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Authors: Schneider, Julie A. | Aggarwal, Neelum T.

Article Type: Obituary

DOI: 10.3233/JAD-201123

Citation: Journal of Alzheimer's Disease, vol. 78, no. 1, pp. 1-2, 2020

Authors: Morris, Martha Clare | Schneider, Julie A. | Tangney, Christine C.

Article Type: Research Article

Abstract: The B-vitamins, including vitamins B12, B6, B1, B2, niacin (B3) and folate (B9), have been implicated as protective risk factors against cognitive decline and Alzheimer's disease. This commentary reviews the evidence to support protective relations of these vitamins, including consideration of known vitamin deficiency syndromes, theories of underlying biologic mechanisms, and the epidemiologic evidence. We also comment on the potential benefits and harms of vitamin supplementation as well as make recommendations for the direction of future studies.

Keywords: Alzheimer disease, B-vitamins, dementia, folate

DOI: 10.3233/JAD-2006-9409

Citation: Journal of Alzheimer's Disease, vol. 9, no. 4, pp. 429-433, 2006

Authors: Schneider, Julie A. | Aggarwal, Neelum T. | Barnes, Lisa | Boyle, Patricia | Bennett, David A.

Article Type: Research Article

Abstract: Community-based cohorts of older persons may differ neuropathologically from clinic-based cohorts. This study investigated age-related pathologies in persons with and without dementia and included autopsied participants from two community-based cohorts, the Rush Religious Orders Study (n=386) and the Memory and Aging Project (n=195), and one clinic-based cohort, the Clinical Core of the Rush Alzheimer's Disease Center (n=392). Final clinical diagnoses included no cognitive impairment (n=202), mild cognitive impairment (MCI) (n=150), probable Alzheimer's disease (AD) (n=474), possible AD (n=88), and other dementias (n=59). Postmortem diagnoses included pathologic AD, cerebral infarcts, and Lewy body disease. Community-based persons with clinical AD had less …severe AD pathology (p<0.001) and had more cerebral infarcts (p<0.001) compared to clinic-based persons. Additionally, community-based persons with MCI had more infarcts compared to clinic-based persons. Overall, there was a higher proportion of Lewy bodies and atypical pathologies in the clinic-based compared to the community-based cohorts (p<0.001). Community-based persons with probable AD show less severe AD pathology and more often have infarcts and mixed pathologies; those with MCI more often have infarcts and mixed pathologies. Overall, clinic-based persons have more Lewy bodies and atypical pathologies. The spectrum of pathologies underlying cognitive impairment in clinic-based cohorts differs from community-based cohorts. Show more

Keywords: Clinic, community, epidemiology, neuropathology, selection bias

DOI: 10.3233/JAD-2009-1227

Citation: Journal of Alzheimer's Disease, vol. 18, no. 3, pp. 691-701, 2009

Authors: Shah, Raj C. | Schneider, Julie A. | Leurgans, Sue | Bennett, David A.

Article Type: Review Article

Abstract: Lower hemoglobin levels have been associated with cognitive decline in older persons. The objective of this study was to investigate the relationship between lower hemoglobin levels and common, age-related neuropathologies associated with cognitive decline. Hemoglobin and neuropathology measures were available in 113 deceased, community-dwelling, older adults participating in the Rush Memory and Aging Project, a prospective, observational, clinical pathology study of aging. The mean hemoglobin level was 13.0 g/dL (SD = 1.4) and was measured 3.2 (SD = 1.3) years prior to death. Thirty-five participants had at least one chronic macroscopic infarction and twenty-nine had at least one chronic microscopic …infarction. Eleven participants had Lewy Bodies. The mean Alzheimer's disease pathology score based on a summary measure of neuritic plaques, diffuse plaques, and neurofibrillary tangles was 0.56 unit (SD = 0.56; range = 0, 2.34). Using logistic regression models adjusted for age at death, gender, and education, each g/dL lower hemoglobin level increased the odds for having a chronic macroscopic infarction by 37% (95% CI = 1.01, 1.86) but not for having a chronic microscopic infarction (OR = 1.11; 95% CI = 0.82, 1.52) or Lewy Bodies (OR = 1.07; 95% CI = 0.68, 1.68). In an adjusted multiple regression model, hemoglobin level was not associated with the global AD pathology measure (parameter estimate = −0.02, SE = 0.03, p = 0.6). In secondary analyses, lower hemoglobin levels were associated with higher odds of having a chronic macroscopic infarction in a subcortical region but not with higher total subcortical chronic macroscopic infarction volume. In conclusion, lower hemoglobin levels appear to be associated with chronic macroscopic infarctions but not other common age-related neuropathologies. Show more

Keywords: Diffuse plaque, hemoglobin, macroscopic infarction, Lewy body, microscopic infarction, neuritic plaque, neurofibrillary tangle, neuropathology

DOI: 10.3233/JAD-2012-120952

Citation: Journal of Alzheimer's Disease, vol. 32, no. 3, pp. 579-586, 2012

Authors: Agarwal, Puja | Brockman, John D. | Wang, Yamin | Schneider, Julie A. | Morris, Martha C.

Article Type: Research Article

Abstract: Background: Bromine is a naturally occurring element that is widely present in the human environment in various chemical forms primarily as flame retardants, pesticides, and water treatments. Objective: In this exploratory study, we investigated the association of brain bromine concentrations on Alzheimer’s disease (AD) neuropathology, cerebral infarcts, and Lewy bodies. Methods: The study was conducted in 215 deceased participants of the Memory and Aging Project, a clinical-pathologic cohort study. Brain bromine levels were measured using instrumental neutron activation analysis. Multiple brain regions were assessed for diffuse and neuritic plaques, neurofibrillary tangles, cerebral macro-and microinfarcts, and Lewy bodies. Standardized measures of …AD pathology (Braak, CERAD, NIA-Reagan, global AD pathology) were computed. Results: In linear regression models, the higher brain bromine levels were associated with more AD neuropathology (Braak (p trend = 0.01); CERAD (p trend = 0.02); NIA-Reagan (p trend = 0.02). Conclusion: Bromine accumulation in the brain is associated with higher level of AD neuropathology. The potential deleterious effects of this element on AD need further exploration. Show more

Keywords: Alzheimer’s disease, bromine, metals, neuropathology

DOI: 10.3233/JAD-190646

Citation: Journal of Alzheimer's Disease, vol. 73, no. 1, pp. 327-332, 2020

Authors: Yu, Lei | Wilson, Robert S. | Schneider, Julie A. | Bennett, David A. | Boyle, Patricia A.

Article Type: Research Article

Abstract: Background: Domain specific literacy is a multidimensional construct that requires multiple resources including cognitive and non-cognitive factors. Objective: We test the hypothesis that domain specific literacy is associated with Alzheimer’s disease (AD) dementia and AD pathology after controlling for cognition. Methods: Participants were community-based older persons who completed a baseline literacy assessment, underwent annual clinical evaluations for up to 8 years, and agreed to organ donation after death. Financial and health literacy was measured using 32 questions and cognition was measured using 19 tests. Annual diagnosis of AD dementia followed standard criteria. AD pathology was examined postmortem by quantifying plaques …and tangles. Cox models examined the association of literacy with incident AD dementia. Performance of model prediction for incident AD dementia was assessed using indices for integrated discrimination improvement and continuous net reclassification improvement. Linear regression models examined the independent association of literacy with AD pathology in autopsied participants. Results: All 805 participants were free of dementia at baseline and 102 (12.7%) developed AD dementia during the follow-up. Lower literacy was associated with higher risk for incident AD dementia (p  < 0.001), and the association persisted after controlling for cognition (hazard ratio = 1.50, p  = 0.004). The model including the literacy measure had better predictive performance than the one with demographics and cognition only. Lower literacy also was associated with higher burden of AD pathology after controlling for cognition (β= 0.07, p  = 0.035). Conclusion: Literacy predicts incident AD dementia and AD pathology in community-dwelling older persons, and the association is independent of traditional measures of cognition. Show more

Keywords: Alzheimer’s disease, cognition, dementia, domain specific literacy, pathology

DOI: 10.3233/JAD-161132

Citation: Journal of Alzheimer's Disease, vol. 56, no. 4, pp. 1485-1493, 2017

Authors: Kapasi, Alifiya | Yu, Lei | Stewart, Christopher | Schneider, Julie A. | Bennett, David A. | Boyle, Patricia A.

Article Type: Research Article

Abstract: Background: Recent findings suggest that poor decision making and increased scam susceptibility are harbingers of Alzheimer’s disease (AD) dementia and may be among the earliest behavioral manifestations of pathologic cognitive aging. However, the degree to which poor decision making and scam susceptibility reflect accumulating Alzheimer’s disease (AD) pathology remains unclear. Objective: To investigate the associations of AD pathology with decision making and scam susceptibility in older adults without dementia. Methods: Data came from 198 deceased participants without clinical dementia (mean age at death = 90 years; 69%women) from two ongoing studies of aging. All underwent annual clinical evaluations, completed assessments of healthcare …and financial decision making and scam susceptibility, and brain donation. Neuropathologic evaluations quantified pathologic hallmarks of AD, amyloid-β and tau-tangles, Lewy body pathology, and TDP-43 proteinopathy. Results: In linear regression models adjusted for demographics, amyloid-β pathology was associated with lower decision making (estimate = –0.35; SE = 0.16, p  = 0.03), particularly healthcare decision making (estimate = –0.20; SE = 0.09, p  = 0.03), as well as greater scam susceptibility (estimate = 0.12; SE = 0.04, p  = 0.003); tau-tangle pathology was not related. Further, TDP-43 pathology was associated with greater scam susceptibility (estimate = 0.10; SE = 0.04; p  = 0.02). Conclusion: Accumulating AD pathology, particularly amyloid-β, is associated with poor decision making and increased scam susceptibility among older persons without overt cognitive impairment. These findings provide compelling evidence that decision making and scam susceptibility are sensitive to the earliest pathological changes of AD. Show more

Keywords: Aging, Alzheimer’s disease pathology, amyloid-beta, decision making, scam

DOI: 10.3233/JAD-210356

Citation: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 879-887, 2021

Authors: de Leeuw, Francisca A. | Honer, William G. | Schneider, Julie A. | Morris, Martha Clare

Article Type: Research Article

Abstract: Background: Higher vitamin E intake has been widely related to lower risks of cognitive decline and dementia. Animal models suggest that this relationship might be (partially) explained by the protection of vitamin E against presynaptic protein oxidation. Objective: In this cross-sectional study, we aimed to examine the associations between brain tocopherols and presynaptic protein levels in elderly humans. Methods: We examined associations of α - and γ -tocopherol brain levels with presynaptic protein levels in 113 deceased participants (age 88.5±6.0 years, 45 (40%) female) from the prospective Memory and Aging project. Three distinct presynaptic proteins, a SNARE protein composite, a …synaptotagmin synaptophysin composite and the protein-protein interaction between synaptosomal-associated protein 25 (SNAP-25), and syntaxin were measured in two cortical brain regions. Linear regression models assessed associations of brain tocopherols with presynaptic protein levels. Results: Higher brain γ -tocopherol levels were associated with higher levels of the SNARE protein composite, complexin-I, complexin-II, the synaptotagmin synaptophysin composite, and septin-5 in the midfrontal cortex (B(SE) = 0.272 to 0.412 (0.084 to 0.091), p  < 0.001 to 0.003). When additionally adjusted for global Alzheimer’s disease pathology, cerebral infarcts, and Lewy body disease pathology, these associations remained largely similar. No associations were found between α -tocopherol and presynaptic protein levels. Conclusion: In this cross-sectional study, we found higher brain γ -tocopherol levels were associated with presynaptic protein levels in the midfrontal cortex. These results are consistent with a proposed role of vitamin E to maintain presynaptic protein levels. Show more

Keywords: Antioxidants, SNARE protein, tocopherols, vitamin E

DOI: 10.3233/JAD-200166

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 619-627, 2020

Authors: Bennett, David A. | Wilson, Robert S. | Arvanitakis, Zoe | Boyle, Patricia A. | de Toledo-Morrell, Leyla | Schneider, Julie A.

Article Type: Review Article

Abstract: The Religious Orders Study and the Rush Memory and Aging Project are both cohort studies of aging and dementia that include organ donation at death. Together, more than 2,700 persons have agreed to annual clinical evaluation and brain donation at death. A subset of participants also participated in a substudy that included ante-mortem imaging. We highlight recent findings that have been highly cited over the past five years. The findings fall into three general categories. The first relates to the neuropathology of probable Alzheimer's disease, mild cognitive impairment, and those without dementia or mild cognitive impairment. The second relates to …risk factors for Alzheimer's disease and neuropathology. The third are clinical and imaging studies of mild cognitive impairment. The findings illustrate the range of insights that can be gained into cognitive aging by incorporating neuropathologic indices into well designed, prospective cohort studies. Show more

Keywords: Clinical-pathology, mild cognitive impairment, risk factors

DOI: 10.3233/JAD-2012-129007

Citation: Journal of Alzheimer's Disease, vol. 33, no. s1, pp. S397-S403, 2013

Authors: Wang, Suqing | Simon, Brook P. | Bennett, David A. | Schneider, Julie A. | Malter, James S. | Wang, Deng-Shun

Article Type: Research Article

Abstract: Pin1 protein, a peptidyl-prolyl cis-trans isomerase plays an important regulatory role in neuronal function. Recent studies indicate that Pin1 may promote the dephosphorylation of tau and restore its ability to bind to and polymerize microtubles. Previous studies on postmortem human brains showed that Pin1 is down-regulated in advanced Alzheimer's disease (AD) brains compared to age-matched non-demented controls. Because AD is a slowly progressive disease with a preclinical period that can last years, the abundance and regulatory function of Pin1 may vary on the course of the disease. In order to evaluate the potential contribution of Pin1 to AD pathogenesis, levels …of mRNA, protein and isomerase activity of Pin1 and phosphorylated tau from postmortem brains of 10 persons with mild-cognitive impairment (MCI), 10 with AD and 10 age-matched no cognitive impairment (NCI) were measured. The relationship between Pin1 and phosphorylated tau as well as clinical and cognitive data were analyzed. The results indicated that Pin1 activity in MCI and AD were significantly higher than in NCI. Phosphorylated tau in MCI and AD was also higher than in NCI group. The positive correlation trend in MCI and the robust correlation in AD between Pin1 activity and phosphorylated tau implies that increasing phosphorylated tau during AD pathogenesis may induce the compensatory activation/up-regulation of Pin1, while the inverse correlation between Pin1 activity and phosphorylated tau in NCI group implies that decreased Pin1 may play a role in the initial accumulation of phosphorylated tau in AD pathogenesis. Show more

Keywords: Alzheimer's disease, Pin1, tau, cognitive, dementia, MCI, AD

DOI: 10.3233/JAD-2007-11105

Citation: Journal of Alzheimer's Disease, vol. 11, no. 1, pp. 13-23, 2007