Publications by authors named "Zachary Kunicki"

Brazilians are a rapidly growing immigrant population in the United States (U.S.), yet little is known about their mental health and access to mental healthcare.

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Background: Subjective cognitive concerns (SCC) may be among the earliest clinical symptoms of dementia. There is growing interest in applying mobile app-based cognitive assessment to remotely screen for cognitive status in preclinical dementia, but the relationship between SCC and relevant mobile assessment metrics is uncertain.

Objective: We characterized the relationship between SCC and adherence, satisfaction, and performance on mobile-app assessments in cognitively unimpaired older adults.

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Background: Events such as global pandemics can force rapid adoption of new modes of assessment. We describe the evaluation of a modified neuropsychological assessment for web and telephone administration.

Methods: Telephone and video conferencing-based neuropsychological assessment procedures were developed and implemented within an ongoing observational study, the Successful Aging following Elective Surgery II (SAGES) study (N = 420 persons).

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Background: Plasma biomarkers have recently emerged for the diagnosis, assessment, and disease monitoring of Alzheimer's disease (AD), but have yet to be fully validated in preclinical AD. In addition to AD pathologic plasma biomarkers (amyloid-β (Aβ) and phosphorylated tau (p-tau) species), a proteomic panel can discriminate between symptomatic AD and cognitively unimpaired older adults in a dementia clinic population.

Objective: Examine the added value of a plasma proteomic panel, validated in symptomatic AD, over standard AD pathologic plasma biomarkers and demographic and genetic (apolipoprotein () ɛ4 status) risk factors in detecting preclinical AD.

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Objectives: Skilled therapies (STs), including audiology, speech-language therapy, occupational therapy, and physical therapy, can address functional deficits in dementia. This study aims to quantify the association between ST and successful discharge after heart failure (HF) hospitalization in persons living with dementia.

Design: Retrospective cohort study.

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Objective: The psychometric rigor of unsupervised, smartphone-based assessments and factors that impact remote protocol engagement is critical to evaluate prior to the use of such methods in clinical contexts. We evaluated the validity of a high-frequency, smartphone-based cognitive assessment protocol, including examining convergence and divergence with standard cognitive tests, and investigating factors that may impact adherence and performance (i.e.

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In this paper, we describe our process of changing language of the National Institute on Aging Imbedded Pragmatic Alzheimer's disease and AD-related dementias Clinical Trials Collaboratory (NIA IMPACT Collaboratory) "Stakeholder Engagement Team" to "Engaging Partners Team" in response to feedback from community partners regarding the problematic connotations of the term "stakeholder." We present a brief history of the term "stakeholder" and its use in clinical and community-engaged research. Then, we summarize critiques of this term, including its colonial history and potential to reinforce complacency with generational traumas, particularly among Indigenous peoples and communities.

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Article Synopsis
  • - The study examines the connection between cerebrovascular disease (CVD) biomarkers and amyloid beta (Aβ) in Alzheimer's disease (AD), finding that certain MRI-based biomarkers like white matter hyperintensities (WMHs) and superficial cerebral microbleeds (CMBs) are positively linked to Aβ positivity on PET scans.
  • - Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), the researchers found that after adjustments, both WMHs and superficial CMBs significantly predicted Aβ-PET positivity, while deep CMBs and lacunes showed mixed results depending on cognitive subgroups.
  • - The research supports the use of CVD biomarkers for diagnosing AD and suggests the need for further investigation into
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  • * The study evaluated the Pandemic Paranoia Scale for Adolescents (PPS-A), adapted from an adult version, and surveyed 462 adolescents in the US and UK, including input from their parents
  • * Results demonstrated that the PPS-A effectively measures paranoia with the same structure as adult measures, revealing a 21% prevalence of pandemic-related paranoia in adolescents, higher in the US than in the UK, underscoring ongoing mental health concerns post-COVID-19
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  • Older adults with heart failure are at increased risk for Alzheimer’s disease and related dementia, potentially influenced by insomnia and depression.
  • This study analyzed data from over 203,000 Veterans to determine how insomnia and depressive episodes affect the timing of dementia diagnosis.
  • Findings showed that patients with both insomnia and depression had the quickest progression to dementia, highlighting the need for screening these conditions to improve early detection and intervention.
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  • The study explores the need for non-invasive methods to detect amyloid-β pathology in Alzheimer’s disease, especially with new treatments available.
  • It evaluates the effectiveness of plasma tau phosphorylated at threonine-217 (P-tau217) as a potential alternative for determining eligibility for DMTs like aducanumab.
  • Results indicate that elevated P-tau217 levels strongly predict Aβ positivity, suggesting that this method could efficiently identify candidates for treatment while also highlighting the complexity of cutoff levels needed for accurate diagnoses.
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  • The study investigates the link between cerebrovascular disease (CVD) and amyloid-β (Aβ) in Alzheimer's disease using MRI-based CVD biomarkers.
  • It analyzed data from 1,352 participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) and found that white matter hyperintensities and superficial cerebral microbleeds correlated positively with Aβ-PET positivity.
  • The findings suggest that CVD biomarkers could enhance the diagnosis of Alzheimer's disease, highlighting a need for further research in this area.
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  • The study investigates non-invasive methods for detecting amyloid-β pathology in early Alzheimer's disease, focusing on the use of plasma tau phosphorylated at threonine-217 (P-tau217) as a potential alternative to costly and invasive techniques like PET and CSF analysis.
  • Researchers developed specific P-tau217 cutoffs and tested them on candidates from a memory and aging program, using ROC analysis to assess diagnostic accuracy against established methods.
  • Results showed high predictive accuracy of P-tau217 for identifying Aβ positivity, with a significant portion of candidates being treated with aducanumab, indicating that these cutoff strategies could improve access to disease-modifying treatments.
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Medical comorbidity, particularly cardiovascular diseases, contributes to high rates of hospital admission and early mortality in people with schizophrenia. The 30 days following hospital discharge represents a critical period for mitigating adverse outcomes. This study examined the odds of successful community discharge among Veterans with schizophrenia compared to those with major affective disorders and those without serious mental illness (SMI) after a heart failure hospital admission.

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Objective: Adults with serious mental illness (SMI) have high rates of cardiovascular disease, particularly heart failure, which contribute to premature mortality. The aims were to examine 90- and 365-day all-cause medical or surgical hospital readmission in Veterans with SMI discharged from a heart failure hospitalization. The exploratory aim was to evaluate 180-day post-discharge engagement in cardiac rehabilitation, an effective intervention for heart failure.

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  • Researchers checked how well digital tests on smartphones and in-person tests can tell if older adults have Alzheimer's disease (AD) changes in their brains.
  • They had 69 older adults do simple tests three times a day for a week and then take some other tests in person.
  • The smartphone memory test was the best at detecting brain changes, showing promise for using these digital tests more widely.
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Introduction: Adults with depression have higher rates of cigarette smoking and are more likely to relapse than those without depression. Pharmacological, psychological, and combined interventions have largely yielded small improvements in smoking outcomes for adults with depression. Aerobic exercise (AE) may facilitate smoking cessation in this subpopulation.

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Objectives: Mitochondrial dysfunction is implicated in the pathophysiology of psychiatric disorders. Levels of circulating cell-free mitochondrial DNA (cf-mtDNA) are observed to be altered in depression. However, the few studies that have measured cf-mtDNA in depression have reported conflicting findings.

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Claims data are a valuable resource for studying Alzheimer's disease and related dementias (ADRD). Alzheimer's disease and related dementias is often identified using a list of claims codes and a fixed lookback period of 3 years of data. However, a 1-year lookback or an approach using all-available lookback data could be beneficial based on different research questions.

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Dementia caregiving experiences are not universal and different factors may influence the risk for burden and depression. This study examined factors such as the relationship with the care recipient, severity of dementia, and relationship satisfaction to uncover different types of caregiver burden profiles using baseline assessment for a telephone-based intervention study for dementia caregivers. Participants (n = 233) completed a battery of psychological and caregiving related surveys.

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