Browsing by Author "Clark, Lindsay R."

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    A harmonized memory composite score for cross‐cohort Alzheimer’s disease and related dementia research: development and validation
    (Wiley, 2025-01-03) Sanderson-Cimino, Mark E.; Gross, Alden L.; Gaynor, Leslie S.; Paolillo, Emily W.; Casaletto, Kaitlin B.; Chatterjee, Ankita; Albert, Marilyn S.; Apostolova, Liana G.; Boersema, Brooke; Boxer, Adam L.; Boeve, Brad F.; Clark, Lindsay R.; La Joie, Renaud; Eloyan, Ani; Tomaszewski Farias, Sarah; Gonzales, Mitzi M.; Hammers, Dustin B.; Wise, Amy B.; Cobigo, Yann; Yballa, Claire; Schonhaut, Daniel R.; Hampstead, Benjamin M.; Mechanic-Hamilton, Dawn; Miller, Bruce L.; Rabinovici, Gil D.; Rascovsky, Katya; Ringman, John M.; Rosen, Howard J.; Ryman, Sephira; Salmon, David P.; Smith, Glenn E.; Decarli, Charles; Kramer, Joel H.; Staffaroni, Adam M.; Neurology, School of Medicine
    Background: The Uniform Data Set (UDS) neuropsychological battery, administered across Alzheimer’s Disease Centers (ADC), includes memory tests but lacks a list‐learning paradigm. ADCs often supplement the UDS with their own preferred list‐learning task. Given the importance of list‐learning for characterizing memory, we aimed to develop a harmonized memory score that incorporates UDS memory tests while allowing centers to contribute differing list‐learning tasks. Method: We applied item‐banking confirmatory factor analysis to develop a composite memory score in 5,287 participants (mean age 67.1; SD = 12.2) recruited through 18 ADCs and four consortia (DiverseVCID, MarkVCID, ALLFTD, LEADS) who completed UDS memory tasks (used as linking‐items) and one of five list‐learning tasks. All analyses used linear regression. We tested whether memory scores were affected by which list‐learning task was administered. To assess construct validity, we tested associations of memory scores with demographics, disease severity (CDR Box Score), an independent memory task (TabCAT Favorites, n = 675), and hippocampal volume (n = 811). We compared performances between cognitively unimpaired (n = 279), AD‐biomarker+ MCI (n = 26), and AD‐biomarker+ dementia (n = 98). In a subsample with amyloid‐ and tau‐PET (n = 49), we compared memory scores from participants with positive vs negative scans determined using established quantitative cutoffs. Result: Model fit indices were excellent (e.g., CFI = 0.998) and factor loadings were strong (0.43‐0.93). Differences in list‐learning task had a negligible effect on scores (average Cohen’s d = 0.11). Higher memory scores were significantly (p’s<.001) correlated with younger age (β = ‐0.18), lower CDR Box Scores (β = ‐0.63), female sex (β = 0.12), higher education (β = 0.19), larger hippocampal volume (β = 0.42), and an independent memory task (β = 0.71, p<0.001). The memory composite declined in a stepwise fashion by diagnosis (cognitively unimpaired>MCI>AD dementia, p<0.001). On average, amyloid‐PET positivity was associated with lower composite scores, but was not statistically significant (β = ‐0.34; p = 0.25; d = 0.40). Tau‐PET positivity was associated with worse performance, demonstrating a large effect size (β = ‐0.75; p<0.002; d = 0.91). Conclusion: The harmonized memory score developed in a large national sample was stable regardless of contributing list‐learning task and its validity for cross‐cohort ADRD research is supported by expected associations with demographics, clinical measures, and Alzheimer’s biomarkers. A processing script will be made available to enhance cross‐cohort ADRD research.
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    Development and validation of a harmonized memory score for multicenter Alzheimer's disease and related dementia research
    (medRxiv, 2025-04-03) Sanderson-Cimino, Mark; Gross, Alden L.; Gaynor, Leslie S.; Paolillo, Emily W.; Saloner, Rowan; Albert, Marilyn S.; Apostolova, Liana G.; Boersema, Brooke; Boxer, Adam L.; Boeve, Bradley F.; Casaletto, Kaitlin B.; Hallgarth, Savannah R.; Diaz, Valentina E.; Clark, Lindsay R.; Maillard, Pauline; Eloyan, Ani; Tomaszewski Farias, Sarah; Gonzales, Mitzi M.; Hammers, Dustin B.; La Joie, Renaud; Cobigo, Yann; Wolf, Amy; Hampstead, Benjamin M.; Mechanic-Hamilton, Dawn; Miller, Bruce L.; Rabinovici, Gil D.; Ringman, John M.; Rosen, Howie J.; Ryman, Sephira G.; Prestopnik, Jillian L.; Salmon, David P.; Smith, Glenn E.; DeCarli, Charles; Rajan, Kumar B.; Jin, Lee-Way; Hinman, Jason; Johnson, David K.; Harvey, Danielle; Fornage, Myriam; Kramer, Joel H.; Staffaroni, Adam M.; Neurology, School of Medicine
    Introduction: List-learning tasks are important for characterizing memory in ADRD research, but the Uniform Data Set neuropsychological battery (UDS-NB) lacks a list-learning paradigm; thus, sites administer a range of tests. We developed a harmonized memory composite that incorporates UDS memory tests and multiple list-learning tasks. Methods: Item-banking confirmatory factor analysis was applied to develop a memory composite in a diagnostically heterogenous sample (n=5943) who completed the UDS-NB and one of five list-learning tasks. Construct validity was evaluated through associations with demographics, disease severity, cognitive tasks, brain volume, and plasma phosphorylated tau (p-tau181 and p-tau217). Test-retest reliability was assessed. Analyses were replicated in a racially/ethnically diverse cohort (n=1058). Results: Fit indices, loadings, distributions, and test-retest reliability were adequate. Expected associations with demographics and clinical measures within development and validation cohorts supported validity. Discussion: This composite enables researchers to incorporate multiple list-learning tasks with other UDS measures to create a single metric.
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    Sex-specific genetic predictors of memory, executive function, and language performance
    (Wiley, 2022) Eissman, Jaclyn M.; Smith, Alexandra N.; Mukherjee, Shubhabrata; Lee, Michael L.; Choi, Seo-Eun; Scollard, Phoebe; Trittschuh, Emily H.; Mez, Jesse B.; Bush, William S.; Engelman, Corinne D.; Lu, Qiongshi; Fardo, David W.; Widaman, Keith F.; Buckley, Rachel F.; Mormino, Elizabeth C.; Kunkle, Brian W.; Naj, Adam C.; Clark, Lindsay R.; Gifford, Katherine A.; Alzheimer’s Disease Neuroimaging Initiative (ADNI); Alzheimer’s Disease Genetics Consortium (ADGC); A4 Study Team; The Alzheimer’s Disease Sequencing Project (ADSP); Cuccaro, Michael L.; Cruchaga, Carlos; Pericak-Vance, Margaret A.; Farrer, Lindsay A.; Wang, Li-San; Schellenberg, Gerard D.; Haines, Jonathan L.; Jefferson, Angela L.; Johnson, Sterling C.; Kukull, Walter A.; Albert, Marilyn S.; Keene, C. Dirk; Saykin, Andrew J.; Larson, Eric B.; Sperling, Reisa A.; Mayeux, Richard; Thompson, Paul M.; Martin, Eden R.; Bennett, David A.; Barnes, Lisa L.; Schneider, Julie A.; Crane, Paul K.; Hohman, Timothy J.; Dumitrescu, Logan; Radiology and Imaging Sciences, School of Medicine
    Background: Alzheimer’s disease (AD) is more prevalent in women than men, and robust evidence shows sex differences in the biological response to the AD neuropathological cascade. However, there is a lack of large-scale genetic studies on sex-specific genetic predictors of AD-related cognitive outcomes. Thus, we sought to elucidate the sex-specific genetic etiology of memory, executive function, and language performance. Method: This study included six cohorts of cognitive aging (Nmales=7,267, Nfemales=9,518). We applied psychometric approaches to build harmonized memory, executive function, and language composite scores. Next, for all domains, we calculated slopes from the cognitive scores (two or more timepoints) with linear mixed effects models. Then we performed sex-stratified and sex-interaction GWAS on these phenotypes, covarying for baseline age and the first three genetic principal components. We meta-analyzed across cohorts with a fixed-effects model. Sensitivity analyses for all models restricted the sample to cognitively unimpaired individuals. Result: In addition to well-established associations with cognition at the APOE locus, we identified three genetic loci that showed sex-specific effects with cognition. A chromosome 16 locus (rs114106271), a splicing-quantitative trait locus for RP11-152O14.4 and LINC02180 in the testis (GTEx), associated with baseline memory performance in men (β=0.13, P=2.40×10-8; PInteraction=8.96×10-6; Figures 1-2) but not in women (β=-0.01, P=0.76). A chromosome 14 locus (rs34074573), an expression-quantitative trait locus (GTEx) for HOMEZ (a homeobox gene), and for BCL2L2 (a previously reported AD risk gene), associated with longitudinal memory performance in men (β=-0.01, P=4.15×10-8; PInteraction=5.83×10-7; Figures 3-4) but not in women (β=0.001, P=0.09). Finally, a chromosome 6 locus (rs9382966) associated with longitudinal language performance in men with near genome-wide significance (β=-0.004, P=6.29×10-8; PInteraction=2.01×10-4) but not in women (β=-0.0003, P=0.61). Conclusion: Our results highlight some key sex differences in the genetic architecture of cognitive outcomes. Findings further suggest that some sex-specific genetic predictors have domain-specific associations, providing an exciting opportunity to better understand the molecular basis of memory, executive function, and language through genomic analysis. Although our findings need to be replicated, our GWAS analyses highlight the contribution of sex-specific genetic predictors beyond the APOE locus in conferring risk for late-life cognitive decline.