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Article ; Online: Association of CT-Derived Skeletal Muscle and Adipose Tissue Metrics with Frailty in Older Adults.

Bunch, Paul M / Rigdon, Joseph / Niazi, Muhammad Khalid Khan / Barnard, Ryan T / Boutin, Robert D / Houston, Denise K / Lenchik, Leon

Academic radiology

2023 Volume 31, Issue 2, Page(s) 596–604

Abstract: Rationale and objectives: Tools are needed for frailty screening of older adults. Opportunistic analysis of body composition could play a role. We aim to determine whether computed tomography (CT)-derived measurements of muscle and adipose tissue are ... ...

Abstract	Rationale and objectives: Tools are needed for frailty screening of older adults. Opportunistic analysis of body composition could play a role. We aim to determine whether computed tomography (CT)-derived measurements of muscle and adipose tissue are associated with frailty. Materials and methods: Outpatients aged ≥ 55 years consecutively imaged with contrast-enhanced abdominopelvic CT over a 3-month interval were included. Frailty was determined from the electronic health record using a previously validated electronic frailty index (eFI). CT images at the level of the L3 vertebra were automatically segmented to derive muscle metrics (skeletal muscle area [SMA], skeletal muscle density [SMD], intermuscular adipose tissue [IMAT]) and adipose tissue metrics (visceral adipose tissue [VAT], subcutaneous adipose tissue [SAT]). Distributions of demographic and CT-derived variables were compared between sexes. Sex-specific associations of muscle and adipose tissue metrics with eFI were characterized by linear regressions adjusted for age, race, ethnicity, duration between imaging and eFI measurements, and imaging parameters. Results: The cohort comprised 886 patients (449 women, 437 men, mean age 67.9 years), of whom 382 (43%) met the criteria for pre-frailty (ie, 0.10 < eFI ≤ 0.21) and 138 (16%) for frailty (eFI > 0.21). In men, 1 standard deviation changes in SMD (β = -0.01, 95% confidence interval [CI], -0.02 to -0.001, P = .02) and VAT area (β = 0.008, 95% CI, 0.0005-0.02, P = .04), but not SMA, IMAT, or SAT, were associated with higher frailty. In women, none of the CT-derived muscle or adipose tissue metrics were associated with frailty. Conclusion: We observed a positive association between frailty and CT-derived biomarkers of myosteatosis and visceral adiposity in a sex-dependent manner.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Frailty/diagnostic imaging ; Adipose Tissue/diagnostic imaging ; Muscle, Skeletal/diagnostic imaging ; Body Composition/physiology ; Tomography, X-Ray Computed
Language	English
Publishing date	2023-07-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1355509-1
ISSN	1878-4046 ; 1076-6332
ISSN (online)	1878-4046
ISSN	1076-6332
DOI	10.1016/j.acra.2023.06.003
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Article ; Online: Associations of plasma proteomics and age-related outcomes with brain age in a diverse cohort.

Casanova, Ramon / Walker, Keenan A / Justice, Jamie N / Anderson, Andrea / Duggan, Michael R / Cordon, Jenifer / Barnard, Ryan T / Lu, Lingyi / Hsu, Fang-Chi / Sedaghat, Sanaz / Prizment, Anna / Kritchevsky, Stephen B / Wagenknecht, Lynne E / Hughes, Timothy M

GeroScience

2024

Abstract: Machine learning models are increasingly being used to estimate "brain age" from neuroimaging data. The gap between chronological age and the estimated brain age gap (BAG) is potentially a measure of accelerated and resilient brain aging. Brain age ... ...

Abstract	Machine learning models are increasingly being used to estimate "brain age" from neuroimaging data. The gap between chronological age and the estimated brain age gap (BAG) is potentially a measure of accelerated and resilient brain aging. Brain age calculated in this fashion has been shown to be associated with mortality, measures of physical function, health, and disease. Here, we estimate the BAG using a voxel-based elastic net regression approach, and then, we investigate its associations with mortality, cognitive status, and measures of health and disease in participants from Atherosclerosis Risk in Communities (ARIC) study who had a brain MRI at visit 5 of the study. Finally, we used the SOMAscan assay containing 4877 proteins to examine the proteomic associations with the MRI-defined BAG. Among N = 1849 participants (age, 76.4 (SD 5.6)), we found that increased values of BAG were strongly associated with increased mortality and increased severity of the cognitive status. Strong associations with mortality persisted when the analyses were performed in cognitively normal participants. In addition, it was strongly associated with BMI, diabetes, measures of physical function, hypertension, prevalent heart disease, and stroke. Finally, we found 33 proteins associated with BAG after a correction for multiple comparisons. The top proteins with positive associations to brain age were growth/differentiation factor 15 (GDF-15), Sushi, von Willebrand factor type A, EGF, and pentraxin domain-containing protein 1 (SEVP 1), matrilysin (MMP7), ADAMTS-like protein 2 (ADAMTS), and heat shock 70 kDa protein 1B (HSPA1B) while EGF-receptor (EGFR), mast/stem-cell-growth-factor-receptor (KIT), coagulation-factor-VII, and cGMP-dependent-protein-kinase-1 (PRKG1) were negatively associated to brain age. Several of these proteins were previously associated with dementia in ARIC. These results suggest that circulating proteins implicated in biological aging, cellular senescence, angiogenesis, and coagulation are associated with a neuroimaging measure of brain aging.
Language	English
Publishing date	2024-03-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2886586-8
ISSN	2509-2723 ; 2509-2715
ISSN (online)	2509-2723
ISSN	2509-2715
DOI	10.1007/s11357-024-01112-4
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Article ; Online: Age-based differences in the disability of spine injuries in pediatric and adult motor vehicle crash occupants.

Lynch, S Delanie / Weaver, Ashley A / Barnard, Ryan T / Kiani, Bahram / Stitzel, Joel D / Zonfrillo, Mark R

Traffic injury prevention

2022 Volume 23, Issue 6, Page(s) 358–363

Abstract: Objective: The objective was to develop a disability-based metric for quantifying disability rates as a result of motor vehicle crash (MVC) spine injuries and compare functional outcomes between pediatric and adult subgroups.: Methods: Disability ... ...

Abstract	Objective: The objective was to develop a disability-based metric for quantifying disability rates as a result of motor vehicle crash (MVC) spine injuries and compare functional outcomes between pediatric and adult subgroups. Methods: Disability rate was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank-Research Data System for the top 95% most frequent Abbreviated Injury Scale (AIS) 3 spine injuries (14 unique injuries). Pediatric (7-18 years), young adult (19-45 years), middle-aged adult (46-65 years), and older adult (66+ years) MVC occupants with FIM scores available and at least one of the 14 spine injuries were included. FIM scores of 1 or 2 at time of discharge were used to define disability and correspond to full functional or modified dependence in self-feeding, locomotion, and/or verbal expression. Disability rate was evaluated on a per injury basis for each AIS 3 spine injury and calculated as the proportion of cases associated with disability (i.e. FIM of 1 or 2) out of the total cases of that particular injury. Disability rates were calculated with and without the exclusion of cases with severe co-injuries (AIS 4+) to minimize bias from additional non-spinal injuries that could have contributed to disability. Associations between adjusted disability rates and existing mortality rates were investigated. Results: Locomotion impairment alone was the most frequent disability type for the top 14 AIS 3 spine injuries (7 cervical, 4 thoracic, and 3 lumbar) across all age groups and spine regions. Adjusted and unadjusted disability rates ranged from 0-69%. Adjusted disability rates increased with age: 14.8 ± 10% (mean ± SD) in pediatrics to 16.2 ± 6.6% (young adults), 29.2 ± 10.9% (middle-aged adults), and 45.0 ± 12.2% (older adults). Among all adult populations, adjusted mortality and disability rates were positively correlated ( Conclusions: Older adults had significantly greater disability rates associated with MVC spine injuries across all spinal regions. MVC disability rates for pediatrics were considerably lower. Overall, rates of mortality were significantly lower than rates of disability. The adjusted disability rates developed can supplement existing injury metrics by accounting for age- and location-specific functional implications of MVC spine injuries.
MeSH term(s)	Abbreviated Injury Scale ; Accidents, Traffic ; Adolescent ; Aged ; Child ; Humans ; Middle Aged ; Motor Vehicles ; Pediatrics ; Spinal Injuries/epidemiology ; Young Adult
Language	English
Publishing date	2022-06-16
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ZDB-ID	2089818-6
ISSN	1538-957X ; 1538-9588
ISSN (online)	1538-957X
ISSN	1538-9588
DOI	10.1080/15389588.2022.2086980
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Article ; Online: 20-year depressive symptoms, dementia, and structural neuropathology in older women.

Alzheimer's & dementia : the journal of the Alzheimer's Association

2024 Volume 20, Issue 5, Page(s) 3472–3484

Abstract: Introduction: The course of depressive symptoms and dementia risk is unclear, as are potential structural neuropathological common causes.: Methods: Utilizing joint latent class mixture models, we identified longitudinal trajectories of annually ... ...

Abstract	Introduction: The course of depressive symptoms and dementia risk is unclear, as are potential structural neuropathological common causes. Methods: Utilizing joint latent class mixture models, we identified longitudinal trajectories of annually assessed depressive symptoms and dementia risk over 21 years in 957 older women (baseline age 72.7 years old) from the Women's Health Initiative Memory Study. In a subsample of 569 women who underwent structural magnetic resonance imaging, we examined whether estimates of cerebrovascular disease and Alzheimer's disease (AD)-related neurodegeneration were associated with identified trajectories. Results: Five trajectories of depressive symptoms and dementia risk were identified. Compared to women with minimal symptoms, women who reported mild and stable and emerging depressive symptoms were at the highest risk of developing dementia and had more cerebrovascular disease and AD-related neurodegeneration. Discussion: There are heterogeneous profiles of depressive symptoms and dementia risk. Common neuropathological factors may contribute to both depression and dementia. Highlights The progression of depressive symptoms and concurrent dementia risk is heterogeneous. Emerging depressive symptoms may be a prodromal symptom of dementia. Cerebrovascular disease and AD are potentially shared neuropathological factors.
MeSH term(s)	Humans ; Female ; Aged ; Depression ; Dementia/pathology ; Dementia/epidemiology ; Longitudinal Studies ; Magnetic Resonance Imaging ; Brain/pathology ; Brain/diagnostic imaging ; Cerebrovascular Disorders/pathology ; Alzheimer Disease/pathology ; Disease Progression ; Risk Factors
Language	English
Publishing date	2024-04-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2211627-8
ISSN	1552-5279 ; 1552-5260
ISSN (online)	1552-5279
ISSN	1552-5260
DOI	10.1002/alz.13781
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Article ; Online: Advanced Automatic Crash Notification Algorithm for Children.

Weaver, Ashley A / Talton, Jennifer W / Barnard, Ryan T / Gaffley, Michaela / Doud, Andrea N / Schoell, Samantha L / Petty, John K / Martin, R Shayn / Meredith, J Wayne / Stitzel, Joel D

Academic pediatrics

2022 Volume 22, Issue 6, Page(s) 1057–1064

Abstract: Background: Advanced automatic crash notification (AACN) can improve triage decision-making by using vehicle telemetry to alert first responders of a motor vehicle crash and estimate an occupant's likelihood of injury. The objective was to develop an ... ...

Abstract	Background: Advanced automatic crash notification (AACN) can improve triage decision-making by using vehicle telemetry to alert first responders of a motor vehicle crash and estimate an occupant's likelihood of injury. The objective was to develop an AACN algorithm to predict the risk that a pediatric occupant is seriously injured and requires treatment at a Level I or II trauma center. Methods: Based on 3 injury facets (severity; time sensitivity; predictability), a list of Target Injuries associated with a child's need for Level I/II trauma center treatment was determined. Multivariable logistic regression of motor vehicle crash occupants was performed creating the pediatric-specific AACN algorithm to predict risk of sustaining a Target Injury. Algorithm inputs included: delta-v, rollover quarter-turns, belt status, multiple impacts, airbag deployment, and age. The algorithm was optimized to achieve under-triage ≤5% and over-triage ≤50%. Societal benefits were assessed by comparing correctly triaged motor vehicle crash occupants using the AACN algorithm against real-world decisions. Results: The pediatric AACN algorithm achieved 25% to 49% over-triage across crash modes, and under-triage rates of 2% for far-side, 3% for frontal and near-side, 8% for rear, and 14% for rollover crashes. Applied to real-world motor vehicle crashes, improvements of 59% in under-triage and 45% in over-triage are estimated: more appropriate triage of 32,320 pediatric occupants annually. Conclusions: This AACN algorithm accounts for pediatric developmental stage and will aid emergency personnel in correctly triaging pediatric occupants after a motor vehicle crash. Once incorporated into the trauma triage network, it will increase triage efficiency and improve patient outcomes.
MeSH term(s)	Accidents, Traffic ; Algorithms ; Child ; Humans ; Logistic Models ; Risk Assessment ; Triage ; Wounds and Injuries
Language	English
Publishing date	2022-03-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2483385-X
ISSN	1876-2867 ; 1876-2859
ISSN (online)	1876-2867
ISSN	1876-2859
DOI	10.1016/j.acap.2022.02.016
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Zs.A 5914: Show issues

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Article ; Online: Is an MRI-derived anatomical measure of dementia risk also a measure of brain aging?

Casanova, Ramon / Anderson, Andrea M / Barnard, Ryan T / Justice, Jamie N / Kucharska-Newton, Anna / Windham, Beverly Gwen / Palta, Priya / Gottesman, Rebecca F / Mosley, Thomas H / Hughes, Timothy M / Wagenknecht, Lynne E / Kritchevsky, Stephen B

GeroScience

2022 Volume 45, Issue 1, Page(s) 439–450

Abstract: Machine learning methods have been applied to estimate measures of brain aging from neuroimages. However, only rarely have these measures been examined in the context of biologic age. Here, we investigated associations of an MRI-based measure of dementia ...

Abstract	Machine learning methods have been applied to estimate measures of brain aging from neuroimages. However, only rarely have these measures been examined in the context of biologic age. Here, we investigated associations of an MRI-based measure of dementia risk, the Alzheimer's disease pattern similarity (AD-PS) scores, with measures used to calculate biological age. Participants were those from visit 5 of the Atherosclerosis Risk in Communities Study with cognitive status adjudication, proteomic data, and AD-PS scores available. The AD-PS score estimation is based on previously reported machine learning methods. We evaluated associations of the AD-PS score with all-cause mortality. Sensitivity analyses using only cognitively normal (CN) individuals were performed treating CNS-related causes of death as competing risk. AD-PS score was examined in association with 32 proteins measured, using a Somalogic platform, previously reported to be associated with age. Finally, associations with a deficit accumulation index (DAI) based on a count of 38 health conditions were investigated. All analyses were adjusted for age, race, sex, education, smoking, hypertension, and diabetes. The AD-PS score was significantly associated with all-cause mortality and with levels of 9 of the 32 proteins. Growth/differentiation factor 15 (GDF-15) and pleiotrophin remained significant after accounting for multiple-testing and when restricting the analysis to CN participants. A linear regression model showed a significant association between DAI and AD-PS scores overall. While the AD-PS scores were created as a measure of dementia risk, our analyses suggest that they could also be capturing brain aging.
MeSH term(s)	Humans ; Proteomics ; Cognitive Dysfunction/metabolism ; Brain/metabolism ; Magnetic Resonance Imaging/methods ; Aging/metabolism ; Alzheimer Disease
Language	English
Publishing date	2022-09-02
Publishing country	Switzerland
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2886586-8
ISSN	2509-2723 ; 2509-2715
ISSN (online)	2509-2723
ISSN	2509-2715
DOI	10.1007/s11357-022-00650-z
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Article ; Online: Age-based differences in the disability of extremity injuries in pediatric and adult occupants.

Gaffley, Michaela / Weaver, Ashley A / Talton, Jennifer W / Barnard, Ryan T / Stitzel, Joel D / Zonfrillo, Mark R

Traffic injury prevention

2019 Volume 20, Issue sup2, Page(s) S63–S68

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Abbreviated Injury Scale ; Accidents, Traffic/mortality ; Adolescent ; Age Factors ; Aged ; Bones of Lower Extremity/injuries ; Bones of Upper Extremity/injuries ; Child ; Disability Evaluation ; Disabled Persons ; Female ; Fractures, Bone/mortality ; Fractures, Bone/rehabilitation ; Humans ; Knee Injuries/mortality ; Knee Injuries/rehabilitation ; Male ; Middle Aged ; Pelvic Bones/injuries ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2019-09-27
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2089818-6
ISSN	1538-957X ; 1538-9588
ISSN (online)	1538-957X
ISSN	1538-9588
DOI	10.1080/15389588.2019.1658873
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Article ; Online: Comparing data-driven and hypothesis-driven MRI-based predictors of cognitive impairment in individuals from the Atherosclerosis Risk in Communities (ARIC) study.

Casanova, Ramon / Hsu, Fang-Chi / Barnard, Ryan T / Anderson, Andrea M / Talluri, Rajesh / Whitlow, Christopher T / Hughes, Timothy M / Griswold, Michael / Hayden, Kathleen M / Gottesman, Rebecca F / Wagenknecht, Lynne E

Alzheimer's & dementia : the journal of the Alzheimer's Association

2021 Volume 18, Issue 4, Page(s) 561–571

Abstract: Introduction: A data-driven index of dementia risk based on magnetic resonance imaging (MRI), the Alzheimer's Disease Pattern Similarity (AD-PS) score, was estimated for participants in the Atherosclerosis Risk in Communities (ARIC) study.: Methods: ... ...

Abstract	Introduction: A data-driven index of dementia risk based on magnetic resonance imaging (MRI), the Alzheimer's Disease Pattern Similarity (AD-PS) score, was estimated for participants in the Atherosclerosis Risk in Communities (ARIC) study. Methods: AD-PS scores were generated for 839 cognitively non-impaired individuals with a mean follow-up of 4.86 years. The scores and a hypothesis-driven volumetric measure based on several brain regions susceptible to AD were compared as predictors of incident cognitive impairment in different settings. Results: Logistic regression analyses suggest the data-driven AD-PS scores to be more predictive of incident cognitive impairment than its counterpart. Both biomarkers were more predictive of incident cognitive impairment in participants who were White, female, and apolipoprotein E gene (APOE) ε4 carriers. Random forest analyses including predictors from different domains ranked the AD-PS scores as the most relevant MRI predictor of cognitive impairment. Conclusions: Overall, the AD-PS scores were the stronger MRI-derived predictors of incident cognitive impairment in cognitively non-impaired individuals.
MeSH term(s)	Alzheimer Disease/diagnostic imaging ; Alzheimer Disease/epidemiology ; Alzheimer Disease/genetics ; Apolipoprotein E4/genetics ; Atherosclerosis/diagnostic imaging ; Atherosclerosis/epidemiology ; Brain/diagnostic imaging ; Cognitive Dysfunction/diagnostic imaging ; Cognitive Dysfunction/epidemiology ; Cognitive Dysfunction/genetics ; Female ; Humans ; Magnetic Resonance Imaging
Chemical Substances	Apolipoprotein E4
Language	English
Publishing date	2021-07-26
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2211627-8
ISSN	1552-5279 ; 1552-5260
ISSN (online)	1552-5279
ISSN	1552-5260
DOI	10.1002/alz.12427
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Article: Computer simulations for assessing cognitively intensive instrumental activities of daily living in older adults.

Rapp, Stephen R / Barnard, Ryan T / Sink, Kaycee M / Chamberlain, Dana G / Wilson, Valerie / Lu, Lingyi / Ip, Edward H

Alzheimer's & dementia (Amsterdam, Netherlands)

2018 Volume 10, Page(s) 237–244

Abstract: Introduction: Aim is to evaluate validity, reliability, diagnostic precision, and user acceptability of computer simulations of cognitively demanding tasks when administered to older adults with and without cognitive impairment.: Methods: Five ... ...

Abstract	Introduction: Aim is to evaluate validity, reliability, diagnostic precision, and user acceptability of computer simulations of cognitively demanding tasks when administered to older adults with and without cognitive impairment. Methods: Five simulation modules were administered to 161 individuals aged ≥60 years with no cognitive impairment (N = 81), mild cognitive impairment (N = 52), or dementia (N = 28). Groups were compared on total accuracy and time to complete the tasks (seconds). Receiver operating characteristics were evaluated. Reliability was assessed over one month. Participants rated face validity and acceptability. Results: Total accuracy ( Discussion: Brief computer simulations can be useful in assessing cognitive functional abilities of older adults and distinguishing varying degrees of impairment.
Language	English
Publishing date	2018-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2832898-X
ISSN	2352-8729
ISSN	2352-8729
DOI	10.1016/j.dadm.2018.01.008
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Article ; Online: Characterization of the occult nature of frequently occurring pediatric motor vehicle crash injuries.

Doud, Andrea N / Schoell, Samantha L / Talton, Jennifer W / Barnard, Ryan T / Petty, John K / Stitzel, Joel D / Weaver, Ashley A

Accident; analysis and prevention

2018 Volume 113, Page(s) 12–18

Abstract: Background: Occult injuries are those likely to be missed on initial assessment by first responders and, though initially asymptomatic, they may present suddenly and lead to rapid patient decompensation. No scoring systems to quantify the occultness of ... ...

Abstract	Background: Occult injuries are those likely to be missed on initial assessment by first responders and, though initially asymptomatic, they may present suddenly and lead to rapid patient decompensation. No scoring systems to quantify the occultness of pediatric injuries have been established. Such a scoring system will be useful in the creation of an Advanced Automotive Crash Notification (AACN) system that assists first responders in making triage decisions following a motor vehicle crash (MVC). Study design: The most frequent MVC injuries were determined for 0-4, 5-9, 10-14 and 15-18 year olds. For each age-specific injury, experts with pediatric trauma expertise were asked to rate the likelihood that the injury may be missed by first responders. An occult score (ranging from 0-1) was calculated by averaging and normalizing the responses of the experts polled. Results: Evaluation of all injuries across all age groups demonstrated greater occult scores for the younger age groups compared to older age groups (mean occult score 0-4yo: 0.61 ± 0.23, 5-9yo: 0.53 ± 0.25, 10-14yo: 0.48 ± 0.23, and 15-18yo: 0.42 ± 0.22, p < 0.01). Body-region specific occult scores revealed that experts judged abdominal, spine and thoracic injuries to be more occult than injuries to other body regions. Conclusions: The occult scores suggested that injuries are more difficult to detect in younger age groups, likely given their inability to express symptoms. An AACN algorithm that can predict the presence of clinically undetectable injuries at the scene can improve triage of children with these injuries to higher levels of care.
MeSH term(s)	Abbreviated Injury Scale ; Abdominal Injuries/diagnosis ; Accidents, Traffic ; Adolescent ; Age Factors ; Algorithms ; Child ; Child, Preschool ; Decision Making ; Emergency Responders ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Motor Vehicles ; Pediatrics ; Probability ; Spinal Injuries/diagnosis ; Thoracic Injuries/diagnosis ; Triage ; Wounds and Injuries/diagnosis
Language	English
Publishing date	2018-04
Publishing country	England
Document type	Evaluation Studies ; Journal Article
ZDB-ID	210223-7
ISSN	1879-2057 ; 0001-4575
ISSN (online)	1879-2057
ISSN	0001-4575
DOI	10.1016/j.aap.2017.12.025
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