Epidemiology of Head Injury and Associations with Clinical and Neuropsychological Test Scores in Older American Indians: Data from the Strong Heart Study.

Background: American Indians have the highest mortality and hospitalizations from head injury of all US groups; however, little is known about prevalence, risk, or outcomes in this population.

Methods: The Strong Heart Study recruited American Indians representing 11 tribes and communities across three regions for two sequential examinations in 2010-2019. Participants were asked to self-report prior head injury, loss of consciousness (LOC), cause, sociodemographics, and behaviors (age, sex, education, bilingual, smoking, alcohol use, stroke).

Psychometric Reliability, Validity, and Generalizability of MoCA in American Indian Adults: The Strong Heart Study.

Standardized neuropsychological instruments are used to evaluate cognitive impairment, but few have been psychometrically evaluated in American Indians. We collected Montreal Cognitive Assessment (MoCA) in 403 American Indians 70 to 95 years, as well as age, sex, education, bilingual status, depression symptoms, and other neuropsychological instruments. We evaluated inferences of psychometric validity, including scoring inference using confirmatory factor analysis and structural equation modeling, generalizability inference using reliability coefficient, and extrapolation inference by examining performance across different contexts and substrata.

Algorithm-defined memory impairment in older American Indians: The Strong Heart Study.

Objective: Assessment of cognition in American Indians poses challenges, including barriers to healthcare, unvalidated clinical standards, and confounding social determinants of health. Alternative strategies for case identification include algorithmic methods, which can outperform clinical judgment in some circumstances.

Method: Algorithmic methods can be maximized using single-domain tests with multiple-serial trial tasks, such as the California Verbal Learning Test II-Short Form (CVLT-SF).

The state of cancer-focused community outreach and engagement (COE): reflections of Black COE directors.

The requirement of community outreach and engagement (COE) as a major component of the National Cancer Institute (NCI) Cancer Center Support Grant has had an enormous impact on the way NCI-designated cancer centers identify, investigate, and address the needs of their catchment area (CA) communities. Given the wide-ranging diversity of our nation, COE's scope of work (SOW) is extremely demanding and complex. Yet, COE is often marginalized and viewed as void of scientific methods when, in fact, it requires specialized scientific knowledge and a broad range of proficiencies.

Epidemiology and prevalence of dementia and Alzheimer's disease in American Indians: Data from the Strong Heart Study.

Introduction: Accurate epidemiologic estimates for dementia are lacking for American Indians, despite substantive social and health disparities.

Methods: The Strong Heart Study, a population-based cohort of 11 American Indian tribes, conducted detailed cognitive testing and examinations over two visits approximately 7 years apart. An expert panel reviewed case materials for consensus adjudication of cognitive status (intact; mild cognitive impairment [MCI]; dementia; other impaired/not MCI) and probable etiology (Alzheimer's disease [AD], vascular bain injury [VBI], traumatic brain injury [TBI], other).