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Mol Psychiatry ; 25(11): 2942-2951, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-30514930

RESUMEN

Categorizing people with late-onset Alzheimer's disease into biologically coherent subgroups is important for personalized medicine. We evaluated data from five studies (total n = 4050, of whom 2431 had genome-wide single-nucleotide polymorphism (SNP) data). We assigned people to cognitively defined subgroups on the basis of relative performance in memory, executive functioning, visuospatial functioning, and language at the time of Alzheimer's disease diagnosis. We compared genotype frequencies for each subgroup to those from cognitively normal elderly controls. We focused on APOE and on SNPs with p < 10-5 and odds ratios more extreme than those previously reported for Alzheimer's disease (<0.77 or >1.30). There was substantial variation across studies in the proportions of people in each subgroup. In each study, higher proportions of people with isolated substantial relative memory impairment had ≥1 APOE ε4 allele than any other subgroup (overall p = 1.5 × 10-27). Across subgroups, there were 33 novel suggestive loci across the genome with p < 10-5 and an extreme OR compared to controls, of which none had statistical evidence of heterogeneity and 30 had ORs in the same direction across all datasets. These data support the biological coherence of cognitively defined subgroups and nominate novel genetic loci.


Asunto(s)
Enfermedad de Alzheimer/genética , Enfermedad de Alzheimer/psicología , Cognición , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/clasificación , Apolipoproteínas E/genética , Función Ejecutiva , Femenino , Genotipo , Humanos , Lenguaje , Masculino , Memoria , Polimorfismo de Nucleótido Simple/genética , Navegación Espacial
3.
J Interprof Care ; 26(6): 444-51, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22924872

RESUMEN

There is a pressing need to redesign health professions education and integrate an interprofessional and systems approach into training. At the core of interprofessional education (IPE) are creating training synergies across healthcare professions and equipping learners with the collaborative skills required for today's complex healthcare environment. Educators are increasingly experimenting with new IPE models, but best practices for translating IPE into interprofessional practice and team-based care are not well defined. Our study explores current IPE models to identify emerging trends in strategies reported in published studies. We report key characteristics of 83 studies that report IPE activities between 2005 and 2010, including those utilizing qualitative, quantitative and mixed method research approaches. We found a wide array of IPE models and educational components. Although most studies reported outcomes in student learning about professional roles, team communication and general satisfaction with IPE activities, our review identified inconsistencies and shortcomings in how IPE activities are conceptualized, implemented, assessed and reported. Clearer specifications of minimal reporting requirements are useful for developing and testing IPE models that can inform and facilitate successful translation of IPE best practices into academic and clinical practice arenas.


Asunto(s)
Personal de Salud/educación , Comunicación Interdisciplinaria , Estudios Interdisciplinarios , Humanos , Modelos Organizacionales , Estudiantes del Área de la Salud
4.
Alzheimers Dement (Amst) ; 12(1): e12055, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32671181

RESUMEN

BACKGROUND: Practice effects (PEs) are improvements in performance after repeated exposure to test materials, and typically viewed as a source of bias in repeated cognitive assessments. We aimed to determine whether characterizing PEs could also provide a useful marker of early cognitive decline. METHODS: We conducted a systematic review of the literature, searching PsycInfo (Ebsco) and PubMed databases for articles studying PEs in aging and dementia populations. Articles published between 1920 and 2019 were included. RESULT: We identified 259 articles, of which 27 studied PEs as markers of cognitive performance. These studies consistently showed that smaller, less-robust PEs were associated with current diagnostic status and/or future cognitive decline. In addition, lower PEs were associated with Alzheimer's disease risk factors and neurodegeneration biomarkers. CONCLUSION: PEs provide a potentially useful marker of cognitive decline, and could prove valuable as part of a cost-effective strategy to select individuals who are at-risk for dementia for future interventions.

5.
J Clin Transl Sci ; 1(2): 140-143, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28649457

RESUMEN

BACKGROUND: How the productivity and careers of KL2 scholars compare with scholars receiving individual K-awards is unknown. METHODS: The productivity of KL2 scholars (n=21) at our institution was compared with that of K08 (n=34) and K23 (n=26) scholars. RESULTS: KL2 and K23 scholars had greater productivity than K08 scholars (p=0.01). Professional advancement was similar among groups. CONCLUSION: At our institution, scholarly productivity and professional advancement did not differ by type of K-award.

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