Browsing by Author "Tam, Joyce W."

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    Design and baseline characteristics of the Cognitive and Aerobic Resilience for the Brain (CARB) study
    (Elsevier, 2023-08) Tam, Joyce W.; Khurshid, Kiran; Sprague, Briana; Clark, Daniel O.; Xu, Huiping; Moser, Lyndsi R.; Miller, Douglas K.; Considine, Robert; Callahan, Christopher M.; Garringer, Holly J.; Rexroth, Daniel; Unverzagt, Frederick W.; Pathology and Laboratory Medicine, School of Medicine
    Background Treatments that delay progression of cognitive impairment in older adults are of great public health significance. This manuscript outlines the protocol, recruitment, baseline characteristics, and retention for a randomized controlled trial of cognitive and aerobic physical training to improve cognition in individuals with subjective cognitive dysfunction, the “Cognitive and Aerobic Resilience for the Brain” (CARB) study. Methods Community-dwelling, older adults with self-reported memory loss were randomly assigned to receive either computer-based cognitive training, aerobic physical training, combined cognitive and physical training, or education control. Treatment was delivered 2- to 3-times per week in 45- to 90-min sessions for 12 weeks by trained facilitators videoconferencing into subject's home. Outcome assessments of were taken at the baseline, immediately following training, and 3-months after training. Results 191 subjects were randomized into the trial (mean age, 75.5 years; 68% female; 20% non-white; mean education, 15.1 years; 30% with 1+ APOE e4 allele). The sample was generally obese, hypertensive, and many were diabetic, while cognition, self-reported mood, and activities of daily living were in the normal range. There was excellent retention throughout the trial. Interventions were completed at high rates, participants found the treatments acceptable and enjoyable, and outcome assessments were completed at high rates. Conclusions This study was designed to determine the feasibility of recruiting, intervening, and documenting response to treatment in a population at risk for progressive cognitive decline. Older adults with self-reported memory loss were enrolled in high numbers and were well engaged with the intervention and outcome assessments.
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    Verbal Fluency in a National Sample: Telephone Administration Methods
    (Wiley, 2019-01-18) Marceaux, Janice C.; Prosje, Michelle A.; McClure, Leslie A.; Kana, Bhumika; Crowe, Michael; Kissela, Brett; Manly, Jennifer; Howard, George; Tam, Joyce W.; Unverzagt, Frederick W.; Wadley, Virginia G.; Psychiatry, School of Medicine
    Objectives: Describe novel methods for ascertaining verbal fluency in a large national sample of adults, examine demographic factors influencing performance, and compare scores to studies using in-person assessment. Methods/Design: Participants were from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national, population-based, longitudinal study of stroke in adults aged 45 years an older. Letter and semantic fluency were gathered, using Letter “F” and Animal Naming, via a telephone-based assessment with computer-assisted scoring of digital recordings. Results: Initial letter and semantic fluency scores were obtained on 18,505 and 18,072 participants, respectively. For both fluency tests, scores were normally distributed. Younger age and more years of education were associated with better performances (p<0.0001). The mean and standard deviation for matched subgroups, based on age, gender, and education, were quite comparable to scores reported out of samples using an in-person administration format. Telephone-based assessment also allowed for a level of quality control not available via in-person measurement. Conclusions: Telephone-based assessment of verbal fluency and computer-assisted scoring programs designed for this study facilitated large scale data acquisition, storage, and scoring of protocols. The resulting scores have similar characteristics to those obtained by traditional methods. These findings extend validation of cognitive assessment methods, using survey research staff and computer-assisted technology for test administration.