Sarah Tomaszewski Farias

University of California, Davis, Davis, CA, United States

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Publications (64)217.39 Total impact

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    ABSTRACT: The everyday functional capacities of older adults are determined by multiple factors. The primary goal of the present study was to evaluate whether apathy and depression have unique influences on degree of functional impairment, independent of the effects of specific cognitive impairments. Participants included 344 older adults (199 normal, 87 with MCI, 58 with dementia). The Everyday Cognition (ECog) scales were used to measure both global and domain-specific functional abilities. Neuropsychiatric symptoms of depression and apathy were measured by the Neuropsychiatric Inventory (NPI), and specific neuropsychological domains measured included episodic memory and executive functioning. Results indicated that worse memory and executive function, as well as greater depression and apathy, were all independent and additive determinants of poorer functional abilities. Apathy had a slightly more restricted effect than the other variables across the specific functional domains assessed. Secondary analysis suggested that neuropsychiatric symptoms may be more strongly associated with everyday function within cognitively normal and MCI groups, while cognitive impairment is more strongly associated with everyday function in dementia. Thus, a somewhat different set of factors may be associated with functional status across various clinical groups.
    The Clinical Neuropsychologist 02/2014; · 1.68 Impact Factor
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    ABSTRACT: Objectives.Poor quality of early life conditions has been associated with poorer late life cognition and increased risk of dementia. Early life physical development can be captured using adult measures of height and head circumference. Availability of resources may be reflected by socioeconomic indicators, such as parental education and family size. We sought to determine the association between early life development and experience and late life semantic memory, episodic memory, and executive functioning abilities, as well as rate of cognitive decline.Method.This study was conducted using the UC Davis Aging Diversity cohort, an ethnically diverse sample of Caucasian, African American, and Hispanic individuals from northern California. We used latent variable modeling to measure growth and childhood socioeconomic environment (SES) and examine their associations with longitudinal cognitive outcomes using mixed effects modeling. Growth was positively related to higher childhood SES. Higher childhood SES was associated with better semantic memory. Both low growth and low SES were associated with increased rate of cognitive decline.Discussion.These findings demonstrate that early life experiences influence the trajectory of cognitive aging. Early life development and experience appears to provide a distal basis upon which additional risk and protective factors interact in the development of dementia.
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 01/2014; · 3.01 Impact Factor
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    ABSTRACT: Generalized linear mixed models were used to examine longitudinal trajectories of everyday functional limitations by diagnostic stability/progression. Older adults (N = 384) were followed an average 3.6 years; participants were grouped by diagnosis at study baseline and last follow-up (normal cognition, Mild Cognitive Impairment, or dementia at each time point). At study baseline there were clear group differences; most notably among participants initially characterized as cognitively normal, those who developed Mild Cognitive Impairment or dementia over follow-up already demonstrated greater functional impairment compared with those who remained cognitively normal. Change in functional impairment progressed slowly in the early disease groups, but showed an accelerated worsening in those converting to dementia. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Psychology and Aging 12/2013; 28(4):1070-5. · 2.73 Impact Factor
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    ABSTRACT: OBJECTIVE: To evaluate the interrater reliability of the new International Behavioural Variant FTD Criteria Consortium (FTDC) criteria for behavioral variant frontotemporal dementia (bvFTD). METHODS: Twenty standardized clinical case modules were developed for patients with a range of neurodegenerative diagnoses, including bvFTD, primary progressive aphasia (nonfluent, semantic, and logopenic variant), Alzheimer disease, and Lewy body dementia. Eighteen blinded raters reviewed the modules and 1) rated the presence or absence of core diagnostic features for the FTDC criteria, and 2) provided an overall diagnostic rating. Interrater reliability was determined by κ statistics for multiple raters with categorical ratings. RESULTS: The mean κ value for diagnostic agreement was 0.81 for possible bvFTD and 0.82 for probable bvFTD ("almost perfect agreement"). Interrater reliability for 4 of the 6 core features had "substantial" agreement (behavioral disinhibition, perseverative/compulsive, sympathy/empathy, hyperorality; κ = 0.61-0.80), whereas 2 had "moderate" agreement (apathy/inertia, neuropsychological; κ = 0.41-0.6). Clinician years of experience did not significantly influence rater accuracy. CONCLUSIONS: The FTDC criteria show promise for improving the diagnostic accuracy and reliability of clinicians and researchers. As disease-altering therapies are developed, accurate differential diagnosis between bvFTD and other neurodegenerative diseases will become increasingly important.
    Neurology 05/2013; · 8.30 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate how demographic variables relate to cognitive change and address whether cross-sectional demographic effects on cognitive tests are mirrored in differences in longitudinal trajectories of cognitive decline. We hypothesized that race and ethnicity, education, and language of test administration would relate to cross-sectional status and that the rate of cognitive decline would differ among African Americans, Hispanics, and Caucasians, across levels of educational attainment, and according to linguistic background. Participants were 404 educationally, ethnically, and cognitively diverse older adults enrolled in an ongoing longitudinal study of cognition. Mixed-effects regression analysis was used to measure baseline status and longitudinal change in episodic memory, executive functioning, and semantic memory. Results showed that ethnicity and education were strongly associated with baseline scores, but were, at most, weakly associated with change in cognition over time after accounting for confounding variables. There was evidence that the episodic-memory scores of Spanish-speaking Hispanic participants with limited education underestimated their true abilities in the initial evaluation, which may reflect lack of familiarity with the testing environment. These results-consistent with other reports in the literature-suggest that cross-sectional effects of demographic variables on cognitive-test scores result from differences in life experiences that directly influence test performance and do not indicate greater disease effects on cognition in minorities and those with limited education. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Psychology and Aging 02/2013; · 2.73 Impact Factor
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    ABSTRACT: The recently developed Everyday Cognition scales (ECog) measure multiple cognitively relevant functional domains (e.g., Everyday Memory, Everyday Language, Everyday Visuospatial abilities, and three everyday executive domains). The present study further evaluated the validity of the ECog by examining its relationship with objective measures of neuropsychological function, and neurobiological markers of disease as reflected by structural neuroimaging. Participants included 474 older adults (244 normals, 142 with MCI, 88 with dementia). The neuropsychological domains measured were episodic memory, semantic memory, spatial ability, and executive functioning. Brain MRI volumes included total brain (BV), hippocampus (HC) and dorsolateral prefrontal cortex (DLPFC). Neuropsychological measures of episodic memory and executive function were most consistently related to the ECog domains; spatial abilities had a specific relationship to the Everyday Visuospatial ECog domain. HC and BV volumes were related to most ECog domains, while DLPFC volume was independently related to two everyday executive domains (Everyday Planning and Everyday Organization). The pattern of associations varied somewhat as a function of diagnosis. Episodic memory and HC had more consistent associations with the ECog domains in older adults with MCI/dementia than in cognitively normal elderly. (JINS, 2013, 19, 1-12).
    Journal of the International Neuropsychological Society 02/2013; · 2.70 Impact Factor
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    ABSTRACT: We provide rigorous psychometric evidence for distinct patterns of cognitive impairment for Alzheimer's disease (AD) and cerebral infarctions using 440 participants from the Religious Order Study. Latent variable models were used to decompose the effects of AD pathology and cerebral infarctions assessed at autopsy on overall cognition and specific neuropsychological tests at one and five years prior to death. Results support clinical and univariate psychometric analyses that memory impairment is more pronounced in AD, and executive impairment is more pronounced in the presence of cerebral infarctions. These specific effects are subtle relative to the stronger associations of both AD neuropathology and cerebral infarctions with overall levels of cognitive impairment.
    Journal of Clinical and Experimental Neuropsychology 12/2012; · 2.16 Impact Factor
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    ABSTRACT: Alzheimer's disease (AD) is associated with a cascade of pathological events involving formation of amyloid-based neuritic plaques and tau-based neurofibrillary tangles, changes in brain structure and function, and eventually, cognitive impairment and functional disability. The precise sequence of when each of these disease markers becomes abnormal is not yet clearly understood. The present study systematically tested the relationship between classes of biomarkers according to a proposed model of temporal sequence by Jack et al. (Lancet Neurology 9:119-128, 2010). We examined temporal relations among four classes of biomarkers: CSF Aβ, CSF tau, neuroimaging variables (hippocampal volume, ventricular volume, FDG PET), and cognitive variables (memory and executive function). Random effects modeling of longitudinal data obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) was used to test hypotheses that putative earlier markers of AD predicted change in later markers, and that intervening markers reduced effects of earlier on later markers. Specifically, we hypothesized that CSF tau would explain CSF Aβ's relation to neuroimaging and cognitive variables, and neuroimaging variables would explain tau's relation to cognitive variables. Consistent with hypotheses, results indicated that CSF Aβ effects on cognition change were substantially attenuated by CSF tau and measures of brain structure and function, and CSF tau effects on cognitive change were attenuated by neuroimaging variables. Contrary to hypotheses, CSF Aβ and CSF tau were observed to have independent effects on neuroimaging and CSF tau had a direct effect on baseline cognition independent of brain structure and function. These results have implications for clarifying the temporal sequence of AD changes and corresponding biomarkers.
    Brain Imaging and Behavior 05/2012; · 2.67 Impact Factor
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    ABSTRACT: GM volume, WMH volume, and FA are each associated with cognition; however, few studies have detected whether these 3 different types of MR imaging measurements exert independent or additive effects on cognitive performance. To detect their extent of contribution to cognitive performance, we explored the independent and additive contributions of GM atrophy, white matter injury, and white matter integrity to cognition in elderly patients. Two hundred and 9 elderly patients participated in the study: 97 were CN adults, 65 had MCI, and 47 had dementia. We measured GM on T1-weighted MR imaging, WMH on FLAIR, and FA on DTI, along with psychometrically matched measures of 4 domains of cognitive performance, including semantic memory, episodic memory, executive function, and spatial abilities. As expected, patients with dementia performed significantly more poorly in all 4 cognitive domains, whereas patients with MCI performed generally less poorly than dementia patients, though considerable overlap in performance was present across groups. GM, FA, and WMH each differed significantly between diagnostic groups and were associated with cognitive measures. In multivariate models that included all 3 MR imaging measures (GM, WMH, and FA), GM volume was the strongest determinant of cognitive performance. These results strongly suggest that MR imaging measures of GM are more closely associated with cognitive function than WM measures across a broad range of cognitive and functional impairment.
    American Journal of Neuroradiology 04/2012; 33(9):1797-803. · 3.17 Impact Factor
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    ABSTRACT: OBJECTIVE: The Nun Study showed that lower linguistic ability in young adulthood, measured by idea density (ID), increased the risk of dementia in late life. The present study examined whether ID measured in late life continues to predict the trajectory of cognitive change. Method. ID was measured in 81 older adults who were followed longitudinally for an average of 4.3 years. Changes in global cognition and 4 specific neuropsychological domains (episodic memory, semantic memory, spatial abilities, and executive function) were examined as outcomes. Separate random effects models tested the effect of ID on longitudinal change in outcomes, adjusted for age and education. RESULTS: Lower ID was associated with greater subsequent decline in global cognition, semantic memory, episodic memory, and spatial abilities. When analysis was restricted to only participants without dementia at the time ID was collected, results were similar. Discussion. Linguistic ability in young adulthood, as measured by ID, has been previously proposed as an index of neurocognitive development and/or cognitive reserve. The present study provides evidence that even when ID is measured in old age, it continues to be associated with subsequent cognitive decline and as such may continue to provide a marker of cognitive reserve.
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 02/2012; 67(6):677-86. · 3.01 Impact Factor
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    Neurobiology of aging 01/2012; 33:1486.e9-15. · 5.94 Impact Factor
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    Neurobiology of aging 01/2012; 33:1486.e9-15. · 5.94 Impact Factor
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    Vineeta Chand, Kathleen Baynes, Lisa M Bonnici, Sarah Tomaszewski Farias
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    ABSTRACT: While past research has demonstrated that low idea density (ID) scores from natural language samples correlate with late life risk for cognitive decline and Alzheimer's disease pathology, there are no published rubrics for collecting and analyzing language samples for idea density to verify or extend these findings into new settings. This unit outlines the history of ID research and findings, discusses issues with past rubrics, and then presents an operationalized method for the systematic measurement of ID in language samples, with an extensive manual available as a supplement to this unit (Analysis of Idea Density, AID). Finally, reliability statistics for this rubric in the context of dementia research on aging populations and verification that AID can replicate the significant association between ID and late-life cognition are presented. Curr. Protoc. Neurosci. 58:10.5.1-10.5.15. © 2012 by John Wiley & Sons, Inc.
    Current protocols in neuroscience / editorial board, Jacqueline N. Crawley ... [et al.] 01/2012; Chapter 10:Unit10.5.
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    Neurobiology of aging 01/2012; 33:1486.e9-15. · 5.94 Impact Factor
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    ABSTRACT: This study describes the development and validation of a shortened version of the Everyday Cognition (ECog) scales [Tomaszewski Farias et al. Neuropsychology 2008;22:531-44], an informant-rated questionnaire designed to detect cognitive and functional decline. External, convergent, and divergent validities and internal consistency were examined. Data were derived from informant ratings of 907 participants who were either cognitively normal, had mild cognitive impairment (MCI), or had dementia. Twelve items were included in the shortened version (ECog-12). The ECog-12 strongly correlated with established functional measures and neuropsychological scores, only weakly with age and education, and demonstrated high internal consistency. The ECog-12 showed excellent discrimination between the dementia and normal groups (area under the receiver operator characteristic curve = 0.95, CI = 0.94-0.97), and showed promise in discriminating normal older adults from those with any cognitive impairment (i.e., MCI or dementia). Discrimination between the MCI and normal groups was poor. The ECog-12 shows promise as a clinical tool for assisting clinicians in identifying individuals with dementia.
    Alzheimer's & dementia: the journal of the Alzheimer's Association 11/2011; 7(6):593-601. · 14.48 Impact Factor
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    ABSTRACT: Cognitive reserve is thought to reflect life experiences. Which experiences contribute to reserve and their relative importance is not understood. Subjects were 652 autopsied cases from the Rush Memory and Aging Project and the Religious Orders Study. Reserve was defined as the residual variance of the regressions of cognitive factors on brain pathology and was captured in a latent variable that was regressed on potential determinants of reserve. Neuropathology variables included Alzheimer's disease markers, Lewy bodies, infarcts, microinfarcts, and brain weight. Cognition was measured with six cognitive domain scores. Determinants of reserve were socioeconomic status (SES), education, leisure cognitive activities at age 40 (CA40) and at study enrollment (CAbaseline) in late life. The four exogenous predictors of reserve were weakly to moderately inter-correlated. In a multivariate model, all except SES had statistically significant effects on Reserve, the strongest of which were CA40 (β = .31) and CAbaseline (β = .28). The Education effect was negative in the full model (β = -.25). Results suggest that leisure cognitive activities throughout adulthood are more important than education in determining reserve. Discrepancies between cognitive activity and education may be informative in estimating late life reserve. (JINS, 2011, 17, 615-624).
    Journal of the International Neuropsychological Society 07/2011; 17(4):615-24. · 2.70 Impact Factor
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    ABSTRACT: This study examined the relationship between white matter hyperintensities (WMH) and executive functioning on episodic memory in a group of older adults who were cognitively normal or diagnosed with MCI or dementia. Volumetric magnetic resonance imaging (MRI) measures of total brain volume, white matter hyperintensity volume, and hippocampal volume along with age, education, and gender were evaluated as predictors of episodic memory. WMH were found to influence both episodic memory and executive functioning independently of other variables. The influence WMH on episodic memory was mediated by executive functioning and was completely eliminated when the interaction between executive functioning and hippocampal volume was entered in the regression model. The results indicate that executive functioning mediates the effects of WMH on episodic memory but that executive functioning and hippocampal volume can also interact such that executive functioning can exacerbate or ameliorate the influence of hippocampal volume on episodic memory.
    Neuropsychologia 06/2011; 49(10):2817-24. · 3.48 Impact Factor
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    ABSTRACT: Better tools for assessing cognitive impairment in the early stages of Alzheimer's disease (AD) are required to enable diagnosis of the disease before substantial neurodegeneration has taken place and to allow detection of subtle changes in the early stages of progression of the disease. The National Institute on Aging and the Alzheimer's Association convened a meeting to discuss state of the art methods for cognitive assessment, including computerized batteries, as well as new approaches in the pipeline. Speakers described research using novel tests of object recognition, spatial navigation, attentional control, semantic memory, semantic interference, prospective memory, false memory and executive function as among the tools that could provide earlier identification of individuals with AD. In addition to early detection, there is a need for assessments that reflect real-world situations in order to better assess functional disability. It is especially important to develop assessment tools that are useful in ethnically, culturally and linguistically diverse populations as well as in individuals with neurodegenerative disease other than AD.
    Alzheimer's & dementia: the journal of the Alzheimer's Association 05/2011; 7(3):e60-e76. · 14.48 Impact Factor
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    Sarah Tomaszewski Farias, Dan Mungas, Ladson Hinton, Mary Haan
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    ABSTRACT: The identification of older adults who are at increased risk of future cognitive decline is often difficult, particularly in individuals of an ethnic minority. This study evaluated which baseline demographic, neuropsychological, and functional variables were most strongly associated with future longitudinal decline in global cognitive function. Participants were part of a community-based prospective longitudinal study of 1,789 older Hispanics (Sacramento Area Latino Study on Aging). A subsample of 639 individuals was evaluated, comprising cognitively normal, mildly impaired, and dementia cases, and were followed longitudinally for up to 7 years. Sixty-three percent were tested in Spanish. Latent growth curve modeling of longitudinal data was used to assess the effects of age, gender, education, language of test administration (Spanish or English), acculturation, baseline measures of neuropsychological function (i.e., verbal memory and confrontation naming), and baseline everyday functioning (as measured by the Informant Questionnaire on Cognitive Decline in the Elderly) on rate of change in global cognitive impairment (measured by the 3MS). Less education, being tested in English, and poorer scores on the neuropsychological tests were all cross-sectionally associated with lower baseline 3MS scores. However, longitudinal decline in global cognition over time was primarily associated with older age and poorer everyday function at baseline. Informant-based ratings of functional impairment, which are easy to collect in a clinical setting, have significant use in identifying Hispanic older adults at increased risk for future cognitive decline.
    The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry 05/2011; 19(5):440-50. · 3.35 Impact Factor
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    ABSTRACT: There is growing interest in the influence of early-life development on clinical manifestations of late-life diseases. Latent variable modeling was used to investigate how maximal brain volume (measured by intracranial volume [ICV]) and current brain volumes uniquely contribute to domain-specific cognitive performance in a group of 401 cognitively and ethnically diverse older adults. Individual effects of volumetric magnetic resonance imaging (MRI) measures including ICV were examined as predictors of episodic memory, semantic memory, spatial ability, and executive function. Total brain matter volume related to all cognitive domains; hippocampal volume was associated primarily with episodic memory; white matter hyperintensity volume was related to executive function and episodic memory. Maximal brain size as measured by ICV was related to semantic memory, executive function, and spatial ability independent of current brain volumes (ps < 0.01). Relationships between magnetic resonance imaging (MRI) variables and cognition did not differ substantially across groups defined by ethnicity, gender, and with minor exceptions, clinical diagnosis. Results suggest maximal brain development and measures of brain injury/atrophy jointly contribute to cognitive function in older people.
    Neurobiology of aging 04/2011; 33(8):1758-68. · 5.94 Impact Factor

Publication Stats

1k Citations
217.39 Total Impact Points


  • 2004–2013
    • University of California, Davis
      • Department of Neurology
      Davis, CA, United States
  • 2012
    • University of Essex
      • Department of Language and Linguistics
      Colchester, ENG, United Kingdom
    • Rush University Medical Center
      • Department of Behavioral Sciences
      Chicago, IL, United States
  • 2011
    • University of Nevada, Las Vegas
      • Department of Psychology
      Las Vegas, NV, United States
  • 2003–2011
    • California State University, Sacramento
      Sacramento, California, United States
  • 2010
    • University of Wisconsin, Madison
      • School of Medicine and Public Health
      Madison, MS, United States
  • 2008
    • U.S. Department of Veterans Affairs
      Washington, Washington, D.C., United States
  • 2006
    • CSU Mentor
      Long Beach, California, United States