Publications by authors named "Emily H. Trittschuh"
Importance: "SuperAgers" are oldest-old adults (ages 80+) whose memory performance resembles that of adults in their 50s to mid-60s. Factors underlying their exemplary memory are underexplored in large, racially diverse cohorts.
Objective: To determine the frequency of genotypes in non-Hispanic Black and non-Hispanic White SuperAgers compared to middle-aged (ages 50-64), old (ages 65-79), and oldest-old (ages 80+) controls and Alzheimer's disease (AD) dementia cases.
Introduction: Accurately assessing temporal order of cognitive decline across multiple domains is critical in Alzheimer's disease (AD). Existing literature presented controversial conclusions likely due to the use of a single cohort and different analytical strategies.
Methods: Harmonized composite cognitive measures in memory, language and executive functions from 13 cohorts in the ADSP-PHC data are used.
Article Synopsis
- - The study aims to gather insights from neuropsychologists on their experiences with non-inclusive practices when assessing LGBTQ+ patients and share strategies for improving inclusivity in testing.
- - A survey was completed by 46 mainly doctoral-level neuropsychologists, revealing widespread encounters with non-inclusive language in assessment tools and a willingness to adapt practices accordingly.
- - Participants emphasized the need for more inclusive neuropsychological instruments and offered suggestions for enhancements, which will inform future research and advocacy efforts for better support of gender and sexual minorities.
Article Synopsis
- Limited research has examined how cardiovascular risk and amyloid levels influence cognitive decline in East Asians, specifically in a study involving 526 participants from the Korean Brain Aging Study.
- Results showed that cognitively normal individuals without amyloid (Aβ-) but with high cardiovascular risk scores had significantly lower cognitive performance than their low-risk counterparts.
- Ultimately, while managing vascular risk is important for early cognitive preservation in Aβ- individuals, amyloid pathology was found to be the main factor driving cognitive decline in both cognitively normal and mild cognitive impairment groups, regardless of vascular risk status.
Article Synopsis
- The study explores the link between retinal changes from age-related macular degeneration (AMD) and brain structure in older adults, specifically focusing on those aged 70 and above.
- Participants underwent a series of tests, including cognitive assessments and brain imaging, to analyze the correlation between retinal thickness and brain morphology.
- Results indicated that thinner outer retinal layers are associated with reduced size and thickness in critical brain areas, suggesting that AMD may have implications for cognitive health and brain aging.
Purpose: Research on Alzheimer's disease (AD) and precursor states demonstrates a thinner retinal nerve fiber layer (NFL) compared to age-similar controls. Because AD and age-related macular degeneration (AMD) both impact older adults and share risk factors, we asked if retinal layer thicknesses, including NFL, are associated with cognition in AMD.
Methods: Adults ≥ 70 years with normal retinal aging, early AMD, or intermediate AMD per Age-Related Eye Disease Study (AREDS) nine-step grading of color fundus photography were enrolled in a cross-sectional study.
Introduction: Although large-scale genome-wide association studies (GWAS) have been conducted on AD, few have been conducted on continuous measures of memory performance and memory decline.
Methods: We conducted a cross-ancestry GWAS on memory performance (in 27,633 participants) and memory decline (in 22,365 participants; 129,201 observations) by leveraging harmonized cognitive data from four aging cohorts.
Results: We found high heritability for two ancestry backgrounds.
Background: Women demonstrate a memory advantage when cognitively healthy yet lose this advantage to men in Alzheimer's disease. However, the genetic underpinnings of this sex difference in memory performance remain unclear.
Methods: We conducted the largest sex-aware genetic study on late-life memory to date (N = 11,942; N = 15,641).
Article Synopsis
- The study investigates how sex and race influence the relationship between apolipoprotein E (APOE) alleles (ε4 and ε2) and cognitive function in Alzheimer’s disease (AD) across different populations.
- Using data from four cohorts of older adults (60+ years) who self-identified as either non-Hispanic White or non-Hispanic Black, researchers analyzed cognitive outcomes related to memory and executive function.
- Findings suggest significant differences in how APOE ε4 impacts cognitive scores based on sex, with the interactions varying by race, indicating that genetic factors influencing cognition in AD are complex and multifaceted.
Background: More than 75 common variant loci account for only a portion of the heritability for Alzheimer's disease (AD). A more complete understanding of the genetic basis of AD can be deduced by exploring associations with AD-related endophenotypes.
Methods: We conducted genome-wide scans for cognitive domain performance using harmonized and co-calibrated scores derived by confirmatory factor analyses for executive function, language, and memory.
Introduction: Research focusing on cognitive aging and dementia is a global endeavor. However, cross-national differences in cognition are embedded in other sociocultural differences, precluding direct comparisons of test scores. Such comparisons can be facilitated by co-calibration using item response theory (IRT).
View Article and Find Full Text PDFObjective: To calibrate cognitive assessment data across multiple waves of the Framingham Heart Study (FHS), addressing study design considerations, ceiling effects, and measurement precision.
Method: FHS participants completed several cognitive assessments including screening instruments and more comprehensive batteries at different study visits. We used expert opinion to assign each cognitive test item to a single domain-memory, executive function, language, visuospatial abilities, or none of the above.
Article Synopsis
- The study aimed to evaluate how accurately cognitive functions are measured in participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI), focusing on those with normal cognition, mild cognitive impairment, and Alzheimer's disease.
- Using data from participant visits, researchers analyzed scores for memory, executive function, language, and visuospatial skills while calculating the standard errors of measurement for each cognitive domain.
- Results showed that participants with normal cognition scored the highest, those with mild cognitive impairment scored in the middle, and those with Alzheimer's scored the lowest, with varying measurement precision across cognitive domains, particularly less precise for memory.
Examination of current tele-neuropsychology (teleNP) practices and attitudes within the clinical neuropsychology community, conducted September - November 2022. Clinical neuropsychologists in U.S.
View Article and Find Full Text PDF: We sought to describe the LGBTQ + related education, training, and clinical practice of independently licensed neuropsychologists in the United States and to identify factors that predict affirmative neuropsychological practices. We hypothesized that LGBTQ + identity, female gender, more recent training, and extent of LGBTQ + education/training would predict use of LGBTQ + practice guidelines. : A workgroup of clinical psychologists with experience in LGBTQ + psychology and neuropsychology developed a survey to identify personal and professional factors that predict affirmative neuropsychological testing practices.
View Article and Find Full Text PDFArticle Synopsis
- The objective of the study is to create a consistent way to measure cognitive test results across different research studies, allowing for better comparisons and data pooling.
- The methodology involves using a variety of established cognitive tests and categorizing their items into different cognitive domains, followed by statistical analysis to create standardized scores for a large combined sample of individuals.
- The results highlight the importance of harmonizing cognitive assessments to facilitate joint analysis and meta-analyses, ultimately allowing for better insights into cognitive aging across various studies.
Article Synopsis
- Veterans with histories of mild traumatic brain injury (mTBI) struggle more with prospective memory (PM) tasks, which involve remembering to perform actions at specific times, especially when no external reminders are present.
- A study compared clock-checking behavior during a PM test between Veterans with mTBI and those without, finding that those with mTBI checked the clock less often, which correlated with poorer performance on time-based tasks.
- The findings suggest that the reduced ability to monitor time may contribute to mTBI-related challenges in managing time-based memories, highlighting a need for further research to explore its impact on daily activities like taking medications.
To provide guidance and resources on how to practice culturally safe and humble neuropsychology with transgender and gender diverse (TGD) individuals and communities. We gathered a multidisciplinary team of clinicians with relevant professional and/or lived experience to review pertinent literature, discuss important concepts, and identify key resources. From this process, we outline practical steps to advance gender affirmative neuropsychological practice.
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- About 30% of elderly adults show no cognitive impairment at death despite having Alzheimer's disease pathology, which suggests exploring their resilience could lead to new treatments for Alzheimer's.
- The study focuses on understanding sex-specific genetic factors that contribute to resilience against Alzheimer's by analyzing cognitive data and genetic factors from a large cohort across multiple studies.
- The research identified a significant genetic variant on chromosome 10 that is linked to higher resilience scores specifically in females, suggesting that certain genes related to RNA processing may play a role in this resilience.
Longitudinal cognitive performance of Alzheimer's disease neuropathological subtypes.
Alzheimers Dement (N Y)
September 2021
Introduction: Alzheimer's disease (AD) neuropathological subtypes (limbic predominant [lpAD], hippocampal sparing [HpSpAD], and typical [tAD]), defined by relative neurofibrillary tangle (NFT) burden in limbic and cortical regions, have not been studied in prospectively characterized epidemiological cohorts with robust cognitive assessments.
Methods: Two hundred ninety-two participants with neuropathologically confirmed AD from the Religious Orders Study and Memory and Aging Project were categorized by neuropathological subtype based on previously specified diagnostic criteria using quantitative regional NFT counts. Rates of cognitive decline were compared across subtypes using linear mixed-effects models that included subtype, time, and a subtype-time interaction as predictors and four cognitive domain factor scores (memory, executive function, language, visuospatial) and a global score as outcomes.
Background: To demonstrate feasibility and utility of the iPad version of the NIH Toolbox Cognition Battery (NIHTB-CB) in a clinical trial of older adults.
Methods: Fifty-one adults, aged 55 and older without dementia were tested twice on NIHTB-CB and more traditional paper-and-pencil neuropsychological measures after meal ingestion, with approximately a 4-week interval. We also compared performances at Time 1 and Time 2 for significant change.
Disentangling biologically distinct subgroups of Alzheimer's disease (AD) may facilitate a deeper understanding of the neurobiology underlying clinical heterogeneity. We employed longitudinal [F]FDG-PET standardized uptake value ratios (SUVRs) to map hypometabolism across cognitively-defined AD subgroups. Participants were 384 amyloid-positive individuals with an AD dementia diagnosis from ADNI who had a total of 1028 FDG-scans (mean time between first and last scan: 1.
View Article and Find Full Text PDFThe clinical presentation of Alzheimer's disease (AD) varies widely across individuals but the neurobiological mechanisms underlying this heterogeneity are largely unknown. Here, we compared regional gray matter (GM) volumes and associated gene expression profiles between cognitively-defined subgroups of amyloid-β positive individuals clinically diagnosed with AD dementia (age: 66 ± 7, 47% male, MMSE: 21 ± 5). All participants underwent neuropsychological assessment with tests covering memory, executive-functioning, language and visuospatial-functioning domains.
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- Familial idiopathic basal ganglia calcification (FIBGC) is a rare genetic disorder marked by calcium buildup in the brain, causing a range of neurological and psychiatric symptoms, as shown in a case study of a father and son with the same genetic mutation.
- Both father (S1) and son (S2) exhibited similar brain calcification patterns but had different onset ages and symptoms; S1 experienced motor issues in his late 60s while S2 faced psychiatric symptoms in his late 30s.
- The findings highlight how the same genetic mutation can lead to varied disease presentations within a family, showing that age of onset may influence symptom types and emphasizing a period of initial change followed by stability in disease progression.
Introduction: Composite scores may be useful to summarize overall language or visuospatial functioning in studies of older adults.
Methods: We used item response theory to derive composite measures for language (ADNI-Lan) and visuospatial functioning (ADNI-VS) from the cognitive battery administered in the Alzheimer's Disease Neuroimaging Initiative (ADNI). We evaluated the scores among groups of people with normal cognition, mild cognitive impairment (MCI), and Alzheimer's disease (AD) in terms of responsiveness to change, association with imaging findings, and ability to differentiate between MCI participants who progressed to AD dementia and those who did not progress.