Publications by authors named "John Best"

Defined as the ability to adapt to adversity with a positive and stable mindset, resilience should be an important factor in coping with long-term evolving setbacks such as the COVID-19 pandemic. Although the negative mental health impacts of the pandemic are well-documented, the course of resilience during the pandemic and recovery periods remains understudied. This study examined resilience trajectories among respondents in the Canadian Personal Impacts of COVID-19 Survey (PICS) who provided data for at least two timepoints ( = 741).

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  • Prolonged bed rest negatively impacts health, particularly cognitive performance in middle-aged and older adults, making it essential to explore exercise as a remedy.
  • A study involved 23 healthy adults aged 55-65, comparing 14 days of bed rest with and without daily exercise, assessing cognitive function using standardized tests.
  • Results indicated that those who exercised during bed rest had significantly better cognitive performance (lower variability) than those who did not, with a notable difference based on sex in the effects of exercise.
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  • - This study explores how obsessive-compulsive disorder (OCD) affects family functioning from the perspectives of affected children, their siblings, and parents, highlighting the often-overlooked views of siblings.
  • - Researchers analyzed data from 185 families, finding that parents reported the most significant impact of OCD, followed by the affected children and then the siblings, with factors such as family accommodation and blame playing key roles in dysfunction.
  • - While the study sheds light on the dynamics of family life affected by pediatric OCD, its cross-sectional nature and missing data limit causal conclusions, emphasizing the need for clinicians to consider all family members' experiences in treatment approaches.
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Background: There are likely many contributors to variation in the rate of cognitive decline in middle and late adulthood, including individual and neighborhood socio-economic factors. This study examines whether individual socio-economic factors, namely income and wealth, correlate with cognitive decline, in part, through neighborhood-level social and material disadvantage.

Methods: Using the three waves of data collection from the Canadian Longitudinal Study on Aging (CLSA), this study included 51,338 participants between the age of 45 and 85 years at baseline (51% female).

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Objectives: To explore whether the association between physical activity (PA) and cognition is moderated by neighbourhood disadvantage, and whether this relationship varies with age.

Study Design: A longitudinal analysis of the Canadian Longitudinal Study on Aging, wherein we included participants (N = 41,599) from urban areas who did not change their residential postal code from baseline (2010-2015) to first follow-up (2015-2018).

Main Outcome Measures: At baseline, we measured PA using the Physical Activity Scale for the Elderly, and neighbourhood disadvantage using the Material and Social Deprivation Indices.

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Given diverse symptom expression and high rates of comorbid conditions, the present study explored underlying commonalities among OCD-affected children and adolescents to better conceptualize disorder presentation and associated features. Data from 830 OCD-affected participants presenting to OCD specialty centers was aggregated. Dependent mixture modeling was used to examine latent clusters based on their age- and gender adjusted symptom severity (as measured by the Children's Yale-Brown Obsessive-Compulsive Scale; CY-BOCS), symptom type (as measured by factor scores calculated from the CY-BOCS symptom checklist), and comorbid diagnoses (as assessed via diagnostic interviews).

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Introduction: In the Investigating the Impact of Alzheimer's Disease Diagnostics in British Columbia (IMPACT-AD BC) study, we aimed to understand how Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarker testing-used in medical care-impacted medical decision-making (medical utility), personal decision-making (personal utility), and health system economics.

Methods: The study was designed as an observational, longitudinal cohort study. A total of 149 patients were enrolled between February 2019 and July 2021.

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Introduction: We described patients' and care partners' experiences with Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarker testing and result disclosure in routine care.

Methods: IMPACT-AD BC is an observational study of clinic patients who underwent AD CSF biomarker testing as part of their routine medical care ( = 142). In the personal utility arm of the study, semi-structured phone interviews were conducted with a subset of patients ( = 34), and separately with their care partners ( = 31).

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Background: Posterior cortical atrophy is a rare syndrome characterised by early, prominent, and progressive impairment in visuoperceptual and visuospatial processing. The disorder has been associated with underlying neuropathological features of Alzheimer's disease, but large-scale biomarker and neuropathological studies are scarce. We aimed to describe demographic, clinical, biomarker, and neuropathological correlates of posterior cortical atrophy in a large international cohort.

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A sedentary lifestyle offers immediate gratification, but at the expense of long-term health. It is thus critical to understand how the brain evaluates immediate rewards and long-term health effects in the context of deciding whether to engage in moderate-to-vigorous physical activity (MVPA) or sedentary behaviour (SB). In this secondary analysis of a 6-month randomized controlled trial to increase MVPA and reduce SB among community-dwelling adults, we explored how neural activity during an executive control task was associated with MVPA and SB levels.

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  • * Researchers analyzed data from over 51,000 participants in the Canadian Longitudinal Study on Aging, using models to consider different age and sex groups in their findings.
  • * Results showed that older adults (ages 65+) who experienced social isolation had reduced physical activity, which led to poorer memory and executive function, highlighting the need for public health strategies to encourage physical activity in socially isolated older individuals.
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Importance: Cognitive impairment is prevalent in survivors of stroke, affecting approximately 30% of individuals. Physical exercise and cognitive and social enrichment activities can enhance cognitive function in patients with chronic stroke, but their cost-effectiveness compared with a balance and tone program is uncertain.

Objective: To conduct a cost-effectiveness and cost-utility analysis of multicomponent exercise or cognitive and social enrichment activities compared with a balance and tone program.

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  • OCD is a mental health disorder that affects around 2% of the world but not much is known about its causes.
  • Most genetic studies on OCD so far have mainly focused on people of European ancestry, which could lead to unfair treatment options for those from other backgrounds.
  • The LATINO project is collecting DNA and health information from 5,000 people with OCD from Latin America to improve understanding of the disorder and develop better treatments for everyone.
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Background And Objectives: Restrictions implemented to mitigate the transmission of coronavirus disease 2019 (COVID-19) affected older adults' ability to engage in social and physical activities. We examined mental health outcomes of older adults reporting worsened ability to be socially and physically active during the pandemic.

Research Design And Methods: Using logistic regression, we examined the relationship between positive screen for depression (10-item Center for Epidemiological Studies-Depression Scale) or anxiety (7-item Generalized Anxiety Scale) at the end of 2020 and worsened ability to engage in social and physical activity during the first 6-9 months of the pandemic among older adults in Canada.

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Background: Research has struggled to understand the temporal relationship between cognition and depression. Some literature suggests that depression may be a risk factor for memory decline, while other work indicates that memory decline may precede depression symptoms. The purpose of this study was to clarify the temporal relationship between memory and depression, examining the moderating role of sex and age.

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Coercive and disruptive behaviors commonly interfere with cognitive-behavioral therapy (CBT) trials among youths with obsessive-compulsive disorder (OCD). Although evidence supports parent management training (PMT) for reducing disruptive behavior, no group-based PMT interventions exist for OCD-related disruptive behaviors. We studied feasibility and effectiveness of group-based adjunctive PMT among non-randomized, OCD-affected families receiving family-based group CBT.

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  • Obsessive-compulsive disorder (OCD) affects about 2% of people around the world, but we don’t know exactly what causes it.
  • Most research so far has focused mainly on people of European descent, which can leave out important information for people from other backgrounds.
  • The LATINO initiative aims to include 5,000 people with OCD from Latin America and other countries, helping to gather more diverse data to improve our understanding and treatment of OCD globally.
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Objectives: Identifying the correlates of mental health resilience (MHR)-defined as the discrepancy between one's reported current mental health and one's predicted mental health based on their physical performance-may lead to strategies to alleviate the burden of poor mental health in aging adults. Socioeconomic factors, such as income and education, may promote MHR via modifiable factors, such as physical activity and social networks.

Design: A cross-sectional study was conducted.

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Introduction: Posterior Cortical Atrophy (PCA) is a neurodegenerative disorder characterized by impairment of higher-order visual processing in the setting of progressive atrophy of the parietal and occipital lobes. The underlying pathology is variable but most commonly Alzheimer's disease. The majority of individuals develop symptoms before 65 years of age; however, delayed diagnosis is common due to misattribution of symptoms to ocular rather than cortical pathology.

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Background: The longitudinal rates of cognitive decline among aging populations are heterogeneous. Few studies have investigated the possibility of implementing prognostic models to predict cognitive changes with the combination of categorical and continuous data from multiple domains.

Objective: Implement a multivariate robust model to predict longitudinal cognitive changes over 12 years among older adults and to identify the most significant predictors of cognitive changes using machine learning techniques.

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Importance: Most epidemiologic studies examine the brain as an outcome in relation to adiposity (ie, the brain-as-outcome perspective), but it is also a potential risk factor associated with adiposity accumulation over time (ie, the brain-as-risk factor perspective). The bidirectionality hypothesis has not been fully explored in adolescent samples previously.

Objective: To assess bidirectional associations between adiposity and cognitive function in youth and test mediational pathways through brain morphology (specifically the lateral prefrontal cortex [LPFC]), lifestyle behaviors, and blood pressure.

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Background: Canadians endured unprecedented mental health (MH) and support access challenges during the first COVID-19 wave. Identifying groups of individuals who remain at risk beyond the acute pandemic phase is key to guiding systemic intervention efforts and policy. We hypothesized that determinants of three complementary, clinically actionable psychiatric outcomes would differ across Canadian age groups.

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  • The UCSF Memory and Aging Center adapted to the COVID-19 pandemic by implementing a telemedicine model for diagnosing and managing Alzheimer’s and related dementias, examining its impact on clinic care indicators.
  • After the transition to video teleconferencing, the percentage of appointments held via telemedicine skyrocketed from 1.9% to 86.4%, with significant reductions in cancellation rates and an increase in completed appointments.
  • Provider surveys indicated a more positive experience among physicians post-transition, while the demographic makeup of patients remained largely unchanged despite longer travel distances for follow-up appointments.
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  • - This study examines the overlap of pediatric obsessive-compulsive disorder (OCD) and eating disorders, particularly focusing on two conditions: pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS).
  • - Researchers aimed to find out how many youth (ages 8-18) with eating disorders also fit the criteria for PANS or PANDAS by surveying 100 participants and analyzing their responses on a parent-report questionnaire.
  • - Results showed that 52% of the participants met the criteria for PANS, while none met the criteria for PANDAS. PANS symptoms commonly included both food restriction and obsessive-compulsive
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