preliminary, these data demonstrate how cognitive measures can estimate understanding as it relates to medical decision-making capacities in these patients. Clinically, these findings suggest that poor verbal memory and expressive language function could serve as "red flags" for reduced consent capacity in this patient population, thus signaling that a more comprehensive medical decision-making capacity evaluation is warranted.
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Affiliation(s)
- Adam Gerstenecker
- Department of Neurology, Division of Neuropsychology, UAB, Birmingham, Alabama
| | - Karen Meneses
- Comprehensive Cancer Center, UAB, Birmingham, Alabama.,School of Nursing, UAB, Birmingham, Alabama
| | - Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, Utah
| | - John B Fiveash
- Comprehensive Cancer Center, UAB, Birmingham, Alabama.,Department of Radiation Oncology, UAB, Birmingham, Alabama
| | - Daniel C Marson
- Department of Neurology, Division of Neuropsychology, UAB, Birmingham, Alabama
| | - Kristen L Triebel
- Department of Neurology, Division of Neuropsychology, UAB, Birmingham, Alabama.,Comprehensive Cancer Center, UAB, Birmingham, Alabama
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Gerstenecker A, Nabors LB, Meneses K, Fiveash JB, Marson DC, Cutter G, Martin RC, Meyers CA, Triebel KL. Cognition in patients with newly diagnosed brain metastasis: profiles and implications. J Neurooncol 2014; 120:179-85. [PMID: 25035099 PMCID: PMC4295820 DOI: 10.1007/s11060-014-1543-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/06/2014] [Indexed: 10/25/2022]
Abstract
Cognitive impairment is a common symptom in patients with brain metastasis, and significant cognitive dysfunction is prevalent in a majority of patients who are still able to engage in basic self-care activities. In the current study, the neurocognitive performance of 32 patients with brain metastasis and 32 demographically-matched controls was examined using a battery of standardized neuropsychological tests, with the goal of comprehensively examining the cognitive functioning of newly diagnosed brain metastasis patients. The cognition of all patients was assessed within 1 week of beginning treatment for brain metastasis. Results indicated impairments in verbal memory, attention, executive functioning, and language in relation to healthy controls. Performance in relation to appropriate normative groups was also examined. Overall, cognitive deficits were prevalent and memory was the most common impairment. Given that cognitive dysfunction was present in this cohort of patients with largely minimal functional impairment, these results have implications for patients, caregivers and health care providers treating patients with brain metastasis.
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Triebel KL, Martin RC, Novack TA, Dreer LE, Turner C, Kennedy R, Marson DC. Recovery over 6 months of medical decision-making capacity after traumatic brain injury. Arch Phys Med Rehabil 2014; 95:2296-303. [PMID: 25152169 DOI: 10.1016/j.apmr.2014.07.413] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 07/14/2014] [Accepted: 07/23/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate recovery of medical decision-making capacity (MDC) over 6 months in persons with traumatic brain injury (TBI) stratified by injury severity. DESIGN Longitudinal study comparing controls and patients with TBI 1 month after injury (t1) and 6 months after injury (t2). SETTING Inpatient TBI rehabilitation unit and outpatient neurology department. PARTICIPANTS Participants (N=151) consisted of control subjects (n=60) and patients with TBI (n=91) stratified by injury severity: mild TBI (mTBI; n=27), complicated mild TBI (cmTBI; n=20), and moderate/severe TBI (msevTBI; n=44). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES We used the Capacity to Consent to Treatment Instrument to evaluate MDC performance on 5 consent standards (expressing choice, reasonable choice, appreciation, reasoning, and understanding). We also assigned capacity impairment ratings on the consent standards to each participant with TBI using cut scores referenced to control performance. RESULTS Control performance was stable across time on the consent standards. Patients with mTBI and cmTBI performed below controls on the understanding standard at t1 but not t2. Patients with msevTBI performed below controls on appreciation, reasoning, and understanding at t1, and on appreciation and understanding at t2, but showed substantial improvement over time. CONCLUSIONS Regardless of injury severity, all groups with TBI demonstrated baseline impairment of MDC with subsequent partial or full recovery of MDC over a 6-month period. However, a sizeable proportion of individual patients with TBI in each group continued to demonstrate capacity compromise at 6 months postinjury. Clinically, this finding suggests that individuals with TBI, regardless of injury severity, need continued monitoring regarding MDC for at least 6 months after injury.
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Affiliation(s)
- Kristen L Triebel
- Division of Neuropsychology, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
| | - Roy C Martin
- Division of Neuropsychology, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
| | - Thomas A Novack
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL
| | - Laura E Dreer
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
| | - Crystal Turner
- Division of Neuropsychology, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
| | - Richard Kennedy
- Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Daniel C Marson
- Division of Neuropsychology, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL.
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Affiliation(s)
- Scott Y H Kim
- From the Department of Bioethics (S.Y.H.K.), Clinical Center, National Institutes of Health, Bethesda, MD; and the Department of Neurology (D.C.M.), Alzheimer's Disease Center, University of Alabama at Birmingham.
| | - Daniel C Marson
- From the Department of Bioethics (S.Y.H.K.), Clinical Center, National Institutes of Health, Bethesda, MD; and the Department of Neurology (D.C.M.), Alzheimer's Disease Center, University of Alabama at Birmingham
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31
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Clark DG, Kapur P, Geldmacher DS, Brockington JC, Harrell L, DeRamus TP, Blanton PD, Lokken K, Nicholas AP, Marson DC. Latent information in fluency lists predicts functional decline in persons at risk for Alzheimer disease. Cortex 2014; 55:202-18. [PMID: 24556551 PMCID: PMC4039569 DOI: 10.1016/j.cortex.2013.12.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/05/2013] [Accepted: 12/25/2013] [Indexed: 01/24/2023]
Abstract
OBJECTIVE We constructed random forest classifiers employing either the traditional method of scoring semantic fluency word lists or new methods. These classifiers were then compared in terms of their ability to diagnose Alzheimer disease (AD) or to prognosticate among individuals along the continuum from cognitively normal (CN) through mild cognitive impairment (MCI) to AD. METHOD Semantic fluency lists from 44 cognitively normal elderly individuals, 80 MCI patients, and 41 AD patients were transcribed into electronic text files and scored by four methods: traditional raw scores, clustering and switching scores, "generalized" versions of clustering and switching, and a method based on independent components analysis (ICA). Random forest classifiers based on raw scores were compared to "augmented" classifiers that incorporated newer scoring methods. Outcome variables included AD diagnosis at baseline, MCI conversion, increase in Clinical Dementia Rating-Sum of Boxes (CDR-SOB) score, or decrease in Financial Capacity Instrument (FCI) score. Receiver operating characteristic (ROC) curves were constructed for each classifier and the area under the curve (AUC) was calculated. We compared AUC between raw and augmented classifiers using Delong's test and assessed validity and reliability of the augmented classifier. RESULTS Augmented classifiers outperformed classifiers based on raw scores for the outcome measures AD diagnosis (AUC .97 vs. .95), MCI conversion (AUC .91 vs. .77), CDR-SOB increase (AUC .90 vs. .79), and FCI decrease (AUC .89 vs. .72). Measures of validity and stability over time support the use of the method. CONCLUSION Latent information in semantic fluency word lists is useful for predicting cognitive and functional decline among elderly individuals at increased risk for developing AD. Modern machine learning methods may incorporate latent information to enhance the diagnostic value of semantic fluency raw scores. These methods could yield information valuable for patient care and clinical trial design with a relatively small investment of time and money.
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Affiliation(s)
- D G Clark
- Birmingham VA Medical Center, USA; Department of Neurology, University of Alabama at Birmingham, USA.
| | - P Kapur
- Department of Biomedical Sciences, Georgia Health Science University, USA
| | - D S Geldmacher
- Department of Neurology, University of Alabama at Birmingham, USA
| | - J C Brockington
- Department of Neurology, University of Alabama at Birmingham, USA
| | - L Harrell
- Department of Neurology, University of Alabama at Birmingham, USA
| | - T P DeRamus
- Department of Psychology and Behavioral Neuroscience, University of Alabama at Birmingham, USA
| | | | - K Lokken
- Birmingham VA Medical Center, USA
| | - A P Nicholas
- Birmingham VA Medical Center, USA; Department of Neurology, University of Alabama at Birmingham, USA
| | - D C Marson
- Department of Neurology, University of Alabama at Birmingham, USA
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Abstract
Over the past 40 years, the assessment and scientific study of capacity in older adults has emerged as a distinct field of clinical and research activity for psychologists. This new field reflects the convergence of several trends: the aging of American society, the growing incidence and prevalence of dementia, and the patient rights, deinstitutionalization, and disability rights movements. Because of these forces, capacity issues now permeate the fabric of everyday life, whether in the form of guardianship petitions, questions of capacity to consent to treatment, the ability to make a new will, or participation in human research. In seeking to resolve these issues, families, clinicians, and legal professionals increasingly turn to psychologists to assess a capacity and to provide empirically supported judgments that properly balance autonomy and protection for the individual. Psychologists have taken a leading role in the development of functional assessment instruments that measure important aspects of the capacity construct. In addition, psychology has been a major contributor to the scientific study of capacity. In collaboration with colleagues from medicine and law, psychologists have articulated crucial theoretical frameworks that integrate legal, clinical, and ethical dimensions of the capacity problem. This article focuses on the evolution of theory, law, science, and practice in the evaluation of capacity in older adults and its recent culmination in a series of interdisciplinary handbooks sponsored by the American Psychological Association and the American Bar Association.
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Affiliation(s)
- Jennifer Moye
- VA Boston Healthcare System, Brockton, MA 02301, USA.
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Griffith HR, Okonkwo OC, Stewart CC, Stoeckel LE, den Hollander JA, Elgin JM, Harrell LE, Brockington JC, Clark DG, Ball KK, Owsley C, Marson DC, Wadley VG. Lower hippocampal volume predicts decrements in lane control among drivers with amnestic mild cognitive impairment. J Geriatr Psychiatry Neurol 2013; 26:259-66. [PMID: 24212246 PMCID: PMC4114386 DOI: 10.1177/0891988713509138] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES There are few methods to discern driving risks in patients with early dementia and mild cognitive impairment (MCI). We aimed to determine whether structural magnetic resonance imaging (MRI) of the hippocampus-a biomarker of probable Alzheimer pathology and a measure of disease severity in those affected--is linked to objective ratings of on-road driving performance in older adults with and without amnestic MCI. METHODS In all, 49 consensus-diagnosed participants from an Alzheimer's Disease Research Center (15 diagnosed with amnestic MCI and 34 demographically similar controls) underwent structural MRI and on-road driving assessments. RESULTS Mild atrophy of the left hippocampus was associated with less-than-optimal ratings in lane control but not with other discrete driving skills. Decrements in left hippocampal volume conferred higher risk for less-than-optimal lane control ratings in the patients with MCI (B = -1.63, standard error [SE] = .74, Wald = 4.85, P = .028), but not in controls (B = 0.13, SE = .415, Wald = 0.10, P = .752). The odds ratio and 95% confidence interval for below-optimal lane control in the MCI group was 4.41 (1.18-16.36), which was attenuated to 3.46 (0.88-13.60) after accounting for the contribution of left hippocampal volume. CONCLUSION These findings suggest that there may be a link between hippocampal atrophy and difficulties with lane control in persons with amnestic MCI. Further study appears warranted to better discern patterns of brain atrophy in MCI and Alzheimer disease and whether these could be early markers of clinically meaningful driving risk.
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Affiliation(s)
- H Randall Griffith
- Departments of Neurology, University of Alabama at Birmingham, AL,Departments of Psychology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL
| | - Ozioma C Okonkwo
- Department of Medicine and Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI
| | | | - Luke E Stoeckel
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Jennifer M Elgin
- Departments of Opthalmology, University of Alabama at Birmingham, AL,Edward R. Roybal Center for Translational Research on Aging and Mobility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lindy E Harrell
- Departments of Neurology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL,Birmingham Regional Veterans Affairs Medical Center, Birmingham, AL, USA
| | - John C Brockington
- Departments of Neurology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL
| | - David G Clark
- Departments of Neurology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL,Birmingham Regional Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Karlene K Ball
- Departments of Psychology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL,Edward R. Roybal Center for Translational Research on Aging and Mobility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cynthia Owsley
- Departments of Opthalmology, University of Alabama at Birmingham, AL,Edward R. Roybal Center for Translational Research on Aging and Mobility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel C Marson
- Departments of Neurology, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL
| | - Virginia G Wadley
- Departments of Medicine, University of Alabama at Birmingham, AL,Alzheimer's Disease Research Center, University of Alabama at Birmingham, AL,Edward R. Roybal Center for Translational Research on Aging and Mobility, University of Alabama at Birmingham, Birmingham, AL, USA
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Stoeckel LE, Stewart CC, Griffith HR, Triebel K, C. Okonkwo O, den Hollander JA, Martin RC, Belue K, Copeland JN, Harrell LE, Brockington JC, Clark DG, Marson DC. MRI volume of the medial frontal cortex predicts financial capacity in patients with mild Alzheimer's disease. Brain Imaging Behav 2013; 7:282-92. [PMID: 23504597 PMCID: PMC3716854 DOI: 10.1007/s11682-013-9226-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Persons with mild Alzheimer's disease (AD) have significant deficits in financial abilities. This study examined the relationship between brain structure volumes, cognition, and financial capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining financial skills in patients with mild AD.
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Affiliation(s)
- Luke E. Stoeckel
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | | | - Kristen Triebel
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
| | - Ozioma C. Okonkwo
- Department of Medicine & Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI
| | | | - Roy C. Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
| | - Katherine Belue
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
| | | | - Lindy E. Harrell
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
- Birmingham Regional Veterans Affairs Medical Center, Birmingham, AL
| | - John C. Brockington
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
| | - David G. Clark
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
- Birmingham Regional Veterans Affairs Medical Center, Birmingham, AL
| | - Daniel C. Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
- Department of Alzheimer’s Disease Research Center, University of Alabama at Birmingham, Birmingham, AL
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35
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Martin RC, Triebel KL, Kennedy RE, Nicholas AP, Watts RL, Stover NP, Brandon M, Marson DC. Impaired financial abilities in Parkinson's disease patients with mild cognitive impairment and dementia. Parkinsonism Relat Disord 2013; 19:986-90. [PMID: 23899743 DOI: 10.1016/j.parkreldis.2013.06.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 06/18/2013] [Accepted: 06/25/2013] [Indexed: 01/30/2023]
Abstract
PURPOSE Financial capacity (FC) is an instrumental activity of daily living (IADL) critical to independent functioning and sensitive to cognitive impairment in dementia. Little is known about FC in cognitively impaired patients with Parkinson's disease (PD). The present study investigated FC in PD patients with prodromal and clinical dementia. METHODS Participants were 20 older controls and 35 PD patients who met consensus criteria for either mild cognitive impairment (PD-MCI, n = 18) or PD dementia (PDD, n = 17). FC was assessed using a standardized performance based measure consisting of 9 domain and two global scores (Financial Capacity Instrument; FCI) (1). FCI domain and global performance scores were compared across groups. Capacity impairment ratings (no impairment, mild/moderate impairment, severe impairment) were calculated for each PD patient's domain and global scores. RESULTS Relative to controls, PD-MCI patients were impaired on both FCI global scores and domains of basic monetary skills, financial concepts, and investment decision-making. Relative to both controls and PD-MCI patients, PDD patients were impaired on virtually all FCI variables. With respect to impairment ratings, greater than 50% of PD-MCI patients and greater than 90% of PDD patients were classified as either mild/moderate or severely impaired on the two FCI global scores. CONCLUSIONS Impairment of financial capacity is already present in PD-MCI and is advanced in PDD. Complex cognitively-mediated IADLs such as financial capacity appear to be impaired early in the course of PD dementia.
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Affiliation(s)
- Roy C Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Alzheimer's Disease Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
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Abstract
In contrast to issues like treatment and research consent capacity, financial capacity has received relatively little clinical and ethical attention in the dementia literature. Yet issues of financial capacity emerge frequently in patients with Alzheimer's disease (AD), Parkinson's disease (PD) and related dementias, and commonly present ethical and clinical challenges for clinicians treating these patients. These issues include whether a patient with possible dementia has sufficient capacity independently to manage their financial affairs, needs referral for financial capacity assessment, and/or is being financially exploited or abused by others. The accurate identification, assessment and successful handling of such financial capacity issues can have a substantial impact on the financial and psychological well-being of patients and their family members. The present commentary presents an overview of financial capacity and associated clinical and ethical issues in dementia, and describes a set of possible clinician roles regarding these issues as they arise in clinical practice. The commentary concludes with a section describing educational resources available to clinicians and bioethicists seeking additional guidance in handling financial capacity issues. The ultimate goal of the paper is to focus clinical and ethical attention on a neglected capacity that is of fundamental importance for patients, families, and health care and legal professionals.
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Affiliation(s)
- Daniel C. Marson
- Department of Neurology University of Alabama at Birmingham, Birmingham, Alabama
- Alzheimer's Disease Center University of Alabama at Birmingham, Birmingham, Alabama
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37
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Marson DC. Clinical and ethical aspects of financial capacity in dementia: a commentary. Am J Geriatr Psychiatry 2013; 21:382-90. [PMID: 23498385 DOI: 10.1016/j.jagp.2013.01.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 03/27/2012] [Accepted: 04/24/2012] [Indexed: 10/26/2022]
Abstract
In contrast to issues such as treatment and research consent capacity, financial capacity has received relatively little clinical and ethical attention in the dementia literature. Yet issues of financial capacity emerge frequently in patients with Alzheimer disease, Parkinson disease, and related dementias, and commonly present ethical and clinical challenges for clinicians treating these patients. These issues include whether a patient with possible dementia has sufficient capacity to manage independently their financial affairs, needs referral for financial capacity assessment, and/or is being financially exploited or abused by others. The accurate identification, assessment and successful handling of such financial capacity issues can have a substantial impact on the financial and psychological well-being of patients and their family members. This commentary presents an overview of financial capacity and associated clinical and ethical issues in dementia and describes a set of possible clinician roles regarding these issues as they arise in clinical practice. The commentary concludes with a section describing educational resources available to clinicians and bioethicists seeking additional guidance in handling financial capacity issues. The ultimate goal of the article is to focus clinical and ethical attention on a neglected capacity that is of fundamental importance for patients, families, and healthcare and legal professionals.
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Affiliation(s)
- Daniel C Marson
- Department of Neurology and Alzheimer's Disease Center, University of Alabama at Birmingham.
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Allen M, Zou F, Chai HS, Younkin CS, Crook J, Pankratz VS, Carrasquillo MM, Rowley CN, Nair AA, Middha S, Maharjan S, Nguyen T, Ma L, Malphrus KG, Palusak R, Lincoln S, Bisceglio G, Georgescu C, Schultz D, Rakhshan F, Kolbert CP, Jen J, Haines JL, Mayeux R, Pericak-Vance MA, Farrer LA, Schellenberg GD, Petersen RC, Graff-Radford NR, Dickson DW, Younkin SG, Ertekin-Taner N, Apostolova LG, Arnold SE, Baldwin CT, Barber R, Barmada MM, Beach T, Beecham GW, Beekly D, Bennett DA, Bigio EH, Bird TD, Blacker D, Boeve BF, Bowen JD, Boxer A, Burke JR, Buros J, Buxbaum JD, Cairns NJ, Cantwell LB, Cao C, Carlson CS, Carney RM, Carroll SL, Chui HC, Clark DG, Corneveaux J, Cotman CW, Crane PK, Cruchaga C, Cummings JL, De Jager PL, DeCarli C, DeKosky ST, Demirci FY, Diaz-Arrastia R, Dick M, Dombroski BA, Duara R, Ellis WD, Evans D, Faber KM, Fallon KB, Farlow MR, Ferris S, Foroud TM, Frosch M, Galasko DR, Gallins PJ, Ganguli M, Gearing M, Geschwind DH, Ghetti B, Gilbert JR, Gilman S, Giordani B, Glass JD, Goate AM, Green RC, Growdon JH, Hakonarson H, Hamilton RL, Hardy J, Harrell LE, Head E, Honig LS, Huentelman MJ, Hulette CM, Hyman BT, Jarvik GP, Jicha GA, Jin LW, Jun G, Kamboh MI, Karlawish J, Karydas A, Kauwe JSK, Kaye JA, Kennedy N, Kim R, Koo EH, Kowall NW, Kramer P, Kukull WA, Lah JJ, Larson EB, Levey AI, Lieberman AP, Lopez OL, Lunetta KL, Mack WJ, Marson DC, Martin ER, Martiniuk F, Mash DC, Masliah E, McCormick WC, McCurry SM, McDavid AN, McKee AC, Mesulam M, Miller BL, Miller CA, Miller JW, Montine TJ, Morris JC, Myers AJ, Naj AC, Nowotny P, Parisi JE, Perl DP, Peskind E, Poon WW, Potter H, Quinn JF, Raj A, Rajbhandary RA, Raskind M, Reiman EM, Reisberg B, Reitz C, Ringman JM, Roberson ED, Rogaeva E, Rosenberg RN, Sano M, Saykin AJ, Schneider JA, Schneider LS, Seeley W, Shelanski ML, Slifer MA, Smith CD, Sonnen JA, Spina S, St George-Hyslop P, Stern RA, Tanzi RE, Trojanowski JQ, Troncoso JC, Tsuang DW, Van Deerlin VM, Vardarajan BN, Vinters HV, Vonsattel JP, Wang LS, Weintraub S, Welsh-Bohmer KA, Williamson J, Woltjer RL. Novel late-onset Alzheimer disease loci variants associate with brain gene expression. Neurology 2012; 79:221-8. [PMID: 22722634 DOI: 10.1212/wnl.0b013e3182605801] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Recent genome-wide association studies (GWAS) of late-onset Alzheimer disease (LOAD) identified 9 novel risk loci. Discovery of functional variants within genes at these loci is required to confirm their role in Alzheimer disease (AD). Single nucleotide polymorphisms that influence gene expression (eSNPs) constitute an important class of functional variants. We therefore investigated the influence of the novel LOAD risk loci on human brain gene expression. METHODS We measured gene expression levels in the cerebellum and temporal cortex of autopsied AD subjects and those with other brain pathologies (∼400 total subjects). To determine whether any of the novel LOAD risk variants are eSNPs, we tested their cis-association with expression of 6 nearby LOAD candidate genes detectable in human brain (ABCA7, BIN1, CLU, MS4A4A, MS4A6A, PICALM) and an additional 13 genes ±100 kb of these SNPs. To identify additional eSNPs that influence brain gene expression levels of the novel candidate LOAD genes, we identified SNPs ±100 kb of their location and tested for cis-associations. RESULTS CLU rs11136000 (p = 7.81 × 10(-4)) and MS4A4A rs2304933/rs2304935 (p = 1.48 × 10(-4)-1.86 × 10(-4)) significantly influence temporal cortex expression levels of these genes. The LOAD-protective CLU and risky MS4A4A locus alleles associate with higher brain levels of these genes. There are other cis-variants that significantly influence brain expression of CLU and ABCA7 (p = 4.01 × 10(-5)-9.09 × 10(-9)), some of which also associate with AD risk (p = 2.64 × 10(-2)-6.25 × 10(-5)). CONCLUSIONS CLU and MS4A4A eSNPs may at least partly explain the LOAD risk association at these loci. CLU and ABCA7 may harbor additional strong eSNPs. These results have implications in the search for functional variants at the novel LOAD risk loci.
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Affiliation(s)
- Mariet Allen
- Department of Neuroscience, Biostatistics Unit, Mayo Clinic Florida, Jacksonville, FL, USA
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Triebel KL, Martin RC, Novack TA, Dreer L, Turner C, Pritchard PR, Raman R, Marson DC. Treatment consent capacity in patients with traumatic brain injury across a range of injury severity. Neurology 2012; 78:1472-8. [PMID: 22496195 DOI: 10.1212/wnl.0b013e3182553c38] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate medical decision-making capacity (MDC) in patients with acute traumatic brain injury (TBI) across a range of injury severity. METHODS We evaluated MDC cross-sectionally 1 month after injury in 40 healthy controls and 86 patients with TBI stratified by injury severity (28 mild [mTBI], 15 complicated mild [cmTBI], 43 moderate/severe [msevTBI]). We compared group performance on the Capacity to Consent to Treatment Instrument and its 5 consent standards (expressing choice, reasonable choice, appreciation, reasoning, understanding). Capacity impairment ratings (no impairment, mild/moderate impairment, severe impairment) on the consent standards were also assigned to each participant with TBI using cut scores referenced to control performance. RESULTS One month after injury, the mTBI group performed equivalently to controls on all consent standards. In contrast, the cmTBI group was impaired relative to controls on the understanding standard. No differences emerged between the mTBI and cmTBI groups. The msevTBI group was impaired on almost all standards relative to both control and mTBI groups, and on the understanding standard relative to the cmTBI group. Capacity compromise (mild/moderate or severe impairment ratings) on the 3 clinically complex standards (understanding, reasoning, appreciation) occurred in 10%-30% of patients with mTBI, 50% of patients with cmTBI, and 50%-80% of patients with msevTBI. CONCLUSIONS One month following injury, MDC is largely intact in patients with mTBI, but is impaired in patients with cmTBI and msevTBI. Impaired MDC is prevalent in acute TBI and is strongly related to injury severity.
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Affiliation(s)
- K L Triebel
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, Birmingham, USA
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Abstract
OBJECTIVE To longitudinally investigate financial capacity (FC) following traumatic brain injury (TBI). DESIGN Longitudinal study comparing FC in cognitively healthy adults and persons with moderate to severe TBI at time of acute hospitalization (Time 1) and at 6 months postinjury (Time 2). SETTING Inpatient brain injury rehabilitation unit. PARTICIPANTS Twenty healthy adult controls and 24 adult persons with moderate to severe TBI. MAIN OUTCOME MEASURES Participants were administered the Financial Capacity Instrument (FCI-9), a standardized instrument that measures performance on 18 financial tasks, 9 domains, and 2 global scores. Between- and within-group differences were examined for each FCI-9 domain and global scores. Using control group referenced cut scores, participants with TBI were also assigned an impairment rating (intact, marginal, or impaired) on each domain and global score. RESULTS At Time 1, participants with TBI performed significantly below controls on the majority of financial variables tested. At Time 2, participants with TBI demonstrated within group improvement on both simple and complex financial domains, but continued to perform below adult controls on complex financial domains and both global scores. Group by time interactions were significant for four domains and both global scores. At Time 1, high percentages of participants with TBI were assigned either "marginal" or "impaired" ratings on the domains and global scores, with significant percentage increases of "intact" ratings at Time 2. CONCLUSIONS Immediately following acute injury, persons with moderate to severe TBI show global impairment of FC. Findings indicate improvement of both simple and complex financial skills over a 6-month period, but continued impairment on more complex financial skills. Future studies should examine loss and recovery of FC following TBI over longer time periods and a wider range of injury severity.
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Affiliation(s)
- Laura E Dreer
- Department of Ophthalmology, University of Alabama at Birmingham, AL, USA
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Naj AC, Jun G, Beecham GW, Wang LS, Vardarajan BN, Buros J, Gallins PJ, Buxbaum JD, Jarvik GP, Crane PK, Larson EB, Bird TD, Boeve BF, Graff-Radford NR, De Jager PL, Evans D, Schneider JA, Carrasquillo MM, Ertekin-Taner N, Younkin SG, Cruchaga C, Kauwe JSK, Nowotny P, Kramer P, Hardy J, Huentelman MJ, Myers AJ, Barmada MM, Demirci FY, Baldwin CT, Green RC, Rogaeva E, St George-Hyslop P, Arnold SE, Barber R, Beach T, Bigio EH, Bowen JD, Boxer A, Burke JR, Cairns NJ, Carlson CS, Carney RM, Carroll SL, Chui HC, Clark DG, Corneveaux J, Cotman CW, Cummings JL, DeCarli C, DeKosky ST, Diaz-Arrastia R, Dick M, Dickson DW, Ellis WG, Faber KM, Fallon KB, Farlow MR, Ferris S, Frosch MP, Galasko DR, Ganguli M, Gearing M, Geschwind DH, Ghetti B, Gilbert JR, Gilman S, Giordani B, Glass JD, Growdon JH, Hamilton RL, Harrell LE, Head E, Honig LS, Hulette CM, Hyman BT, Jicha GA, Jin LW, Johnson N, Karlawish J, Karydas A, Kaye JA, Kim R, Koo EH, Kowall NW, Lah JJ, Levey AI, Lieberman AP, Lopez OL, Mack WJ, Marson DC, Martiniuk F, Mash DC, Masliah E, McCormick WC, McCurry SM, McDavid AN, McKee AC, Mesulam M, Miller BL, Miller CA, Miller JW, Parisi JE, Perl DP, Peskind E, Petersen RC, Poon WW, Quinn JF, Rajbhandary RA, Raskind M, Reisberg B, Ringman JM, Roberson ED, Rosenberg RN, Sano M, Schneider LS, Seeley W, Shelanski ML, Slifer MA, Smith CD, Sonnen JA, Spina S, Stern RA, Tanzi RE, Trojanowski JQ, Troncoso JC, Van Deerlin VM, Vinters HV, Vonsattel JP, Weintraub S, Welsh-Bohmer KA, Williamson J, Woltjer RL, Cantwell LB, Dombroski BA, Beekly D, Lunetta KL, Martin ER, Kamboh MI, Saykin AJ, Reiman EM, Bennett DA, Morris JC, Montine TJ, Goate AM, Blacker D, Tsuang DW, Hakonarson H, Kukull WA, Foroud TM, Haines JL, Mayeux R, Pericak-Vance MA, Farrer LA, Schellenberg GD. Common variants at MS4A4/MS4A6E, CD2AP, CD33 and EPHA1 are associated with late-onset Alzheimer's disease. Nat Genet 2011; 43:436-41. [PMID: 21460841 PMCID: PMC3090745 DOI: 10.1038/ng.801] [Citation(s) in RCA: 1447] [Impact Index Per Article: 111.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Accepted: 03/10/2011] [Indexed: 12/24/2022]
Abstract
The Alzheimer Disease Genetics Consortium (ADGC) performed a genome-wide association study of late-onset Alzheimer disease using a three-stage design consisting of a discovery stage (stage 1) and two replication stages (stages 2 and 3). Both joint analysis and meta-analysis approaches were used. We obtained genome-wide significant results at MS4A4A (rs4938933; stages 1 and 2, meta-analysis P (P(M)) = 1.7 × 10(-9), joint analysis P (P(J)) = 1.7 × 10(-9); stages 1, 2 and 3, P(M) = 8.2 × 10(-12)), CD2AP (rs9349407; stages 1, 2 and 3, P(M) = 8.6 × 10(-9)), EPHA1 (rs11767557; stages 1, 2 and 3, P(M) = 6.0 × 10(-10)) and CD33 (rs3865444; stages 1, 2 and 3, P(M) = 1.6 × 10(-9)). We also replicated previous associations at CR1 (rs6701713; P(M) = 4.6 × 10(-10), P(J) = 5.2 × 10(-11)), CLU (rs1532278; P(M) = 8.3 × 10(-8), P(J) = 1.9 × 10(-8)), BIN1 (rs7561528; P(M) = 4.0 × 10(-14), P(J) = 5.2 × 10(-14)) and PICALM (rs561655; P(M) = 7.0 × 10(-11), P(J) = 1.0 × 10(-10)), but not at EXOC3L2, to late-onset Alzheimer's disease susceptibility.
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Affiliation(s)
- Adam C Naj
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida, USA
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Abstract
Purpose To investigate research consent capacity (RCC) in patients with malignant gliomas (MGs) and identify cognitive abilities and clinical factors associated with RCC in MG. Patients and Methods Participants were 22 healthy controls and 26 patients with diagnosed and histologically verified MG. All patients with MG were receiving various combinations of treatment (surgery, radiation, chemotherapy, medication). Both groups were administered a neurocognitive test battery and a standardized RCC measure (Capacity to Consent to Research Instrument [CCRI]). Capacity performance was evaluated across four core consent abilities (choice, appreciation, reasoning, understanding), and categorical capacity impairment ratings (no impairment, mild/moderate impairment, severe impairment) were also identified for individual patients with MG. Stepwise regression analyses identified cognitive predictors of CCRI performance in the MG group. Results The MG patient group performed significantly below the control group on the three clinically relevant consent standards (appreciation, reasoning, and understanding). Patients with MG performed equivalently to controls in evidencing a simple research participation choice. Approximately one third of patients with MG showed compromised impairment ratings (mild/moderate impairment or severe impairment) on the three consent abilities. Cognitive measures of phonemic and semantic word fluency predicted performance on the consent standards. Steroid treatment and anticonvulsant use were related to poorer CCRI performance. Conclusion A substantial portion of patients with MG after diagnosis show impairments in research consent capacity. Word fluency measures reflecting expressive language and executive function abilities are strongly associated with these consent impairments. This study highlights the importance of careful attention to consent issues when enrolling patients with MG in clinical trials and other research studies.
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Affiliation(s)
- Daniel C. Marson
- From the Divisions of Neuropsychology and Neuro-oncology; and the Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Roy C. Martin
- From the Divisions of Neuropsychology and Neuro-oncology; and the Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Kristen L. Triebel
- From the Divisions of Neuropsychology and Neuro-oncology; and the Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Louis B. Nabors
- From the Divisions of Neuropsychology and Neuro-oncology; and the Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
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Putzke JD, Rickert EJ, Duke LW, Marson DC, Harrell L. Differential Automatic Processing Deficits in Early Stage Alzheimer's Disease. Aging, Neuropsychology, and Cognition 2010. [DOI: 10.1076/1382-5585(200006)7:2;1-u;ft112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rickert EJ, Duke LW, Putzke JD, Marson DC, Graham K. Early Stage Alzheimer's Disease Disrupts Encoding of Contextual Information. Aging, Neuropsychology, and Cognition 2010. [DOI: 10.1076/anec.5.1.73.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Earnst KS, Wadley VG, Aldridge TM, Steenwyk AB, Hammond AE, Harrell LE, Marson DC. Loss of Financial Capacity in Alzheimer's Disease: The Role of Working Memory. Aging, Neuropsychology, and Cognition 2010. [DOI: 10.1076/anec.8.2.109.839] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Griffith HR, Okonkwo OC, den Hollander JA, Belue K, Copeland J, Harrell LE, Brockington JC, Clark DG, Marson DC. Brain metabolic correlates of decision making in amnestic mild cognitive impairment. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2010; 17:492-504. [PMID: 20373179 DOI: 10.1080/13825581003646135] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Persons with amnestic mild cognitive impairment (MCI) have subtle impairments in medical decision-making capacity (MDC). We examined the relationship between proton magnetic resonance spectroscopy (MRS) and MDC in MCI. Twenty-nine MCI patients and 42 controls underwent MRS to obtain ratios of N-acetylaspartate (NAA)/Creatine (Cr), Choline (Cho)/Cr, and myo-Inositol (mI)/Cr of the posterior cingulate. They also completed the Capacity to Consent to Treatment Instrument (CCTI), a vignette-based instrument measuring decisional standards of expressing choice, appreciating consequences of choice, providing rational reasons for choice, and understanding treatment choices. Patients showed abnormal MRS ratios of mI/Cr and Cho/Cr compared to controls, and impairments on the CCTI understanding and reasoning Standards. Performance on the reasoning standard of the CCTI was correlated with NAA/Cr (r = .46, p < .05). The relationship of NAA/Cr with decision-making suggests a role for posterior cortical neuronal functioning in performance of complex IADLs in MCI.
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Affiliation(s)
- H Randall Griffith
- Departments of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Griffith HR, Stewart CC, Stoeckel LE, Okonkwo OC, den Hollander JA, Martin RC, Belue K, Copeland JN, Harrell LE, Brockington JC, Clark DG, Marson DC. Magnetic resonance imaging volume of the angular gyri predicts financial skill deficits in people with amnestic mild cognitive impairment. J Am Geriatr Soc 2010; 58:265-74. [PMID: 20374402 DOI: 10.1111/j.1532-5415.2009.02679.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To better understand how brain atrophy in amnestic mild cognitive impairment (MCI) as measured using magnetic resonance imaging (MRI) volumetrics could affect instrumental activities of daily living (IADLs) such as financial abilities. DESIGN Controlled, matched-sample, cross-sectional analysis regressing MRI volumetrics with financial performance measures. SETTING University medical and research center. PARTICIPANTS Thirty-eight people with MCI and 28 older adult controls. MEASUREMENTS MRI volumetric measurement of the hippocampi, angular gyri, precunei, and medial frontal lobes. Participants also completed neuropsychological tests and the Financial Capacity Instrument (FCI). RESULTS Correlations were performed between FCI scores and MRI volumes in the group with MCI. People with MCI performed significantly below controls on the FCI and had significantly smaller hippocampi. Among people with MCI, performance on the FCI was moderately correlated with angular gyri and precunei volumes. Regression models demonstrated that angular gyrus volumes were predictive of FCI scores. Tests of mediation showed that measures of arithmetic and possibly attention partially mediated the relationship between angular gyrus volume and FCI score. CONCLUSION Impaired financial abilities in amnestic MCI correspond with volume of the angular gyri as mediated by arithmetic knowledge. The findings suggest that early neuropathology within the lateral parietal region in MCI leads to a breakdown of cognitive abilities that affect everyday financial skills. The findings have implications for diagnosis and clinical care of people with MCI and AD.
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Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Abstract
OBJECTIVE Patients with malignant glioma (MG) must make ongoing medical treatment decisions concerning a progressive disease that erodes cognition. We prospectively assessed medical decision-making capacity (MDC) in patients with MG using a standardized psychometric instrument. METHODS Participants were 22 healthy controls and 26 patients with histologically verified MG. Group performance was compared on the Capacity to Consent to Treatment Instrument (CCTI), a psychometric measure of MDC incorporating 4 standards (choice, understanding, reasoning, and appreciation), and on neuropsychological and demographic variables. Capacity outcomes (capable, marginally capable, or incapable) on the CCTI standards were identified for the MG group. Within the MG group, scores on demographic, clinical, and neuropsychological variables were correlated with scores on each CCTI standard, and significant bivariate correlates were subsequently entered into exploratory stepwise regression analyses to identify multivariate cognitive predictors of the CCTI standards. RESULTS Patients with MG performed significantly below controls on consent standards of understanding and reasoning, and showed a trend on appreciation. Relative to controls, more than 50% of the patients with MG demonstrated capacity compromise (marginally capable or incapable outcomes) in MDC. In the MG group, cognitive measures of verbal acquisition/recall and, to a lesser extent, semantic fluency predicted performance on the appreciation, reasoning, and understanding standards. Karnofsky score was also associated with CCTI performance. CONCLUSIONS Soon after diagnosis, patients with malignant glioma (MG) have impaired capacity to make treatment decisions relative to controls. Medical decision-making capacity (MDC) impairment in MG seems to be primarily related to the effects of short-term verbal memory deficits. Ongoing assessment of MDC in patients with MG is strongly recommended.
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Affiliation(s)
- Kristen L Triebel
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, AL 35294-0017, USA
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