Suzanne Satterfield

The University of Tennessee Health Science Center, Memphis, Tennessee, United States

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Publications (182)1259.61 Total impact

  • Journal of the American Geriatrics Society 03/2015; 63(3). DOI:10.1111/jgs.13291 · 4.22 Impact Factor
  • Journal of Pain and Symptom Management 02/2015; 49(2):332-333. DOI:10.1016/j.jpainsymman.2014.11.034 · 2.74 Impact Factor
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    ABSTRACT: Mid-thigh cross-sectional muscle area (CSA), muscle attenuation, and greater trochanter soft tissue thickness have been shown to be independent risk factors of hip fracture. Our aim was to determine whether muscle and adipose tissue measures derived from DXA scans would have a similar risk association as those measured using other imaging methods. Using a case-cohort study design, we identified 169 incident hip fracture cases over an average of 13.5 years among participants from the Health ABC Study, a prospective study of 3,075 individuals initially aged 70-79. We modeled the thigh 3D geometry and compared DXA and CT measures. DXA-derived thigh CSA, muscle attenuation, and subcutaneous fat thickness were found to be highly correlated to their CT counterparts (Pearson's r = 0.82, 0.45, and 0.91, respectively; p < 0.05). The fracture risk of men and women were calculated separately. We found that decreased subcutaneous fat, CT thigh muscle attenuation, and appendicular lean mass by height squared (ALM/Ht2) were associated with fracture risk in men, hazard ratios (HR) equal 1.44 (1.02, 2.02), 1.40 (1.05, 1.85), and 0.58 (0.36, 0.91) respectively after adjusting for age, race, clinical site, BMI, chronic disease, hip BMD, self-reported health, alcohol use, smoking status, education, physical activity, cognitive function. In a similar model for women, only decreases in subcutaneous fat and DXA CSA were associated with hip fracture risk, HR equal 1.39 (1.07, 1.82) and 0.78 (0.62, 0.97) respectively. Men with a high ALM/Ht2 and low subcutaneous fat thickness had over 8 times higher risk for hip fracture compared to those with low ALM/Ht2 and high subcutaneous fat. In women, ALM/Ht2 did not improve the model when subcutaneous fat included. We conclude that the DXA-derived subcutaneous fat thickness is a strong marker for hip fracture risk in both men and women, and especially men with high ALM/Ht2. This article is protected by copyright. All rights reserved
    Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 01/2015; DOI:10.1002/jbmr.2469 · 6.04 Impact Factor
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    ABSTRACT: We sought to develop and validate a risk index for prospective cognitive decline in older adults based on blood-derived markers. The index was based on 8 markers that have been previously associated with cognitive aging: APOE genotype, plasma β-amyloid 42/40 ratio, telomere length, cystatin C, glucose, C-reactive protein, interleukin-6, and albumin. The outcome was person-specific cognitive slopes (Modified Mini-Mental State Examination) from 11 years of follow-up. A total of 1,445 older adults comprised the development sample. An index based on dichotomized markers was divided into low-, medium-, and high-risk categories; the risk categories were validated with the remaining sample (n = 739) using linear regression. Amyloid was measured on a subsample (n = 865) and was included only in a secondary index. The risk categories showed significant differences from each other and were predictive of prospective cognitive decline in the validation sample, even after adjustment for age and baseline cognitive score: the low-risk group (24.8%) declined 0.32 points/y (95% confidence interval [CI]: -0.46, -0.19), the medium-risk group (58.7%) declined 0.55 points/y (95% CI: -0.65, 0.45), and the high-risk group (16.6%) declined 0.69 points/y (95% CI: -0.85, -0.54). Using the secondary index, which included β-amyloid 42/40 (validation n = 279), the low-risk group (26.9%) declined 0.20 points/y (95% CI: -0.42, 0.01), the medium-risk group (61.3%) declined 0.55 points/y (95% CI: -0.72, -0.38), and the high-risk group (11.8%) declined 0.83 points/y (95% CI: -1.14, -0.51). A risk index based on 8 blood-based markers was modestly able to predict cognitive decline over an 11-year follow-up. Further validation in other cohorts is necessary. © 2015 American Academy of Neurology.
    Neurology 01/2015; 84(7). DOI:10.1212/WNL.0000000000001263 · 8.30 Impact Factor
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    ABSTRACT: Apolipoprotein E (APOE) ε4 is an established risk factor for cognitive decline and the development of dementia, but other factors may help to minimize its effects. Using APOE ε4 as an indicator of high risk, we investigated factors associated with cognitive resilience among black and white older adults who are APOE ε4 carriers. Participants included 2487 community-dwelling older (aged 69-80 years at baseline) black and white adults examined at 2 community clinics in the prospective cohort Health, Aging, and Body Composition (Health ABC) study. The baseline visits occurred from May 1997 through June 1998. Our primary analytic cohort consisted of 670 APOE ε4 carriers (329 black and 341 white participants) who were free of cognitive impairment at baseline and underwent repeated cognitive testing during an 11-year follow-up (through 2008) using the Modified Mini-Mental State Examination. We stratified all analyses by race. Using the Modified Mini-Mental State Examination scores, we assessed normative cognitive change in the entire cohort (n = 2487) and classified the APOE ε4 carriers as being cognitively resilient vs nonresilient by comparing their cognitive trajectories with those of the entire cohort. We then conducted bivariate analyses and multivariable random forest and logistic regression analyses to explore factors predictive of cognitive resilience in APOE ε4 carriers. Among white APOE ε4 carriers, the strongest predictors of cognitive resilience were, in relative order of importance, no recent negative life events, a higher literacy level, advanced age, a higher educational level, and more time spent reading. Among black APOE ε4 carriers, the strongest predictors of cognitive resilience were, in relative order of importance, a higher literacy level, a higher educational level, female sex, and the absence of diabetes mellitus. In follow-up logistic regression models, higher literacy level (adjusted odds ratio [OR], 9.50 [95% CI, 2.67-60.89]), a higher educational level (adjusted OR for college graduate vs less than high school, 3.81 [95% CI, 1.13-17.56]), and age (adjusted OR for 73-76 vs 69-72 years, 2.01 [95% CI, 1.13-3.63]) had significant independent effects in predicting cognitive resilience among white APOE ε4 carriers. Among black APOE ε4 carriers, a higher literacy level (adjusted OR, 2.27 [95% CI, 1.29-4.06]) and a higher educational level (adjusted OR for high school graduate/some college vs less than high school, 2.86 [95% CI, 1.54-5.49]; adjusted OR for college graduate vs less than high school, 2.52 [95% CI, 1.14-5.62]) had significant independent effects in predicting cognitive resilience. Although APOE ε4 carriers are at high risk for cognitive decline, our findings suggest possible intervention targets, including the enhancement of cognitive reserve and improvement of other psychosocial and health factors, to promote cognitive resilience among black and white APOE ε4 carriers.
    JAMA Neurology 01/2015; DOI:10.1001/jamaneurol.2014.3978 · 7.01 Impact Factor
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    ABSTRACT: To assess the relationship between sensorimotor nerve function and incident mobility disability over 10 years. Prospective cohort study with longitudinal analysis. Two U.S. clinical sites. Population-based sample of community-dwelling older adults with no mobility disability at 2000/01 examination (N = 1,680; mean age ± SD 76.5 ± 2.9, body mass index 27.1 ± 4.6; 50.2% female, 36.6% black, 10.7% with diabetes mellitus). Motor nerve conduction amplitude (poor <1 mV) and velocity (poor <40 m/s) were measured on the deep peroneal nerve. Sensory nerve function was measured using 10- and 1.4-g monofilaments and vibration detection threshold at the toe. Lower extremity symptoms included numbness or tingling and aching or burning pain. Incident mobility disability assessed semiannually over 8.5 years (interquartile range 4.5-9.6 years) was defined as two consecutive self-reports of a lot of difficulty or inability to walk one-quarter of a mile or climb 10 steps. Nerve impairments were detected in 55% of participants, and 30% developed mobility disability. Worse motor amplitude (HR = 1.29 per SD, 95% CI = 1.16-1.44), vibration detection threshold (HR = 1.13 per SD, 95% CI = 1.04-1.23), symptoms (HR = 1.65, 95% CI = 1.26-2.17), two motor impairments (HR = 2.10, 95% CI = 1.43-3.09), two sensory impairments (HR = 1.91, 95% CI = 1.37-2.68), and three or more nerve impairments (HR = 2.33, 95% CI = 1.54-3.53) predicted incident mobility disability after adjustment. Quadriceps strength mediated relationships between certain nerve impairments and mobility disability, although most remained significant. Poor sensorimotor nerve function independently predicted mobility disability. Future work should investigate modifiable risk factors and interventions such as strength training for preventing disability and improving function in older adults with poor nerve function. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.
    Journal of the American Geriatrics Society 12/2014; 62(12). DOI:10.1111/jgs.13152 · 4.22 Impact Factor
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    ABSTRACT: Identifying factors associated with functional declines in older adults is important given the aging of the population. We investigated if hearing impairment is independently associated with objectively measured declines in physical functioning in a community-based sample of older adults. Prospective observational study of 2,190 individuals from the Health, Aging, and Body Composition study. Participants were followed annually for up to 11 visits. Hearing was measured with pure-tone audiometry. Physical functioning and gait speed were measured with the Short Physical Performance Battery (SPPB). Incident disability and requirement for nursing care were assessed semiannually through self-report. In a mixed-effects model, greater hearing impairment was associated with poorer physical functioning. At both Visit 1 and Visit 11, SPPB scores were lower in individuals with mild (10.14 [95% CI 10.04-10.25], p < .01; 7.35 [95% CI 7.12-7.58], p < .05) and moderate or greater hearing impairment (10.04 [95% CI 9.90-10.19], p < .01; 7.00 [95% CI 6.69-7.32], p < .01) than scores in normal hearing individuals (10.36 [95% CI 10.26-10.46]; 7.71 [95% CI 7.49-7.92]). We observed that women with moderate or greater hearing impairment had a 31% increased risk of incident disability (Hazard ratio [HR] =1.31 [95% CI 1.08-1.60], p < .01) and a 31% increased risk of incident nursing care requirement (HR = 1.31 [95% CI 1.05-1.62], p = .02) compared to women with normal hearing. Hearing impairment is independently associated with poorer objective physical functioning in older adults, and a 31% increased risk for incident disability and need for nursing care in women. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 12/2014; DOI:10.1093/gerona/glu207 · 4.31 Impact Factor
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    ABSTRACT: Objectives To examine the association between statin use and objectively assessed decline in gait speed in community-dwelling older adults.DesignLongitudinal cohort study.SettingHealth, Aging and Body Composition (Health ABC) Study.ParticipantsTwo thousand five participants aged 70–79 at baseline with medication and gait speed data at 1998–99, 1999–2000, 2001–02, and 2002–03.MeasurementsThe independent variables were any statin use and their standardized daily doses (low, moderate, high) and lipophilicity. The primary outcome measure was decline in gait speed of 0.1 m/s or more in the following year of statin use. Multivariable generalized estimating equations were used, adjusting for demographic characteristics, health-related behaviors, health status, and access to health care.ResultsStatin use increased from 16.2% in 1998–99 to 25.6% in 2002–03. The overall proportions of those with decline in gait speed of 0.1 m/s or more increased from 22.2% in 1998 to 23.9% in 2003. Statin use was not associated with decline in gait speed of 0.1 m/s or more (adjusted odds ratio (AOR) = 0.90, 95% confidence interval (CI) = 0.77–1.06). Similar nonsignificant trends were also seen with the use of hydrophilic or lipophilic statins. Users of low-dose statins were found to have a 22% lower risk of decline in gait speed than nonusers (AOR = 0.78, 95% CI = 0.61–0.99), which was mainly driven by the results from 1999–2000 follow-up.Conclusion These results suggest that statin use did not increase decline in gait speed in community-dwelling older adults.
    Journal of the American Geriatrics Society 12/2014; 63(1). DOI:10.1111/jgs.13134 · 4.22 Impact Factor
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    ABSTRACT: Protracted, systemic inflammation has been associated with adverse effects on cognition and brain structure, and may accelerate neurodegenerative disease processes; however, it is less clear whether changes in inflammation are associated with brain structure.Methods We studied 276 black and white older adults (mean age=83 years at time of imaging) enrolled in a prospective study of aging. Inflammation (measured with CRP) was assessed repeatedly over 6 years (i.e. Year 2, 4, 6, & 8). Brain MRIs were obtained at years 10-11 with DTI; regions of interest included late-myelinating areas vulnerable to aging, including frontal-parietal [superior longitudinal fasciculus (SLF)-dorsal] and temporal (SLF-temporal; uncinate) white matter tracts.ResultsMean CRP values significantly declined (t=-5.54, p<.0001) over 6 years, and subject-specific slopes (BLUPs) all showed a decline (mean=-.57, SD=.53) for our participant sample. More than 50% of study participants were still in the moderate to high cardiovascular risk range based on CRP values at Year 8. After controlling for demographics, vascular risk factors and MRI white matter hyperintensities, larger decreases in CRP values over time were significantly associated with higher fractional anisotropy in the SLF-dorsal [Beta=-0.0052, standard error (SE)=0.003; 95% confidence interval (CI)= -0.0103 to -0.0025, p=.04], SLF-temporal (Beta=-0.0109, SE=0.004; 95%CI=-0.0189 to -0.0029, p=.008), and uncinate (Beta=-0.0067, SE=0.003; 95%CI=-0.0132 to -0.0001, p=.05) fasciculi.Conclusions Results suggest that in a prospective cohort of older individuals, faster declines in inflammation over time are related to indicators of white matter health, even after accounting for vascular risk factors.
    Neurobiology of Aging 11/2014; DOI:10.1016/j.neurobiolaging.2014.11.004 · 4.85 Impact Factor
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    ABSTRACT: Objective: To quantify racial differences in brain structural characteristics in white and black octogenarians, and to examine whether these characteristics contribute to cognition. Methods: Cross-sectional study of 283 adults 79-89 years old(59.4% white;42.0% women) with data on gray matter integrity via diffusion tensor imaging(mean diffusivity), gray matter atrophy (GMA), whitematter hyperintensities (WMH), literacy, smoking, drinking, income, hypertension and diabetes. Participants were recruited from an ongoing epidemiological study of older adults living in the community with a range of chronic conditions, physical and cognitive function. Standardized betas (sβ) of neuroimaging markers predicting digit symbol substitution test (DSST) and modified mini-mental test(3MS)were computed in multivariable regression models stratified by race. Results: Compared to whites, blacks had lower DSST (p=0.001) and lower 3MS (p=0.006), but also lower mean diffusivity (e.g. higher gray matter micro-structural integrity, p=0.032), independent of sex, income, literacy, body mass index, diabetes and drinking habits. Racial differences were not significant for WMH (p=0.062) or GMA(p=0.4).Among blacks, mean diffusivity and WMH were associated with DSST (sβ=-.209, p=0.037and -.211, p=.038)independent of each other and of covariates; among whites, mean diffusivity, but not WMH, was significantly associated with DSST and 3MS(sβ =-.277, p=.002and -.250, p=0.029). Conclusions: In this cohort of octogenarians living in the community, blacks appeared to have higher microstructural integrity of gray matter as compared to whites. This neuroimaging marker was related to higher cognition even in the presence of WMH and other cardiovascular conditions. If confirmed, these findings suggest microstructural gray matter integrity may be a target to improve cognition, especially among blacks who survive to very old age with a range of chronic cardiovascular conditions.
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    ABSTRACT: Cross-sectional studies have found that low serum bicarbonate is associated with slower gait speed. Whether bicarbonate levels independently predict the development of functional limitation has not been previously studied. Whether bicarbonate was associated with incident persistent lower extremity functional limitation and whether the relationship differed in individuals with and without CKD were assessed in participants in the Health, Aging, and Body Composition study, a prospective study of well functioning older individuals DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Functional limitation was defined as difficulty in walking 0.25 miles or up 10 stairs on two consecutive reports 6 months apart in the same activity (stairs or walking). Kidney function was measured using eGFR by the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and CKD was defined as an eGFR<60 ml/min per 1.73 m(2). Serum bicarbonate was measured using arterialized venous blood gas. Cox proportional hazards analysis was used to assess the association of bicarbonate (<23, 23-25.9, and ≥26 mEq/L) with functional limitation. Mixed model linear regression was performed to assess the association of serum bicarbonate on change in gait speed over time.
    Clinical Journal of the American Society of Nephrology 11/2014; 9(12). DOI:10.2215/CJN.05480614 · 5.25 Impact Factor
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    ABSTRACT: Inflammation may represent a common physiological pathway linking both short and long sleep duration to mortality. We evaluated inflammatory markers as mediators of the relationship between sleep duration and mortality in community-dwelling older adults.
    Sleep 10/2014; · 5.06 Impact Factor
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    ABSTRACT: Poor peripheral nerve function is common in older adults and may be a risk factor for strength decline, although this has not been assessed longitudinally.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 10/2014; DOI:10.1093/gerona/glu183 · 4.31 Impact Factor
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    ABSTRACT: We sought to determine which systolic blood pressure (SBP) characteristics are associated with reduced brain integrity and whether these associations are stronger for white or gray matter. We hypothesized that exposure to higher and variable SBP will be associated with lower structural integrity of both gray and white matter.
    American Journal of Hypertension 08/2014; DOI:10.1093/ajh/hpu134 · 3.40 Impact Factor
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    ABSTRACT: Hearing impairment (HI) is highly prevalent in older adults and is associated with social isolation, depression, and risk of dementia. Whether HI is associated with broader downstream outcomes is unclear. We undertook this study to determine whether audiometric HI is associated with mortality in older adults.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 07/2014; DOI:10.1093/gerona/glu094 · 4.31 Impact Factor
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    ABSTRACT: Results from numerous studies suggest protective effects of the Mediterranean diet for cardiovascular disease, cancer, and mortality. Evidence for an association with a decreased risk of cognitive decline is less consistent and studies are limited by a lack of diversity in their populations.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 07/2014; DOI:10.1093/gerona/glu097 · 4.98 Impact Factor
  • Alzheimer's and Dementia 07/2014; 10(4):P230. DOI:10.1016/j.jalz.2014.04.329 · 17.47 Impact Factor
  • Alzheimer's and Dementia 07/2014; 10(4):P654. DOI:10.1016/j.jalz.2014.05.1164 · 17.47 Impact Factor
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    ABSTRACT: We aimed to examine trajectories of inflammatory markers and cognitive decline over 10 years. Cox proportional hazards models were used to examine the association between interleukin-6 and C-reactive protein (CRP) trajectory components (slope, variability, and baseline level) and cognitive decline among 1323 adults, aged 70-79 years in the Health, Aging, and Body Composition Study. We tested for interactions by sex and apolipoprotein E (APOE) genotype. In models adjusted for multiple covariates and comorbidities, extreme CRP variability was significantly associated with cognitive decline (hazard ratio [HR] 1.6, 95% confidence interval [CI]: 1.1-2.3). This association was modified by sex and APOE e4 (p < 0.001 for both), such that the association remained among women (HR = 1.8; 95% CI: 1.1, 3.0) and among those with no APOE e4 allele (HR = 1.6; 95% CI: 1.1, 2.5). There were no significant associations between slope or baseline level of CRP and cognitive decline nor between interleukin-6 and cognitive decline. We believe CRP variability likely reflects poor control of or greater changes in vascular or metabolic disease over time, which in turn is associated with cognitive decline.
    Neurobiology of Aging 06/2014; 35(12). DOI:10.1016/j.neurobiolaging.2014.05.030 · 4.85 Impact Factor
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    ABSTRACT: Whether apolipoprotein E (APOE) E4 allele status which is associated with an increased risk of cognitive decline is also associated with hearing impairment is unknown.
    American Journal of Alzheimer s Disease and Other Dementias 06/2014; DOI:10.1177/1533317514537549 · 1.43 Impact Factor

Publication Stats

7k Citations
1,259.61 Total Impact Points


  • 2007–2015
    • The University of Tennessee Health Science Center
      • • Department of Preventive Medicine
      • • Department of Medicine
      Memphis, Tennessee, United States
  • 1999–2015
    • University of Tennessee
      • Department of Preventive Medicine
      Knoxville, Tennessee, United States
  • 2013
    • Bristol-Myers Squibb
      New York, New York, United States
    • University of Connecticut
      • UConn Center on Aging
      Storrs, Connecticut, United States
  • 2012–2013
    • San Francisco VA Medical Center
      San Francisco, California, United States
    • University of Missouri - St. Louis
      Saint Louis, Michigan, United States
  • 2009–2013
    • The University of Tennessee Medical Center at Knoxville
      Knoxville, Tennessee, United States
    • National Institute on Aging
      • • Laboratory of Epidemiology, Demography and Biometry (LEDB)
      • • Clinical Research Branch (CRB)
      Baltimore, Maryland, United States
    • California Pacific Medical Center Research Institute
      • Research Institute
      San Francisco, CA, United States
  • 2005–2013
    • University of California, San Francisco
      • • Division of Hospital Medicine
      • • Department of Psychiatry
      • • Department of Epidemiology and Biostatistics
      San Francisco, CA, United States
    • Maastricht University
      Maestricht, Limburg, Netherlands
  • 2011–2012
    • University of Pittsburgh
      • Department of Epidemiology
      Pittsburgh, PA, United States
    • Johns Hopkins Bloomberg School of Public Health
      • Department of Health Policy and Management
      Baltimore, MD, United States
    • Cleveland Clinic
      • Department of Pathobiology
      Cleveland, OH, United States
    • State University of New York Downstate Medical Center
      • Department of Epidemiology and Biostatistics (EPID, BIOS)
      Brooklyn, NY, United States
  • 2006–2011
    • The University of Memphis
      Memphis, Tennessee, United States
    • VU University Amsterdam
      Amsterdamo, North Holland, Netherlands
    • University of San Francisco
      San Francisco, California, United States
    • Kent State University
      Кент, Ohio, United States
  • 2010
    • Duke University
      Durham, North Carolina, United States
    • University of Lausanne
      • Faculté de biologie et de médecine (FBM)
      Lausanne, VD, Switzerland
  • 2007–2009
    • VU University Medical Center
      • Department of Psychiatry
      Amsterdam, North Holland, Netherlands
  • 2005–2009
    • University of Florida
      • Department of Aging and Geriatric Research
      Gainesville, FL, United States
    • Wake Forest School of Medicine
      • • Sticht Center on Aging
      • • Section on Gerontology and Geriatric Medicine
      Winston-Salem, NC, United States
  • 2008
    • University of Louisville
      • Department of Psychological and Brain Sciences
      Louisville, KY, United States
    • Emory University
      • Division of Cardiology
      Atlanta, GA, United States
    • Boston University
      • Department of Epidemiology
      Boston, MA, United States
  • 2006–2008
    • Vanderbilt University
      • • Department of Neurology
      • • Division of Cardiovascular Medicine
      Nashville, MI, United States
  • 1993–1994
    • Brigham and Women's Hospital
      • • Center for Brain Mind Medicine
      • • Department of Medicine
      Boston, MA, United States
    • University of Washington Seattle
      Seattle, Washington, United States
  • 1991
    • Harvard Medical School
      • Department of Medicine
      Boston, Massachusetts, United States