Megan Zuelsdorff

Mindfulness meditation for alcohol relapse prevention: a feasibility pilot study.

Objectives:Meditation is a promising treatment for alcohol dependence. This 16-week prospective case series was designed to gather preliminary data about the efficacy of meditation for relapse prevention and to evaluate study methods feasibility. Methods:Nineteen adult alcohol-dependent graduates of an intensive outpatient program were enrolled. Fifteen subjects completed the 8-week meditation course supplemented by at-home meditation and “standard of care” therapy. Outcome measures included surveys and 2 stress-responsive biomarkers. Results:Subjects (N = 19, 38.4 standard deviation [SD] = 8.6-year-old) were abstinent for 30.9 (SD = 22.2) days at enrollment. Completers (N = 15) attended 82% of meditation course sessions and meditated on average 4.6 (SD = 1.1) days per week; they were abstinent on 94.5% (SD = 7.4) of study days, with 47% reporting complete abstinence and 47% reporting 1 or more heavy drinking days. Their severity of depression, anxiety, stress (P < 0.05), and craving (P < 0.08), documented relapse triggers, decreased, and the degree of mindfulness increased (P < 0.05). The meditation course was rated as a “very important” (8.7/10, SD = 1.8) and “useful relapse prevention tool” (8.5/10, SD = 2.1); participants reported being “very likely” to continue meditating (9.0/10, SD = 1.5). “Gaining skills to reduce stress,” “coping with craving,” and “good group support” were the most common qualitative comments about the course value. Compared with baseline, at 16 weeks, interleukin-6 levels decreased (N = 12, P = 0.05); cortisol levels (N = 10) were reduced but not significantly. There were no adverse events or side effects. Conclusions:Meditation may be an effective adjunctive therapy for relapse prevention in alcohol dependence, worthy of investigation in a larger trial. The study methods are appropriate for such a trial.

Epidemiologic study of the C-3 epimer of 25-hydroxyvitamin D3 in a population-based sample

BACKGROUND & AIMS Vitamin D is associated with many health outcomes and the blood concentration of 25-hydroxyvitamin D [25(OH)D] is commonly measured in clinical practice. A C-3 epimer of this compound, 3-epi-25(OH)D3, has recently been detected in blood samples. Few clinical assays currently detect this epimer and its physiological function is unknown, as are the demographic, behavioral, and physiologic factors that may be correlated with it. We sought to determine the correlation between these factors and 3-epi-25(OH)D3. METHODS We conducted a cross-sectional population-based study of 303 non-Hispanic white participants in the Survey of the Health of Wisconsin. Serum 25(OH)D2, 25(OH)D3 and 3-epi-25(OH)D3 were measured by high-performance liquid chromatography tandem mass spectrometry. We measured vitamin D intake from foods and supplements via a food frequency questionnaire, sun exposure by spectrophotometry, waist circumference during a physical exam, and additional demographic and behavioral factors by questionnaire. We calculated the percent of 3-epi-25(OH)D3 out of the total 25(OH)D3. RESULTS Summer season (P = 0.009), higher alcohol intake (P = 0.007), and higher vitamin D intake from supplements (P = 0.0004), but not food (P = 0.20), were significantly associated with a higher percent of 3-epi-25(OH)D3 relative to the total 25(OH)D3, although these associations appear to be partially driven by individuals with low 3-epi-25(OH)D3. Moreover, the percent of 3-epi-25(OH)D3 was significantly correlated with the total 25(OH)D3 (r = 0.37, P < 0.0001). CONCLUSIONS We report findings from an epidemiologic study of 3-epi-25(OH)D3 and show that individuals with lower total 25(OH)D3 tend to have a lower percent of 3-epi-25(OH)D3 relative to the total. While this is the largest reported sample of adults with measured 3-epi-25(OH)D3, the sample size of 303 is relatively small and replication of our findings is necessary.

Treatment retention among African-Americans in the Dane County Drug Treatment Court.

Drug treatment courts (DTCs) provide substance abuse treatment and case management services to offenders with substance use disorders as an alternative to incarceration. Studies indicate that African Americans less frequently complete DTC programming. The current study analyzed data from the Dane County Drug Treatment Court (n = 573). The study ascertained factors associated with failure to complete treatment among African American DTC participants. Significant factors were unemployment (p = 0.011), previous criminal history (p = 0.013), and, possibly, the presence of a cocaine use disorder (p = 0.064). Treatment plans for DTC participants should incorporate services addressing needs specific to African Americans, who are over-represented in the U.S. correctional system. The current results indicate that employment, prior corrections involvement, and the presence of a cocaine use disorder may be specific issues to consider.

Stressful Events, Social Support, and Cognitive Function in Middle-Aged Adults With a Family History of Alzheimer’s Disease

Objective: To examine the associations of stressful experiences and social support with cognitive function in a sample of middle-aged adults with a family history of Alzheimer’s disease (AD). Method: Using data from the Wisconsin Registry for Alzheimer’s Prevention (WRAP; N = 623), we evaluated relationships between stressful events experienced in the past year, as well as social support, and cognitive performance in four domains: speed and flexibility, immediate memory, verbal learning and memory, and working memory. We assessed interactions between psychosocial predictors, and with APOE ε4 status. Results: Greater number of stressful events was associated with poorer performance on tests of speed and flexibility. Greater social support was associated with better performance in the same domain; this relationship was diminished by the presence of the ε4 allele. No associations were seen in the remaining three domains. Discussion: Psychosocial factors may influence cognition in at-risk individuals; influence varies by cognitive domain and ε4 status.

Reliability of a Novel Social Activity Questionnaire: Perceived Social Support and Verbal Interaction in the Wisconsin Registry for Alzheimer’s Prevention

Objective: Social activity is associated with healthy aging and preserved cognition. Such activity includes a confluence of social support and verbal interaction, each influencing cognition through rarely parsed, mechanistically distinct pathways. We created a novel verbal interaction measure for the Wisconsin Registry for Alzheimer’s Prevention (WRAP) and assessed reliability of resultant data, a first step toward mechanism-driven examination of social activity as a modifiable predictor of cognitive health. Method: Two WRAP subsamples completed a test–retest study to determine 8-week stability (n = 107) and 2-year stability (n = 136) of verbal interaction, and 2-year stability of perceived social support. Reliability was determined using quadratic-weighted kappa, percent agreement, or correlation coefficients. Results: Reliability was fair to almost perfect. The association between social support and interaction quantity decreased with age. Discussion: Social activity data demonstrate moderate to excellent temporal stability. Moreover, in older individuals, social support and verbal interaction represent two distinct dimensions of social activity.

LIFETIME STRESSFUL EXPERIENCES, RACIAL DISPARITIES, AND COGNITIVE PERFORMANCE: FINDINGS FROM THE WISCONSIN REGISTRY FOR ALZHEIMER’S PREVENTION (WRAP) STUDY

WISCONSIN REGISTRY FOR ALZHEIMER’S PREVENTION (WRAP) STUDY Megan Zuelsdorff, Carey E. Gleason, Amy J. Kind, Rebecca L. Koscik, Sterling C. Johnson, Ozioma C. Okonkwo, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; University of Wisconsin, Madison, Madison, WI, USA; Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Contact e-mail: mlzuelsd@wisc.edu

Apathy in Preclinical Alzheimer’s Disease: Psychometric Validation of the Apathy Evaluation Scale

Objectives: The purpose of the present study was to validate the Apathy Evaluation Scale, self-rated version (AES-S), and assess the severity of apathy in a cognitively healthy middle-aged cohort at risk for Alzheimer’s disease (AD). Method: Three hundred and sixteen middle-aged adults were selected to represent a subset of the Wisconsin Alzheimer’s Disease Research Center Clinical Core: the Investigating Memory in People At-risk, Causes and Treatments cohort. Results: An exploratory factor analysis (EFA) with varimax rotation identified 3 subscales: apathy, disinterest, and social withdrawal factors. Confirmatory factor analysis confirmed the EFA findings. Results indicated acceptable convergent and discriminant validity. The AES-S is a reliable instrument to quantify apathy in cognitively healthy middle-aged individuals at risk for AD. Discussion: This study demonstrates the AES-S is a psychometrically sound measurement tool for assessing levels of apathy in a cognitively healthy middle-aged cohort at risk for AD.

INCIDENT DEMENTIA IN NON-HISPANIC AFRICAN AMERICANS AND WHITES WITH MILD COGNITIVE IMPAIRMENT: CAN WE MAKE RACIAL COMPARISONS USING ALZHEIMER’S DISEASE CENTER DATA?

Model 1 .125 31.13** MFE-Total informants -.359 -5.58** -.53, -.25 Model 2 .134 17.31** MFE-Total informants -.341 -5.26** -.51, -.23 GDS -.115 -1.78 -.98, .05 Model 3 .399 47.63** MFE-Total informants -.227 -4.10** -.36, -.13 GDS -.10 -1.89 -.84, .02 Age -.528 -9.65** -.63, -.42 Model 4 .582 74.58** MFE-Total informants -.186 -4.02** -.3, -.10 GDS -.033 -.73 -.50, .23 Age -.324 -6.43** -.42, -.22 Years of schooling .487 9.62** .64, .98

PSYCHOSOCIAL PREDICTORS OF HIPPOCAMPAL VOLUME AND COGNITION AMONG AFRICAN AMERICAN AND WHITE OLDER ADULTS AT RISK FOR ALZHEIMER’S DISEASE

Frontal 6.87 1.37 (.16) 1.28 (.07) .01 .10 4.92 1.36 (.14) 1.28 (.11) .03 .07 Lateral temporal 5.54 1.32 (.14) 1.24 (.08) .02 .08 7.05 1.33 (.13) 1.24 (.10) .01 .11 Hippocampal 2.65 0.96 (.08) .93 (.05) .11 .03 5.66 .97 (.07) .92 (.06) .02 .09 Posterior cingulate 3.50 1.63 (.17) 1.56 (.09) .07 .05 9.62 1.65 (.15) 1.54 (.11) .003 .15 Precuneus 7.18 1.50 (.15) 1.41 (-08) .01 .11 8.30 1.51 (.12) 1.41 (.11) .006 .13 Supramarginal gyrus 6.83 1.31 (-15) 1.22(-09) .01 .10 4.90 1.31 (.15) 1.23 (11) .03 .07 Angular gyrus 10.01 1.42 (.15) 1.31 (.08) .003 .15 4.42 1.41 (.14) 1.33 (.12) .04 .06

TOBACCO EXPOSURE AND CESSATION IS ASSOCIATED WITH INCIDENT DEMENTIA AND NURSING HOME PLACEMENT

Background:It has been suggested that illiteracy and low level of education are risk factors for developing dementia, but also that bilingualism could function as a protective factor. In Peru, both conditions are very frequent. We observed a dementia prevalence of 6.85% in schooled subjects and 15.2% for illiterates; but there is still no data on how bilingualism modulates cognitive response in healthy illiterates, especially in executive function. Therefore, our objectivewas to compare performance of bilingual andmonolingual healthy elder illiterates in executive control tasks, controlling the influence of age and the type of work. Methods:We evaluated 56 healthy illiterate elderlies, 40 bilinguals (M 1⁄4 71.20, SD 1⁄4 5.94) and 16monolinguals (M1⁄4 75.25, SD1⁄4 10.28) with inhibitory control tasks (modified Stroop, see figure 1), response suppression (Go / No Go), cognitive flexibility (Hanoi tower) and working memory (forward and backward digits, WAIS III). Non-parametric contrast statistics (U Mann Whitney) and covariance analysis were used, where the fixed factors were bilingualism and type of work (elementary or instrumental) and age as a covariate. Results: We observed significant differences between number and symbol (Z 1⁄4 -3.38, p <.001) and interference (Z1⁄4 -2.61, p <.009) of the Stroop tasks; in both cases bilinguals score better than monolinguals (see figure 2). The analysis of covariance also showed a greater effect of bilingualism on the measures of inhibitory control (Numbers and symbols, F 1⁄4 8.085, p <.006 and interference, F 1⁄4 9.604, p <.003) than age and type of work. No significant differences were observed in the other components of executive control. Conclusions: a bilingual advantage is observed in inhibitory control tasks in healthy illiterate older adults, which is not associated with age or type of work. This advantage seems to be associated with the activation of executive control mechanisms formore complex tasks. These data show that bilingualism modulates the cognitive response and functions as a cognitive reserve factor; hence the importance of its promotion and empowerment. We recommend conducting epidemiological and follow-up studies in this population.