Research News

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Life expectancy for community-dwelling persons with dementia and severe disability

April 27, 2022

For people with dementia or a severe disability having a clear understanding of their prognosis can help them, their care partners, and clinicians anticipate and plan for future social, financial, functional, and clinical needs.

While prior work around life expectancy and needs of persons with dementia have focused on either overall life expectancy at the time of diagnosis or on end-of-life estimates in nursing home settings, there have been no studies examining life expectancy in community-dwelling persons with dementia, even though the majority of care partners and persons with dementia want to remain at home.

In a first of its kind study, NCIRE Board Director Kristine Yaffe, MD, and fellow NCIRE-supported investigator John Boscardin, PhD, and their colleagues found that among the 842 community-dwelling persons with dementia and severe disability evaluated, the median life expectancy is 1.7 years; one quarter died within 7 months.

The paper was published in the Journal of the American Geriatrics Society.

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Association of Vitamin D Status and COVID-19-Related Hospitalization and Mortality

April 20, 2022

The relationship between vitamin D status and COVID-19-related clinical outcomes is controversial. Prior studies have been conducted in smaller, single-site, or homogeneous populations limiting adjustments for social determinants of health (race/ethnicity and poverty) common to both vitamin D deficiency and COVID-19 outcomes.

NCIRE Board Director Carl Grunfeld, MD, PhD, and fellow NCIRE-supported investigators, Karen Seal, MD and Daniel Bikle, MD, PhD, co-authored a study that evaluates the dose-response relationship between continuous 25(OH)D and risk for COVID-19-related hospitalization and mortality after adjusting for covariates associated with both vitamin D deficiency and COVID-19 outcomes.

The retrospective cohort study investigated 4,599 Veteran patients receiving care in U.S. Department of Veteran Affairs health care facilities with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test and a blood 25(OH)D test between February 20, 2020, and November 8, 2020, followed for up to 60 days.

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Screening and enrollment of underrepresented ethnocultural and educational populations in the Alzheimer's Disease Neuroimaging Initiative (ADNI) 

April 1, 2022

According to the Alzheimer’s Association, older Black Americans are about twice as likely to have Alzheimer’s or other dementias as whites; older Hispanics are one-and-a-half times as likely to have these disorders as whites. By 2030, nearly 40 percent of all Americans living with Alzheimer’s will be Black or Latino, according to UsAgainstAlzheimer’s, an organization founded in 2010 to diversify Alzheimer’s research.

With this is mind, NCIRE-supported Investigator Michael Weiner, MD and his cohorts conducted an analysis of the ethnocultural and socioeconomic composition of Alzheimer's Disease Neuroimaging Initiative (ADNI) participants to assess the generalizability of ADNI data to diverse populations.

ADNI, which began in 2004 under Weiner’s leadership, is the most extensive Alzheimer’s observational study globally and considered by many to be the gold standard for clinical trials for the disease. The study has attracted more than 2,000 subjects since 2004 at 60 sites across the U.S. and Canada.

In the analysis, ADNI data collected between October 2004 and November 2020 were used to determine ethnocultural and educational composition of the sample and differences in the following metrics: screening, screen fails, enrollment, biomarkers.

Of the 3739 screened individuals, 11 percent identified as being from ethnoculturally underrepresented populations (e.g., Black, Latinx) and 16 percent had less than 12 years of education. Of the 2286 enrolled participants, 11 percent identified as ethnoculturally underrepresented individuals and 15 percent had less than 12 years of education. This participation is considerably lower than US Census data for adults 60+ (ethnoculturally underrepresented populations: 25 percent; less than 12 years of education: 4 percent). Individuals with less than 12 years of education failed screening at a higher rate.

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A rare case of axillary keratoacanthoma arising in hidradenitis suppurativa

March 31, 2022

Keratoacanthoma (KA), a cutaneous, often spontaneously regressing tumor characteristically presenting as an umbilicated nodule with a central keratin plug, occurs most frequently in lightly pigmented individuals with sun damage. NCIRE-supported Investigator Maria Wei, MD, PhD co-published a study that reports an unusual case of KA with a large pedunculated morphology, diagnosed in an African American man, that arose in hidradenitis suppurativa (HS), a relapsing inflammatory skin disease affecting hair follicles in intertriginous areas.

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Thomas Neylan, MD, 2021 Robert S. Laufer Memorial Award recipient

March 30, 2022

The International Society for Traumatic Stress Studies honored NCIRE-supported Investigator Thomas Neylan, MD with its 2021 Robert S. Laufer Memorial Award.

This award is given to an individual or group who has made an outstanding contribution to research in the field of traumatic stress. Robert S. Laufer, PhD, was a sociologist who made early and important contributions to the field of traumatic stress and PTSD through his research on the effects of war experiences on Vietnam combat veterans. Laufer was Professor of Sociology at Brooklyn College of the City University of New York and an author of the groundbreaking study of returning veterans, entitled Legacies of Vietnam: Comparative Adjustment of Veterans and Their Peers, published in 1981, with Arthur Egendorf, Ellen Frey-Wouters, and others.

 

Laufer and colleagues expanded the concept of combat exposure to include multiple dimensions. In particular, he focused on witnessing or participating in abusive violence, an important new focus for a guerilla war where there were no front lines, and where enemy combatants and civilians were often difficult to distinguish. He found that abusive violence followed from more extreme exposure to combat, and was associated with distinctive psychological and behavioral outcomes, including different aspects of PTSD. Laufer died prematurely of cancer in 1989 at the age of 47. This award is made in his memory.

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Daniel Mathalon, PhD honored with Lifetime Achievement Award

March 29, 2022

NCIRE-supported Investigator Daniel Mathalon, PhD was one of five psychological and brain sciences alumni honored by the University of Indiana at its Department of Psychological and Brain Sciences’ 2021 Alumni Recognition Day back in October 2021.

Dr. Mathalon received the department’s Lifetime Achievement Award for his prestigious work in the field of psychiatry.  

The department, in the IU Bloomington College of Arts and Sciences, has acknowledged outstanding graduates of its bachelor’s and Ph.D. programs with a series of awards since 2013, the year of the department’s 125th anniversary.

Dr. Mathalon is the Deputy Vice Chair for Research at the San Francisco VA Health Care System, and professor with the Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences at University of California, San Francisco.

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Deep learning for Alzheimer's disease: Mapping large-scale histological tau protein for neuroimaging biomarker validation

March 28, 2022

Definite diagnosis of Alzheimer’s disease is now determined at autopsy when the abnormal spread in the brain of proteins – including “tau” – are evident. But researchers at the UCSF Center for Intelligent Imaging (ci2), including NCIRE-supported Investigator Duygu Tosun-Turgut, PhD, suggest that “in vivo tau PET imaging” may be a game changer by visualizing tau deposition in living people.

 

Their study in the March issue of NeuroImage (https://www.sciencedirect.com/science/article/pii/S1053811921010570) opens avenues for thorough and systematic validation of new neuroimaging tracers and expediting their approval for clinical use.

"This work outlines an end-to-end deep learning-powered pipeline to facilitate dense quantification of whole-brain tau inclusions observed at autopsy in perfect alignment with in vivo neuroimaging, which will allow directly linking imaging measures to ground-truth neuropathological inclusions at autopsy," said Dr. Tosun.

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Moral injury increases Veterans’ suicide risk

February 16, 2022

Moral injury during military service increases suicide risk in both men and women, according to a study by NCIRE-supported Investigator Shira Maguen, PhD. The study of more than 14,000 Veterans found that men who experienced moral injury were 50 percent more likely to attempt suicide during their service and twice as likely to do so after leaving the military, compared with those without moral injury. Men who felt betrayed were nearly twice as likely than those without these feelings to attempt suicide during service, but no more likely after service.

Women who experienced betrayal were over 50 percent more likely to attempt suicide both during and after service. Perpetrating a morally injurious act did not increase the suicide risk of women Veterans.

 

The study, published in Psychological Medicine, suggests that moral injury assessment should take gender difference into account.

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New study reevaluates Annual Growth Rate of Nonsyndromic Ascending Thoracic Aortic Aneurysms

February 7, 2022

While previous studies of nonsyndromic ascending thoracic aortic aneurysms (aTAAs) reported that the typical aTAA growth rate was approximately 0.6 mm/year, there are few studies that have measured the annual growth of aTAAs using computed tomography (CT) imaging. NCIRE Board Director Michael Hope, MD, and NCIRE-supported Investigator Elaine Tseng, MD, FACS, co-published a study that reevaluates the annual growth rate of nonsyndromic aTAAs that do not meet criteria for surgical repair in Veterans in the contemporary era, using modern CT imaging suitable for highly accurate and reproducible aneurysm measurement.

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Connection found between ACE inhibiters and reduced risks associated with COVID-19 infections

February 3, 2022

Past studies have shown that SARS-CoV-2 (the virus that leads to COVID-19 infections) enters cells using the Angiotensin-converting enzyme 2 (ACE2) receptors.

But what happens in patients who are taking angiotensin receptor blockers, metformin, ACE inhibiters, and similar medication?

In the study titled “Association of the patterns of use of medications with mortality of COVID-19 infection: a hospital-based observational study”, investigators found that such medications have the potential to counter the dysregulation of ACE2 by the virus and protect against viral injury.

The study was co-published by NCIRE-supported Investigator, Arthur Wallace, MD and appeared in the peer-reviewed British Medical Journal.

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Anxiety and PTSD linked to increased myelin in brain’s gray matter

January 11, 2022

We all respond differently to traumatic stressors, but what is the biological reason behind our various behavioral reactions to stress? Recent studies have shown that stress influences the plasticity of oligodendrocytes and the myelin they produce, demonstrating a mechanism by which trauma induces abnormal structural and functional changes in the adult brain. 

An oligodendrocyte is a type of large glial cell found in the central nervous system that assembles myelin, a multilayered sheath of membrane that wraps around the axonal segments between nerve cells, aiding in faster communication between cells.

Taking a translational approach to test the hypothesis that gray matter oligodendrocytes contribute to traumatic-stress-induced behavioral variation, NCIRE-supported Investigators Linda Chao, PhD, and Thomas Neylan, MD, co-published a study in the peer-reviewed medical journal Translational Psychiatry linking anxiety and Post-traumatic Stress Disorder (PTSD) to increased myelin in brain’s gray matter.

Titled “Regional gray matter oligodendrocyte- and myelin-related measures are associated with differential susceptibility to stress-induced behavior in rats and humans”, the aim of this study was to determine the relationship between oligodendrocytes and the behavioral outcomes of trauma.

Conducting brain MRI scans of 38 Veterans — half with PTSD, half without — investigators found an increase in myelination in the gray matter of those with PTSD compared to that seen in the brains of those not suffering from PTSD.

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Roam Robotics launches partnership with NCIRE and the San Francisco VA Health Care System to study the impact of its robotic wearable on the Veteran population

December 7, 2021

Roam Robotics, a company making innovations in the expansion of human mobility with wearable robotics, announced today that the Northern California Institute for Research and Education (NCIRE) and the San Francisco VA Health Care System (SFVAHCS) has begun enrolling patients to study the impact of Ascend, a first-of-its-kind smart brace, on the Veteran population.

Ascend, from Roam Robotics, is a smart knee orthosis designed to provide relief from knee pain and intuitively support everyday mobility.

Ascend is the first wearable robotic device to show usefulness in everyday life for people suffering from knee joint pain who want to regain independence and live more active lifestyles. A previous clinical study of knee osteoarthritis participants demonstrated an average of 46 percent pain reduction, and 67 percent exhibited functional improvement when using the device.  Ascend is also registered with the FDA as a Class I medical device.

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Study Finds Significant COVID-19 Vaccine Effectiveness Decline Amongst US Veterans

November 4, 2021

In the first study of its kind of more than 780,000 US Veterans, NCIRE-supported Investigator, Arthur Wallace, MD, and cohorts found that protection against any COVID-19 infection declined for all vaccine types, with overall vaccine protection declining from 87.9% in February to 48.1% by October 2021. The novel study was co-published in Science Magazine.

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Investigating the Gene-Environment Interactions Related to Parkinson’s Disease Susceptibility

October 20, 2021

Parkinson’s disease (PD) is a neurodegenerative disease that progresses over time as small clusters of dopamine‐producing brain cells deteriorate, causing motor issues such as tremors, loss of coordination, and difficulty speaking. The Parkinson’s Foundation states that approximately one million Americans currently living with PD. Although the exact cause of disease onset is unknown, it is thought that a combination of genetic and environmental factors, as well as the interaction between them, are contributors. Through a Neurotoxin Exposure Treatment Parkinson’s Program (NETP) Fiscal Year 2019 Investigator‐Initiated Research Award, NCIRE-supported Investigators, Drs. Samuel Goldman and Raymond Swanson, aim to uncover the link between genetic and environmental factors that may contribute to the risk for PD.

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Dr. Bruce Ovbiagele elected to the National Academy of Medicine

October 18, 2021

NCIRE-supported scientist and Board Member Dr. Bruce Ovbiagele has been elected as a new member of the prestigious National Academy of Medicine, as announced at its annual meeting held on October 18, 2021.

“I am, and have always been, committed to discovering new and innovative ways to ensure that health and wellness are not dependent on one’s race, ethnicity, geographic, or socioeconomic status,” said Dr. Ovbiagele. “This recognition by the National Academy of Medicine is a tremendous privilege and a meaningful validation of the efforts of my team to address health disparities here and abroad.”

New members are elected by current members of the Academy through a rigorous selection process that considers only the most exceptional individuals who have made major contributions to the advancement of the medical sciences, health care, and public health.

 

Dr. Ovbiagele was selected for his research focusing on the health of vulnerable populations (racial and ethnic minorities, the uninsured, rural dwellers, and military veterans) in the United States and Africa.

 

NCIRE congratulates Dr. Ovbiagele on his election to the National Academy of Medicine! We are proud and appreciative of his vital and ground-breaking work on behalf of often-overlooked and underserved communities both here and abroad.

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Dr. Kenneth E. Covinsky co-publishes in Journal of the American Geriatrics Society 

October 14, 2021

Alzheimer's disease and other dementias are progressive and terminal conditions that create immeasurable suffering for those it afflicts and their loved ones. Though the FDA recently approved aducanumab (Aduhelm, Biogen) for the treatment of Alzheimer's disease, its less-than-desirable clinical effectiveness and high price tag ($50,000 annual cost to patients) is causing much concern in the research community. NCIRE-supported scientist Dr. Kenneth E. Covinsky co-published an article with Drs. Lauren Hunt and Krista Harrison in the Journal of the American Geriatrics Society entitled “Instead of Wasting Money on Aducanumab, Pay for Programs Proven to Help People Living with Dementia”.

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Dr. Louise Walter co-publishes study in the Journal of the American Geriatrics Society

October 5, 2021

Maintenance of function during cancer treatment is important to older adults; yet little was known about the characteristics associated with pretreatment life-space mobility and changes during non-small cell lung cancer (NSCLC) treatment. NCIRE-supported scientist and Board Member Dr. Louise Walter, with colleagues Drs. Melisa Wong and Alex Smith, conducted a mixed methods cohort study of adults 65 and older with advanced NSCLC over the course of six months to examine patient experience of life-space change during treatment.

Their published study can be found in the Journal of the American Geriatrics Society.

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Glycoprotein associated with cardiac valve damage in animal models of infective endocarditis

September 21, 2021

Some oral bacteria colonize on tooth surfaces, but they can seep into the bloodstream and settle inside the heart’s chambers and valves. They may even cause infective endocarditis (IE), which can lead to stroke and heart failure. In a study in the journal Glycobiology, SFVAHCS researcher Dr. Barbara Bensing identifies a group of proteins, expressed by oral bacteria, and how they help the organisms bind and colonize on cardiac valve surfaces.

 

She found significantly higher levels of a particular glycoprotein, lubricin, in laboratory animals with damaged or infected valves, as compared to healthy animals. Presence of this protein could serve as a biomarker for endocardial injury or infection, suggests the study.

 

Dr. Bensing, was formerly a postdoctoral fellow in the laboratory of NCIRE-supported scientist Paul Sullam, MD, who was a co-author of the study.