Browsing by Author "Wang, Sophia"

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    Accelerating diversity in Alzheimer's disease research by partnering with a community advisory board
    (Wiley, 2023-05-28) Pena-Garcia, Alex; Richards, Ralph; Richards, Mollie; Campbell, Christopher; Mosley, Hank; Asper, Joseph; Eliacin, Johanne; Polsinelli, Angelina; Apostolova, Liana; Hendrie, Hugh; Tackett, Andrew; Elliott, Caprice; Van Heiden, Sarah; Gao, Sujuan; Saykin, Andrew; Wang, Sophia; Medicine, School of Medicine
    Introduction: Community advisory boards (CABs) and researcher partnerships present a promising opportunity to accelerate enrollment of underrepresented groups (URGs). We outline the framework for how the CAB and researchers at the Indiana Alzheimer's Disease Research Center (IADRC) partnered to accelerate URG participation in AD neuroimaging research. Methods: CAB and the IADRC researchers partnered to increase the CAB's impact on URG study enrollment through community and research interactions. Community interactions included the CAB collaboratively building a network of URG focused community organizations and collaborating with those URG-focused organizations to host IADRC outreach and recruitment events. Research interactions included direct impact (CAB members referring themselves or close contacts as participants) and strategic impact, mainly by the CAB working with researchers to develop and refine URG focused outreach and recruitment strategies for IADRC and affiliated studies to increase URG representation. We created a database infrastructure to measure how these interactions impacted URG study enrollment. Results: Out of the 354 URG research referrals made to the IADRC between October 2019 and December 2022, 267 referrals were directly referred by the CAB (N = 36) or from community events in which CAB members organized and/or volunteered at (N = 231). Out of these 267 referrals, 34 were enrolled in IADRC and 2 were enrolled in Indiana University Longitudinal Early Onset AD Study (IU LEADS). Of note, both studies require the prospective participants to be willing to do MRI and PET scans. As of December 2022, 30 out of the 34 enrolled participants have received a consensus diagnosis; the majority were cognitively normal (64.7%), with the remainder having mild cognitive impairment (17.6%) or early-stage AD (2.9%). Discussion: The IADRC CAB-researcher partnership had a measurable impact on the enrollment of African American/Black adults in AD neuroimaging studies. Future studies will need to test whether this conceptual model works for other sites and for other URGs.
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    Age-dependent phenotypes of cognitive impairment as sequelae of SARS-CoV-2 infection
    (Frontiers Media, 2025-01-07) Gonzalez Aleman, Gabriela; Vavougios, George D.; Tartaglia, Carmela; Uvais, Nalakath A.; Guekht, Alla; Hosseini, Akram A.; Lo Re, Vincenzina; Ferreccio, Catterina; D'Avossa, Giovanni; Zamponi, Hernan P.; Figueredo Aguiar, Mariana; Yecora, Agustin; Ul Haq Katshu, Mohammad Zia; Stavrou, Vasileios T.; Boutlas, Stylianos; Gourgoulianis, Konstantinos I.; Botero, Camila; González Insúa, Francisco; Perez-Lloret, Santiago; Zinchuk, Mikhail; Gersamija, Anna; Popova, Sofya; Bryzgalova, Yulia; Sviatskaya, Ekaterina; Russelli, Giovanna; Avorio, Federica; Wang, Sophia; Edison, Paul; Niimi, Yoshiki; Sohrabi, Hamid R.; Mukaetova Ladinska, Elizabeta B.; Neidre, Daria; de Erausquin, Gabriel A.; Psychiatry, School of Medicine
    Cognitive changes associated with PASC may not be uniform across populations. We conducted individual-level pooled analyses and meta-analyses of cognitive assessments from eight prospective cohorts, comprising 2,105 patients and 1,432 controls from Argentina, Canada, Chile, Greece, India, Italy, Russia, and the UK. The meta-analysis found no differences by country of origin. The profile and severity of cognitive impairment varied by age, with mild attentional impairment observed in young and middle-aged adults, but memory, language, and executive function impairment in older adults. The risk of moderate to severe impairment doubled in older adults. Moderately severe or severe impairment was significantly associated with infection diagnoses (chi-square = 26.57, p ≤ 0.0001) and the severity of anosmia (chi-square = 31.81, p ≤ 0.0001). We found distinct age-related phenotypes of cognitive impairment in patients recovering from COVID-19. We identified the severity of acute illness and the presence of olfactory dysfunction as the primary predictors of dementia-like impairment in older adults.
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    Aging and Post-Intensive Care Syndrome (PICS): A Critical Need for Geriatric Psychiatry
    (Elsevier, 2017) Wang, Sophia; Allen, Duane; Kheir, You Na; Campbell, Noll; Khan, Babar; Department of Psychiatry, IU School of Medicine
    Due to the aging of the intensive care unit (ICU) population and an improvement in survival rates after ICU hospitalization, an increasing number of older adults are suffering from long-term impairments due to critical illness, known as post-intensive care syndrome (PICS). This paper focuses on PICS-related cognitive, psychological, and physical impairments, and the impact of ICU hospitalization on families and caregivers. The authors also describe innovative models of care for PICS, and what roles geriatric psychiatrists could play in the future of this rapidly growing population.
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    Aging and Post-Intensive Care Syndrome–Family (PICS-F): A Critical Need for Geriatric Psychiatry
    (Elsevier, 2019) Serrano, Patricia; Kheir, You Na P.; Wang, Sophia; Khan, Sikandar; Scheunemann, Leslie; Khan, Babar; Psychiatry, School of Medicine
    Post-intensive care syndrome–family (PICS-F) describes the psychological symptoms that affect the family members of patients hospitalized in the intensive care unit (ICU) or recently discharged from the ICU. Geriatric psychiatrists should be concerned about PICS-F for several reasons. First, ICU hospitalization in older adults is associated with higher rates of cognitive and physical impairment, compared to older adults hospitalized in non-ICU settings or dwelling in the community. This confers a special burden on the caregivers of these older ICU survivors compared to other geriatric populations. Second, as caregivers themselves age, caring for this unique burden can be more challenging compared to other geriatric populations. Third, evidence for models of care centered on patients with multimorbidity and their caregivers is limited. A deeper understanding of how to care for PICS and PICS-F may inform clinical practice for other geriatric populations with multimorbidity and their caregivers. Geriatric psychiatrists may play a key role in delivering coordinated care for PICS-F by facilitating timely diagnosis and interdisciplinary collaboration, advocating for the healthcare needs of family members suffering from PICS-F, and leading efforts within healthcare systems to increase awareness and treatment of PICS-F. This clinical review will appraise the current literature about the impact of critical illness on the family members of ICU survivors and identify crucial gaps in our knowledge about PICS-F among aging patients and caregivers.
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    Aging and Post-Intensive Care Syndrome–Family (PICS-F): A Critical Need for Geriatric Psychiatry
    (Elsevier, 2019) Serrano, Patricia; Kheir, You Na P.; Wang, Sophia; Khan, Sikandar; Scheunemann, Leslie; Khan, Babar; Psychiatry, School of Medicine
    Postintensive care syndrome–family (PICS-F) describes the psychological symptoms that affect the family members of patients hospitalized in the intensive care unit (ICU) or recently discharged from the ICU. Geriatric psychiatrists should be concerned about PICS-F for several reasons. First, ICU hospitalization in older adults is associated with higher rates of cognitive and physical impairment compared with older adults hospitalized in non-ICU settings or dwelling in the community. This confers a special burden on the caregivers of these older ICU survivors compared with other geriatric populations. Second, as caregivers themselves age, caring for this unique burden can be more challenging compared with other geriatric populations. Third, evidence for models of care centered on patients with multimorbidity and their caregivers is limited. A deeper understanding of how to care for PICS and PICS-F may inform clinical practice for other geriatric populations with multimorbidity and their caregivers. Geriatric psychiatrists may play a key role in delivering coordinated care for PICS-F by facilitating timely diagnosis and interdisciplinary collaboration, advocating for the healthcare needs of family members suffering from PICS-F, and leading efforts within healthcare systems to increase awareness and treatment of PICS-F. This clinical review will appraise the current literature about the impact of critical illness on the family members of ICU survivors and identify crucial gaps in our knowledge about PICS-F among aging patients and caregivers.
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    Amyloid and Tau Pathology are Associated with Cerebral Blood Flow in a Mixed Sample of Nondemented Older Adults with and without Vascular Risk Factors for Alzheimer’s Disease
    (Elsevier, 2023) Swinford, Cecily G.; Risacher, Shannon L.; Vosmeier, Aaron; Deardorff, Rachael; Chumin, Evgeny J.; Dzemidzic, Mario; Wu, Yu-Chien; Gao, Sujuan; McDonald, Brenna C.; Yoder, Karmen K.; Unverzagt, Frederick W.; Wang, Sophia; Farlow, Martin R.; Brosch, Jared R.; Clark, David G.; Apostolova, Liana G.; Sims, Justin; Wang, Danny J.; Saykin, Andrew J.; Radiology and Imaging Sciences, School of Medicine
    Identification of biomarkers for the early stages of Alzheimer's disease (AD) is an imperative step in developing effective treatments. Cerebral blood flow (CBF) is a potential early biomarker for AD; generally, older adults with AD have decreased CBF compared to normally aging peers. CBF deviates as the disease process and symptoms progress. However, further characterization of the relationships between CBF and AD risk factors and pathologies is still needed. We assessed the relationships between CBF quantified by arterial spin-labeled magnetic resonance imaging, hypertension, APOEε4, and tau and amyloid positron emission tomography in 77 older adults: cognitively normal, subjective cognitive decline, and mild cognitive impairment. Tau and amyloid aggregation were related to altered CBF, and some of these relationships were dependent on hypertension or APOEε4 status. Our findings suggest a complex relationship between risk factors, AD pathologies, and CBF that warrants future studies of CBF as a potential early biomarker for AD.
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    Antidepressant Use and Depressive Symptoms in Intensive Care Unit Survivors
    (SHM, 2017) Wang, Sophia; Mosher, Chris; Gao, Sujuan; Kirk, Kayla; Lasiter, Sue; Khan, Sikandar; Kheir, You Na; Boustani, Malaz; Khan, Babar; Psychiatry, School of Medicine
    Nearly 30% of intensive care unit (ICU) survivors have depressive symptoms 2-12 months after hospital discharge. We examined the prevalence of depressive symptoms and risk factors for depressive symptoms in 204 patients at their initial evaluation in the Critical Care Recovery Center (CCRC), an ICU survivor clinic based at Eskenazi Hospital in Indianapolis, Indiana. Thirty-two percent (N = 65) of patients had depressive symptoms on initial CCRC visit. For patients who are not on an antidepressant at their initial CCRC visit (N = 135), younger age and lower education level were associated with a higher likelihood of having depressive symptoms. For patients on an antidepressant at their initial CCRC visit (N = 69), younger age and being African American race were associated with a higher likelihood of having depressive symptoms. Future studies will need to confirm these findings and examine new approaches to increase access to depression treatment and test new antidepressant regimens for post-ICU depression.
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    Assessment of Interest and Resources Needed for the Development of Scalable Healthcare Professionals Facilitated Strategies to Diversify Alzheimer’s Disease Research Participation
    (Wiley, 2025-01-09) Parker, Monica W.; Glover, Crystal M.; Johnson, David K.; Arce Rentería, Miguel; Biber, Sarah A.; Wang, Sophia; Psychiatry, School of Medicine
    Background: Increasing underrepresented racial and ethnic minority group (URG) participation in early‐stage Alzheimer’s disease and related dementias (ADRD) research is critical to inclusive characterization of underlying pathology and testing of disease‐modifying treatments. One promising recruitment strategy to accelerate URG participation is for healthcare professionals (HCPs) to facilitate referrals. The use of HCP‐facilitated recruitment strategies across the Alzheimer’s Disease Research Center (ADRC) network, a major referral source for ADRD multisite observational and clinical trials, has not been examined. We hypothesized that there would be interest in the development of scalable HCP‐facilitated recruitment strategies to accelerate URG participation across the ADRC network. Methods: We emailed Outreach, Recruitment and Engagement (ORE) Cores within the NIA‐funded ADRC network to complete a web‐based REDCap™ survey on their current HCP‐facilitated recruitment strategies for URG participants, resources enhancing use of these strategies, and their interest in strategy development. We conducted descriptive statistics using SPSS 29.0. Results: Out of 37 ADRCs, 27 (73.0%) completed the survey. Although the majority of ADRCs (66.7%, N = 18) reported HCPs referring URG participants (Table 1), they mostly relied on HCP faculty based at the ADRC (48.1%, N = 13) or the ADRC affiliated academic medical center (51.9%, N = 14) (Table 2). Nearly all (92.5%, N = 25) ORE Cores expressed interest in participating in or learning more about future efforts to develop HCP‐facilitated recruitment strategies for increasing URG participation. Resources which would increase use of HCP‐facilitated strategies for URG referrals included guidance on outreach and engagement strategies (70.4%, N = 19), culturally tailored resources for HCPs to refer participants (59.3%, N = 16), technology and informatic recruitment strategies (63.0%, N = 17), and staff effort (63.0%, N = 17) (Table 3). Conclusions: Our survey identified key opportunities to develop novel scalable HCP‐facilitated recruitment strategies to accelerate URG participation. Although most ORE Cores expressed interest in expanding their HCP‐facilitated recruitment strategies to have more inclusive research participation, there is need for both higher‐level strategic guidance and ready‐to‐use resources to implement these strategies. Future studies will need to develop and test scalable HCP‐facilitated strategies and resources to systematically accelerate URG research participation.
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    Association between BrainAGE and Alzheimer's disease biomarkers
    (Wiley, 2025-02-27) Abughofah, Yousaf; Deardorff, Rachael; Vosmeier, Aaron; Hottle, Savannah; Dage, Jeffrey L.; Dempsey, Desarae; Apostolova, Liana G.; Brosch, Jared; Clark, David; Farlow, Martin; Foroud, Tatiana; Gao, Sujuan; Wang, Sophia; Zetterberg, Henrik; Blennow, Kaj; Saykin, Andrew J.; Risacher, Shannon L.; Radiology and Imaging Sciences, School of Medicine
    Introduction: The brain age gap estimation (BrainAGE) method uses a machine learning model to generate an age estimate from structural magnetic resonance imaging (MRI) scans. The goal was to study the association of brain age with Alzheimer's disease (AD) imaging and plasma biomarkers. Methods: One hundred twenty-three individuals from the Indiana Memory and Aging Study underwent structural MRI, amyloid and tau positron emission tomography (PET), and plasma sampling. The MRI scans were processed using the software program BrainAgeR to receive a "brain age" estimate. Plasma biomarker concentrations were measured, and partial Pearson correlation models were used to evaluate their relationship with brain age gap (BAG) estimation (BrainAGE = chronological age - MRI estimated brain age). Results: Significant associations between BAG and amyloid and tau levels on PET and in plasma were observed depending on diagnostic categories. Discussion: These findings suggest that BAG is potentially a biomarker of pathology in AD which can be applied to routine brain imaging. Highlights: Novel research that uses an artificial intelligence learning tool to estimate brain age. Findings suggest that brain age gap is associated with plasma and positron emission tomography Alzheimer's disease (AD) biomarkers. Differential relationships are seen in different stages of disease (preclinical vs. clinical). Results could play a role in early AD diagnosis and treatment.
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    Association between Change in the peripheral biomarkers of inflammation, astrocyte activation, and neuroprotection at one week of critical illness and hospital mortality in patients with delirium: A prospective cohort study
    (Public Library of Science, 2023-09-01) Khan, Sikandar H.; Perkins, Anthony J.; Eltarras, Ahmed M.; Chi, Rosalyn; Athar, Ammar A.; Wang, Sophia; Campbell, Noll L.; Gao, Sujuan; Boustani, Malaz A.; Khan, Babar A.; Medicine, School of Medicine
    Objective: In critically ill adults with delirium, biomarkers of systemic inflammation, astrocyte activation, neuroprotection, and systemic inflammation measured at one week of critical illness may be associated with mortality. Design: Prospective observational study. Setting: Intensive care unit (ICU). Patients: 178 ICU patients with delirium, alive and remaining in ICU at one week. Interventions: None. Measurements and main results: Blood samples collected for a pair of previously published, negative, clinical trials were utilized. Samples were collected at study enrollment/ICU admission (Day 1 sample) and one week later (Day 8 sample), and analyzed for interleukins (IL)-6, 8, 10, Insulin-like Growth Factor (IGF), S100 Binding Protein (S100B), Tumor Necrosis Factor Alpha (TNF-A) and C-Reactive Protein (CRP). Delirium, delirium severity, and coma were assessed twice daily using Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), CAM-ICU-7, and Richmond Agitation-Sedation Scale (RASS), respectively. Mortality was assessed until discharge using the electronic medical record. Logistic regression models adjusting for age, sex, severity of illness, comorbidities, sepsis, and randomization status, were used to assess the relationship among biomarkers and mortality. Higher IL-10 quartiles at day 8 were associated with increased odds of hospital mortality (IL-10: OR 2.00 95%CI: 1.1-3.65, p = 0.023). There was a significant interaction between day 1 and day 8 biomarker quartiles only for IL-6. Patients with IL-6 values in the first three quartiles on admission to the ICU that transitioned to higher IL-6 quartiles at day 8 had increased probability of hospital mortality. Conclusion: In this hypothesis-generating study, higher IL-6 and IL-10 quartiles at one week, and increase in IL-6 from day 1 to day 8 were associated with increased hospital mortality. Studies with larger sample sizes are needed to confirm the mechanisms for these observations.