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Browsing by Author "Nosheny, Rachel L."
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Item Relationship of Hoarding and Depression Symptoms in Older Adults(Elsevier, 2024) Nutley, Sara; Nguyen, Binh K.; Mackin, R. Scott; Insel, Philip S.; Tosun, Duygu; Butters, Meryl; Aisen, Paul; Raman, Rema; Saykin, Andrew J.; Toga, Arthur W.; Jack, Clifford; Weiner, Michael W.; Nelson, Craig; Kassel, Michelle; Kryza-Lacombe, Maria; Eichenbaum, Joseph; Nosheny, Rachel L.; Mathews, Carol A.; Radiology and Imaging Sciences, School of MedicineHoarding disorder (HD) is a debilitating neuropsychiatric condition that affects 2%-6% of the population and increases in incidence with age. Major depressive disorder (MDD) co-occurs with HD in approximately 50% of cases and leads to increased functional impairment and disability. However, only one study to date has examined the rate and trajectory of hoarding symptoms in older individuals with a lifetime history of MDD, including those with current active depression (late-life depression; LLD). We therefore sought to characterize this potentially distinct phenotype. We determined the incidence of HD in two separate cohorts of participants with LLD (n = 73) or lifetime history of MDD (n = 580) and examined the reliability and stability of hoarding symptoms using the Saving Inventory-Revised (SI-R) and Hoarding Rating Scale-Self Report (HRS), as well as the co-variance of hoarding and depression scores over time. HD was present in 12% to 33% of participants with MDD, with higher rates found in those with active depressive symptoms. Hoarding severity was stable across timepoints in both samples (all correlations >0.75), and fewer than 30% of participants in each sample experienced significant changes in severity between any two timepoints. Change in depression symptoms over time did not co-vary with change in hoarding symptoms. These findings indicate that hoarding is a more common comorbidity in LLD than previously suggested, and should be considered in screening and management of LLD. Future studies should further characterize the interaction of these conditions and their impact on outcomes, particularly functional impairment in this vulnerable population.Item The Advisory Group on Risk Evidence Education for Dementia: Multidisciplinary and Open to All(IOS Press, 2022) Rosen, Allyson C.; Arias, Jalayne J.; Ashford, J. Wesson; Blacker, Deborah; Chhatwal, Jasmeer P.; Chin, Nathan A.; Clark, Lindsay; Denny, Sharon S.; Goldman, Jill S.; Gleason, Carey E.; Grill, Joshua D.; Heidebrink, Judith L.; Henderson, Victor W.; Lavacot, James A.; Lingler, Jennifer H.; Menon, Malavika; Nosheny, Rachel L.; Oliveira, Fabricio F.; Parker, Monica W.; Rahman-Filipiak, Annalise; Revoori, Anwita; Rumbaugh, Malia C.; Sanchez, Danurys L.; Schindler, Suzanne E.; Schwarz, Christopher G.; Toy, Leslie; Tyrone, Jamie; Walter, Sarah; Wang, Li-san; Wijsman, Ellen M.; Zallen, Doris T.; Aggarwal, Neelum T.; Medical and Molecular Genetics, School of MedicineThe brain changes of Alzheimer’s disease and other degenerative dementias begin long before cognitive dysfunction develops, and in people with subtle cognitive complaints, clinicians often struggle to predict who will develop dementia. The public increasingly sees benefits to accessing dementia risk evidence (DRE) such as biomarkers, predictive algorithms, and genetic information, particularly as this information moves from research to demonstrated usefulness in guiding diagnosis and clinical management. For example, the knowledge that one has high levels of amyloid in the brain may lead one to seek amyloid reducing medications, plan for disability, or engage in health promoting behaviors to fight cognitive decline. Researchers often hesitate to share DRE data, either because they are insufficiently validated or reliable for use in individuals, or there are concerns about assuring responsible use and ensuring adequate understanding of potential problems when one’s biomarker status is known. Concerns include warning people receiving DRE about situations in which they might be compelled to disclose their risk status potentially leading to discrimination or stigma. The Advisory Group on Risk Evidence Education for Dementia (AGREEDementia) welcomes all concerned with how best to share and use DRE. Supporting understanding in clinicians, stakeholders, and people with or at risk for dementia and clearly delineating risks, benefits, and gaps in knowledge is vital. This brief overview describes elements that made this group effective as a model for other health conditions where there is interest in unfettered collaboration to discuss diagnostic uncertainty and the appropriate use and communication of health-related risk information.