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2. Tackling a Major Deficiency of Diversity in Alzheimer's Disease Therapeutic Trials: An CTAD Task Force Report

Author

Raman, Rema, Aisen, P, Carillo, MC, Detke, M, Grill, JD, Okonkwo, OC, Rivera-Mindt, M, Sabbagh, M, Vellas, B, Weiner, M, Sperling, R, and Force, CTAD Task

Subjects
Biological Psychology, Psychology, Health Disparities, Neurodegenerative, Clinical Trials and Supportive Activities, Minority Health, Dementia, Acquired Cognitive Impairment, Neurosciences, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Clinical Research, Alzheimer's Disease, Brain Disorders, Aging, 6.9 Resources and infrastructure (treatment evaluation), Neurological, Advisory Committees, Alzheimer Disease, Humans, Alzheimer's disease, clinical trials, participant diversity, generalizability, Alzheimer’s disease, Biological psychology, Cognitive and computational psychology
Abstract

As the last opportunity to assess treatment effect modification in a controlled setting prior to formal approval, clinical trials are a critical tool for understanding the safety and efficacy of new treatments in diverse populations. Recruitment of diverse participants in Alzheimer's Disease (AD) clinical trials are therefore essential to increase the generalizability of study results, with diversity broadly described to be representative and inclusive. This representation of study participants is equally critical in longitudinal cohort (observational) studies, which will be key to understanding disease disparities and are often used to design adequately powered AD clinical trials. New and innovative recruitment initiatives and enhanced infrastructure facilitate increased participant diversity in AD clinical studies.

Published
2022

3. Diagnosing Symptomatic HIV-Associated Neurocognitive Disorders: Self-Report Versus Performance-Based Assessment of Everyday Functioning

Author

Blackstone, K, Moore, DJ, Heaton, RK, Franklin, DR, Woods, SP, Clifford, DB, Collier, AC, Marra, CM, Gelman, BB, McArthur, JC, Morgello, S, Simpson, DM, Rivera-Mindt, M, Deutsch, R, Ellis, RJ, Atkinson, J Hampton, and Grant, I

Subjects
Allied Health and Rehabilitation Science, Biomedical and Clinical Sciences, Health Sciences, Psychology, Sexually Transmitted Infections, Mental Health, Infectious Diseases, Clinical Research, Acquired Cognitive Impairment, Behavioral and Social Science, HIV/AIDS, Neurodegenerative, Neurosciences, Brain Disorders, Activities of Daily Living, Adult, Aged, Cognition Disorders, Cohort Studies, Depression, Female, HIV Infections, HN Protein, Humans, Immunoenzyme Techniques, Lipopolysaccharide Receptors, Logistic Models, Male, Middle Aged, Motor Activity, Neuropsychological Tests, Psychiatric Status Rating Scales, Self Report, Sensitivity and Specificity, Statistics, Nonparametric, Young Adult, Cognition disorders, Activities of daily living, Infectious disease, Self assessments, Employment, CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Group, Medical and Health Sciences, Psychology and Cognitive Sciences, Experimental Psychology, Biomedical and clinical sciences, Health sciences
Abstract

Three types of HIV-associated neurocognitive disorders (HAND) exist that are distinguished by presence and severity of impairment in cognitive and everyday functioning. Although well-validated neurocognitive measures exist, determining impairment in everyday functioning remains a challenge. We aim to determine whether Self-Report measures of everyday functioning are as effective in characterizing HAND as Performance-Based measures. We assessed 674 HIV-infected participants with a comprehensive neurocognitive battery; 233 met criteria for a HAND diagnosis by having at least mild neurocognitive impairment. Functional decline was measured via Self-Report and Performance-Based measures. HAND diagnoses were determined according to published criteria using three approaches to assess functional decline: (1) Self-Report measures only, (2) Performance-Based measures only, and (3) Dual-method combining Self-Report and Performance-Based measures. The Dual-method classified the most symptomatic HAND, compared to either singular method. Singular method classifications were 76% concordant with each other. Participants classified as Performance-Based functionally impaired were more likely to be unemployed and more immunosuppressed, whereas those classified as Self-Report functionally impaired had more depressive symptoms. Multimodal methods of assessing everyday functioning facilitate detection of symptomatic HAND. Singular Performance-Based classifications were associated with objective functional and disease-related factors; reliance on Self-Report classifications may be biased by depressive symptoms.

Published
2012

4. HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: Differences in rates, nature, and predictors

Author

Heaton, RK, Franklin, DR, Ellis, RJ, McCutchan, JA, Letendre, SL, LeBlanc, S, Corkran, SH, Duarte, NA, Clifford, DB, Woods, SP, Collier, AC, Marra, CM, Morgello, S, Rivera Mindt, M, Taylor, MJ, Marcotte, TD, Atkinson, JH, Wolfson, T, Gelman, BB, McArthur, JC, Simpson, DM, Abramson, I, Gamst, A, Fennema-Notestine, C, Jernigan, TL, Wong, J, and Grant, I

Abstract

Combination antiretroviral therapy (CART) has greatly reduced medical morbidity and mortality with HIV infection, but high rates of HIV-associated neurocognitive disorders (HAND) continue to be reported. Because large HIV-infected (HIV+) and uninfected (HIV-) groups have not been studied with similar methods in the pre-CART and CART eras, it is unclear whether CART has changed the prevalence, nature, and clinical correlates of HAND. We used comparable methods of subject screening and assessments to classify neurocognitive impairment (NCI) in large groups of HIV + and HIV - participants from the pre-CART era (1988-1995; N=857) and CART era (2000-2007; N=937). Impairment rate increased with successive disease stages (CDC stages A, B, and C) in both eras: 25%, 42%, and 52% in pre-CART era and 36%, 40%, and 45% in CART era. In the medically asymptomatic stage (CDC-A), NCI was significantly more common in the. CART era. Low nadir CD4 predicted NCI in both eras, whereas degree of current immunosuppression, estimated duration of infection, and viral suppression in CSF (on treatment) were related to impairment only pre-CART. Pattern of NCI also differed: pre-CART had more impairment in motor skills, cognitive speed, and verbal fluency, whereas CART era involved more memory (learning) and executive function impairment. High rates of mild NCI persist at all stages of HIV infection, despite improved viral suppression and immune reconstitution with CART. The consistent association of NCI with nadir CD4 across eras suggests that earlier treatment to prevent severe immunosuppression may also help prevent HAND. Clinical trials targeting HAND prevention should specifically examine timing of ART initiation. © The Author(s) 2010.

Published
2011

5. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy

Author

Heaton, RK, Clifford, DB, Franklin, DR, Woods, SP, Ake, C, Vaida, F, Ellis, RJ, Letendre, SL, Marcotte, TD, Atkinson, JH, Rivera-Mindt, M, Vigil, OR, Taylor, MJ, Collier, AC, Marra, CM, Gelman, BB, McArthur, JC, Morgello, S, Simpson, DM, McCutchan, JA, Abramson, I, Gamst, A, Fennema-Notestine, C, Jernigan, TL, Wong, J, and Grant, I

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Neurodegenerative, Clinical Research, Behavioral and Social Science, Mental Health, Infectious Diseases, HIV/AIDS, Sexually Transmitted Infections, Brain Disorders, Neurosciences, Prevention, Acquired Cognitive Impairment, Aging, 6.1 Pharmaceuticals, Infection, Activities of Daily Living, Adult, Algorithms, Antiretroviral Therapy, Highly Active, Cognition Disorders, Cross-Over Studies, Disability Evaluation, Enzyme-Linked Immunosorbent Assay, Female, HIV Infections, Humans, Male, Middle Aged, Models, Statistical, Neurologic Examination, Neuropsychological Tests, Observation, Psychiatric Status Rating Scales, Retrospective Studies, CHARTER Group, Clinical Sciences, Cognitive Sciences, Neurology & Neurosurgery, Clinical sciences
Abstract

ObjectivesThis is a cross-sectional, observational study to determine the frequency and associated features of HIV-associated neurocognitive disorders (HAND) in a large, diverse sample of infected individuals in the era of combination antiretroviral therapy (CART).MethodsA total of 1,555 HIV-infected adults were recruited from 6 university clinics across the United States, with minimal exclusions. We used standardized neuromedical, psychiatric, and neuropsychological (NP) examinations, and recently published criteria for diagnosing HAND and classifying 3 levels of comorbidity (minimal to severe non-HIV risks for NP impairment).ResultsFifty-two percent of the total sample had NP impairment, with higher rates in groups with greater comorbidity burden (40%, 59%, and 83%). Prevalence estimates for specific HAND diagnoses (excluding severely confounded cases) were 33% for asymptomatic neurocognitive impairment, 12% for mild neurocognitive disorder, and only 2% for HIV-associated dementia (HAD). Among participants with minimal comorbidities (n = 843), history of low nadir CD4 was a strong predictor of impairment, and the lowest impairment rate on CART occurred in the subset with suppressed plasma viral loads and nadir CD4 ≥200 cells/mm(3) (30% vs 47% in remaining subgroups).ConclusionsThe most severe HAND diagnosis (HAD) was rare, but milder forms of impairment remained common, even among those receiving CART who had minimal comorbidities. Future studies should clarify whether early disease events (e.g., profound CD4 decline) may trigger chronic CNS changes, and whether early CART prevents or reverses these changes.

Published
2010

6. Understanding Online Registry Facilitators and Barriers Experienced by Black Brain Health Registry Participants: The Community Engaged Digital Alzheimers Research (CEDAR) Study.

Author

Ashford, M, Ashford, M, Zhu, D, Bride, J, McLean, E, Aaronson, A, Conti, C, Cypress, C, Griffin, P, Ross, R, Duncan, T, Deng, X, Ulbricht, A, Fockler, J, Camacho, M, Flenniken, D, Truran, D, Mackin, S, Hill, C, Byrd, D, Turner Ii, R, Cham, H, Rivera Mindt, M, Nosheny, R, Weiner, Michael, Ashford, M, Ashford, M, Zhu, D, Bride, J, McLean, E, Aaronson, A, Conti, C, Cypress, C, Griffin, P, Ross, R, Duncan, T, Deng, X, Ulbricht, A, Fockler, J, Camacho, M, Flenniken, D, Truran, D, Mackin, S, Hill, C, Byrd, D, Turner Ii, R, Cham, H, Rivera Mindt, M, Nosheny, R, and Weiner, Michael

Abstract

BACKGROUND: Failure of Alzheimers disease and related diseases (ADRD) research studies to include and engage Black participants is a major issue, which limits the impact and generalizability of research findings. Little is known about participation of Black adults in online ADRD-related research registries. OBJECTIVES: As part of the Community Engaged Digital Alzheimers Research (CEDAR) Study, this study aims to increase our understanding of facilitators and barriers of Black adults to participating in ADRD-related online registries, as well as to understand their preferences for communication channels. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: We invited all Black participants enrolled in the Brain Health Registry (BHR) to complete a cross-sectional online survey. The survey consisted of rating scales and open-text questions asking about their attitudes towards brain health research, reasons for joining and continuing to participate in BHR, difficulties with participating, and preferences for modes of contact and website usage. RESULTS: Of all invited Black BHR participants (N=3,636), 198 (5.5%) completed the survey. The mean age was 58.4 (SD=11.3), mean years of education were 16.3 (SD=2.4), and 85.5% identified as female. Reported facilitators for joining and continuing to participate in BHR were personal interest (e.g., learning more about own brain health) and altruism (e.g., helping research). Among additional registry features which could encourage return, receiving feedback or scores about BHR tasks was rated the highest. Of those who found BHR participation difficult (21%), the most frequent reason was time burden. The most preferred way of receiving study information was via email. Participants reported that the websites that they used the most were YouTube and Facebook. DISCUSSION: The results of our study can inform the development of culturally-responsive registry features and engagement efforts to improve inclusion and participation of Black adults

Published
2023

7. Understanding Online Registry Facilitators and Barriers Experienced by Black Brain Health Registry Participants: The Community Engaged Digital Alzheimer’s Research (CEDAR) Study

Author

Ashford, M.T., primary, Zhu, D., additional, Bride, J., additional, McLean, E., additional, Aaronson, A., additional, Conti, C., additional, Cypress, C., additional, Griffin, P., additional, Ross, R., additional, Duncan, T., additional, Deng, X., additional, Ulbricht, A., additional, Fockler, J., additional, Camacho, M.R., additional, Flenniken, D., additional, Truran, D., additional, Mackin, S.R., additional, Hill, C., additional, Weiner, M.W., additional, Byrd, D., additional, Turner II, R.W., additional, Cham, H., additional, Rivera Mindt, M., additional, and Nosheny, R.L., additional

Published
2023
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8. Tackling a Major Deficiency of Diversity in Alzheimer's Disease Therapeutic Trials: An CTAD Task Force Report.

Author

Raman, R, Raman, R, Aisen, PS, Carillo, MC, Detke, M, Grill, JD, Okonkwo, OC, Rivera-Mindt, M, Sabbagh, M, Vellas, B, Weiner, M, Sperling, R, Raman, R, Raman, R, Aisen, PS, Carillo, MC, Detke, M, Grill, JD, Okonkwo, OC, Rivera-Mindt, M, Sabbagh, M, Vellas, B, Weiner, M, and Sperling, R

Abstract

As the last opportunity to assess treatment effect modification in a controlled setting prior to formal approval, clinical trials are a critical tool for understanding the safety and efficacy of new treatments in diverse populations. Recruitment of diverse participants in Alzheimer's Disease (AD) clinical trials are therefore essential to increase the generalizability of study results, with diversity broadly described to be representative and inclusive. This representation of study participants is equally critical in longitudinal cohort (observational) studies, which will be key to understanding disease disparities and are often used to design adequately powered AD clinical trials. New and innovative recruitment initiatives and enhanced infrastructure facilitate increased participant diversity in AD clinical studies.

Published
2022

9. How Will Aducanumab Approval Impact AD Research?

Author

Weiner, M.W., primary, Aisen, P.S., additional, Beckett, L.A., additional, Green, R.C., additional, Jagust, W., additional, Morris, J.C., additional, Okonkwo, O., additional, Perrin, R.J., additional, Petersen, R.C., additional, Rivera Mindt, M., additional, Saykin, A.J., additional, Shaw, L.M., additional, Toga, A.W., additional, and Trojanowski, J.Q., additional

Published
2021
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11. A-078 Examining the Neuropsychological Effects of Opioid Use in the Aging Population of People Living with HIV

Author

Breen E, Summers A, Byrd D, Fidaleo K, Slaughter A, Savin M, Crook C, and Rivera Mindt M

Subjects
Population ageing, business.industry, Patient interview, Opioid use, Human immunodeficiency virus (HIV), Neuropsychology, General Medicine, medicine.disease_cause, medicine.disease, Comorbidity, Psychiatry and Mental health, Clinical Psychology, Neuropsychology and Physiological Psychology, medicine, Verbal fluency test, Opioid analgesics, business, Clinical psychology
Abstract

Objective People living with HIV (PLWH) exhibit accelerated and premature cognitive aging in comparison to age-matched, seronegative controls. Although opioid use is elevated among PLWH, literature regarding the neurocognitive effects of opioid use across the lifespan of PLWH is limited. This cross-sectional study examines the neurocognitive effects of opioid use across the mid-older adult lifespan of PLWH. Methods One-hundred fifty-two PLWH (72% Latinx; 71% Male; Mdn(IQR) Age = 47(43, 51) years; M Education = 133 years) completed comprehensive neurocognitive, neuromedical, quality of education (Wide Range Achievement Test- 4 [WRAT-4]), psychiatric/substance-use (Composite International Diagnostic Interview [CIDI]), and urine toxicology assessments. Opioid users were defined by DSM diagnostics for lifetime opioid use disorder. A series of LSR tested the interactive effects of age and opioid use across seven neurocognitive domains. Results After controlling for covariates (e.g., CD4 cell count; WRAT-4; comorbid substance use), a least-squares regression demonstrated significant interactive effects between age and opioid use upon verbal fluency, such that older opioid users exhibited greater verbal fluency scores (F [11] = 4.28, p Discussion The moderate observed effect sizes indicate a positive relationship between older age and lifetime opioid use upon verbal fluency among PLWH. These findings may be representative of a selective survival bias among opioid users within this population. Nonetheless, verbal fluency could serve as a marker of greater survivability among PLWH with opioid use histories. Future directions should examine this interaction longitudinally and evaluate differences in the severity/duration of opioid use.

Published
2020
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12. A-077 Relationship Between Mental Health and Physical Health and Neurocognitive Function among Latinx People Living With HIV

Author

Aghvinian M, Byrd D, Summers A, Stiver J, Rivera Mindt M, Savin M, Fidaleo K, Slaughter A, and Breen E

Subjects
media_common.quotation_subject, Human immunodeficiency virus (HIV), Physical health, Cognition, General Medicine, medicine.disease_cause, medicine.disease, Mental health, Psychiatry and Mental health, Clinical Psychology, Neuropsychology and Physiological Psychology, medicine, Somatization disorder, Self report, Psychology, Function (engineering), Neurocognitive, Clinical psychology, media_common
Abstract

Objective The relationship between self-reported mental health (MH), physical health (PH), and neurocognition (NC) is vastly understudied among Latinx people living with HIV (PLWH). Evidence of increased somatization in this group suggests that self-reported MH and PH may contextualize cognitive outcomes among Latinx PLWH. Thus, this study examines the relationship between self-reported MH/PH and NC in a sample of Latinx PLWH. Method This study included 76 Latinx PLWH (33% female; M age = 46.0, SD = 7.08) who completed the Medical Outcomes Study HIV Health Survey (MOS-HIV) and a comprehensive neurocognitive battery. MH and PH were defined by the MOS-HIV, where higher MH and PH summary scores indicate better perceived health. Demographically-corrected T-scores were used to compute average global NC and domain scores. Results Within Latinx PLWH, partial correlations controlling for age and education found PH was associated with better processing speed (r = .28, p = .03), and MH was related to better global NC, fluency, learning, and processing speed (ps Conclusions Findings indicate that MH and PH correlated with global and domain-specific NC within Latinx PLWH. Better self-reported MH may improve attention/working memory and global NC in Latinx PLWH. Somatization is important when considering MH/PH and cognition within Latinx PLWH; physicians should consider the impact of patients’ self-reported MH/PH on NC in Latinx PLWH.

Published
2020
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14. Does Literacy Moderate the Relationship between Age of Migration and Cognitive Change: Results from the Washington Heights-Inwood Community Aging Project (WHICAP)

Author

Carrión, C I, primary, Arias, F, additional, Diaz-Santos, M, additional, Levy, S-A, additional, Hill-Jarrett, T G, additional, Avila, J, additional, Jones, R, additional, Rivera Mindt, M, additional, Arce, M, additional, Schupf, N, additional, Mayeux, R, additional, and Manly, J, additional

Published
2019
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26. Normative Data for Wisconsin Card Sorting Test-64 Item in a Spanish Speaking Adult Population Living in the US/Mexico Border Region

Author

Yassai-Gonzalez, D, primary, Marquine, M J, additional, Perez-Tejada, A, additional, Umlauf, A, additional, Kamalyan, L, additional, Morlett Paredes, A, additional, Suarez, P, additional, Rivera Mindt, M, additional, Artiola i Fortuny, L, additional, Franklin, D R, additional, Cherner, M, additional, and Heaton, R K, additional

Published
2019
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31. Comparing three methods of computerised cognitive training for older adults with subclinical cognitive decline

Author

Kirwin Pd, Rivera Mindt M, Joanna M. Fiszdon, Devanand D, Wilkins K, van Dyck Ch, Bell, Gooding Al, and Choi J

Subjects
Male, Neuropsychological Tests, Verbal learning, Treatment and control groups, 03 medical and health sciences, 0302 clinical medicine, Arts and Humanities (miscellaneous), Memory, Humans, Cognitive Dysfunction, 030212 general & internal medicine, Cognitive rehabilitation therapy, Cognitive decline, Applied Psychology, Aged, Aged, 80 and over, Rehabilitation, Neurological Rehabilitation, Neuropsychology, Cognition, Verbal Learning, Cognitive training, Neuropsychology and Physiological Psychology, Therapy, Computer-Assisted, Female, Verbal memory, Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Cognitive rehabilitation for mild cognitive impairment (MCI) and early Alzheimer's disease is readily available to the geriatric population. Initial evidence suggests that techniques incorporating motivational strategies to enhance treatment engagement may provide more benefit than computerised training alone. Seventy four adults with subclinical cognitive decline were randomly assigned to computerised cognitive training (CCT), Cognitive Vitality Training (CVT), or an Active Control Group (ACG), and underwent neuropsychological evaluations at baseline and four-month follow-up. Significant differences were found in changes in performance on the Modified Mini Mental State Examination (mMMSE) and measures of verbal learning and memory across treatment groups. Experimental groups showed greater preservation of functioning on the mMMSE than the ACG group, the CVT group performed better than the ACG group on one measure of verbal learning and both measures of verbal memory, and the CCT group performed better than the ACG group on one measure of verbal learning and one measure of verbal memory. There were no significant group differences between the CVT and CCT groups on measures of verbal learning or memory. It was concluded that computerised cognitive training may offer the most benefit when incorporated into a therapeutic milieu rather than administered alone, although both appear superior to more generic forms of cognitive stimulation.

Published
2015
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33. Grand Rounds

Author

Fayolle, G., primary, Levick, W., additional, Lajiness-O'Neill, R., additional, Fastenau, P., additional, Briskin, S., additional, Bass, N., additional, Silva, M., additional, Critchfield, E., additional, Nakase-Richardson, R., additional, Hertza, J., additional, Loughan, A., additional, Perna, R., additional, Northington, S., additional, Boyd, S., additional, Anderson, A., additional, Peery, S., additional, Chafetz, M., additional, Maris, M., additional, Ramezani, A., additional, Sylvester, C., additional, Goldberg, K., additional, Constantinou, M., additional, Karekla, M., additional, Hall, J., additional, Edwards, M., additional, Balldin, V., additional, Strutt, A., additional, Pavlik, V., additional, Marquez de la Plata, C., additional, Cullum, M., additional, lacritz, l., additional, Reisch, J., additional, Massman, P., additional, Royall, D., additional, Barber, R., additional, Younes, S., additional, Wiechmann, A., additional, O'Bryant, S., additional, Patel, K., additional, Suhr, J., additional, Chari, S., additional, Yokoyama, J., additional, Bettcher, B., additional, Karydas, A., additional, Miller, B., additional, Kramer, J., additional, Zec, R., additional, Fritz, S., additional, Kohlrus, S., additional, Robbs, R., additional, Ala, T., additional, Gifford, K., additional, Cantwell, N., additional, Romano, R., additional, Jefferson, A., additional, Holland, A., additional, Newton, S., additional, Bunting, J., additional, Coe, M., additional, Carmona, J., additional, Harrison, D., additional, Puente, A., additional, Terry, D., additional, Faraco, C., additional, Brown, C., additional, Patel, A., additional, Watts, A., additional, Kent, A., additional, Siegel, J., additional, Miller, S., additional, Ernst, W., additional, Chelune, G., additional, Holdnack, J., additional, Sheehan, J., additional, Duff, K., additional, Pedraza, O., additional, Crawford, J., additional, Miller, L., additional, Hobson Balldin, V., additional, Benavides, H., additional, Johnson, L., additional, Tshuma, L., additional, Dezhkam, N., additional, Hayes, L., additional, Love, C., additional, Stephens, B., additional, Webbe, F., additional, Mulligan, K., additional, Dunham, K., additional, Shadi, S., additional, Sofko, C., additional, Denney, R., additional, Rolin, S., additional, Sibson, J., additional, Ogbeide, S., additional, Glover, M., additional, Warchol, A., additional, Hunter, B., additional, Nichols, C., additional, Riccio, C., additional, Cohen, M., additional, Dennison, A., additional, Wasserman, T., additional, Schleicher-Dilks, S., additional, Adler, M., additional, Golden, C., additional, Olivier, T., additional, LeMonda, B., additional, McGinley, J., additional, Pritchett, A., additional, Chang, L., additional, Cloak, C., additional, Cunningham, E., additional, Lohaugen, G., additional, Skranes, J., additional, Ernst, T., additional, Parke, E., additional, Thaler, N., additional, Etcoff, L., additional, Allen, D., additional, Andrews, P., additional, McGregor, S., additional, Daniels, R., additional, Hochsztein, N., additional, Miles-Mason, E., additional, Granader, Y., additional, Vasserman, M., additional, MacAllister, W., additional, Casto, B., additional, Patrick, K., additional, Hurewitz, F., additional, Chute, D., additional, Booth, A., additional, Koch, C., additional, Roid, G., additional, Balkema, N., additional, Kiefel, J., additional, Bell, L., additional, Maerlender, A., additional, Belkin, T., additional, Katzenstein, J., additional, Semerjian, C., additional, Culotta, V., additional, Band, E., additional, Yosick, R., additional, Burns, T., additional, Arenivas, A., additional, Bearden, D., additional, Olson, K., additional, Jacobson, K., additional, Ubogy, S., additional, Sterling, C., additional, Taub, E., additional, Griffin, A., additional, Rickards, T., additional, Uswatte, G., additional, Davis, D., additional, Sweeney, K., additional, Llorente, A., additional, Boettcher, A., additional, Hill, B., additional, Ploetz, D., additional, Kline, J., additional, Rohling, M., additional, O'Jile, J., additional, Holler, K., additional, Petrauskas, V., additional, Long, J., additional, Casey, J., additional, Duda, T., additional, Hodsman, S., additional, Stricker, S., additional, Martner, S., additional, Hansen, R., additional, Ferraro, F., additional, Tangen, R., additional, Hanratty, A., additional, Tanabe, M., additional, O'Callaghan, E., additional, Houskamp, B., additional, McDonald, L., additional, Pick, L., additional, Guardino, D., additional, Pietz, T., additional, Kayser, K., additional, Gray, R., additional, Letteri, A., additional, Crisologo, A., additional, Witkin, G., additional, Sanders, J., additional, Mrazik, M., additional, Harley, A., additional, Phoong, M., additional, Melville, T., additional, La, D., additional, Gomez, R., additional, Berthelson, L., additional, Robbins, J., additional, Lane, E., additional, Rahman, P., additional, Konopka, L., additional, Fasfous, A., additional, Zink, D., additional, Peralta-Ramirez, N., additional, Perez-Garcia, M., additional, Su, S., additional, Lin, G., additional, Kiely, T., additional, Schatzberg, A., additional, Keller, J., additional, Dykstra, J., additional, Feigon, M., additional, Renteria, L., additional, Fong, M., additional, Piper, L., additional, Lee, E., additional, Vordenberg, J., additional, Contardo, C., additional, Magnuson, S., additional, Doninger, N., additional, Luton, L., additional, Drane, D., additional, Phelan, A., additional, Stricker, W., additional, Poreh, A., additional, Wolkenberg, F., additional, Spira, J., additional, DeRight, J., additional, Jorgensen, R., additional, Fitzpatrick, L., additional, Crowe, S., additional, Woods, S., additional, Doyle, K., additional, Weber, E., additional, Cameron, M., additional, Cattie, J., additional, Cushman, C., additional, Grant, I., additional, Blackstone, K., additional, Moore, D., additional, Roberg, B., additional, Somogie, M., additional, Thelen, J., additional, Lovelace, C., additional, Bruce, J., additional, Gerstenecker, A., additional, Mast, B., additional, Litvan, I., additional, Hargrave, D., additional, Schroeder, R., additional, Buddin, W., additional, Baade, L., additional, Heinrichs, R., additional, Boseck, J., additional, Berry, K., additional, Koehn, E., additional, Davis, A., additional, Meyer, B., additional, Gelder, B., additional, Sussman, Z., additional, Espe-Pfeifer, P., additional, Musso, M., additional, Barker, A., additional, Jones, G., additional, Gouvier, W., additional, Johnson, V., additional, Zaytsev, L., additional, Freier-Randall, M., additional, Sutton, G., additional, Ringdahl, E., additional, Olsen, J., additional, Byrd, D., additional, Rivera-Mindt, M., additional, Fellows, R., additional, Morgello, S., additional, Wheaton, V., additional, Jaehnert, S., additional, Ellis, C., additional, Olavarria, H., additional, Loftis, J., additional, Huckans, M., additional, Pimental, P., additional, Frawley, J., additional, Welch, M., additional, Jennette, K., additional, Rinehardt, E., additional, Schoenberg, M., additional, Strober, L., additional, Genova, H., additional, Wylie, G., additional, DeLuca, J., additional, Chiaravalloti, N., additional, Ibrahim, E., additional, Seiam, A., additional, Bohlega, S., additional, Lloyd, H., additional, Goldberg, M., additional, Marceaux, J., additional, Fallows, R., additional, McCoy, K., additional, Yehyawi, N., additional, Luther, E., additional, Hilsabeck, R., additional, Fulton, R., additional, Stevens, P., additional, Erickson, S., additional, Dodzik, P., additional, Williams, R., additional, Dsurney, J., additional, Najafizadeh, L., additional, McGovern, J., additional, Chowdhry, F., additional, Acevedo, A., additional, Bakhtiar, A., additional, Karamzadeh, N., additional, Amyot, F., additional, Gandjbakhche, A., additional, Haddad, M., additional, Johnson, M., additional, Wade, J., additional, Harper, L., additional, Barghi, A., additional, Mark, V., additional, Christopher, G., additional, Marcus, D., additional, Spady, M., additional, Bloom, J., additional, Zimmer, A., additional, Miller, M., additional, Schuster, D., additional, Ebner, H., additional, Mortimer, B., additional, Palmer, G., additional, Happe, M., additional, Paxson, J., additional, Jurek, B., additional, Graca, J., additional, Meyers, J., additional, Lange, R., additional, Brickell, T., additional, French, L., additional, Iverson, G., additional, Shewchuk, J., additional, Madler, B., additional, Heran, M., additional, Brubacher, J., additional, Ivins, B., additional, Baldassarre, M., additional, Paper, T., additional, Herrold, A., additional, Chin, A., additional, Zgaljardic, D., additional, Oden, K., additional, Lambert, M., additional, Dickson, S., additional, Miller, R., additional, Plenger, P., additional, Sutherland, E., additional, Glatts, C., additional, Schatz, P., additional, Walker, K., additional, Philip, N., additional, McClaughlin, S., additional, Mooney, S., additional, Seats, E., additional, Carnell, V., additional, Raintree, J., additional, Brown, D., additional, Hodges, C., additional, Amerson, E., additional, Kennedy, C., additional, Moore, J., additional, Ferris, C., additional, Roebuck-Spencer, T., additional, Vincent, A., additional, Bryan, C., additional, Catalano, D., additional, Warren, A., additional, Monden, K., additional, Driver, S., additional, Chau, P., additional, Seegmiller, R., additional, Baker, M., additional, Malach, S., additional, Mintz, J., additional, Villarreal, R., additional, Peterson, A., additional, Leininger, S., additional, Strong, C., additional, Donders, J., additional, Merritt, V., additional, Vargas, G., additional, Rabinowitz, A., additional, Arnett, P., additional, Whipple, E., additional, Schultheis, M., additional, Robinson, K., additional, Iacovone, D., additional, Biester, R., additional, Alfano, D., additional, Nicholls, M., additional, Klas, P., additional, Jeffay, E., additional, Zakzanis, K., additional, Vandermeer, M., additional, Womble, M., additional, Corley, E., additional, Considine, C., additional, Fichtenberg, N., additional, Harrison, J., additional, Pollock, M., additional, Mouanoutoua, A., additional, Brimager, A., additional, Lebby, P., additional, Sullivan, K., additional, Edmed, S., additional, Kieffer, K., additional, McCarthy, M., additional, Wiegand, L., additional, Lindsey, H., additional, Hernandez, M., additional, Noniyeva, Y., additional, Lapis, Y., additional, Padua, M., additional, Poole, J., additional, Brooks, B., additional, McKay, C., additional, Meeuwisse, W., additional, Emery, C., additional, Mazur-Mosiewicz, A., additional, Sherman, E., additional, Kirkwood, M., additional, Gunner, J., additional, Miele, A., additional, Silk-Eglit, G., additional, Lynch, J., additional, McCaffrey, R., additional, Stewart, J., additional, Tsou, J., additional, Scarisbrick, D., additional, Chan, R., additional, Bure-Reyes, A., additional, Cortes, L., additional, Gindy, S., additional, Biddle, C., additional, Shah, D., additional, Jaberg, P., additional, Moss, R., additional, Horner, M., additional, VanKirk, K., additional, Dismuke, C., additional, Turner, T., additional, Muzzy, W., additional, Dunnam, M., additional, Warner, G., additional, Donnelly, K., additional, Donnelly, J., additional, Kittleson, J., additional, Bradshaw, C., additional, Alt, M., additional, Margolis, S., additional, Ostroy, E., additional, Higgins, K., additional, Eng, K., additional, Akeson, S., additional, Wall, J., additional, Davis, J., additional, Hansel, J., additional, Wang, B., additional, Gervais, R., additional, Greiffenstein, M., additional, Denning, J., additional, VonDran, E., additional, Campbell, E., additional, Brockman, C., additional, Teichner, G., additional, Waid, R., additional, Buican, B., additional, Armistead-Jehle, P., additional, Bailie, J., additional, Dilay, A., additional, Cottingham, M., additional, Boyd, C., additional, Asmussen, S., additional, Neff, J., additional, Schalk, S., additional, Jensen, L., additional, DenBoer, J., additional, Hall, S., additional, Holcomb, E., additional, Axelrod, B., additional, Demakis, G., additional, Rimland, C., additional, Ward, J., additional, Ross, M., additional, Bailey, M., additional, Stubblefield, A., additional, Smigielski, J., additional, Geske, J., additional, Karpyak, V., additional, Reese, C., additional, Larrabee, G., additional, Allen, L., additional, Celinski, M., additional, Gilman, J., additional, LaDuke, C., additional, DeMatteo, D., additional, Heilbrun, K., additional, Swirsky-Sacchetti, T., additional, Dedman, A., additional, Withers, K., additional, Deneen, T., additional, Fisher, J., additional, Spray, B., additional, Savage, R., additional, Wiener, H., additional, Tyer, J., additional, Ningaonkar, V., additional, Devlin, B., additional, Go, R., additional, Sharma, V., additional, Fontanetta, R., additional, Calderon, C., additional, Coad, S., additional, Fontaneta, R., additional, Vertinski, M., additional, Verbiest, R., additional, Snyder, J., additional, Kinney, J., additional, Rach, A., additional, Young, J., additional, Crouse, E., additional, Schretlen, D., additional, Weaver, J., additional, Buchholz, A., additional, Gordon, B., additional, Macciocchi, S., additional, Seel, R., additional, Godsall, R., additional, Brotsky, J., additional, DiRocco, A., additional, Houghton-Faryna, E., additional, Bolinger, E., additional, Hollenbeck, C., additional, Hart, J., additional, Lee, B., additional, Strauss, G., additional, Adams, J., additional, Martins, D., additional, Catalano, L., additional, Waltz, J., additional, Gold, J., additional, Haas, G., additional, Brown, L., additional, Luther, J., additional, Goldstein, G., additional, Kelley, E., additional, Raba, C., additional, Trettin, L., additional, Solvason, H., additional, Buchanan, R., additional, Baldock, D., additional, Etherton, J., additional, Phelps, T., additional, Richmond, S., additional, Tapscott, B., additional, Thomlinson, S., additional, Cordeiro, L., additional, Wilkening, G., additional, Parikh, M., additional, Graham, L., additional, Grosch, M., additional, Hynan, L., additional, Weiner, M., additional, Cullum, C., additional, Menon, C., additional, Lacritz, L., additional, Castro-Couch, M., additional, Irani, F., additional, Houshyarnejad, A., additional, Norman, M., additional, Fonseca, F., additional, Browne, B., additional, Alvarez, J., additional, Jiminez, Y., additional, Baez, V., additional, Resendiz, C., additional, Scott, B., additional, Farias, G., additional, York, M., additional, Lozano, V., additional, Mahoney, M., additional, Hernandez Mejia, M., additional, Pacheco, E., additional, Homs, A., additional, Ownby, R., additional, Nici, J., additional, Hom, J., additional, Lutz, J., additional, Dean, R., additional, Finch, H., additional, Pierce, S., additional, Moses, J., additional, Mann, S., additional, Feinberg, J., additional, Choi, A., additional, Kaminetskaya, M., additional, Pierce, C., additional, Zacharewicz, M., additional, Gavett, B., additional, Horwitz, J., additional, Ory, J., additional, Carbuccia, K., additional, Morra, L., additional, Garcon, S., additional, Lucas, M., additional, Donovick, P., additional, Whearty, K., additional, Campbell, K., additional, Camlic, S., additional, Brinckman, D., additional, Ehrhart, L., additional, Weisser, V., additional, Medaglia, J., additional, Merzagora, A., additional, Reckess, G., additional, Ho, T., additional, Testa, S., additional, Woolery, H., additional, Farcello, C., additional, Klimas, N., additional, Meyer, J., additional, Barwick, F., additional, Drayer, K., additional, Galusha, J., additional, Schmitt, A., additional, Livingston, R., additional, Stewart, R., additional, Quarles, L., additional, Pagitt, M., additional, Barke, C., additional, Baker, A., additional, Baker, N., additional, Cook, N., additional, Ahern, D., additional, Correia, S., additional, Resnik, L., additional, Barnabe, K., additional, Gnepp, D., additional, Benjamin, M., additional, Zlatar, Z., additional, Garcia, A., additional, Harnish, S., additional, Crosson, B., additional, Vaughan, L., additional, Fedio, A., additional, Sexton, J., additional, Cummings, S., additional, Logemann, A., additional, Lassiter, N., additional, Fedio, P., additional, Gremillion, A., additional, Nemeth, D., additional, Whittington, T., additional, Reckow, J., additional, Lewandowski, C., additional, Cole, J., additional, Lewandowski, A., additional, Spector, J., additional, Ford-Johnson, L., additional, Lengenfelder, J., additional, Sumowski, J., additional, Morse, C., additional, McKeever, J., additional, Zhao, L., additional, Leist, T., additional, Marcinak, J., additional, Piecora, K., additional, Al-Khalil, K., additional, Martin, P., additional, Thompson, L., additional, Kowalczyk, W., additional, Golub, S., additional, Lemann, E., additional, Piehl, J., additional, Rita, N., additional, Moss, L., additional, Nogin, R., additional, Drapeau, C., additional, Malm, S., additional, Armstrong, L., additional, Glidewell, R., additional, Orr, W., additional, Mears, G., additional, Allen, C., additional, Pierson, E., additional, Kavanaugh, B., additional, Tayim, F., additional, Llanes, S., additional, Poston, K., additional, Beathard, J., additional, Stolberg, P., additional, Jones, W., additional, Mayfield, J., additional, Weller, J., additional, Demireva, P., additional, McInerney, K., additional, Riddle, T., additional, Primus, M., additional, Highsmith, J., additional, Everhart, D., additional, Lehockey, K., additional, Sullivan, S., additional, Mandava, S., additional, Murphy, B., additional, Lalwani, L., additional, Rosselli, M., additional, Carrasco, R., additional, Zuckerman, S., additional, Brand, J., additional, Rivera Mindt, M., additional, Schaffer, S., additional, Alper, K., additional, Devinsky, O., additional, Barr, W., additional, Langer, K., additional, Fraiman, J., additional, Scagliola, J., additional, Roman, E., additional, Martinez, A., additional, Konopacki, K., additional, Juliano, A., additional, Whiteside, D., additional, Widmann, G., additional, Franzwa, M., additional, Sokal, B., additional, Morgan, E., additional, Bondi, M., additional, Delano-Wood, L., additional, Cormier, R., additional, Cumley, N., additional, Elek, M., additional, Green, M., additional, Kruger, A., additional, Pacheco, L., additional, Robinson, G., additional, Welch, H., additional, Parriott, D., additional, Loe, S., additional, Hughes, L., additional, Natta, L., additional, Quenicka, W., additional, McGoldirck, K., additional, Bennett, T., additional, Soper, H., additional, Collier, S., additional, Connolly, M., additional, Di Pinto, M., additional, Handel, E., additional, Davidson, K., additional, Livers, E., additional, Frantz, S., additional, Allen, J., additional, Jerard, T., additional, Sakhai, S., additional, Barney, S., additional, McGoldrick, K., additional, Sordahl, J., additional, Torrence, N., additional, and John, S., additional

Published
2012
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34. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study.

Author

Heaton, RK, Heaton, RK, Clifford, DB, Franklin, DR, Woods, SP, Ake, C, Vaida, F, Ellis, RJ, Letendre, SL, Marcotte, TD, Atkinson, JH, Rivera-Mindt, M, Vigil, OR, Taylor, MJ, Collier, AC, Marra, CM, Gelman, BB, McArthur, JC, Morgello, S, Simpson, DM, McCutchan, JA, Abramson, I, Gamst, A, Fennema-Notestine, C, Jernigan, TL, Wong, J, Grant, I, CHARTER Group, Heaton, RK, Heaton, RK, Clifford, DB, Franklin, DR, Woods, SP, Ake, C, Vaida, F, Ellis, RJ, Letendre, SL, Marcotte, TD, Atkinson, JH, Rivera-Mindt, M, Vigil, OR, Taylor, MJ, Collier, AC, Marra, CM, Gelman, BB, McArthur, JC, Morgello, S, Simpson, DM, McCutchan, JA, Abramson, I, Gamst, A, Fennema-Notestine, C, Jernigan, TL, Wong, J, Grant, I, and CHARTER Group

Abstract

ObjectivesThis is a cross-sectional, observational study to determine the frequency and associated features of HIV-associated neurocognitive disorders (HAND) in a large, diverse sample of infected individuals in the era of combination antiretroviral therapy (CART).MethodsA total of 1,555 HIV-infected adults were recruited from 6 university clinics across the United States, with minimal exclusions. We used standardized neuromedical, psychiatric, and neuropsychological (NP) examinations, and recently published criteria for diagnosing HAND and classifying 3 levels of comorbidity (minimal to severe non-HIV risks for NP impairment).ResultsFifty-two percent of the total sample had NP impairment, with higher rates in groups with greater comorbidity burden (40%, 59%, and 83%). Prevalence estimates for specific HAND diagnoses (excluding severely confounded cases) were 33% for asymptomatic neurocognitive impairment, 12% for mild neurocognitive disorder, and only 2% for HIV-associated dementia (HAD). Among participants with minimal comorbidities (n = 843), history of low nadir CD4 was a strong predictor of impairment, and the lowest impairment rate on CART occurred in the subset with suppressed plasma viral loads and nadir CD4 ≥200 cells/mm(3) (30% vs 47% in remaining subgroups).ConclusionsThe most severe HAND diagnosis (HAD) was rare, but milder forms of impairment remained common, even among those receiving CART who had minimal comorbidities. Future studies should clarify whether early disease events (e.g., profound CD4 decline) may trigger chronic CNS changes, and whether early CART prevents or reverses these changes.

Published
2010

35. Diagnosing Symptomatic HIV-Associated Neurocognitive Disorders: Self-Report Versus Performance-Based Assessment of Everyday Functioning

Author

Blackstone, K., primary, Moore, D.J., additional, Heaton, R.K., additional, Franklin, D.R., additional, Woods, S.P., additional, Clifford, D.B., additional, Collier, A.C., additional, Marra, C.M., additional, Gelman, B.B., additional, McArthur, J.C., additional, Morgello, S., additional, Simpson, D.M., additional, Rivera-Mindt, M., additional, Deutsch, R., additional, Ellis, R.J., additional, Hampton Atkinson, J., additional, and Grant, I., additional

Published
2011
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40. The Consortium for Clarity in ADRD Research Through Imaging (CLARiTI).

Author

Mormino EC, Biber SA, Rahman-Filipiak A, Arfanakis K, Clark L, Dage JL, Detre JA, Dickerson BC, Donohue MC, Kecskemeti S, Hohman TJ, Jagust WJ, Keene DC, Kukull W, Levendovszky SR, Rosen H, Thompson PM, Villemagne VL, Wolk DA, Okonkwo OC, Rabinvovici GD, Rivera-Mindt M, Foroud T, and Johnson SC

Subjects
Humans, Dementia diagnostic imaging, Longitudinal Studies, Brain diagnostic imaging, Brain pathology, Biomedical Research, Female, Male, Aged, Neuroimaging methods, Alzheimer Disease diagnostic imaging
Abstract

The presence of multiple pathologies is the largest predictor of dementia. A major gap in the field is the in vivo detection of mixed pathologies and their antecedents. The Alzheimer's Disease Research Centers (ADRCs) are uniquely positioned to address this gap. The ADRCs longitudinally follow ≈ 17,000 participants, ranging from cognitively unimpaired to dementia, arising from Alzheimer's disease (AD) and related dementias (ADRD; e.g., AD, Lewy body disorders, vascular). Motivated by the Alzheimer's Disease Neuroimaging Initiative's (ADNI) impact, the ADRC Consortium for Clarity in ADRD Research Through Imaging (CLARiTI) was formed. Leveraging existing ADRC infrastructure, CLARiTI will integrate standardized imaging and plasma collection to characterize mixed pathologies and use community-engaged research methods to ensure that ≥ 25% of the sample is from underrepresented populations (e.g., ethnoculturally minoritized, low education). The resulting ADRD profiles, within a more diverse sample, will provide key resources for ADRCs and an unprecedented, more generalizable publicly available imaging-plasma dataset. HIGHLIGHTS: In vivo detection of mixed pathologies is critical for Alzheimer's disease and related dementias research. The Alzheimer's Disease Research Centers (ADRCs) are uniquely positioned to address gaps related to mixed pathologies. The ADRC Consortium for Clarity in ADRD Research Through Imaging (CLARiTI) will enhance this national program by adding standardized imaging and plasma collection to existing ADRC infrastructure. This effort will provide key resources for ADRCs and an unprecedented publicly available imaging-plasma-neuropath dataset., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Published
2025
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41. Overview of Alzheimer's Disease Neuroimaging Initiative and future clinical trials.

Author

Weiner MW, Kanoria S, Miller MJ, Aisen PS, Beckett LA, Conti C, Diaz A, Flenniken D, Green RC, Harvey DJ, Jack CR Jr, Jagust W, Lee EB, Morris JC, Nho K, Nosheny R, Okonkwo OC, Perrin RJ, Petersen RC, Rivera-Mindt M, Saykin AJ, Shaw LM, Toga AW, Tosun D, and Veitch DP

Subjects
Humans, Positron-Emission Tomography, Biomarkers cerebrospinal fluid, Alzheimer Disease diagnostic imaging, Alzheimer Disease drug therapy, Neuroimaging methods, Clinical Trials as Topic
Abstract

The overall goal of the Alzheimer's Disease Neuroimaging Initiative (ADNI) is to optimize and validate biomarkers for clinical trials while sharing all data and biofluid samples with the global scientific community. ADNI has been instrumental in standardizing and validating amyloid beta (Aβ) and tau positron emission tomography (PET) imaging. ADNI data were used for the US Food and Drug Administration (FDA) approval of the Fujirebio and Roche Elecsys cerebrospinal fluid diagnostic tests. Additionally, ADNI provided data for the trials of the FDA-approved treatments aducanumab, lecanemab, and donanemab. More than 6000 scientific papers have been published using ADNI data, reflecting ADNI's promotion of open science and data sharing. Despite its enormous success, ADNI has some limitations, particularly in generalizing its data and findings to the entire US/Canadian population. This introduction provides a historical overview of ADNI and highlights its significant accomplishments and future vision to pioneer "the clinical trial of the future" focusing on demographic inclusivity. HIGHLIGHTS: The Alzheimer's Disease Neuroimaging Initiative (ADNI) introduced a novel model for public-private partnerships and data sharing. It successfully validated amyloid and Tau PET imaging, as well as CSF and plasma biomarkers, for diagnosing Alzheimer's disease. ADNI generated and disseminated vital data for designing AD clinical trials., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Published
2025
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43. The Alzheimer's Disease Neuroimaging Initiative-4 (ADNI-4) Engagement Core: A culturally informed, community-engaged research (CI-CER) model to advance brain health equity.

Author

Rivera Mindt M, Arentoft A, Calcetas AT, Guzman VA, Amaza H, Ajayi A, Ashford MT, Ayo O, Barnes LL, Camuy A, Conti C, Diaz A, Easter B, Gonzalez DJ, Dotson YG, Hoang I, Germano KK, Maestre GE, Magaña F, Meyer OL, Miller MJ, Nosheny R, Park VMT, Parkins S, Thomas LR, Strong J, Talavera S, Verney SP, Weisensel T, Weiner MW, and Okonkwo OC

Subjects
Humans, Community-Based Participatory Research, Male, Aged, Female, Brain diagnostic imaging, Brain pathology, Alzheimer Disease diagnostic imaging, Alzheimer Disease ethnology, Neuroimaging, Health Equity
Abstract

Introduction: The Alzheimer's Disease Neuroimaging Initiative-4 (ADNI-4) Engagement Core was launched to advance Alzheimer's disease (AD) and AD-related dementia (ADRD) health equity research in underrepresented populations (URPs). We describe our evidence-based, scalable culturally informed, community-engaged research (CI-CER) model and demonstrate its preliminary success in increasing URP enrollment., Methods: URPs include ethnoculturally minoritized, lower education (≤ 12 years), and rural populations. The CI-CER model includes: (1) culturally informed methodology (e.g., less restrictive inclusion/exclusion criteria, sociocultural measures, financial compensation, results disclosure, Spanish Language Capacity Workgroup) and (2) inclusive engagement methods (e.g., the Engagement Core team; Hub Sites; Community-Science Partnership Board)., Results: As of April 2024, 60% of ADNI-4 new in-clinic enrollees were from ethnoculturally or educationally URPs. This exceeds ADNI-4's ≥ 50% URP representation goal for new enrollees but may not represent final enrollment., Discussion: Findings show a CI-CER model increases URP enrollment in AD/ADRD clinical research and has important implications for clinical trials to advance health equity., Highlights: The Alzheimer's Disease Neuroimaging Initiative-4 (ADNI-4) uses a culturally informed, community-engaged research (CI-CER) approach. The CI-CER approach is scalable and sustainable for broad, multisite implementation. ADNI-4 is currently exceeding its inclusion goals for underrepresented populations., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Published
2024
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44. Disparate trajectories of cognitive aging among American Indian and Alaskan Native people with and without HIV.

Author

Savin MJ, Byrd D, Cysique L, Rourke S, Verney SP, Radford K, Judd T, Aghvinian M, Crook C, Oleas D, Slaughter A, Armenta R, Franklin D, Marcotte T, Cham H, and Rivera Mindt M

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Executive Function, Longitudinal Studies, Neuropsychological Tests statistics & numerical data, Cognitive Aging, HIV Infections psychology, American Indian or Alaska Native psychology
Abstract

Objective: This study describes trajectories of cognitive aging among American Indian/Alaskan Native (AI/AN) adults with and without HIV and the role of immunosenescence longitudinally., Method: We characterized trajectories of cognitive aging in a sample of 333 AI/AN and 309 non-Hispanic White (NHW) adults who were followed longitudinally for up to 20 years by the HIV Neurobehavioral Research Program (HNRP) across six U.S. research sites. We used growth curve modeling with autoregressive Lag-1 structures and heterogeneous residual variances to assess the role of ethnoracial identity and HIV grouping upon decline in trajectories of cognitive aging., Results: HIV- AI/AN adults demonstrated earlier and steeper decline in normative trajectories of cognitive aging on tasks of processing speed, timed tasks of attention/working memory, executive function, and psychomotor speed in comparison to HIV- NHW adults. Accentuated trajectories of cognitive aging were evident in both HIV+ and HIV+ immunosuppressed groups in comparison to HIV- peers and were primarily driven by the role of immunosenescence., Conclusions: AI/AN disparities in trajectories of cognitive aging are evident and are likely explained by the interplay of biopsychosociocultural factors, including immunosenescence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Published
2024
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45. A Protocol for the Inclusion of Minoritized Persons in Alzheimer Disease Research From the ADNI3 Diversity Taskforce.

Author

Okonkwo OC, Rivera Mindt M, Ashford MT, Conti C, Strong J, Raman R, Donohue MC, Nosheny RL, Flenniken D, Miller MJ, Diaz A, Soto AM, Ances BM, Beigi MR, Doraiswamy PM, Duara R, Farlow MR, Grossman HT, Mintzer JE, Reist C, Rogalski EJ, Sabbagh MN, Salloway S, Schneider LS, Shah RC, Petersen RC, Aisen PS, and Weiner MW

Subjects
Humans, Aged, Female, Male, Cross-Sectional Studies, Aged, 80 and over, Middle Aged, Patient Selection, United States, Longitudinal Studies, Cognitive Dysfunction, Alzheimer Disease ethnology, Hispanic or Latino statistics & numerical data, Black or African American statistics & numerical data
Abstract

Importance: Black or African American (hereinafter, Black) and Hispanic or Latino/a/x (hereinafter, Latinx) adults are disproportionally affected by Alzheimer disease, but most research studies do not enroll adequate numbers of both of these populations. The Alzheimer's Disease Neuroimaging Initiative-3 (ADNI3) launched a diversity taskforce to pilot a multipronged effort to increase the study inclusion of Black and Latinx older adults., Objective: To describe and evaluate the culturally informed and community-engaged inclusion efforts to increase the screening and enrollment of Black and Latinx older adults in ADNI3., Design, Setting, and Participants: This cross-sectional study used baseline data from a longitudinal, multisite, observational study conducted from January 15, 2021, to July 12, 2022, with no follow-up. The study was conducted at 13 ADNI3 sites in the US. Participants included individuals aged 55 to 90 years without cognitive impairment and those with mild cognitive impairment or Alzheimer disease., Exposures: Efforts included (1) launch of an external advisory board, (2) changes to the study protocol, (3) updates to the digital prescreener, (4) selection and deployment of 13 community-engaged research study sites, (5) development and deployment of local and centralized outreach efforts, and (6) development of a community-science partnership board., Main Outcomes and Measures: Screening and enrollment numbers from centralized and local outreach efforts, digital advertisement metrics, and digital prescreener completion., Results: A total of 91 participants enrolled in the trial via centralized and local outreach efforts, of which 22 (24.2%) identified as Latinx and 55 (60.4%) identified as Black (median [IQR] age, 65.6 [IQR, 61.5-72.5] years; 62 women [68.1%]). This represented a 267.6% increase in the monthly rate of enrollment (before: 1.11 per month; during: 4.08 per month) of underrepresented populations. For the centralized effort, social media advertisements were run between June 1, 2021, and July 31, 2022, which resulted in 2079 completed digital prescreeners, of which 1289 met criteria for subsequent site-level screening. Local efforts were run between June 1, 2021, to July 31, 2022. A total of 151 participants underwent site-level screening (100 from local efforts, 41 from centralized efforts, 10 from other sources)., Conclusions and Relevance: In this cross-sectional study of pilot inclusion efforts, a culturally informed, community-engaged approach increased the inclusion of Black and Latinx participants in an Alzheimer disease cohort study.

Published
2024
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46. Interpreting reliable change on the Spanish-language NIH toolbox cognition battery.

Author

Karr JE, Rivera Mindt M, and Iverson GL

Subjects
Adult, Humans, Female, Male, Neuropsychological Tests, Educational Status, Cognition, Reading
Abstract

This study applied a reliable change methodology to the test-retest data from the Spanish-language NIH Toolbox Cognition Battery (NIHTB-CB) normative sample. Participants included Spanish-speaking adults ( n  = 48; 54.2% women, 100% Latinx) evaluated twice within one to two weeks on the Spanish-language NIHTB-CB, consisting of two crystallized and five fluid cognitive tests. Test-retest means, standard deviations, and intraclass correlations were used to calculate upper and lower bounds of 70, 80, and 90% confidence intervals (CIs) around change scores, with these bounds used as cutoffs for inferring reliable change. Cutoffs were calculated for raw scores, age-adjusted standard scores (SS; M  = 100, SD  = 15), and demographic-adjusted T-scores (T; M  = 50, SD  = 10), adjusting for age, gender, and education. Test-retest change scores on the Spanish-language NIHTB-CB exceeding the following cutoffs indicate reliable change based on an 80% CI (i.e., values exceeding these cutoffs indicate greater decline or greater improvement than 90% of the sample): Dimensional Change Card Sort (SS ≥ 15/T ≥ 11), Flanker (SS ≥ 13/T ≥ 10), List Sorting (SS ≥ 13/T ≥ 9), Picture Sequence Memory (SS ≥ 14/T ≥ 9), Pattern Comparison (SS ≥ 14/T ≥ 10), Picture Vocabulary (SS ≥ 8/T ≥ 6), Oral Reading (SS ≥ 7/T ≥ 5), Fluid Cognition Composite (SS ≥ 12/T ≥ 9), Crystallized Cognition Composite (SS ≥ 6/T ≥ 5), and Total Cognition Composite (SS ≥ 8/T ≥ 7). These cutoffs are one of few resources to interpret cognitive change at retest among Spanish-speaking patients and participants.

Published
2024
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47. Relationship Between Cognitive Impairment and Depression Among Middle Aged and Older Adults in Primary Care.

Author

Federman AD, Becker J, Carnavali F, Rivera Mindt M, Cho D, Pandey G, Chan L, Curtis L, Wolf MS, and Wisnivesky JP

Abstract

Objectives: To determine rates of previously undetected cognitive impairment among patients with depression in primary care. Methods: Patients ages 55 and older with no documented history of dementia or mild cognitive impairment were recruited from primary care practices in New York City, NY and Chicago, IL ( n  = 855). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) and depression with the Patient Health Questionnaire-8. Results: The mean age was 66.8 (8.0) years, 45.3% were male, 32.7% Black, and 29.2% Latinx. Cognitive impairment increased with severity of depression: 22.9% in persons with mild depression, 27.4% in moderate depression and 41.8% in severe depression ( p  = .0002). Severe depression was significantly associated with cognitive impairment in multivariable analysis (standardized β = -.11, SE  = 0.33, p  < .0001). Discussion: Depression was strongly associated with previously undetected cognitive impairment. Primary care clinicians should consider screening, or expand their screening, for both conditions., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Wisnivesky received consulting honoraria from Sanofi, PPD, Banook, and Prospero and research grants from Sanofi, Regeneron, Axella, and Arnold Consultants. Dr. Wolf reports grants from the Gordon and Betty Moore Foundation, and Eli Lilly, and personal fees from Pfizer, Sanofi, Luto UK, University of Westminster, and Lundbeck outside the submitted work., (© The Author(s) 2024.)

Published
2024
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48. The Alzheimer's Disease Neuroimaging Initiative in the era of Alzheimer's disease treatment: A review of ADNI studies from 2021 to 2022.

Author

Veitch DP, Weiner MW, Miller M, Aisen PS, Ashford MA, Beckett LA, Green RC, Harvey D, Jack CR Jr, Jagust W, Landau SM, Morris JC, Nho KT, Nosheny R, Okonkwo O, Perrin RJ, Petersen RC, Rivera Mindt M, Saykin A, Shaw LM, Toga AW, and Tosun D

Subjects
Humans, Amyloid beta-Peptides, Neuroimaging methods, Biomarkers, Disease Progression, tau Proteins, Alzheimer Disease diagnostic imaging, Alzheimer Disease therapy, Cognitive Dysfunction diagnostic imaging
Abstract

The Alzheimer's Disease Neuroimaging Initiative (ADNI) aims to improve Alzheimer's disease (AD) clinical trials. Since 2006, ADNI has shared clinical, neuroimaging, and cognitive data, and biofluid samples. We used conventional search methods to identify 1459 publications from 2021 to 2022 using ADNI data/samples and reviewed 291 impactful studies. This review details how ADNI studies improved disease progression understanding and clinical trial efficiency. Advances in subject selection, detection of treatment effects, harmonization, and modeling improved clinical trials and plasma biomarkers like phosphorylated tau showed promise for clinical use. Biomarkers of amyloid beta, tau, neurodegeneration, inflammation, and others were prognostic with individualized prediction algorithms available online. Studies supported the amyloid cascade, emphasized the importance of neuroinflammation, and detailed widespread heterogeneity in disease, linked to genetic and vascular risk, co-pathologies, sex, and resilience. Biological subtypes were consistently observed. Generalizability of ADNI results is limited by lack of cohort diversity, an issue ADNI-4 aims to address by enrolling a diverse cohort., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Published
2024
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49. Neurocognitive, Sociocultural, and Psychological Factors Impacting Medication Beliefs Among HIV-Seropositive Latinx Adults.

Author

Fuentes A, Coulehan K, Byrd D, Arentoft A, Miranda C, Arce Rentería M, Monzones J, Rosario A, and Rivera Mindt M

Subjects
Adult, Humans, Hispanic or Latino psychology, Mental Health, Self Report, Surveys and Questionnaires, HIV Infections drug therapy, HIV Infections psychology, Medication Adherence psychology
Abstract

Among Latinx people living with HIV (PLWH), neurocognitive (NC) function, culture, and mental health impact medication adherence. Similarly, health beliefs and attitudes play a role in health care barriers and health behaviors. Research has not examined the effect that compromised neurocognition, sociocultural factors, and mental health have on health beliefs and attitudes. This is especially relevant for Latinx PLWH who are disproportionately impacted by HIV, given that sociocultural factors may uniquely impact HIV-related NC and psychological sequelae. This study investigated the associations between neurocognition, sociocultural factors, mental health, health beliefs, and health attitudes among Latinx HIV-seropositive adults. Within a sample of 100 Latinx PLWH, better verbal learning and executive functioning abilities were associated with more positive attitudes about the benefits of medications and memory for medications. In terms of sociocultural factors, higher English language competence was related to better self-reported memory for medications, and overall, higher US acculturation was associated with more positive attitudes toward health professionals. Depressive symptomatology was negatively associated with attitudes toward medications and health professionals, as well as with self-reported memory for medications. These findings highlight the important interplay between NC, sociocultural, psychological factors, and health beliefs among Latinx PLWH. Adherence intervention strategies and suggestions for dispensing medical information are presented for clinicians and health care practitioners.

Published
2023
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50. Greater executive dysfunction in patients post-COVID-19 compared to those not infected.

Author

Becker JH, Lin JJ, Twumasi A, Goswami R, Carnavali F, Stone K, Rivera-Mindt M, Kale MS, Naasan G, Festa JR, and Wisnivesky JP

Subjects
Humans, Female, Middle Aged, Male, Prospective Studies, Executive Function physiology, Learning, COVID-19 complications, Cognitive Dysfunction etiology
Abstract

Background: A number of patients post-coronavirus disease-19 (COVID-19) report cognitive impairment (CI), even months after acute infection. We aimed to assess if COVID-19 is associated with increased incidence of CI in comparison to controls., Methods: We analyzed data from the Mount Sinai Health System Post-COVID-19 Registry in New York City, a prospective cohort of patients post-COVID-19 ≥18 years of age and non-infected controls. CI was defined by scores ≥ 1.0 standard deviation below population norms, and was assessed using well-validated measures of attention, working memory, processing speed, executive functioning/cognitive flexibility, language, learning, and memory. Logistic regression models assessed odds for CI in each domain in patients post-COVID-19 vs. controls after adjusting for potential confounders. In exploratory analyses, we assessed odds for CI by site of acute COVID-19 care as a proxy for disease severity., Findings: 417 patients post-COVID-19 and 151 controls (mean age 49 years, 63% female, 21% Black, 17% Latinx) were included. In adjusted analyses, patients were significantly more likely than controls to have CI in executive functioning (odds ratio [OR]: 2.19; 95% confidence interval [CI]: 1.03 to 4.67), particularly those treated in outpatient (OR: 2.22; 95% CI: 1.02 to 4.82) and inpatient hospital (OR: 3.59; 95% CI: 1.27 to 10.16) settings. There were no significant associations between CI in other domains and history of COVID-19 or site of acute care., Interpretation: Patients post-COVID-19 have greater odds of executive dysfunction, suggesting that focused cognitive screening may be prudent, even in those with mild to moderate disease. Studies should explore the pathophysiology and potential treatments for CI in this population., Funding: This work was funded by the Icahn School of Medicine at Mount Sinai., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Published
2023
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