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Hermann, B. P.

Publications and source records attributed to Hermann, B. P..

3 recordsLinked to original sources

Characterizing the effects of sex, APOE 4, and literacy on mid-life cognitive trajectories: Application of Information-Theoretic model-averaging and multi-model inference techniques to the Wisconsin Registry for Alzheimer’s Prevention Study

In this paper we apply Information-Theoretic (IT) model averaging to characterize a set of complex interactions in a longitudinal study on cognitive decline. Prior research has identified numerous genetic (including sex), education, health and lifestyle factors that predict abnormal cognitive decline.Traditional model selection approaches (e.g., backward or stepwise selection), attempt to find models that best fit the observed data; these techniques risk interpretations that only the selected predictors are important. In reality, several models may fit similarly well but result in different conclusions (e.g., about size and significance of parameter estimates), and inference from a single model chosen after a selection procedure can lead to overly simplistic conclusions. Here we utilize longitudinal cognitive data from the Wisconsin Registry for Alzheimers Prevention to examine the effects of sex and the Apolipoprotein E (APOE) 4 allele (non-modifiable factors), and reading literacy achievement (modifiable) on cognitive decline. For each outcome, we applied IT model averaging to a model set with combinations of interactions among sex, APOE, literacy, and age. For a list-learning test, model-averaged results showed better performance for women vs men, with faster decline among men; increased literacy was associated with better performance, particularly among men. APOE had less effect in this age range (~40-70). These results illustrate the utility of the IT approach and point to verbal ability as a potential modifier of decline. Whether the protective effect of literacy is due to educational attainment or intrinsic verbal intellectual ability is the topic of ongoing work.

neuroscience

Longitudinal standards for mid-life cognitive performance: Identifying abnormal within-person changes in the Wisconsin Registry for Alzheimer’s Prevention

A major challenge in the field of cognitive aging is differentiating disease-related cognitive change that has not yet become overt impairment from the more gradual decline in performance expected with normal aging. Published normative reference values are nearly always for single time point performances rather than longitudinal change in performance. To gain insight into how we might tackle the problem of identifying worrisome trajectories, we borrow a method from anthropometry: the development of standards that are conditional on an individuals past measurements. We use quantile regression to create growth-curve-like models of performance on several common neuropsychological tests of memory and executive function while accounting for age, sex, education, estimated verbal ability, and past performance on the test, and then use these to estimate individuals percentile ranks. Choosing the 7th percentile as a threshold (corresponding to approximately 1.5 standard deviations below the expected mean), we then explore relationships between subthreshold performance, clinical outcomes, and subjective impairment. Participants whose performance fell below the 7th percentile were more likely to be given an abnormal research diagnosis at the current visit, but not at later visits. Performance below this threshold was also linked to subjective and informant reports of worsening memory function. We discuss potential uses of this method in theoretical and applied research and clinical settings.

neuroscience

The Wisconsin Registry for Alzheimer’s Prevention: A Review of findings and current directions

The Wisconsin Registry for Alzheimers Prevention (WRAP) is a longitudinal observational cohort study enriched with persons with a parental history (PH) of probable Alzheimers Disease (AD) dementia. Since late 2001, WRAP has enrolled 1,561 people at a mean baseline age of 54. Participants return for a second visit four years after baseline and subsequent visits occur every two years. Eighty-one percent (1270) of participants remain active in the study at a current mean age of 64 and 9 years of follow-up. Serially assessed cognition, self-reported medical and lifestyle histories (e.g. diet, physical and cognitive activity, sleep, and mood), laboratory tests, genetics, and linked studies comprising molecular imaging, structural imaging and cerebrospinal fluid data, have yielded many important findings. In this cohort, PH of probable AD is associated with 46% APOE {varepsilon}4 positivity, more than twice the rate of 22% among persons without PH. Subclinical or worse cognitive decline relative to internal normative data has been observed in 17.6% of the cohort. Twenty-eight percent exhibit amyloid and/or tau positivity. Biomarker elevations, but not APOE or PH status, are associated with cognitive decline. Salutary health and lifestyle factors are associated with better cognition and brain structure, and lower AD pathophysiologic burden. Of paramount importance is establishing the amyloid and tau AD endophenotypes to which cognitive outcomes can be linked. Such data will provide new knowledge on the early temporal course of AD pathophysiology and inform the design of secondary prevention clinical trials.

neuroscience