Browsing by Author "Rossetti, Heidi Christine"
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Item Subclinical Atherosclerosis and Cognitive Functioning in a Population-Based Sample(2010-11-02) Rossetti, Heidi Christine; Lacritz, Laura H.Clinical risk factors for and signs of atherosclerosis have been linked to Alzheimer disease and milder forms of cognitive impairment. This study examines the relationship between subclinical atherosclerosis and cognition in a sample from the Dallas Heart Study (DHS), a population-based study of cardiovascular disease, who were followed 8 years later (DHS-II); N = 1904, mean age = 42.9, SD = 10.5, range 8-65. Weanalyzed atherosclerosis data from DHS-I participants who had completed the Montreal Cognitive Assessment (MoCA) in DHS-II. The relationship between MoCA scores, coronary artery calcium (CAC), abdominal aortic plaque, and abdominal aortic wall thickness (AWT) was examined in the group as a whole, and in relation to age and ApoE4 allele status. Indirect measures of atherosclerosis (diabetes, hypertension, hypercholesterolemia, abdominal obesity) were also examined. Logistic regression was used to examine the association between direct and indirect measures of subclinical atherosclerosis and cognitive function, adjusting for other correlates of cognition. CAC (N = 1414, rho = -.06), abdominal AWT (N = 1284, rho = -.04), and abdominal aortic plaque (N = 1286, rho = -.06) did not correlate with MoCA Total Score (p ≥.048). Though MoCA scores were successively lower with increasing numbers of both direct atherosclerotic indicators [F(2, 633) = 1.40)] and indirect atherosclerotic indicators [F(2, 1048) = 1.09], the differences were not significant (p ≥ .248).The factors that most related to lower MoCA performance were race, gender, and education. There was no difference in MoCA Total Scores or measures of atherosclerosis between participants with an E4 allele and those without the E4 allele. There was no significant relationship between positive CAC, elevated abdominal AWT, and abdominal aortic plaque to MoCA scores obtained 7-8 years later. This relationship did not significantly increase with age and was not influenced by the presence of one or more apolipoprotein E4 alleles. This study does not support an association between direct or indirect measures of atherosclerosis in middle age and global cognition assessed 8 years later in this ethnically diverse population-based sample.Item Utility of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychological Battery Total Score in the Progression of Alzheimer's Disease(2007-08-08) Rossetti, Heidi Christine; Lacritz, Laura H.The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) created a neuropsychological battery that is both brief and sensitive to dementia (Morris et al., 1989). Chandler et al. (2005) put forth a method of calculating a Total Score for the CERAD along with normative data. The objective of this study was to determine the utility of the Total Score as a measure of progression of Alzheimer's disease (AD). Subjects included CERAD registry normal controls (NC; N = 383) and AD subjects (N = 655) with a baseline assessment and at least one follow-up assessment. Change Scores were calculated along with Reliable Change Indexes (RCI). The AD sample declined an average of -7.2 points per year, compared to a 1.0 point annual increase obtained by the NC sample. By the third annual assessment, the majority of AD subjects (65.2%) exceeded the confidence interval established by the RCI. Annualized CERAD Change Scores significantly correlated with change scores on the MMSE (r = .66), CDR Sum of Boxes (r = -.42), and BDRS (r = -.38). The impact of race, gender, education, and age-at-baseline on AD progression was examined with analysis of covariance and multiple regression. Demographic variables accounted for only 4% of the variance in annualized change in CERAD performance, with greater annualized decline in Total Score observed in Caucasians (M = -7.64, SD = 6.82) versus African- Americans (M = -4.60, SD = 7.03); males (M = -8.22, SD = 6.70) versus females (M = 6-.44, SD = 7.04); and younger age-at-baseline (M = -8.72, SD = 6.44) versus older age-at-baseline (M = -6.85, SD = 7.01). Neither education nor dementia severity significantly impacted annualized Change Scores. The current study provides support for the validity of the CERAD Total Score as a measure of progression in AD.