Browsing by Author "Snitz, Beth"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Cognitive testing in older primary care patients: A cluster-randomized trial
    (Elsevier, 2015-09) Fowler, Nicole R.; Morrow, Lisa; Chiappetta, Laurel; Snitz, Beth; Huber, Kimberly; Rodriguez, Eric; Saxton, Judith; Department of Medicine, IU School of Medicine
    INTRODUCTION: This study investigated whether neuropsychological testing in primary care (PC) offices altered physician-initiated interventions related to cognitive impairment (CI) or slowed the rate of CI progression. METHODS: This 24-month, cluster-randomized study included 11 community-based PC practices randomized to either treatment as usual (5 practices) or cognitive report (CR; 6 practices) arms. From 2005 to 2008, 533 patients aged ≥65 years and without a diagnosis of CI were recruited; 423 were retested 24 months after baseline. RESULTS: CR physicians were significantly more likely to order cognitive-related interventions (P = .02), document discussions about cognition (P = .003), and order blood tests to rule out reversible CI (P = .002). At follow-up, significantly more CR patients had a medication for cognition listed in their chart (P = .02). There was no difference in the rate of cognitive decline between the groups. DISCUSSION: Providing cognitive information to physicians resulted in higher rates of physician-initiated interventions for patients with CI.
  • Thumbnail Image
    Item
    Genetic Risk Score Predicts Late-Life Cognitive Impairment
    (Hindawi, 2015-08-23) Wollam, Mariegold E.; Weinstein, Andrea M.; Saxton, Judith A.; Morrow, Lisa; Snitz, Beth; Fowler, Nicole R.; Suever Erickson, Barbara L.; Roecklein, Kathryn A.; Erickson, Kirk I.; Medicine, School of Medicine
    Introduction. A family history of Alzheimer's disease is a significant risk factor for its onset, but the genetic risk associated with possessing multiple risk alleles is still poorly understood. Methods. In a sample of 95 older adults (Mean age = 75.1, 64.2% female), we constructed a genetic risk score based on the accumulation of risk alleles in BDNF, COMT, and APOE. A neuropsychological evaluation and consensus determined cognitive status (44 nonimpaired, 51 impaired). Logistic regression was performed to determine whether the genetic risk score predicted cognitive impairment above and beyond that associated with each gene. Results. An increased genetic risk score was associated with a nearly 4-fold increased risk of cognitive impairment (OR = 3.824, P = .013) when including the individual gene polymorphisms as covariates in the model. Discussion. A risk score combining multiple genetic influences may be more useful in predicting late-life cognitive impairment than individual polymorphisms.