Publications by authors named "Stephanie Rainey Smith"

Background: The success of therapeutic options for treatment of Alzheimer's disease (AD) and the growing emphasis for such treatment to commence in the pre-clinical phase makes it necessary to have robust empirical models of clinical disease progression to understand findings from clinical trials, allow clinicians to evaluate effects of new drugs, and to select individuals for future trials. Such models have been developed from relatively small samples, with incomplete data/substantial loss to follow-up. The ADOPIC consortium provides the largest complete AD natural history sample to date.

View Article and Find Full Text PDF

Sleep discrepancy (negative discrepancy reflects worse self-reported sleep than objective measures, such as actigraphy, and positive discrepancy the opposite) has been linked to adverse health outcomes. This study is first to investigate the relationship between sleep discrepancy and brain glucose metabolism (assessed globally and regionally via positron emission tomography), and to evaluate the contribution of insomnia severity and depressive symptoms to any associations. Using data from cognitively unimpaired community-dwelling older adults ( = 68), cluster analysis was used to characterise sleep discrepancy (for total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE)), and logistic regression was used to explore sleep discrepancy's associations with brain glucose metabolism, while controlling for insomnia severity and depressive symptoms.

View Article and Find Full Text PDF
Article Synopsis
  • Plasma phospho-tau 217 (pTau217) assays, when performed on the common Lumipulse-G® platform, can effectively identify Alzheimer's disease (AD) by analyzing β-amyloid (Aβ) status and tau staging in patients.
  • In a study with 388 participants, pTau217 showed strong correlations with PET imaging results, achieving high accuracy rates in distinguishing between Aβ-negative and Aβ-positive individuals, as well as different stages of tau pathology.
  • The findings suggest that the plasma pTau217 assay is a reliable tool for predicting who might benefit from anti-β-amyloid treatments, emphasizing its potential for broader clinical use in AD diagnostics.
View Article and Find Full Text PDF

Introduction: We investigated longitudinal associations between self-reported exercise and Alzheimer's disease (AD)-related biomarkers in individuals with autosomal dominant AD (ADAD) mutations.

Methods: Participants were 308 ADAD mutation carriers aged 39.7 ± 10.

View Article and Find Full Text PDF

Introduction: Dietary nitrate is potentially beneficial for cardiovascular, cerebrovascular, and nervous systems due to its role as a nitric oxide (NO) precursor. Increased nitrate intake improves cardiovascular health and therefore could protect against dementia, given the cardiovascular-dementia link.

Objective: To investigate the association between source-dependent nitrate intake and dementia-related mortality.

View Article and Find Full Text PDF

This was the first study to use cluster analysis to characterise sleep discrepancy (the discordance between self-reported and objective sleep) across multiple sleep parameters, in community-dwelling older adults. For sleep efficiency, negative discrepancy (the tendency to self-report worse sleep than objectively-measured) was associated with poorer memory, independent of insomnia severity, depressive symptoms and objective sleep. This suggests a unique role for sleep discrepancy as a possible risk factor for future cognitive decline, and warrants the need for further research.

View Article and Find Full Text PDF

Purpose Of Review: This narrative review evaluates the role of diet in the relationship between depression and Alzheimer's disease (AD).

Recent Findings: AD and depression are often comorbid, and depression appears to independently increase the future risk of AD. Evidence suggests diet influences the risk of both conditions directly and indirectly.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how β-amyloid (Aβ) buildup in early Alzheimer’s disease (AD) relates to brain atrophy and cognitive decline, particularly in memory and attention.
  • Participants were analyzed over a median of 6.1 years, revealing that those with Aβ present (both cognitively unimpaired and with mild cognitive impairment) experienced faster brain volume loss and cognitive decline compared to cognitively unimpaired Aβ-negative participants.
  • Results indicate that atrophy in key brain regions, including the basal forebrain and hippocampus, mediates the relationship between Aβ levels and declining cognitive functions, highlighting the hippocampus's significant role in memory decline.
View Article and Find Full Text PDF

Introduction: This study investigated whether self-reported sleep quality is associated with brain amyloid beta (Aβ) accumulation.

Methods: Linear mixed effect model analyses were conducted for 189 cognitively unimpaired (CU) older adults (mean ± standard deviation 74.0 ± 6.

View Article and Find Full Text PDF

Introduction: The Finnish Geriatric Intervention Study (FINGER) led to the global dementia risk reduction initiative: World-Wide FINGERS (WW-FINGERS). As part of WW-FINGERS, the Australian AU-ARROW study mirrors aspects of FINGER, as well as US-POINTER.

Method: AU-ARROW is a randomized, single-blind, multisite, 2-year clinical trial ( = 600; aged 55-79).

View Article and Find Full Text PDF

Physical activity is a promising preventative strategy for Alzheimer's disease: it is associated with lower dementia risk, better cognition, greater brain volume and lower brain beta-amyloid. Blood-based biomarkers have emerged as a low-cost, non-invasive strategy for detecting preclinical Alzheimer's disease, however, there is limited literature examining the effect of exercise (a structured form of physical activity) on blood-based biomarkers. The current study investigated the influence of a 6-month exercise intervention on levels of plasma beta-amyloid (Aβ42 Aβ40, Aβ42/40), phosphorylated tau (p-tau181), glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) chain in cognitively unimpaired older adults, and as a secondary aim, whether blood-based biomarkers related to cognition.

View Article and Find Full Text PDF

Alzheimer's disease (AD), the most prevalent form of dementia, is characterized by the accumulation of amyloid-beta (Aβ) plaques and hyperphosphorylated tau tangles. Currently, Alzheimer's disease (AD) impacts 50 million individuals, with projections anticipating an increase to 152 million by the year 2050. Despite the increasing global prevalence of AD, its underlying pathology remains poorly understood, posing challenges for early diagnosis and treatment.

View Article and Find Full Text PDF

Introduction: The current study evaluated the relationship between habitual physical activity (PA) levels and brain amyloid beta (Aβ) over 15 years in a cohort of cognitively unimpaired older adults.

Methods: PA and Aβ measures were collected over multiple timepoints from 731 cognitively unimpaired older adults participating in the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study of Aging. Regression modeling examined cross-sectional and longitudinal relationships between PA and brain Aβ.

View Article and Find Full Text PDF

Background: Exercise can improve cognition in aging, however it is unclear exercise influences cognition, and sleep may partially explain this association. The current study aimed to investigate whether objectively measured sleep mediates the effect of an acute exercise intervention on cognition in older adults.

Methods: Participants were 30 cognitively unimpaired, physically active older adults (69.

View Article and Find Full Text PDF

Objectives: Observational studies consistently demonstrate that physical activity is associated with elevated cognitive function, however, there remains significant heterogeneity in cognitive outcomes from randomized exercise interventions. Individual variation in sleep behaviours may be a source of variability in the effectiveness of exercise-induced cognitive change, however this has not yet been investigated. The current study aimed to (1) investigate the influence of a 6-month exercise intervention on sleep, assessed pre- and post-intervention and, (2) investigate whether baseline sleep measures moderate exercise-induced cognitive changes.

View Article and Find Full Text PDF

Dysfunction of the cholinergic basal forebrain (BF) system and amyloid-β (Aβ) deposition are early pathological features in Alzheimer's disease (AD). However, their association in early AD is not well-established. This study investigated the nature and magnitude of volume loss in the BF, over an extended period, in 516 older adults who completed Aβ-PET and serial magnetic resonance imaging scans.

View Article and Find Full Text PDF

Osteoporosis and Alzheimer's disease (AD) mainly affect older individuals, and the possibility of an underlying link contributing to their shared epidemiological features has rarely been investigated. In the current study, we investigated the association between levels of plasma sclerostin (SOST), a protein primarily produced by bone, and brain amyloid-beta (Aβ) load, a pathological hallmark of AD. The study enrolled participants meeting a set of screening inclusion and exclusion criteria and were stratified into Aβ- (n = 65) and Aβ+ (n = 35) according to their brain Aβ load assessed using Aβ-PET (positron emission tomography) imaging.

View Article and Find Full Text PDF

Sirtuin-1 (Sirt1), encoded by the gene, is a conserved Nicotinamide adenine dinucleotide (NAD+) dependent deacetylase enzyme, considered as the master regulator of metabolism in humans. Sirt1 contributes to a wide range of biological pathways via several mechanisms influenced by lifestyle, such as diet and exercise. The importance of a healthy lifestyle is of relevance to highly prevalent modern chronic diseases, such as Alzheimer's disease (AD).

View Article and Find Full Text PDF

Background & Aims: Dietary nitrate improves cardiovascular health via a nitric oxide (NO) pathway. NO is key to both cardiovascular and brain health. There is also a strong association between vascular risk factors and brain health.

View Article and Find Full Text PDF

Sleep plays a major role in brain health, and cognition. Disrupted sleep is a well-described symptom of Alzheimer's disease (AD). However, accumulating evidence suggests suboptimal sleep also increases AD risk.

View Article and Find Full Text PDF

Background: Astrocyte reactivity is an early event along the Alzheimer's disease (AD) continuum. Plasma glial fibrillary acidic protein (GFAP), posited to reflect astrocyte reactivity, is elevated across the AD continuum from preclinical to dementia stages. Monoamine oxidase-B (MAO-B) is also elevated in reactive astrocytes observed using 18F-SMBT-1 PET in AD.

View Article and Find Full Text PDF

Introduction: The current study investigated the association between objectively measured physical activity and cognition in older adults over approximately 8 years.

Methods: We utilized data from 199 cognitively unimpaired individuals from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study, aged ≥60. Actigraphy was used to measure physical activity (intensity, total activity, and energy expenditure) at baseline.

View Article and Find Full Text PDF

Introduction: Plasma amyloid beta (Aβ)1-42/Aβ1-40 ratio, phosphorylated-tau181 (p-tau181), glial fibrillary acidic protein (GFAP), and neurofilament light (NfL) are putative blood biomarkers for Alzheimer's disease (AD). However, head-to-head cross-sectional and longitudinal comparisons of the aforementioned biomarkers across the AD continuum are lacking.

Methods: Plasma Aβ1-42, Aβ1-40, p-tau181, GFAP, and NfL were measured utilizing the Single Molecule Array (Simoa) platform and compared cross-sectionally across the AD continuum, wherein Aβ-PET (positron emission tomography)-negative cognitively unimpaired (CU Aβ-, n = 81) and mild cognitive impairment (MCI Aβ-, n = 26) participants were compared with Aβ-PET-positive participants across the AD continuum (CU Aβ+, n = 39; MCI Aβ+, n = 33; AD Aβ+, n = 46) from the Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (AIBL) cohort.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how well the plasma amyloid beta (Aβ) and phosphorylated tau (p-tau) levels predict Alzheimer’s disease status and cognitive decline.
  • The p-tau181/Aβ ratio was found to be the most effective predictor of abnormal amyloid PET scans and cognitive deterioration in participants across different stages of cognitive health.
  • This ratio shows promise as a useful diagnostic tool and screening method for identifying individuals at risk of developing Alzheimer’s disease in future clinical trials.
View Article and Find Full Text PDF

There is currently no effective treatment for dementia, of which Alzheimer's disease (AD) is the most common form. It is, therefore, imperative to focus on evidence-based preventive strategies to combat this extremely debilitating chronic disease. Nitric oxide (NO) is a key signalling molecule in the cardiovascular, cerebrovascular, and central nervous systems.

View Article and Find Full Text PDF