A5012611116- Dementia and Cognitive Impairment Research
- Pharmaceutical Practices and Patient Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Alzheimer's disease research and treatments
- Medication Adherence and Compliance
- Blood Pressure and Hypertension Studies
- Neurobiology of Language and Bilingualism
- Chronic Disease Management Strategies
- Intensive Care Unit Cognitive Disorders
- Functional Brain Connectivity Studies
- Olfactory and Sensory Function Studies
- Psychosomatic Disorders and Their Treatments
- Frailty in Older Adults
- Neurological Disease Mechanisms and Treatments
- Personality Disorders and Psychopathology
- Geriatric Care and Nursing Homes
- Balance, Gait, and Falls Prevention
- Advanced Neuroimaging Techniques and Applications
- Mental Health and Psychiatry
- Palliative Care and End-of-Life Issues
- Pharmaceutical studies and practices
- Emergency and Acute Care Studies
- Advanced Chemical Sensor Technologies
- Literature, Magical Realism, García Márquez
- Pharmacy and Medical Practices
University of California, San Francisco
2009-2025
San Francisco VA Medical Center
2021-2025
Harvard University
2011-2023
San Francisco VA Health Care System
2023
Geriatric Research Education and Clinical Center
2023
Beth Israel Deaconess Medical Center
2019-2023
City College of San Francisco
2022
Brigham and Women's Hospital
2015-2019
University Memory and Aging Center
2009-2017
Massachusetts General Hospital
2015
Resting-state or intrinsic connectivity network functional magnetic resonance imaging provides a new tool for mapping large-scale neural function and dysfunction. Recently, we showed that behavioural variant frontotemporal dementia Alzheimer's disease cause atrophy within two major networks, an anterior 'Salience Network' (atrophied in dementia) posterior 'Default Mode disease). These networks exhibit anti-correlated relationship with each other the healthy brain. The diseases also feature...
To characterize cognitive and behavioral features, physical findings, brain atrophy patterns in pathology-proven corticobasal degeneration (CBD) syndrome (CBS) with known histopathology.We reviewed clinical magnetic resonance imaging data all patients evaluated at our center either an autopsy diagnosis of CBD (n = 18) or CBS first presentation histopathology 40). Atrophy were compared using voxel-based morphometry.CBD was associated 4 syndromes: progressive nonfluent aphasia 5), variant...
To compare the diagnostic performance of PET with amyloid ligand Pittsburgh compound B (PiB-PET) to fluorodeoxyglucose (FDG-PET) in discriminating between Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD).Patients meeting clinical criteria for AD (n = 62) FTLD 45) underwent PiB FDG-PET. scans were classified as positive or negative by 2 visual raters blinded diagnosis, using a quantitative threshold derived from controls 25). FDG visually rated consistent FTLD,...
Background: Racial inequities for patients with heart failure (HF) have been widely documented. HF who receive cardiology care during a hospital admission better outcomes. It is unknown whether there are differences in to or general medicine service by race. This study examined the relationship between race and service, its effect on 30-day readmission mortality Methods: We performed retrospective cohort from September 2008 November 2017 at single large urban academic referral center of all...
The left posterior inferior frontal cortex (IFC) is important for syntactic processing, and has been shown in many functional imaging studies to be differentially recruited the processing of syntactically complex sentences relative simpler ones. In nonfluent variant primary progressive aphasia (PPA), degeneration IFC associated with expressive receptive agrammatism; however, status this region PPA not well understood. Our objective was determine whether atrophic PPA. Using structural...
Our objective was to investigate cross-sectional associations between odor identification ability and imaging biomarkers of neurodegeneration amyloid deposition in clinically normal (CN) elderly individuals, specifically testing the hypothesis that there may be an interaction predicting dysfunction.Data were collected on 215 CN participants from Harvard Aging Brain Study. Measurements included 40-item University Pennsylvania Smell Identification Test neuropsychological testing, hippocampal...
This Viewpoint explains the Hospital Elder Life Program (HELP), which enhances mobility for elderly patients while decreasing risk of falls in hospital setting, and how implementing programs like HELP can have several potentially beneficial effects.
<h3>Background/Objective:</h3> Patients with posterior cortical atrophy (PCA) often have Alzheimer disease (AD) at autopsy, yet are cognitively and anatomically distinct from patients clinical AD. We sought to compare the distribution of β-amyloid glucose metabolism in PCA AD vivo using Pittsburgh compound B (PiB) FDG-PET. <h3>Methods:</h3> (n = 12, age 57.5 ± 7.4, Mini-Mental State Examination [MMSE] 22.2 5.1), 14, 58.8 9.6, MMSE 23.8 6.7), normal controls (NC, n 30, 73.6 6.4) underwent PiB...
Antihypertensive medication deprescribing is common among nursing home residents, yet its association with cognitive decline remains uncertain.
This cohort study examines the use of cholinesterase inhibitors and memantine among older adults with dementia after admission into hospice care despite medications’ limited clinical benefit following enrollment hospice.
Abstract Background/objectives In older persons with dementia (PWD), extensive medication use is often unnecessary, discordant goals of care, and possibly harmful. The objective this study was to determine the prevalence constituents polypharmacy among PWD attending outpatient visits in United States. Design Cross‐sectional analysis. Setting participants without (PWOD) aged ≥65 years recorded nationally representative National Ambulatory Medical Care Survey (NAMCS), 2014–2016. Measurements...
Non-cognitive features including personality changes are increasingly recognized in the three PPA variants (semantic-svPPA, non fluent-nfvPPA, and logopenic-lvPPA). However, differences emotion processing among its association with white matter tracts unknown. We compared detection across healthy controls (HC), related them to tract integrity cortical degeneration. Personality traits group were also examined relation tracts. Thirty-three patients svPPA, nfvPPA, lvPPA, 32 HC underwent...
Despite the extensive frontal atrophy and behavioral disinhibition that characterizes variant frontotemporal dementia (bvFTD), many studies of early bvFTD suggest normal executive functioning (EF). The current study examined cognitive control in patients with who otherwise seemed cognitively normal.Subjects included 7 neuropsychological test scores, matched for Mini-Mental State Examination score but impaired 14 controls. A flanker paradigm other measures EF were administered to...
Abstract Background People with dementia (PWD) take medications that may be unnecessary or harmful. This problem can addressed through deprescribing, but it is unclear if PWD would willing to engage in deprescribing their providers. Our goal was investigate attitudes toward among PWD. Methods a cross‐sectional study of 422 aged ≥65 years who completed the module National Health and Aging Trends Study (NHATS) 2016. Proxies provided responses when participant unable respond due health...
<h3>Background</h3> Different degenerative brain diseases result in distinct personality changes as a of divergent patterns damage; however, little is known about the natural history these throughout course each disease. <h3>Objective</h3> To investigate how interpersonal traits change function disease type and severity. <h3>Methods</h3> Using Interpersonal Adjective Scales, informant ratings retrospective premorbid current scores for dominance, extraversion, warmth ingenuousness were...
Abstract Background Prescribing cascades are important contributors to polypharmacy. Little is known about which older adults at highest risk of experiencing prescribing cascades. We explored veterans the gabapentinoid (including gabapentin and pregabalin)–loop diuretic (LD) cascade, given dramatic increase in recent years. Methods Using Veterans Affairs Medicare claims data (2010–2019), we performed a prescription sequence symmetry analysis (PSSA) assess loop initiation before after among...
Abstract Background More than one‐fourth of older adults with cognitive impairment (CI) live alone; these individuals often lack support for medication management and face a high risk adverse drug events. We characterized the frequency types high‐risk medications used by CI living alone and, context, compared patterns those in others. Methods This was cross‐sectional study National Health Aging Trends Study (NHATS) data Medicare claims (2015–2017). ascertained status from NHATS use Part D...
Abstract Background Persons with dementia (PWD) have high rates of polypharmacy. While previous studies examined specific types problematic medication use in PWD, we sought to characterize a broad spectrum misuse and overuse among community‐dwelling PWD. Methods We included adults aged ≥66 the Health Retirement Study from 2008 2018 linked Medicare classified as having using validated algorithm. Medication usage was ascertained over 1‐year prior an HRS interview date. Potentially medications...
This multidisciplinary article compares the pattern of memory loss described in Gabriel Garcı ´a Ma ´rquez's One Hundred Years Solitude to that exhibited by patients with semantic dementia (SD).In his renowned novel, ´rquez depicts plight Macondo, a town struck dreaded insomnia plague.The most devastating symptom plague is not impossibility sleep, but rather 'the name and notion things'.In an effort combat this insidious knowledge, protagonist, Jose ´Arcadio Buendı ´a, 'marked everything its...