Secondary endpoints included the ADCS-ADL and the NPI. Efficacy analyses were based on the ITT da... more Secondary endpoints included the ADCS-ADL and the NPI. Efficacy analyses were based on the ITT data set using LOCF and PP. Results: Of 217 patients randomized, 197 patients were included in the ITT data set (females 77. 2%; age 75.2 years). A significant superiority of Cerebrolysin to donepezil and a marginal significant superiority of the combination to donepezil in the overall clinical functioning (CIBICþ) was shown at week 28. In the other domains tested, there was no statistically significant difference between treatment groups. However, best and similar results were obtained with Cerebrolysin and the combination for the cognitive domain (ADAS-cogþ), the global clinical impression (CIBICþ) and the activities of daily living (ADCS-ADL). In the neuropsychiatric symptoms (NPI), monotherapy was superior to the combination and Cerebrolysin to donepezil. Similar results were observed in the PP analysis set. Cerebrolysin in a dose of 10ml given as monotherapy or in combination with donepezil was safe and well tolerated. The incidence of treatment-emergent AEs was similar in all treatment groups, however, gastrointestinal disorders were reported more frequently with donepezil (monotherapy or in combination), nervous system disorders with Cerebrolysin (monotherapy or in combination) and psychiatric disorders with the combination therapy. Four patients suffered from an SAE. Analyses of lab parameters, vital signs, physical and neurological examinations did not show any group-specific differences or relevant changes. Conclusions: These results have shown that therapy with Cerebrolysin is as good as with donepezil and descriptively even better and that a combination of neurotrophic treatment (Cerebrolysin) with cholinesterase inhibitors (donepezil) is a safe treatment option and provides synergistic treatment effects in patients suffering from mild to moderate Alzheimer's disease.
Veterans are an increasing population in postsecondary education. Many student veterans have disa... more Veterans are an increasing population in postsecondary education. Many student veterans have disabilities affecting their well-being and success in college. This study aims to add to current knowledge on well-being by exploring the relationship between flourishing, personality traits, and service-connected disability among student veterans. First, we set out to psychometrically validate the Flourishing Scale (FS) for student veterans. Second, we evaluated the association of the Big-Five personality traits and flourishing. Finally, we evaluated the differences in flourishing among student veterans with and without service-connected disabilities. Two hundred five student veterans were recruited for the current study. A random split-half approach was adopted to perform an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Subsequent to conducting the EFA and CFA, a hierarchical multiple regression analysis was performed to investigate the relationships between fl...
Obstetrics and Gynecology Clinics of North America
This article reviews the role of endogenous estrogen in neural and cognitive processing, followed... more This article reviews the role of endogenous estrogen in neural and cognitive processing, followed by an examination of longitudinal cognitive data captured in various stages of the menopausal transition. The remaining text reviews the contradictory results from major hormone therapy trials to date, evidence for the "timing hypothesis," and closes with recommendations for future research and for practicing clinicians.
The effects of 2 frequently used formulations of menopausal hormone therapy (mHT) on brain struct... more The effects of 2 frequently used formulations of menopausal hormone therapy (mHT) on brain structure and cognition were investigated 3 years after the end of a randomized, placebo-controlled trial in recently menopausal women with good cardiovascular health. Participants (aged 42-56 years; 5-36 months past menopause) were randomized to one of the following: 0.45 mg/d oral conjugated equine estrogen (oCEE); 50 μg/d transdermal 17β-estradiol (tE2); or placebo pills and patch for 4 years. Oral progesterone (200 mg/d) was given to mHT groups for 12 days each month. MRIs were performed at baseline, at the end of 4 years of mHT, and 3 years after the end of mHT (n = 75). A subset of participants also underwent Pittsburgh compound B-PET (n = 68). Ventricular volumes increased more in the oCEE group compared to placebo during the 4 years of mHT, but the increase in ventricular volumes was not different from placebo 3 years after the discontinuation of mHT. Increase in white matter hyperinte...
Journal of the American Medical Informatics Association : JAMIA, Jan 27, 2018
Despite increased risk for negative outcomes, cognitive impairment (CI) is greatly under-detected... more Despite increased risk for negative outcomes, cognitive impairment (CI) is greatly under-detected during hospitalization. While automated EHR-based phenotypes have potential to improve recognition of CI, they are hindered by widespread under-diagnosis of underlying etiologies such as dementia-limiting the utility of more precise structured data elements. This study examined unstructured data on symptoms of CI in the acute-care EHRs of hip and stroke fracture patients with dementia from two hospitals. Clinician reviewers identified and classified unstructured EHR data using standardized criteria. Relevant narrative text was descriptively characterized and evaluated for key terminology. Most patient EHRs (90%) had narrative text reflecting cognitive and/or behavioral dysfunction common in CI that were reliably classified (κ 0.82). The majority of statements reflected vague descriptions of cognitive/behavioral dysfunction as opposed to diagnostic terminology. Findings from this prelimi...
Alzheimer's disease (AD) biomarkers are emerging as critically important for disease detectio... more Alzheimer's disease (AD) biomarkers are emerging as critically important for disease detection and monitoring. Most biomarkers are obtained through invasive, resource-intense procedures. A cognitive marker, intra-individual cognitive variability (IICV) may provide an alternative or adjunct marker of disease risk for individuals unable or disinclined to undergo lumbar puncture. To contrast risk of incident AD and mild cognitive impairment (MCI) associated with IICV to risk associated with well-established biomarkers: cerebrospinal fluid (CSF) phosphorylated tau protein (p-tau181) and amyloid-β 42 (Aβ42) peptide. Dispersion in cognitive performance, IICV, was estimated with a published algorithm, and included Trail Making Test A and B, Rey Auditory Verbal Learning Test (RAVLT), and the American National Adult Reading Test (ANART). CSF biomarkers were expressed as a ratio: p-tau181/Aβ42, wherein high values signified pathognomonic profiles. Logistic regression models included longi...
Background: Mobility changes are concerning for elderly patients with cognitive decline. Given fr... more Background: Mobility changes are concerning for elderly patients with cognitive decline. Given frail older individuals' vulnerability to injury, it is critical to identify contributors to limited mobility. Objective: To examine whether structural brain abnormalities, including reduced gray matter volume and white matter hyperintensities, would be associated with limited mobility among individuals with cognitive impairment, and to determine whether cognitive impairment would mediate this relationship. Methods: Thirty-four elderly individuals with mild cognitive impairment (MCI) and Alzheimer's disease underwent neuropsychological evaluation, mobility assessment, and structural brain neuroimaging. Linear regression was conducted with predictors including gray matter volume in six regions of interest (ROI) and white matter hyperintensity (WMH) burden, with mobility measures as outcomes. Results: Lower gray matter volume in caudate nucleus was associated with slower speed on a f...
Journal of the International Neuropsychological Society : JINS, 2016
Intraindividual cognitive variability (IICV) has been shown to differentiate between groups with ... more Intraindividual cognitive variability (IICV) has been shown to differentiate between groups with normal cognition, mild cognitive impairment (MCI), and dementia. This study examined whether baseline IICV predicted subsequent mild to moderate cognitive impairment in a cognitively normal baseline sample. Participants with 4 waves of cognitive assessment were drawn from the Wisconsin Registry for Alzheimer's Prevention (WRAP; n=684; 53.6(6.6) baseline age; 9.1(1.0) years follow-up; 70% female; 74.6% parental history of Alzheimer's disease). The primary outcome was Wave 4 cognitive status ("cognitively normal" vs. "impaired") determined by consensus conference; "impaired" included early MCI (n=109), clinical MCI (n=11), or dementia (n=1). Primary predictors included two IICV variables, each based on the standard deviation of a set of scores: "6 Factor IICV" and "4 Test IICV". Each IICV variable was tested in a series of logistic ...
Objective: To investigate the effects of hormone therapy on brain structure in a randomized, doub... more Objective: To investigate the effects of hormone therapy on brain structure in a randomized, double-blinded, placebo-controlled trial in recently postmenopausal women. Methods: Participants (aged 42-56 years, within 5-36 months past menopause) in the Kronos Early Estrogen Prevention Study were randomized to (1) 0.45 mg/d oral conjugated equine estrogens (CEE), (2) 50 mg/d transdermal 17b-estradiol, or (3) placebo pills and patch for 48 months. Oral progesterone (200 mg/d) was given to active treatment groups for 12 days each month. MRI and cognitive testing were performed in a subset of participants at baseline, and at 18, 36, and 48 months of randomization (n 5 95). Changes in whole brain, ventricular, and white matter hyperintensity volumes, and in global cognitive function, were measured. Results: Higher rates of ventricular expansion were observed in both the CEE and the 17b-estradiol groups compared to placebo; however, the difference was significant only in the CEE group (p 5 0.01). Rates of ventricular expansion correlated with rates of decrease in brain volume (r 5 20.58; p # 0.001) and with rates of increase in white matter hyperintensity volume (r 5 0.27; p 5 0.01) after adjusting for age. The changes were not different between the CEE and 17b-estradiol groups for any of the MRI measures. The change in global cognitive function was not different across the groups. Conclusions: Ventricular volumes increased to a greater extent in recently menopausal women who received CEE compared to placebo but without changes in cognitive performance. Because the sample size was small and the follow-up limited to 4 years, the findings should be interpreted with caution and need confirmation. Classification of evidence: This study provides Class I evidence that brain ventricular volume increased to a greater extent in recently menopausal women who received oral CEE compared to placebo. Neurology ® 2016;87:887-896 GLOSSARY CEE 5 conjugated equine estrogens; FLAIR 5 fluid-attenuated inversion recovery; KEEPS 5 Kronos Early Estrogen Prevention Study; WHIMS 5 Women's Health Initiative Memory Study; WMH 5 white matter hyperintensity. Hormone therapy with conjugated equine estrogens (CEE) and medroxyprogesterone acetate initiated later in menopause increased the risk of dementia in the Women's Health Initiative Memory Study (WHIMS). 1 Whether alternative formulations of hormone therapy can preserve neuronal integrity and decrease the risk of dementia when administered early in menopause remains controversial. 2-10 Determining the effects of hormone therapy during the early postmenopausal years on the risk of dementia would require decades of follow-up. However, noninvasive imaging markers related to cognitive health have been suggested as short-term surrogate outcomes to assess the effects of menopausal hormone therapy on the brain. Thus, age-associated changes in From the Departments of Radiology (K.
Introduction: The potential of intra-individual cognitive variability (IICV) to predict incident ... more Introduction: The potential of intra-individual cognitive variability (IICV) to predict incident mild cognitive impairment (MCI) or Alzheimer's disease (AD) was examined and compared to wellestablished neuroimaging and genetic predictors. Methods: IICV was estimated using four neuropsychological measures for n 5 1324 Alzheimer's Disease Neuroimaging Initiative (ADNI) participants who were cognitively healthy or diagnosed with MCI at baseline. IICV was used to predict time to incident MCI or AD, and compared to hippocampal volume loss and APOE ε4 status via survival analysis. Results: In survival analyses, controlling for age, education, baseline diagonosis, and APOE ε4 status, likelihood ratio tests indicate that IICV is associated with time to cognitive status change in the full sample (P , .0001), and when the sample was restricted to individuals with MCI at baseline (P , .0001). Discussion: These findings suggest IICV may be a low-cost, noninvasive alternative to traditional AD biomarkers.
... Carey E. Gleason, Western State Hospital. ... eg, Burgio & Bourgeois, 1992; Burgio, Scill... more ... Carey E. Gleason, Western State Hospital. ... eg, Burgio & Bourgeois, 1992; Burgio, Scilley, Hoar, Washington, & Tunstall, 1993; Cariaga, Burgio, Flynn, & Martin, 1991; Jones, 1996; Sloane, 1997; Sloane, Lindeman, Phillips, Moritz, & Kock, 1995; Teri, 1990; White, Kaas, & Rhine ...
Journal of Alzheimer's disease : JAD, Apr 12, 2016
Type 2 diabetes is associated with an increased risk for Alzheimer's disease (AD). Regulation... more Type 2 diabetes is associated with an increased risk for Alzheimer's disease (AD). Regulation of normal insulin function may be important in reducing the prevalence of dementia due to AD, particularly in individuals who harbor genetic risk for, or have a parental family history of, AD. The relationship between insulin resistance (IR) and AD pathology remains poorly understood, particularly in midlife prior to the onset of clinical metabolic disease or cognitive decline. We examined associations between IR as indexed by HOMA-IR, cerebrospinal fluid (CSF) biomarkers of AD pathology, and memory in middle-aged adults enriched for AD. We postulated that higher HOMA-IR and APOEɛ4 carriage would be associated with greater CSF AD pathology and poor memory performance. Cognitively asymptomatic middle-aged adults (N = 70, mean age = 57.7 years) from the Wisconsin Alzheimer's Disease Research Center with a parental family history of dementia due to AD underwent lumbar puncture, blood d...
$333 severe AD). Methods: A multi-step review that included identification of databases, abstract... more $333 severe AD). Methods: A multi-step review that included identification of databases, abstraction of individual articles and the creation of evidence tables was conducted. Articles were sought that described costs by severity of AD (based primarily on changes in cognition). Results: Literature Review-Six articles of an initial 702 were identified for full text review. These studies differed considerably in terms of country where the study was conducted, types of patients included (AD only or AD and non-AD patients, non-institutionalized only), study design (cross sectional or cohort), type of test used to categorize patients by AD severity (MMSE or CDR) and adjustment for important covariates.
It remains controversial whether hormone therapy in recently postmenopausal women modifies the ri... more It remains controversial whether hormone therapy in recently postmenopausal women modifies the risk of Alzheimer's disease (AD). To investigate the effects of hormone therapy on amyloid-β deposition in recently postmenopausal women. Participants within 5-36 months past menopause in the Kronos Early Estrogen Prevention Study, a randomized, double blinded placebo-controlled clinical trial, were randomized to: 1) 0.45 mg/day oral conjugated equine estrogens (CEE); 2) 50μg/day transdermal 17β-estradiol; or 3) placebo pills and patch for four years. Oral progesterone (200 mg/day) was given to active treatment groups for 12 days each month. 11C Pittsburgh compound B (PiB) PET imaging was performed in 68 of the 118 participants at Mayo Clinic approximately seven years post randomization and three years after stopping randomized treatment. PiB Standard unit value ratio (SUVR) was calculated. Women (age = 52-65) randomized to transdermal 17β-estradiol (n = 21) had lower PiB SUVR compared...
Secondary endpoints included the ADCS-ADL and the NPI. Efficacy analyses were based on the ITT da... more Secondary endpoints included the ADCS-ADL and the NPI. Efficacy analyses were based on the ITT data set using LOCF and PP. Results: Of 217 patients randomized, 197 patients were included in the ITT data set (females 77. 2%; age 75.2 years). A significant superiority of Cerebrolysin to donepezil and a marginal significant superiority of the combination to donepezil in the overall clinical functioning (CIBICþ) was shown at week 28. In the other domains tested, there was no statistically significant difference between treatment groups. However, best and similar results were obtained with Cerebrolysin and the combination for the cognitive domain (ADAS-cogþ), the global clinical impression (CIBICþ) and the activities of daily living (ADCS-ADL). In the neuropsychiatric symptoms (NPI), monotherapy was superior to the combination and Cerebrolysin to donepezil. Similar results were observed in the PP analysis set. Cerebrolysin in a dose of 10ml given as monotherapy or in combination with donepezil was safe and well tolerated. The incidence of treatment-emergent AEs was similar in all treatment groups, however, gastrointestinal disorders were reported more frequently with donepezil (monotherapy or in combination), nervous system disorders with Cerebrolysin (monotherapy or in combination) and psychiatric disorders with the combination therapy. Four patients suffered from an SAE. Analyses of lab parameters, vital signs, physical and neurological examinations did not show any group-specific differences or relevant changes. Conclusions: These results have shown that therapy with Cerebrolysin is as good as with donepezil and descriptively even better and that a combination of neurotrophic treatment (Cerebrolysin) with cholinesterase inhibitors (donepezil) is a safe treatment option and provides synergistic treatment effects in patients suffering from mild to moderate Alzheimer's disease.
Veterans are an increasing population in postsecondary education. Many student veterans have disa... more Veterans are an increasing population in postsecondary education. Many student veterans have disabilities affecting their well-being and success in college. This study aims to add to current knowledge on well-being by exploring the relationship between flourishing, personality traits, and service-connected disability among student veterans. First, we set out to psychometrically validate the Flourishing Scale (FS) for student veterans. Second, we evaluated the association of the Big-Five personality traits and flourishing. Finally, we evaluated the differences in flourishing among student veterans with and without service-connected disabilities. Two hundred five student veterans were recruited for the current study. A random split-half approach was adopted to perform an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Subsequent to conducting the EFA and CFA, a hierarchical multiple regression analysis was performed to investigate the relationships between fl...
Obstetrics and Gynecology Clinics of North America
This article reviews the role of endogenous estrogen in neural and cognitive processing, followed... more This article reviews the role of endogenous estrogen in neural and cognitive processing, followed by an examination of longitudinal cognitive data captured in various stages of the menopausal transition. The remaining text reviews the contradictory results from major hormone therapy trials to date, evidence for the "timing hypothesis," and closes with recommendations for future research and for practicing clinicians.
The effects of 2 frequently used formulations of menopausal hormone therapy (mHT) on brain struct... more The effects of 2 frequently used formulations of menopausal hormone therapy (mHT) on brain structure and cognition were investigated 3 years after the end of a randomized, placebo-controlled trial in recently menopausal women with good cardiovascular health. Participants (aged 42-56 years; 5-36 months past menopause) were randomized to one of the following: 0.45 mg/d oral conjugated equine estrogen (oCEE); 50 μg/d transdermal 17β-estradiol (tE2); or placebo pills and patch for 4 years. Oral progesterone (200 mg/d) was given to mHT groups for 12 days each month. MRIs were performed at baseline, at the end of 4 years of mHT, and 3 years after the end of mHT (n = 75). A subset of participants also underwent Pittsburgh compound B-PET (n = 68). Ventricular volumes increased more in the oCEE group compared to placebo during the 4 years of mHT, but the increase in ventricular volumes was not different from placebo 3 years after the discontinuation of mHT. Increase in white matter hyperinte...
Journal of the American Medical Informatics Association : JAMIA, Jan 27, 2018
Despite increased risk for negative outcomes, cognitive impairment (CI) is greatly under-detected... more Despite increased risk for negative outcomes, cognitive impairment (CI) is greatly under-detected during hospitalization. While automated EHR-based phenotypes have potential to improve recognition of CI, they are hindered by widespread under-diagnosis of underlying etiologies such as dementia-limiting the utility of more precise structured data elements. This study examined unstructured data on symptoms of CI in the acute-care EHRs of hip and stroke fracture patients with dementia from two hospitals. Clinician reviewers identified and classified unstructured EHR data using standardized criteria. Relevant narrative text was descriptively characterized and evaluated for key terminology. Most patient EHRs (90%) had narrative text reflecting cognitive and/or behavioral dysfunction common in CI that were reliably classified (κ 0.82). The majority of statements reflected vague descriptions of cognitive/behavioral dysfunction as opposed to diagnostic terminology. Findings from this prelimi...
Alzheimer's disease (AD) biomarkers are emerging as critically important for disease detectio... more Alzheimer's disease (AD) biomarkers are emerging as critically important for disease detection and monitoring. Most biomarkers are obtained through invasive, resource-intense procedures. A cognitive marker, intra-individual cognitive variability (IICV) may provide an alternative or adjunct marker of disease risk for individuals unable or disinclined to undergo lumbar puncture. To contrast risk of incident AD and mild cognitive impairment (MCI) associated with IICV to risk associated with well-established biomarkers: cerebrospinal fluid (CSF) phosphorylated tau protein (p-tau181) and amyloid-β 42 (Aβ42) peptide. Dispersion in cognitive performance, IICV, was estimated with a published algorithm, and included Trail Making Test A and B, Rey Auditory Verbal Learning Test (RAVLT), and the American National Adult Reading Test (ANART). CSF biomarkers were expressed as a ratio: p-tau181/Aβ42, wherein high values signified pathognomonic profiles. Logistic regression models included longi...
Background: Mobility changes are concerning for elderly patients with cognitive decline. Given fr... more Background: Mobility changes are concerning for elderly patients with cognitive decline. Given frail older individuals' vulnerability to injury, it is critical to identify contributors to limited mobility. Objective: To examine whether structural brain abnormalities, including reduced gray matter volume and white matter hyperintensities, would be associated with limited mobility among individuals with cognitive impairment, and to determine whether cognitive impairment would mediate this relationship. Methods: Thirty-four elderly individuals with mild cognitive impairment (MCI) and Alzheimer's disease underwent neuropsychological evaluation, mobility assessment, and structural brain neuroimaging. Linear regression was conducted with predictors including gray matter volume in six regions of interest (ROI) and white matter hyperintensity (WMH) burden, with mobility measures as outcomes. Results: Lower gray matter volume in caudate nucleus was associated with slower speed on a f...
Journal of the International Neuropsychological Society : JINS, 2016
Intraindividual cognitive variability (IICV) has been shown to differentiate between groups with ... more Intraindividual cognitive variability (IICV) has been shown to differentiate between groups with normal cognition, mild cognitive impairment (MCI), and dementia. This study examined whether baseline IICV predicted subsequent mild to moderate cognitive impairment in a cognitively normal baseline sample. Participants with 4 waves of cognitive assessment were drawn from the Wisconsin Registry for Alzheimer's Prevention (WRAP; n=684; 53.6(6.6) baseline age; 9.1(1.0) years follow-up; 70% female; 74.6% parental history of Alzheimer's disease). The primary outcome was Wave 4 cognitive status ("cognitively normal" vs. "impaired") determined by consensus conference; "impaired" included early MCI (n=109), clinical MCI (n=11), or dementia (n=1). Primary predictors included two IICV variables, each based on the standard deviation of a set of scores: "6 Factor IICV" and "4 Test IICV". Each IICV variable was tested in a series of logistic ...
Objective: To investigate the effects of hormone therapy on brain structure in a randomized, doub... more Objective: To investigate the effects of hormone therapy on brain structure in a randomized, double-blinded, placebo-controlled trial in recently postmenopausal women. Methods: Participants (aged 42-56 years, within 5-36 months past menopause) in the Kronos Early Estrogen Prevention Study were randomized to (1) 0.45 mg/d oral conjugated equine estrogens (CEE), (2) 50 mg/d transdermal 17b-estradiol, or (3) placebo pills and patch for 48 months. Oral progesterone (200 mg/d) was given to active treatment groups for 12 days each month. MRI and cognitive testing were performed in a subset of participants at baseline, and at 18, 36, and 48 months of randomization (n 5 95). Changes in whole brain, ventricular, and white matter hyperintensity volumes, and in global cognitive function, were measured. Results: Higher rates of ventricular expansion were observed in both the CEE and the 17b-estradiol groups compared to placebo; however, the difference was significant only in the CEE group (p 5 0.01). Rates of ventricular expansion correlated with rates of decrease in brain volume (r 5 20.58; p # 0.001) and with rates of increase in white matter hyperintensity volume (r 5 0.27; p 5 0.01) after adjusting for age. The changes were not different between the CEE and 17b-estradiol groups for any of the MRI measures. The change in global cognitive function was not different across the groups. Conclusions: Ventricular volumes increased to a greater extent in recently menopausal women who received CEE compared to placebo but without changes in cognitive performance. Because the sample size was small and the follow-up limited to 4 years, the findings should be interpreted with caution and need confirmation. Classification of evidence: This study provides Class I evidence that brain ventricular volume increased to a greater extent in recently menopausal women who received oral CEE compared to placebo. Neurology ® 2016;87:887-896 GLOSSARY CEE 5 conjugated equine estrogens; FLAIR 5 fluid-attenuated inversion recovery; KEEPS 5 Kronos Early Estrogen Prevention Study; WHIMS 5 Women's Health Initiative Memory Study; WMH 5 white matter hyperintensity. Hormone therapy with conjugated equine estrogens (CEE) and medroxyprogesterone acetate initiated later in menopause increased the risk of dementia in the Women's Health Initiative Memory Study (WHIMS). 1 Whether alternative formulations of hormone therapy can preserve neuronal integrity and decrease the risk of dementia when administered early in menopause remains controversial. 2-10 Determining the effects of hormone therapy during the early postmenopausal years on the risk of dementia would require decades of follow-up. However, noninvasive imaging markers related to cognitive health have been suggested as short-term surrogate outcomes to assess the effects of menopausal hormone therapy on the brain. Thus, age-associated changes in From the Departments of Radiology (K.
Introduction: The potential of intra-individual cognitive variability (IICV) to predict incident ... more Introduction: The potential of intra-individual cognitive variability (IICV) to predict incident mild cognitive impairment (MCI) or Alzheimer's disease (AD) was examined and compared to wellestablished neuroimaging and genetic predictors. Methods: IICV was estimated using four neuropsychological measures for n 5 1324 Alzheimer's Disease Neuroimaging Initiative (ADNI) participants who were cognitively healthy or diagnosed with MCI at baseline. IICV was used to predict time to incident MCI or AD, and compared to hippocampal volume loss and APOE ε4 status via survival analysis. Results: In survival analyses, controlling for age, education, baseline diagonosis, and APOE ε4 status, likelihood ratio tests indicate that IICV is associated with time to cognitive status change in the full sample (P , .0001), and when the sample was restricted to individuals with MCI at baseline (P , .0001). Discussion: These findings suggest IICV may be a low-cost, noninvasive alternative to traditional AD biomarkers.
... Carey E. Gleason, Western State Hospital. ... eg, Burgio & Bourgeois, 1992; Burgio, Scill... more ... Carey E. Gleason, Western State Hospital. ... eg, Burgio & Bourgeois, 1992; Burgio, Scilley, Hoar, Washington, & Tunstall, 1993; Cariaga, Burgio, Flynn, & Martin, 1991; Jones, 1996; Sloane, 1997; Sloane, Lindeman, Phillips, Moritz, & Kock, 1995; Teri, 1990; White, Kaas, & Rhine ...
Journal of Alzheimer's disease : JAD, Apr 12, 2016
Type 2 diabetes is associated with an increased risk for Alzheimer's disease (AD). Regulation... more Type 2 diabetes is associated with an increased risk for Alzheimer's disease (AD). Regulation of normal insulin function may be important in reducing the prevalence of dementia due to AD, particularly in individuals who harbor genetic risk for, or have a parental family history of, AD. The relationship between insulin resistance (IR) and AD pathology remains poorly understood, particularly in midlife prior to the onset of clinical metabolic disease or cognitive decline. We examined associations between IR as indexed by HOMA-IR, cerebrospinal fluid (CSF) biomarkers of AD pathology, and memory in middle-aged adults enriched for AD. We postulated that higher HOMA-IR and APOEɛ4 carriage would be associated with greater CSF AD pathology and poor memory performance. Cognitively asymptomatic middle-aged adults (N = 70, mean age = 57.7 years) from the Wisconsin Alzheimer's Disease Research Center with a parental family history of dementia due to AD underwent lumbar puncture, blood d...
$333 severe AD). Methods: A multi-step review that included identification of databases, abstract... more $333 severe AD). Methods: A multi-step review that included identification of databases, abstraction of individual articles and the creation of evidence tables was conducted. Articles were sought that described costs by severity of AD (based primarily on changes in cognition). Results: Literature Review-Six articles of an initial 702 were identified for full text review. These studies differed considerably in terms of country where the study was conducted, types of patients included (AD only or AD and non-AD patients, non-institutionalized only), study design (cross sectional or cohort), type of test used to categorize patients by AD severity (MMSE or CDR) and adjustment for important covariates.
It remains controversial whether hormone therapy in recently postmenopausal women modifies the ri... more It remains controversial whether hormone therapy in recently postmenopausal women modifies the risk of Alzheimer's disease (AD). To investigate the effects of hormone therapy on amyloid-β deposition in recently postmenopausal women. Participants within 5-36 months past menopause in the Kronos Early Estrogen Prevention Study, a randomized, double blinded placebo-controlled clinical trial, were randomized to: 1) 0.45 mg/day oral conjugated equine estrogens (CEE); 2) 50μg/day transdermal 17β-estradiol; or 3) placebo pills and patch for four years. Oral progesterone (200 mg/day) was given to active treatment groups for 12 days each month. 11C Pittsburgh compound B (PiB) PET imaging was performed in 68 of the 118 participants at Mayo Clinic approximately seven years post randomization and three years after stopping randomized treatment. PiB Standard unit value ratio (SUVR) was calculated. Women (age = 52-65) randomized to transdermal 17β-estradiol (n = 21) had lower PiB SUVR compared...
Uploads
Papers by Carey Gleason