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Wiese LK, Williams IC, Holt JK, Williams CL, Lingler J, Galvin JE, Schoenberg NE. Testing the 'Faith Moves Mountains model' to increase Alzheimer's disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults. Aging Ment Health 2023:1-14. [PMID: 38127408 DOI: 10.1080/13607863.2023.2294062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Racially and ethnically diverse populations have recently contributed to the majority of rural and small-town growth. Consequently, the disproportionately high risk and prevalence of Alzheimer's disease and related dementias (ADRD) among rural and minoritized older residents will likely increase. To address this threat, we tested the hypotheses that (1) a faith-based, resident-led approach would increase basic ADRD knowledge and diagnosis, and (2) older age, female gender, lower educational levels, and more years lived rural would predict number of referrals, new dementia diagnoses, and treatment. METHODS An adaptation of Schoenberg's Faith Moves Mountains model, previously successful in detection and management of other chronic illnesses in rural settings, guided this community-based participatory research. Local faith community members were trained as research assistants to recruit, administer surveys, conduct brief memory assessments, teach brain health strategies, and follow-up with residents. Outreaches were offered virtually during the pandemic, then in-person monthly at rotating church sites, and repeated ∼1 year later. RESULTS This rural sample was racially and ethnically diverse (74.5% non-White), with 28% reporting eight or less years of formal education. Findings included that referrals and years lived rural were significant and positive predictors of new ADRD treatments [(b = 3.74, χ2(1, n = 235) = 13.01, p < 0.001); (b = 0.02, χ2(1, n = 235 = 3.93, p = 0.048)], respectively, regardless of participant characteristics. CONCLUSION Resident-led action research in rural, diverse, faith communities is a successful approach to increasing ADRD disease knowledge, detection, diagnosis, and treatment.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Ishan C Williams
- University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Janet K Holt
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
- Southern Illinois University, Edwardsville, IL, USA
| | | | - Jennifer Lingler
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, FL, USA
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Rahman-Filipiak A, Bolton C, Grill JD, Rostamzadeh A, Chin N, Heidebrink J, Getz S, Fowler NR, Rosen A, Lingler J, Wijsman E, Clark L. Biomarker disclosure protocols in prodromal Alzheimer's disease clinical trials. Alzheimers Dement 2023; 19:4270-4275. [PMID: 37450489 PMCID: PMC10530125 DOI: 10.1002/alz.13380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION The development of biomarkers for Alzheimer's disease (AD) has allowed researchers to increase sample homogeneity and test candidate treatments earlier in the disease. The integration of biomarker "screening" criteria should be met with a parallel implementation of standardized methods to disclose biomarker testing results to research participants; however, the extent to which protocolized disclosure occurs in trials is unknown. METHODS We reviewed the literature to identify prodromal AD trials published in the past 10 years. From these, we quantified the frequency of biomarker disclosure reporting and the depth of descriptions provided. RESULTS Of 30 published trials using positron emission tomography or cerebrospinal fluid-based amyloid positivity as an eligibility criterion, only one mentioned disclosure, with no details on methods. DISCUSSION Possible reasons for and implications of this information gap are discussed. Recommendations are provided for trialists considering biomarker screening as part of intervention trials focused on prodromal AD. HIGHLIGHTS Few prodromal Alzheimer's disease (AD) trial papers discuss biomarker disclosure. Disclosure has implications for participants, family members, and trial success. Disclosure must be consistently integrated and reported in prodromal AD trials. Best practice guidelines and training resources for disclosure are needed.
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Affiliation(s)
- Annalise Rahman-Filipiak
- Research Program on Cognition & Neuromodulation Based Interventions, University of Michigan, 2101 Commonwealth Blvd, Suite C., Ann Arbor, MI, USA 48105
- Michigan Alzheimer’s Disease Research Center, University of Michigan, 2101 Commonwealth Blvd, Suite C., Ann Arbor, MI, USA 48105
| | - Corey Bolton
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, 1207 17th Ave. S, Suite 204, Nashville, TN, USA 37212
- Department of Neurology, Vanderbilt University Medical Center, 1301 Medical Center Dr. #3930, Nashville, TN, USA 37232
| | - Joshua D. Grill
- Departments of Psychiatry and Human Behavior and Neurobiology and Behavior, Institute for Memory Impairments and Neurological Disorders, University of California Irvine, 2642 Biological Sciences III, Irvine, CA, USA 92697-4545
| | - Ayda Rostamzadeh
- Department of Psychiatry and Psychotherapy, Center for Memory Disorders, Faculty of Medicine and University Hospital, University of Cologne, Albertus-Magnus-Platz, 50923 Köln, Germany
| | - Nathaniel Chin
- Wisconsin Alzheimer’s Disease Research Center, 600 Highland Ave J5/1 Mezzanine, Madison, WI, USA 53792
- Department of Medicine, Division of Geriatrics & Gerontology, University of Wisconsin-Madison School of Medicine and Public Health, 750 Highland Ave, Madison, WI, USA 53726
| | - Judith Heidebrink
- Michigan Alzheimer’s Disease Research Center, University of Michigan, 2101 Commonwealth Blvd, Suite C., Ann Arbor, MI, USA 48105
- Department of Neurology, University of Michigan, 1500 E Medical Center Dr # 1914, Ann Arbor, MI, USA 48109
| | - Sarah Getz
- Department of Neurology, University of Miami School of Medicine, 1150 NW 14 St Ste 609, Miami, FL, USA 33136
| | - Nicole R. Fowler
- Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, 340 West 10th Street, Fairbanks Hall, Suite 6200, Indianapolis, IN, USA 46202-3082
- Indiana University Center for Aging Research, Regenstrief Institute, Inc., 1101 W 10th St, Indianapolis, IN, USA 46202
| | - Allyson Rosen
- Palo Alto Veterans Affairs Medical Center, 3801 Miranda Avenue. Palo Alto, CA, USA 94304-1207
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, USA 94305
| | - Jennifer Lingler
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, 3500 Victoria Street, 415 Victoria Building, Pittsburgh, PA, USA 15261
- University of Pittsburgh Alzheimer’s Disease Research Center, UPMC Montefiore, 4th floor, Suite 421, 200 Lothrop Street, Pittsburgh, PA, USA 15213
| | - Ellen Wijsman
- Division of Medical Genetics, Department of Medicine and Department of Biostatistics, University of Washington, Health Sciences Building, K253, Box 357720, Seattle, WA, USA 98195-7720
| | - Lindsay Clark
- Department of Medicine, Division of Geriatrics & Gerontology, University of Wisconsin-Madison School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI, USA 53705-2281
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, USA 53705
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Ren D, Lopez O, Lingler J. Analysis of Survival Data with Competing Risks in ADRD (Alzheimer's Disease and Related Dementias) Research. Innov Aging 2021. [DOI: 10.1093/geroni/igab046.2436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Competing risk is an event that precludes the occurrence of the primary event of interest. For example, when studying risk factors associated with dementia, death before the onset of dementia serve as a competing event. A subject who dies is no longer at risk of dementia. This issue play more important role in ADRD research given the elderly population. Conventional methods for survival analysis assume independent censoring and ignore the competing events. However, there are some challenge issues using those conventional methods in the presence of competing risks. First, no one-to-one link between hazard function and cumulative incidence function (CIF), and Kaplan-Meier approach overestimates the cumulative incidence of the event of interest. Second, the effect of covariates on hazard rate cannot be directly linked to the effect of cumulative incidence (the risk). We will discuss two types of analyses in the presence of competing risk: Cause-specific hazard model and Fine-Gray subdistribution hazard model. Cause-specific hazard model directly quantify the cause-specific hazard among subjects who are at risk of developing the event of interest, while Fine-Gray subdistribution hazard model directly model the effects of covariates on the cumulative incidence function. The type of research questions (Association vs. Prediction) may guide the choice of different statistical approaches. We will illustrate those two competing risk analyses using the large national dataset from National Alzheimer’s Coordinating Center (NACC). We will analyze the association between baseline diabetes status and the incidence of dementia, in which death before the onset of dementia is a competing event.
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Affiliation(s)
- Dianxu Ren
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Oscar Lopez
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Jennifer Lingler
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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Wiese L, Williams I, Schoenberg N, Galvin J, Lingler J. Promoting Inclusivity in Dementia Education and Screening in an Ethnically Diverse, Rural Community During a Pandemic. Innov Aging 2021. [PMCID: PMC8679555 DOI: 10.1093/geroni/igab046.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Rural, ethnically diverse older adults experience disparities in dementia detection/management. The Covid-19 quarantine exacerbated these disparities, and threatened faith-based dementia education and screening activities. We investigated the effectiveness of a telephone-based outreach for increasing dementia knowledge and detecting cognitive risk among a rural, diverse, underserved community of 89% African American, Hispanic, and Haitian Creole residents, Faith-based health educators, trained using virtual Alzheimer’s Association resources, contacted church congregants who responded to radio worship service announcements. Participants completed telephone measures of basic dementia knowledge and cognitive risk. Of the estimated 120 persons across five churches who received an invitation, 75% (n = 90) participated in dementia education and memory screening via telephone. Twelve (80%) of the 15 participants assessed as being at risk followed up with their provider. Rural residents are known for preferring face-to-face contact. Their willingness to complete health-promoting research activities by telephone highlighted the community’s interest in dementia awareness.
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Affiliation(s)
- Lisa Wiese
- Florida Atlantic University, C.E. Lynn College of Nursing, Florida, United States
| | - Ishan Williams
- University of Virginia, Charlottesville, Virginia, United States
| | | | - James Galvin
- University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Jennifer Lingler
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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Ganguli M, Hughes TF, Jia Y, Lingler J, Jacobsen E, Chang CCH. Aging and Functional Health Literacy: A Population-based Study. Am J Geriatr Psychiatry 2021; 29:972-981. [PMID: 33349506 PMCID: PMC8197766 DOI: 10.1016/j.jagp.2020.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/23/2020] [Accepted: 12/08/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate functional health literacy and its associated factors among older adults drawn from a disadvantaged area. DESIGN Cross-sectional epidemiologic study. SETTING Population-based cohort randomly selected from the voter registration lists. PARTICIPANTS Individuals aged 65+ (N=1066). MEASUREMENTS The Short Test of Functional Health Literacy in Adults (S-TOFHLA); demographics; self-rated health; number of prescription drugs; modified Center for Epidemiologic Studies- Depression scale; Mini-Mental State Examination; Wechsler Test of Adult Reading; Clinical Dementia Rating; cognitive domain composite scores; independence in Instrumental Activities of Daily Living and medication management; health services utilization (emergency/urgent care visits and hospitalizations). RESULTS Low (inadequate or marginal) S-TOFHLA scores were obtained by 7.04% of the sample. In unadjusted analyses, participants with low S-TOFHLA scores were significantly more likely than those with higher scores to be older, male, non-White, with lesser education and lower household income, to have lower scores on the Wechsler Test of Adult Reading, the Mini-Mental State Examination, and all cognitive domains; to be more dependent in Instrumental Activities of Daily Living and be taking more prescription drugs. In a multiple regression model including all covariates, only older age, male sex, and lower reading level were independently associated with inadequate or marginal S-TOFHLA scores. CONCLUSION In a population-based sample of older adults, low functional health literacy was associated with age, sex, education, and reading ability. Basic functional health literacy is essential for understanding health information and instructions. Clinicians should formally or informally assess health literacy in their older patients to ensure effective communication and enhance health outcomes.
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Affiliation(s)
- Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
| | - Tiffany F. Hughes
- Department of Health Professions, Bitonte College of Health and Human Services, Youngstown State University, Youngstown, OH
| | - Yichen Jia
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Jennifer Lingler
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA,Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA,Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Erin Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Chung-Chou H. Chang
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA,Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA
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Wiese LK, Williams IC, Schoenberg NE, Galvin JE, Lingler J. Overcoming the COVID-19 Pandemic for Dementia Research: Engaging Rural, Older, Racially and Ethnically Diverse Church Attendees in Remote Recruitment, Intervention and Assessment. Gerontol Geriatr Med 2021; 7:23337214211058919. [PMID: 34825019 PMCID: PMC8609097 DOI: 10.1177/23337214211058919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Access to cognitive screening in rural underserved communities is limited and was further diminished during the COVID-19 pandemic. We examined whether a telephone-based cognitive screening intervention would be effective in increasing ADRD knowledge, detecting the need for further cognitive evaluation, and making and tracking the results of referrals. METHOD Using a dependent t-test design, older, largely African American and Afro-Caribbean participants completed a brief educational intervention, pre/post AD knowledge measure, and cognitive screening. RESULTS Sixty of 85 eligible individuals consented. Seventy-percent of the sample self-reported as African American, Haitian Creole, or Hispanic, and 75% were female, with an average age of 70. AD knowledge pre-post scores improved significantly (t (49) = -3.4, p < .001). Of the 11 referred after positive cognitive screening, 72% completed follow-up with their provider. Five were newly diagnosed with dementia. Three reported no change in diagnosis or treatment. Ninety-percent consented to enrolling in a registry for future research. CONCLUSION Remote engagement is feasible for recruiting, educating, and conducting cognitive screening with rural older adults during a pandemic.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | | | | | - James. E. Galvin
- Professor of Neurology, University of Miami Miller School of
Medicine, Miami, FL, USA
| | - Jennifer Lingler
- School of Nursing, Health & Community
Systems, University of Pittsburgh, Pittsburgh, PA, USA
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Wiese LK, Lingler J, Lindauer A. Alzheimer's disease and Lewy body dementia: Discerning the differences: Assessment is key for optimal management. Am Nurse J 2021; 16:10-17. [PMID: 35815334 PMCID: PMC9266700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Lisa Kirk Wiese
- Lisa Kirk Wiese is an associate professor of nursing at the Florida Atlantic University C. E. Lynn College of Nursing in Boca Raton
| | - Jennifer Lingler
- Jennifer Lingler is professor and vice chair for research at the Health and Community Systems University of Pittsburgh School of Nursing in Pittsburgh, Pennsylvania
| | - Allison Lindauer
- Allison Lindauer is an assistant professor of neurology at the School of Medicine Oregon Health and Science University and the Layton Aging and Alzheimer's Disease Center director of outreach, recruitment, and education in Portland
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Lingler J, Coble DW, Bollinger R, Edwards DF, Gabel M, Grill JD, Knox M, Stark S. Perceptions of research burden among participants in ADC cohorts. Alzheimers Dement 2020. [DOI: 10.1002/alz.044605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | - Dorothy Farrar Edwards
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | | | | | - Susan Stark
- Washington University Alzheimer's Disease Research Center St. Louis MO USA
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Wiese LK, Lingler J, Williams IC, Schoenberg NE, Galvin JE. Engaging rural older minority adults in dementia research during a pandemic‐associated quarantine. Alzheimers Dement 2020. [PMCID: PMC7883203 DOI: 10.1002/alz.047225] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Rural‐dwelling individuals are at heightened risk for dementia syndromes as they age. Recognizing that faith institutions are bulwarks in rural communities, we partnered with churches to design research that aims to improve knowledge of, and promote screening for, dementia. Since recruitment began just as COVID‐19 emerged, in‐person recruitment ceased. We developed a virtual protocol to train health educators and engage rural, racially diverse congregants. Method Guided by Schoenberg’s (2011) “Faith Moves Mountains” model, health educators were trained via videoconferencing, using Alzheimer’s Association online English/Spanish resources. Educators approached 35 congregants to administer telephone‐based teaching, pre‐post tests of dementia knowledge, and dementia screening. Results Thirty rural older adults responded to faith health educator tele‐recruitment and intervention. Pre‐post knowledge surveys showed significant improvement (r=.67, p=.04). Thirteen (43%) completed dementia screening, followed by referral to a memory telehealth clinic. Conclusion This faith‐based model shows promise for reaching isolated rural residents facing dementia risk.
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Gabel M, Coble DW, Bollinger R, Edwards DF, Lingler J, Chin E, Grill JD, Stark S. Perceived facilitators and barriers to continued enrollment in longitudinal studies of Alzheimer disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.044609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | | | - Dorothy Farrar Edwards
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | - Erin Chin
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | - Susan Stark
- Washington University Alzheimer's Disease Research Center St. Louis MO USA
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Edwards DF, Lingler J, Chin E, Gabel M, Coble DW, Grill JD, Stark S. Perceptions of research burden reported by study partners of longitudinal ADC cohort participants. Alzheimers Dement 2020. [DOI: 10.1002/alz.044604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Dorothy Farrar Edwards
- University of Wisconsin School of Medicine and Public Health Department of Medicine Division of Geriatrics Madison WI USA
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | - Erin Chin
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | | | | | - Susan Stark
- Washington University Alzheimer's Disease Research Center St. Louis MO USA
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Kim H, Sereika SM, Bender C, Albert S, Lingler J. Illness perceptions and affective symptoms: Predictors of self‐management behaviors in mild cognitive impairment. Alzheimers Dement 2020. [DOI: 10.1002/alz.037490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hyejin Kim
- Pennsylvania State University University Park PA USA
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Ren D, Lopez OL, Lingler J, Conley Y. The effect of APOE ɛ2/ɛ4 genotype on the incidence of Alzheimer's disease (AD) and mild cognitive impairment (MCI) in African Americans. Alzheimers Dement 2020. [DOI: 10.1002/alz.041188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Dianxu Ren
- University of Pittsburgh Pittsburgh PA USA
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Rosen AC, Alber J, Al‐Janabi OM, Arias JJ, Bardach SH, Blacker D, Denny SS, Dorociak K, Edwards DF, Erickson CM, Fargo K, Frank L, Gleason CE, Goldman J, Green RC, Grill JD, Heidebrink JL, Henderson VW, Hummel CH, Jwa AS, Karlawish J, Lah JJ, Langbaum JB, Langston AH, Largent EA, Lee AKW, Lingler J, Milne R, Moore RC, Mozersky J, Nosheny RL, Parker MW, Roberts JS, Rogalski EJ, Rumbaugh M, Saykin AJ, Shapiro R, Stites SD, Tyrone J, Vogel B, Walter S, Wang L, Wijsman E, Aggarwal NT. The formation of the advisory group on risk evaluation education for dementia. Alzheimers Dement 2020. [DOI: 10.1002/alz.045562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Allyson C Rosen
- VA Medical Center‐Palo Alto Palo Alto CA USA
- Stanford University School of Medicine Stanford CA USA
| | | | | | | | | | - Deborah Blacker
- Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Sharon S Denny
- The Association for Frontotemporal Degeneration Radnor PA USA
| | | | - Dorothy Farrar Edwards
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Claire M Erickson
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | | | - Carey E Gleason
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | - Robert C Green
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | | | | | - Victor W Henderson
- Department of Health Research and Policy Stanford University Stanford CA USA
| | | | | | | | - James J Lah
- Emory Goizueta Alzheimer's Disease Research Center Atlanta GA USA
| | | | | | | | | | | | | | | | | | - Rachel L Nosheny
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Affairs Medical Center San Francisco CA USA
| | | | | | | | - Malia Rumbaugh
- VA Puget Sound Health Care System University of Washington Seattle WA USA
| | | | | | | | - Jamie Tyrone
- Beating Alzheimer's by Embracing Science Ramona CA USA
| | - Briana Vogel
- University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Sarah Walter
- Alzheimer’s Therapeutic Research Institute/USC San Diego CA USA
| | - Li‐San Wang
- University of Pennsylvania Philadelphia PA USA
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Lingler J, Sereika SM, Cohen A, Knox M, Tamres L, Roberts JS, Klunk WE. P4-564: SHORT-TERM OUTCOMES OF A RANDOMIZED CONTROLLED TRIAL OF AMYLOID PET RESULTS DISCLOSURE IN MILD COGNITIVE IMPAIRMENT. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.08.111] [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: 11/27/2022]
Affiliation(s)
| | | | - Ann Cohen
- Alzheimer's Disease Research Center; Pittsburgh PA USA
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Lingler J. S1‐01‐02: HEALTH LITERACY AND ACCESS TO DEMENTIA CARE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hunsaker A, Lingler J, Tang F, Engel R, Rosen D. WHAT SOCIODEMOGRAPHIC AND HEALTH FACTORS RELATE TO PARTICIPATION IN NEUROIMAGING FOR DEMENTIA RESEARCH? Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1973] [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: 11/13/2022] Open
Affiliation(s)
- A Hunsaker
- IKMZ - Institute of Communication and Media Research, University of Zurich
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Mattos M, Sereika S, Kim H, Tamres L, Knox M, Lingler J. DIFFERENCES IN ILLNESS PERCEPTIONS BETWEEN PARTICIPANTS WITH MILD COGNITIVE IMPAIRMENT AND THEIR CARE PARTNERS. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3438] [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: 11/13/2022] Open
Affiliation(s)
- M Mattos
- . University of Virginia, School of Nursing
| | | | - H Kim
- University of Pittsburgh, School of Nursing
| | - L Tamres
- University of Pittsburgh, School of Nursing
| | - M Knox
- University of Pittsburgh, School of Nursing
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Grill JD, Apostolova LG, Bullain S, Burns JM, Cox CG, Dick M, Hartley D, Kawas C, Kremen S, Lingler J, Lopez OL, Mapstone M, Pierce A, Rabinovici G, Roberts JS, Sajjadi SA, Teng E, Karlawish J. Communicating mild cognitive impairment diagnoses with and without amyloid imaging. Alzheimers Res Ther 2017; 9:35. [PMID: 28472970 PMCID: PMC5418690 DOI: 10.1186/s13195-017-0261-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/06/2017] [Indexed: 11/10/2022]
Abstract
Background Mild cognitive impairment (MCI) has an uncertain etiology and prognosis and may be challenging for clinicians to discuss with patients and families. Amyloid imaging may aid specialists in determining MCI etiology and prognosis, but creates novel challenges related to disease labeling. Methods We convened a workgroup to formulate recommendations for clinicians providing care to MCI patients. Results Clinicians should use the MCI diagnosis to validate patient and family concerns and educate them that the patient’s cognitive impairment is not normal for his or her age and education level. The MCI diagnosis should not be used to avoid delivering a diagnosis of dementia. For patients who meet Appropriate Use Criteria after standard-of-care clinical workup, amyloid imaging may position specialists to offer more information about etiology and prognosis. Clinicians must set appropriate expectations, including ensuring that patients and families understand the limitations of amyloid imaging. Communication of negative results should include that patients remain at elevated risk for dementia and that negative scans do not indicate a specific diagnosis or signify brain health. Positive amyloid imaging results should elicit further monitoring and conversations about appropriate advance planning. Clinicians should offer written summaries, including referral to appropriate social services. Conclusions In patients with MCI, there is a need to devote considerable time and attention to patient education and shared decision-making. Amyloid imaging may be a tool to aid clinicians. Careful management of patient expectations and communication of scan results will be critical to the appropriate use of amyloid imaging information.
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Affiliation(s)
- Joshua D Grill
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA. .,Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA. .,Institute for Memory Impairments and Neurological Disorders, University of California, 3204 Biological Sciences III, Irvine, CA, 92697, USA.
| | - Liana G Apostolova
- Alzheimer's Disease Center, Department of Neurology, Radiology, Medical and Molecular Genetics, University of Indiana, Indianapolis, IN, USA.,Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Szofia Bullain
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.,Department of Neurology, University of California, Irvine, CA, USA
| | | | - Chelsea G Cox
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Malcolm Dick
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | | | - Claudia Kawas
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.,Department of Neurology, University of California, Irvine, CA, USA
| | - Sarah Kremen
- Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | | | | | - Mark Mapstone
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.,Department of Neurology, University of California, Irvine, CA, USA
| | - Aimee Pierce
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.,Department of Neurology, University of California, Irvine, CA, USA
| | | | - J Scott Roberts
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Seyed Ahmad Sajjadi
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.,Department of Neurology, University of California, Irvine, CA, USA
| | - Edmond Teng
- Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA.,Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Lingler J, Hu L, Mattos MH. P3‐204: Decision‐Making Regarding Pet Amyloid Imaging: A Qualitative Analysis of Patient and Family Member Perspectives. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Lu Hu
- University of PittsburghPittsburghPA USA
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21
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Erlen JA, Lingler J, Tamres L, Sereika SM, Houze M, Kaufman R. O3‐03‐06: Medication reconciliation: A vital process to correct medication mismanagement. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.07.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Lingler J, Hu L, Butters M, McDade E, Parker LS, Roberts JS, Sereika SM. P4‐093: PET amyloid imaging: Implications for estimating risk of progression to Alzheimer's disease in individuals with mild cognitive impairment. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Lu Hu
- University of PittsburghPittsburghPAUSA
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23
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Tang F, Jang H, Lingler J, Tamres LK, Erlen JA. Stressors and Caregivers' Depression: Multiple Mediators of Self-Efficacy, Social Support, and Problem-Solving Skill. Soc Work Health Care 2015; 54:651-68. [PMID: 26317766 PMCID: PMC4864007 DOI: 10.1080/00981389.2015.1054058] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Caring for an older adult with memory loss is stressful. Caregiver stress could produce negative outcomes such as depression. Previous research is limited in examining multiple intermediate pathways from caregiver stress to depressive symptoms. This study addresses this limitation by examining the role of self-efficacy, social support, and problem solving in mediating the relationships between caregiver stressors and depressive symptoms. Using a sample of 91 family caregivers, we tested simultaneously multiple mediators between caregiver stressors and depression. Results indicate that self-efficacy mediated the pathway from daily hassles to depression. Findings point to the importance of improving self-efficacy in psychosocial interventions for caregivers of older adults with memory loss.
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Affiliation(s)
- Fengyan Tang
- Associate Professor, University of Pittsburgh, School of Social Work, 2217C Cathedral of Learning, Pittsburgh, PA 15260, Phone: 412-648-9356, Fax: 412-624-6323
| | - Heejung Jang
- Research Assistant, University of Pittsburgh, School of Social Work
| | - Jennifer Lingler
- Assistant Professor, Department of Health and Community Systems, University of Pittsburgh, School of Nursing
| | - Lisa K. Tamres
- Research Associate, Department of Health and Community Systems, University of Pittsburgh, School of Nursing
| | - Judith A. Erlen
- Professor and Chair, Department of Health and Community Systems, University of Pittsburgh, School of Nursing
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Abstract
PURPOSE The purpose of this study was to describe humor and laughter in persons with cognitive impairment (PWCI) and caregivers who were recalling a shared experience in a focus group. DESIGN Twenty participants attended an Art Engagement Activity at the Andy Warhol Art Museum, which included a guided tour and an art project. All PWCI had medically diagnosed cognitive disorders and all caregiver participants did not. Four focus groups were conducted and transcripts of audio-recorded sessions were transferred to a qualitative software program. METHOD Words, phrases, and episodes of humor and laughter were used to construct codes, which were refined during group analysis using constant comparison. FINDINGS Humor and laughter were present in all four focus groups. Emerging themes of humor included silliness, sarcasm, and commenting about hardships of dementia. Laughter was identified in segments with and without humor. Some PWCI were unable to follow social cues. CONCLUSIONS Humor and laughter played a role in creating a safe social environment. PWCI were able to engage in humor during social interactions, yet some had difficulty recognizing social cues. Further study may reveal roles of humor and laughter in adaptation to cognitive decline and holistic interventions for improved quality of life.
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25
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Witte M, Barnes J, Lingler J, Agronin M, Hochstetler H, Healey K, Hake A, Trzepacz P. O1–04–01: Testing the use of standardized scripts for disclosing ‘hypothetical/mock’ amyloid PET scan results to nondemented cognitively impaired patients and their care partners. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.04.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Michael Witte
- Eli Lilly and Company Indianapolis Indiana United States
| | - Janet Barnes
- Eli Lilly and Company and/or one of its wholly owned subsidiaries Indianapolis Indiana United States
| | | | - Marc Agronin
- Miami Jewish Health Systems Miami Florida United States
| | - Helen Hochstetler
- Eli Lilly and Company and/or one of its wholly owned subsidiaries Indianapolis Indiana United States
| | - Kristine Healey
- Eli Lilly and Company and/or one of its wholly owned subsidiaries Indianapolis Indiana United States
| | - Ann Hake
- Eli Lilly and Company and/or one of its wholly owned subsidiaries Indianapolis Indiana United States
| | - Paula Trzepacz
- Eli Lilly and Company and/or one of its wholly owned subsidiaries Indianapolis Indiana United States
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Lingler J, Roberts S, Butters M, Lisa P, Schulz R, Hu L, Seaman J, Klunk W. O3–08–03: Disclosing amyloid imaging results in MCI: What do patients and families want, and why? Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.04.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Scott Roberts
- University of Michigan School of Public Health Ann Arbor Michigan United States
| | - Meryl Butters
- University of Pittsburgh Pittsburgh Pennsylvania United States
| | - Parker Lisa
- University of Pittsburgh Pittsburgh Pennsylvania United States
| | - Richard Schulz
- University of Pittsburgh Pittsburgh Pennsylvania United States
| | - Lu Hu
- School of Nursing, University of Pittsburgh Pittsburgh Pennsylvania United States
| | - Jennifer Seaman
- University of Pittsburgh Pittsburgh Pennsylvania United States
| | - William Klunk
- University of Pittsburgh Pittsburgh Pennsylvania United States
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Erlen JA, Lingler J, Sereika SM, Tamres LK, Happ MB, Tang F. Characterizing caregiver-mediated medication management in patients with memory loss. J Gerontol Nurs 2013; 39:30-9. [PMID: 23445184 DOI: 10.3928/00989134-20130220-91] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/18/2013] [Indexed: 12/11/2022]
Abstract
Increasingly, family members are assisting with the complex task of medication management when patients are experiencing cognitive decline. To date, limited published research addresses caregiver-mediated medication management of patients with impaired cognition. Thus, the purpose of this study was to describe the characteristics and correlates of caregiver-mediated medication management in community-dwelling patients with memory loss. We used baseline data from the 91 patient-caregiver dyads participating in a randomized controlled trial designed to assist caregivers of patients with memory loss with medication management. The patient's level of cognitive impairment was not related to medication errors; however, the number of medications that patients were prescribed and taking was related to medication errors. Important factors to consider when discussing medication management with caregivers of patients with memory loss include the caregiver's age, cognitive ability, and depressive symptoms, as well as the caregiver's perception of the impact of the patient's behavioral problems.
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Affiliation(s)
- Judith A Erlen
- Department of Health and Community System, University of Pittsburgh, PA 15261, USA.
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Lingler J, Tamres L, Knox M, Arida J, Amspaugh C, Erlen J. P3‐285: Frequency and type of medication errors by dementia caregivers. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1508] [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: 11/27/2022]
Affiliation(s)
| | - Lisa Tamres
- University of PittsburghPittsburghPennsylvaniaUnited States
| | - Melissa Knox
- University of PittsburghPittsburghPennsylvaniaUnited States
| | - Janet Arida
- University of PittsburghPittsburghPennsylvaniaUnited States
| | | | - Judith Erlen
- University of PittsburghPittsburghPennsylvaniaUnited States
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Reynolds CF, Happ MB, Lingler J, Garand L, Dunbar-Jacob J. Comment on: filling the void in geriatric mental health: the Geropsychiatric Nursing Collaborative as a model for change. Nurs Outlook 2011; 59:241-2. [PMID: 21757082 DOI: 10.1016/j.outlook.2011.05.020] [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] [Received: 05/31/2011] [Accepted: 05/31/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Charles F Reynolds
- John A. Hartford Center of Excellence in Geriatric Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
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