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Articles
by
Kristine Yaffe |
Total Records (
4 ) for
Kristine Yaffe |
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Kala M. Mehta
,
Anita L. Stewart
,
Kenneth M. Langa
,
Kristine Yaffe
,
Sandra Moody- Ayers
,
Brie A. Williams
and
Kenneth E. Covinsky
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Background
A low level of formal education is becoming accepted as a risk factor for Alzheimer's disease (AD). Although increasing attention has been paid to differences in educational quality, no previous studies addressed participants' own characterizations of their overall performance in school. We examined whether self-assessed school performance is associated with AD beyond the effects of educational level alone.
Methods
Participants were drawn from the population-representative Aging, Demographics, and Memory Study (ADAMS, 2000-2002). The ADAMS participants were asked about their performance in school. Possible response options included above average average, or below average. The ADAMS participants also underwent a full neuropsychological battery, and received a research diagnosis of possible or probable AD.
Results
The 725 participants (mean age, 81.8 years; 59% female; 16% African-American) varied in self-assessed educational performance: 29% reported above average, 64% reported average, and 7% reported below average school performance. Participants with a lower self-assessed school performance had higher proportions of AD: 11% of participants with above average self-assessed performance had AD, as opposed to 12% of participants with average performance and 26% of participants with below average performance (P < 0.001). After controlling for subjects' years in school, a literacy test score (Wide-Range Achievement Test), age, sex, race/ethnicity, apolipoprotein E-ɛ4 status, socioeconomic status, and self-reported comorbidities, respondents with below average self-assessed school performance were four times more likely to have AD compared with those of average performance (odds ratio, 4.0; 95% confidence interval, 1.214). Above average and average self-assessed school performance did not increase or decrease the odds of having AD (odds ratio, 0.9; 95% confidence interval, 0.51.7).
Conclusions
We suggest an association between below average self-assessed school performance and AD beyond the known association with formal education. Efforts to increase cognitive reserve through better school performance, in addition to increasing the number of years of formal education in early life, may be important in reducing vulnerability throughout the life course. |
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Richard Mayeux
,
Christiane Reitz
,
Adam M. Brickman
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Mary N. Haan
,
Jennifer J. Manly
,
M. Maria Glymour
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Christopher C. Weiss
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Kristine Yaffe
,
Laura Middleton
,
Hugh C. Hendrie
,
Lauren H. Warren
,
Kathleen M. Hayden
,
Kathleen A. Welsh- Bohmer
,
John C.S. Breitner
and
John C. Morris
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In this article, the challenges faced by several noted population studies for Alzheimer dementia in operationalizing current clinical diagnostic criteria for Alzheimers disease (AD) have been reviewed. Differences in case ascertainment, methodological biases, cultural and educational influences on test performance, inclusion of special populations such as underrepresented minorities and the oldest old, and detection of the earliest symptomatic stages of underlying AD have been considered. Classification of Alzheimer dementia may be improved by the incorporation of biomarkers for AD if the sensitivity, specificity, and predictive value of the biomarkers are established and if they are appropriate for epidemiological studies, as may occur should a plasma biomarker be developed. Biomarkers for AD could also facilitate studies of the interactions of various forms of neurodegenerative disorders with cerebrovascular disease, resulting in mixed dementia. |
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Andrea Weston
,
Cynthia Barton
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Julia Lesselyong
and
Kristine Yaffe
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Background
Diagnostic criteria for mild cognitive impairment (MCI) include no significant functional decline, but recent studies have suggested that subtle deficits often exist. It is not known whether these differ by MCI type. We investigated the level and type of functional impairment among patients with MCI.
Methods
We studied 498 patients, evaluated at the Alzheimers Disease Research Centers of California between 2006 and 2009, who had multidisciplinary evaluations by experts, including neurologic examination and neuropsychological testing. Patients were diagnosed with MCI and subtype was determined using cognitive domain scores. In a cross-sectional descriptive study, we examined whether functional impairment differed by MCI subtype, using the Blessed Roth Dementia Rating Scale (range: 017, higher scores indicating more impairment).
Results
Among the participants, the mean age was 75.4 years, 50.7% were women, and 81.7% were white. Patients with amnestic- (n = 392, 78.7%) and nonamnestic-type (n = 106, 21.3%) MCI had similar total Blessed Roth Dementia Rating Scale (1.6 and 1.5, respectively; P = .84) and Mini-Mental State Examination (26.5 and 26.7, respectively; P = .60) scores. Patients with amnestic MCI were more likely to have difficulty in remembering lists and recalling recent events (P < .05 for both) and less likely to have difficulty in eating and with continence (P = .01 for both), as compared with those with nonamnestic MCI.
Conclusions
Despite the MCI diagnostic criteria suggesting no functional impairment, our results indicate that patients with MCI experience mild functional deficits that vary according to the type of MCI. |
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Kristine Yaffe
,
Michael Tocco
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Ronald C. Petersen
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Catherine Sigler
,
Leah C. Burns
,
Christel Cornelius
,
Ara S. Khachaturian
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Michael C. Irizarry
and
Maria C. Carrillo
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Epidemiological studies increasingly inform Alzheimers disease (AD) public health impact, prevention strategies, drug targets, therapeutic interventions, and clinical trial design. For this reason, the Alzheimers Association Research Roundtable convened an international group of AD experts with experience in conducting both observational and clinical trials for a meeting on October 19 and 20, 2010, in Washington, DC, to discuss the role of epidemiologic studies in AD research and therapeutic advances. Topics included wellness markers and risk factors, with a focus on special populations such as those at elevated risk, super agers, and underserved populations. Discussions also highlighted lessons learned from observational studies of aging, cardiovascular disease, and other disease areas, as well as how new technologies have enabled the gathering of data relevant to drug development and clinical trial conduct. |
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