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Articles by Kathleen S. Hall
Total Records ( 3 ) for Kathleen S. Hall
  Kathleen S. Hall , Sujuan Gao , Olusegun Baiyewu , Kathleen A. Lane , Oye Gureje , Jianzhao Shen , Adesola Ogunniyi , Jill R. Murrell , Frederick W. Unverzagt , Jeanne Dickens , Valerie Smith- Gamble and Hugh C. Hendrie
  Background This study compares age-specific and overall prevalence rates for dementia and Alzheimer's disease (AD) in two nonoverlapping, population-based cohorts of elderly African Americans in Indianapolis in 2001 and 1992. Methods We used a two-stage design. The first stage involves the Community Screening Interview for Dementia (CSI-D). The CSI-D scores are grouped into good, intermediate, and poor performance before selection for clinical assessment. Diagnoses were performed using standard criteria in a consensus diagnosis conference; clinicians were blind to performance groups. In 1992, interviewers visited randomly sampled addresses to enroll self-identified African Americans aged ≥65 years. Of 2582 eligible, 2212 enrolled (9.6% refused, and 4.7% were too sick). In 2001, Medicare rolls were used for African Americans aged >70 years. Of 4260 eligible, 1892 (44%) enrolled, 1999 (47%) refused, and the remainder did not participate for other reasons. Results The overall age-adjusted prevalence rate for dementia at age ≥70 years in 2001 was 7.45% (95 confidence interval [CI], 4.27–10.64), and in the 1992 cohort, this prevalence rate was 6.75% (95% CI, 5.77–7.74). The overall age-adjusted prevalence rate at age ≥70 years for AD in the 2001 cohort was 6.77% (95% CI, 3.65–9.90), and for the 1992 cohort, it was 5.47% (95% CI, 4.51–6.42). Rates for dementia and AD were not significantly different in the two cohorts (dementia, P = .3534; AD, P = .2649). Conclusions We found no differences in the prevalence rates of dementia and AD between 1992 and 2001, despite significant differences in medical history and medical treatment within these population-based cohorts of African American elderly.
  Walter A. Rocca , Ronald C. Petersen , David S. Knopman , Liesi E. Hebert , Denis A. Evans , Kathleen S. Hall , Sujuan Gao , Frederick W. Unverzagt , Kenneth M. Langa , Eric B. Larson and Lon R. White
  Declines in heart disease and stroke mortality rates are conventionally attributed to reductions in cigarette smoking, recognition and treatment of hypertension and diabetes, effective medications to improve serum lipid levels and to reduce clot formation, and general lifestyle improvements. Recent evidence implicates these and other cerebrovascular factors in the development of a substantial proportion of dementia cases. Analyses were undertaken to determine whether corresponding declines in age-specific prevalence and incidence rates for dementia and cognitive impairment have occurred in recent years. Data spanning 1 or 2 decades were examined from community-based epidemiological studies in Minnesota, Illinois, and Indiana, and from the Health and Retirement Study, which is a national survey. Although some decline was observed in the Minnesota cohort, no statistically significant trends were apparent in the community studies. A significant reduction in cognitive impairment measured by neuropsychological testing was identified in the national survey. Cautious optimism appears justified.
  Alette M. Wessels , Kathleen A. Lane , Sujuan Gao , Kathleen S. Hall , Frederick W. Unverzagt and Hugh C. Hendrie
  Background Diabetes mellitus is associated with an increased risk for cognitive impairment and vascular factors seem to play a role in this relationship. In a sample involving elderly African Americans, we tested the hypothesis that diabetes accelerates cognitive decline and explored possible mediating mechanisms within a follow-up period of 15 years. Methods A total of 1702 subjects, of whom 441 had diabetes, were given the community screening interview for dementia to measure cognitive functioning at six different time points spread over a 15-year follow-up period. Mixed effects models with repeated measures were used to examine the association of diabetes and vascular risk factors with cognitive scores over time. Results African American subjects with diabetes reported having a significant accelerated cognitive decline as compared with those without diabetes (P = .046), when controlling for basic demographics and baseline comorbid conditions (heart disease, hypertension, stroke, and depression). Adjusting for incident heart disease, and especially stroke, weakened this association (P = .098), thereby indicating a mediating effect of stroke on the association between diabetes and cognitive decline. However, when incident stroke was incorporated into the model, the effect for participants with diabetes increased greatly (P = .007). Conclusions Diabetes, mediated by cerebrovascular pathology, accelerates cognitive decline within a follow-up period of 15 years in a sample comprising African Americans.
 
 
 
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