A5063873783- Dementia and Cognitive Impairment Research
- Health disparities and outcomes
- Cancer-related cognitive impairment studies
- Advanced Causal Inference Techniques
- Health Systems, Economic Evaluations, Quality of Life
- HIV/AIDS Research and Interventions
- Glioma Diagnosis and Treatment
- Aging and Gerontology Research
- Alzheimer's disease research and treatments
- HIV, Drug Use, Sexual Risk
- Health and Well-being Studies
- Geriatric Care and Nursing Homes
- Brain Metastases and Treatment
- Nutritional Studies and Diet
- Meta-analysis and systematic reviews
- Statistical Methods and Bayesian Inference
- Pneumocystis jirovecii pneumonia detection and treatment
- Health Policy Implementation Science
- Acute Ischemic Stroke Management
- Child Abuse and Trauma
- Health, Environment, Cognitive Aging
- Mental Health Treatment and Access
- Frailty in Older Adults
- Pelvic floor disorders treatments
- Sex work and related issues
University of California, Los Angeles
2020-2025
UCLA Health
2020-2025
University of Southern California
2024-2025
Fielding Graduate University
2021-2024
University of California System
2024
Columbia University
2017-2021
ICAP Global Health
2018
Analysis Group (United States)
2013-2014
Awareness of Pre-exposure prophylaxis (PrEP) was assessed among a cohort substance-using black men who have sex with and transgender women (MSM/TGW) participating in the STAR Study, which recruited MSM/TGW New York City for HIV testing linked HIV-infected individuals into care from July 2012 to April 2015. Sociodemographic, psychosocial, known risk factors, PrEP awareness were participants. Multivariable logistic regression conducted assess factors associated awareness. Of 1673 participants,...
Importance High education protects against dementia, but returns on educational attainment may be different across sociodemographic groups owing to various social factors. Asian American individuals are a growing and diverse group, little research has assessed dementia determinants in this population. Objective To examine the association of with large cohort individuals, stratifying by ethnicity nativity. Design, Setting, Participants This study used electronic health record (EHR) survey...
Abstract INTRODUCTION The challenge of accounting for practice effects (PEs) when modeling cognitive change was amplified by the COVID‐19 pandemic, which introduced period and mode that may bias estimation trajectory. METHODS In three Kaiser Permanente Northern California prospective cohorts, we compared predicted trajectories association grip strength with decline using approaches: (1) no acknowledgment PE, (2) inclusion a wave indicator, (3) constraining PE based on preliminary model (APM)...
Prior studies suggested that metformin may be associated with reduced dementia incidence, but associations confounded by disease severity and prescribing trends. Cessation of therapy in people diabetes typically occurs due to signs kidney dysfunction sometimes is less serious adverse effects metformin.
Abstract INTRODUCTION Depressive symptoms are associated with higher risk of dementia, but how they impact cognition in diverse populations is unclear. METHODS Asian, Black, Latino, or White participants ( n = 2227) the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) Study African Americans 50+) underwent up to three waves cognitive assessments over 4 years. Multilevel models stratified by race/ethnicity were used examine whether depressive decline associations differed...
<h3>Importance</h3> Dementia research is susceptible to bias arising from selective survival, a process that results in individuals with certain characteristics disproportionately surviving old age. Spurious associations between risk factors and dementia may be induced when associated longer survival also influence incidence. <h3>Objective</h3> To assess the role of explaining reported sex/gender differences <h3>Design, Setting, Participants</h3> This decision analytical model used simulated...
Some evidence suggests that neighborhood socioeconomic disadvantage is associated with dementia-related outcomes. However, prior research predominantly among non-Latino Whites.
Background: Parental education is an important determinant of late-life cognition, but the extent to which intervening on midlife risk factors, such as hypertension, mitigates impact early-life factors unclear. Novel methodological approaches, causal decomposition, facilitate assessment contributors health inequities through hypothetical interventions mediating factors. Methods: Using harmonized cohorts (Kaiser Healthy Aging and Diverse Life Experiences Study; Study in African Americans) a...
Limited evidence exists on stroke incidence and its impact dementia risk in Asian American older adults, a population with lower than other racial ethnic groups. We aimed to estimate the cumulative of assess effect over 10 years among Chinese, Filipino, Japanese, South Asian, non-Latino White adults Northern California. This cohort study included Kaiser Permanente California members who participated surveys between 2002 2009 linked electronic health record data through 2020. participants...
Background: Cognitive change is an important factor in understanding dementia. Estimating effects of exposures on cognitive requires choosing analytical timescale, typically time study or current age. There limited consensus regarding timescale choice epidemiologic aging research. Methods: Using a coordinated analytic approach ten cohorts older adults, we evaluated whether estimated two memory differed depending (time age). We modeled APOE ε4 genotype (a time-invariant exposure) and diabetes...
Limited data exist on the prevalence and correlates, including stigma, of mental health conditions, depressive symptoms alcohol use, among patients co-infected with tuberculosis (TB) human immunodeficiency virus (HIV) in sub-Saharan Africa, despite their negative impact outcomes.To assess correlates hazardous/harmful use TB-HIV Start TB ART Retain Treatment (START) study.START, a mixed-methods cluster-randomized trial, evaluated combination intervention package vs. standard care (SOC) to...
Most dementia studies are not population-representative; statistical tools can be applied to samples obtain critically-needed population-representative estimates, but yet widely used.We pooled data from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study California Behavioral Risk Factor Surveillance System (CA-BRFSS), a study. Using weights accounting for sociodemographic/health differences between KHANDLE CA-BRFSS, we estimated cognitive impairment prevalence age-...
Literature shows heterogeneous age-standardized dementia incidence rates across US Asian American, Native Hawaiian, and Pacific Islanders (AANHPI), but no estimates of population-representative exist due to lack AANHPI longitudinal probability samples. We compared harmonized characteristics between Kaiser Permanente Northern California members (KPNC cohort) the target population 60+ with private or Medicare insurance using Health Interview Survey. used stabilized inverse odds selection...
We evaluated whether competing risk of death or selective survival could explain the reported inverse association between cancer history and dementia incidence (incidence rate ratio [IRR] ≈ 0.62-0.85).A multistate simulation model a cancer- dementia-free cohort 65-year-olds was parameterized with real-world data (cancer incidence, mortality), assuming no effect on (true IRR = 1.00). To introduce death, increased mortality. survival, we included factor (prevalence ranging from 10% to 50%)...
Background/Objectives Given the lack of effective pharmacologic strategies to prevent, slow, or reverse dementia progression, maximizing quality life (QOL) is a major priority for persons living with dementia. Despite well‐documented racial/ethnic disparities in incidence and prevalence, it unknown whether there are QOL among The objective this study was determine if differences poor health‐related (HRQOL) without nationally‐representative cohort. Design Repeated measures cross‐sectional...
Abstract Introduction The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study enrolled Asian, Black, Latino, White adults ages 65+ without prior dementia diagnosis (N = 1709). We evaluated the prevalence of cognitive impairment (mild or dementia) accounting for potential biases. Methods A random subgroup 541) received clinical evaluation others were if they failed a screen. Diagnoses made under two conditions: (1) demographics‐blind, based on exam demographically adjusted...
Abstract Incomplete longitudinal data are common in life-course epidemiology and may induce bias leading to incorrect inference. Multiple imputation (MI) is increasingly preferred for handling missing data, but few studies explore MI-method performance feasibility real-data settings. We compared 3 MI methods using real under 9 missing-data scenarios, representing combinations of 10%, 20%, 30% missingness completely at random, not random. Using from Health Retirement Study (HRS) participants,...
Literature shows lower dementia incidence in Asian American groups versus whites, varying by ethnicity. One hypothesized driver is nativity differences (eg, healthy immigrant effect).We followed a cohort of 6243 Chinese, 4879 Filipino, 3256 Japanese, and 141,158 white Kaiser Permanente Northern California members for incident (2002 to 2020), estimating age-adjusted rates ethnicity nativity, hazard ratios (HR) on using ethnicity-stratified age- sex-adjusted Cox proportional hazards...
The Adult Changes in Thought (ACT) study is a cohort of Kaiser Permanente Washington members ages 65+ that began 1994.
Most prior work in quantitative approaches to generalizability and transportability emphasizes extending causal effect estimates from randomized trials target populations. Extending findings observational studies is also of scientific interest, identifiability assumptions estimation methods differ settings when there selection on both the exposure exposure-outcome mediators combination with confounders (and can modify effects). We argue that this structure common studies, particularly field...