Hiroko Hayama Dodge

Oregon Health & Science University and University of Michigan · Department of Neurology

Seasonal variation in rest-activity patterns has been observed in healthy adult populations. This study examined seasonal variation in total time spent overnight in the bedroom by cognitively intact older adults and older adults with mild cognitive impairment (MCI). We hypothesize that seasonal variation in rest-activity patterns is observed in the...

In recent years, behavioral markers such as spoken language and lexical preferences have been studied in the early detection of mild cognitive impairment (MCI) using conversations. While the combination of linguistic and acoustic signals have been shown to be effective in detecting MCI, they have generally been restricted to structured conversation...

Introduction: Reproducibility and replicability of results are rarely achieved for digital biomarkers analyses. We reproduced and replicated previously reported sample size estimates based on digital biomarker and neuropsychological test outcomes in a hypothetical 4-year early-phase Alzheimer's disease trial. Methods: Original data and newly col...

The Internet-Based Conversational Engagement Clinical Trial (I-CONECT, ClinicalTrials.gov: NCT02871921) is a multi-center randomized, 12-month efficacy study. There is converging evidence that social isolation is a risk factor of cognitive decline and dementia. We hypothesized that increasing social interaction in older adults with normal cognition...

Socially isolated older adults with MCI are at greater risk of developing ADRD. This study compares the emotional status of older adults with MCI to their cognitively normal counterparts within a socially isolated sample. We used baseline data from the Internet-based Conversational Engagement Clinical Trial (NCT02871921). MCI status was determined...

This study aimed to simultaneously examine the associations between social activity and connectedness and depressive symptoms in older adult couples. Using SEM and data from 116 community-dwelling couples (age 76.18 ± 8.49), we found that engagement in social activities was associated with lower depressive symptoms in men (p = 0.014), whereas more...

Indoor room transition is an underexplored real-world activity outcome. We estimated the stability and variability of indoor room transitions and their associations with mild cognitive impairment (MCI) in older adults. Older adults living-alone (n=159, age=78.3±8.8 years, 14% MCI) from the Oregon Center for Aging & Technology (ORCATECH) and the Min...

Identifying the leading health and lifestyle factors for the risk of incident dementia and Alzheimer's disease has yet to translate to risk reduction. To understand why, we examined the discrepancies between observational and clinical trial evidence for seven modifiable risk factors: type 2 diabetes, dyslipidemia, hypertension, estrogens, inflammat...

Background/objectives: The COVID-19 global outbreak allowed a natural experiment to observe how older adults changed social patterns and how it affected their emotional well-being. We studied the frequency and modes of social contact and their effects on older adults' mood before and during the COVID-19 pandemic. Design: Phone-based surveys were...

Background: Social isolation is a risk factor for dementia, but the underlying mechanism is not well understood. It is possible that lack of social contacts negatively affects emotional well-being, which leads to cognitive decline. To shed light on this potential mediation mechanism, we examined changes in type and frequency of social contacts and...

In recent years, speech‐related behavioral markers such as spoken language and lexical preferences have been studied in the early detection of mild cognitive impairment (MCI). While the combination of linguistic and acoustic signals has been shown to be effective in detecting MCI, they have generally been restricted to structured conversations in w...

Blood levels of marine n‐3 PUFA (20:5; 22:6) are inversely associated with cerebral white matter lesion volume (WML), suggesting that n‐3 may offer one approach to reduce this major vascular contributor to cognitive impairment and dementia. This trial determined whether n‐3 slows WML progression and sustains white matter integrity over 3‐years in o...

Racial/ethnic differences in cross‐sectional assessment of cognitive test performance are well known. However, longitudinal studies of differences in cognitive decline have been mixed. The purpose of this study was to examine racial/ethnic differences in baseline and longitudinal change on the Uniform Data Set (UDS) version 3 of the NIA Alzheimer’s...

A diagnosis of Mild Cognitive Impairment (MCI) has been found to be associated with changes in emotional wellbeing and social relationships. Socially isolated older adults with MCI are at greater risk of developing Alzheimer's Disease and Related Dementias. Better understanding the emotional functioning of individuals with MCI could inform the deve...

Background: Changes in emotional health are common both as part of typical aging and for individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Thus, there is a critical need to identify differences in emotional functioning between adults with and without cognitive impairment. In the current study, we explore whether the NI...

Introduction: Early detection of cognitive decline in older adults is a public health priority. Advancing Reliable Measurement in Alzheimer's Disease and Cognitive Aging (ARMADA), a multisite study, is validating cognition, emotion, motor, and sensory modules of the National Institutes of Health Toolbox for Assessment of Neurological and Behaviora...

There is an urgent need for interventions that can prevent or delay cognitive decline and dementia. Decades of epidemiological research have identified potential pharmacological strategies for risk factor modification to prevent these serious conditions, but clinical trials have failed to confirm the potential efficacy for such interventions. Our m...

Background: Older adults spend a considerable amount of time inside their residences; however, most research investigates out-of-home mobility and its health correlates. We measured indoor mobility using room-to-room transitions, tested their psychometric properties, and correlated indoor mobility with cognitive and functional status. Materials and...

Background: The ability to capture people's movement throughout their home is a powerful approach to inform spatiotemporal patterns of routines associated with cognitive impairment. The study estimated indoor room activities over 24 hours and investigated relationships between diurnal activity patterns and mild cognitive impairment (MCI). Methods...

Aims: We aim to establish the feasibility and acceptability of the Tele-STELLA (Support via Telehealth: Living and Learning with Advancing Alzheimer's Disease and Related Dementias) intervention. We will also assess the efficacy of the intervention in reducing the frequency of behavioural symptoms of dementia as well as family Care Partner reactiv...

Background: Consensus guidance for the development and identification of high-quality Alzheimer's disease clinical trials is needed for protocol development and conduct of clinical trials. Methods: An ad hoc consensus committee was convened in conjunction with the Alzheimer's Association to develop consensus recommendations. Results: Consensus...

Background: Increasing social interactions through communication technologies could offer a cost-effective prevention approach that slows cognitive decline and delays the onset of Alzheimer's disease. This paper describes the protocol of an active project named “Internet-based conversational engagement clinical trial (I-CONECT)” ( ClinicalTrials.go...

Background and Objectives The COVID-19 pandemic has limited older adults’ access to in-person medical care, including screenings for cognitive and functional decline. Remote, technology-based tools have shown recent promise in assessing changes in older adults’ daily activities and mood, which may serve as indicators of underlying health-related ch...

Federated learning is a distributed learning framework that is communication efficient and provides protection over participating users' raw training data. One outstanding challenge of federate learning comes from the users' heterogeneity, and learning from such data may yield biased and unfair models for minority groups. While adversarial learning...

1569 Background: Knowledge of changes in health that precede a cancer diagnosis is challenging because of a lack of longitudinal, objective measurement techniques. Current approaches rely on periodic assessment via self-report which may miss when and how health changes, particularly when changes may appear subtly over time. Remote-monitoring techno...

Background Social isolation is associated with an increased risk of adverse health outcomes, including functional decline, cognitive decline, and dementia. Intergenerational engagement, i.e. structured or semi structured interactions between non-familial older adults and younger generations is emerging as tool to reduce social isolation in older ad...

Introduction: The use of digital biomarker data in dementia research provides the opportunity for frequent cognitive and functional assessments that was not previously available using conventional approaches. Assessing high-frequency digital biomarker data can potentially increase the opportunities for early detection of cognitive and functional d...

Key activities and life events that impact quality of life and health may be gleaned from cross-sectional annual surveys or for medical data, derived intermittently from electronic health records. These methods cannot reflect the day-to-day and week-to-week changes that typically occur in domestic life. To assess the frequency and types of major li...

Despite the clear and compelling association between social connections and well-being, the underlying mechanisms that help stave off adverse health impacts are not well understood, particularly among older adults in disadvantaged groups. Social relationships in older age may be instrumental for exchanging and gaining knowledge that further influen...

Background: The COVID-19 pandemic has changed the health security of older adults. Few have examined how older US veterans have reacted and coped with the COVID-19 pandemic. We aimed to identify changes in physical health and their differential impact by rurality of older veterans. Method: Participants were veterans (aged ≥ 62 years) and their coha...

I-CONECT is a randomized controlled clinical trial to examine the impact of social interaction delivered via video-chat on cognitive function (clinicaltrials.gov number: NCT02871921, project website: www.I-CONECT.org ). We aimed to enroll 320 community-dwelling socially isolated older adults (age >=75 years). The recruitment of participants has sta...

Physical/functional limitations are known to lead to loneliness, but there is little research on protective factors that may mediate their adverse association, particularly in vulnerable populations. This study used cross-sectional survey data from 147 (aged 58-90 years; 75% females) predominantly low-income African American homebound community dwe...

Older Veterans are at especially high risk of depression and social isolation due to COVID-19 stay-at-home orders and necessary safety precautions. We aimed to objectively measure differences in mood reports before and after COVID-19 stay-at-home orders in rural older Veterans. Participants age > 62 were enrolled in the Collaborative Aging Research...

An active lifestyle is associated with better cognitive health in older individuals. This relationship is understudied in U.S. Veterans, a population at risk of cognitive impairment due to the high prevalence of associated risk factors and comorbidities. Passive monitoring of daily activities provides objective measures of activity that may serve a...

Periventricular T2 MRI white matter hyperintensities (WMH) are commonly observed in older individuals and are associated with cognitive and motor decline. While likely vascular in origin, the specific etiology of WMH remains unknown. Vascular insufficiency due to venous collagenosis has been implicated. Collagenosis may also interfere with perivasc...

Changes in mood, loneliness, pain, and need for assistance may be potential early markers of cognitive decline in older adults. These changes can be subtle, and fluctuating, and thus easily missed during intermittent clinic visits. Continuous long‐term monitoring of these self‐reported internal states and needs, and their relationship to developing...

Weight loss has been associated with earlier onset of dementia and accelerated cognitive decline. Current methods of assessing nutritional health, including body mass and dietary habits, occur in clinic settings semiannually to annually. A home‐based non‐invasive system allows for continuous data collection that could generate clinically meaningful...

The relationship between amyloid (Aβ) production and clearance is disturbed in Alzheimer’s disease (AD). Evidence suggests that a decrease in clearance efficiency from cortical gray matter (GM) is relevant in late‐onset cases, a framework supported by findings of concomitant decreases in cerebrospinal fluid Aβ. A peri/paravascular bulk flow pathway...

The use of digital biomarker data provides the opportunity for frequent functional and cognitive assessments that were not previously available. Digital biomarker data are often collected in the form of time stamped data, which requires processing for interpretable applications in health care research. In general, time stamped data can be averaged,...

National Institute on Aging (NIA)‐funded Alzheimer’s Disease Centers in the United States have been using a standardized neuropsychological test battery as part of the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS) since 2005. Version 3 (V3) of the UDS was implemented in 2015 and included several changes to its neuropsycholo...

The n‐3 PUFA may modulate risk for age‐related cognitive impairment through vascular mechanisms. MRI derived cerebral white matter hyperintensities (WMH) presumptively reflect small vessel disease and their accumulation increases risk for age‐related cognitive decline and dementia. Blood n‐3 PUFA are consistently associated with reduced WMH and str...

Increasing social interaction could be a promising intervention for improving the cognitive well‐being of socially isolated older adults. However, we expect that the efficacy of a social intervention can differ across subjects due to personality traits, preference for specific activities, and different pathological stages, even within the same clin...

High‐frequency biomarkers (HFB) are measurements collected weekly, on a daily basis or even more frequently. They are designed to detect early progression from one cognitive state to a later stage. Examples include home‐based measurements, e.g., computer usage and sleep patterns. In randomized controlled trials (RCT), we aim to detect the differenc...

Early identification and accurate assessment of Mild Cognitive Impairment (MCI) is critical for clinical‐trial enrichment as well as the early intervention of the neurodegenerative disease. Continuous home‐based measurements of functions using simple embedded sensors and devices could provide an opportunity to improve the sensitivity and specificit...

Previous studies investigating potential beneficial effects of Omega‐3 Polyunsaturated Fatty Acids (PUFA) on vascular health have shown inconsistent results. Oxylipins, produced from the oxidation of PUFAs, have potent vascular effects shown to be relevant to human disease. We have previously reported the cytochrome P450‐derived Omega‐3 PUFA Docosa...

Sleep duration is associated with cognitive health in older individuals and is increasingly recognized as an important modifiable factor related to dementia risk. Sleep and its relationship with cognitive function is understudied in rural U.S. Veterans, who are under‐represented in clinical research aging studies. Participants (age > 57) were enrol...

The search for early biomarkers of mild cognitive impairment (MCI) has been central to Alzheimer's Disease (AD) and the dementia research community in recent years. While there exist in‐vivo biomarkers (e.g., beta‐amyloid and tau) that can serve as indicators of pathological progression toward AD, biomarker screenings are prohibitively expensive to...

Older adults are at high risk for both cognitive decline and social isolation. A higher level of social interaction, however, confers a protective effect against cognitive decline, and intervention studies have demonstrated the efficacy of social interactions to enhance cognitive function. The biological mechanism of this enhancement is unclear. He...

Introduction: Future digital health research hinges on methodologies to conduct remote clinical assessments and in-home monitoring. The Collaborative Aging Research Using Technology (CART) initiative was introduced to establish a digital technology research platform that could widely assess activity in the homes of diverse cohorts of older adults a...

The primary outcome of Randomized clinical Trials (RCTs) are typically dichotomous, continuous, multivariate continuous, or time-to-event. However, what if this outcome is unstructured, e.g., a list of variables of mixed types, longitudinal sequences, images, audio recordings, etc. When the outcome is unstructured it is unclear how to assess RCT su...

Introduction: Federally funded Alzheimer's Disease Centers in the United States have been using a standardized neuropsychological test battery as part of the National Alzheimer's Coordinating Center Uniform Data Set (UDS) since 2005. Version 3 (V3) of the UDS replaced the previous version (V2) in 2015. We compared V2 and V3 neuropsychological test...

Background Current conventional cognitive assessments are limited in their efficiency and sensitivity, often relying on a single score such as the total correct items. Typically, multiple features of response go uncaptured. Objectives We aim to explore a new set of automatically derived features from the Digit Span (DS) task that address some of t...

Dementia is a risk factor for epilepsy. While seizures have a well-established association with Alzheimer's disease (AD), their association with dementia with Lewy bodies (DLB) is not established. We utilized the National Alzheimer's Coordinating Centers' Uniform Data Set (NACC-UDS V1-3) to analyze occurrence of seizures in DLB and seizure occurren...

In the past decade a large body of evidence has accumulated on risk factors for dementia, primarily from Europe and North America. Drawing on recent integrative reviews and a consensus workshop, the International Research Network on Dementia Prevention developed a consensus statement on priorities for future research. Significant gaps in geographic...

Abstract Introduction Agitation, experienced by patients with dementia, is difficult to manage and stressful for caregivers. Currently, agitation is primarily assessed by caregivers or clinicians based on self‐report or very brief periods of observation. This limits availability of comprehensive or sensitive enough reporting to detect early signs o...

Conversation is a complex cognitive task that engages multiple aspects of cognitive functions to remember the discussed topics, monitor the semantic and linguistic elements, and recognize others' emotions. In this paper, we propose a computational method based on the lexical coherence of consecutive utterances to quantify topical variations in semi...

Background: Norms for the Uniform Data Set Version 3 Neuropsychological Battery are available for cognitively normal individuals based on age, education, and sex; however, these norms do not include race. We provide expanded norms for African Americans and whites. Methods: Data from 32 Alzheimer's Disease Centers (ADCs) and ADC affiliated cohort...

Introduction: Clinically relevant information can go uncaptured in the conventional scoring of a verbal fluency test. We hypothesize that characterizing the temporal aspects of the response through a set of time related measures will be useful in distinguishing those with MCI from cognitively intact controls. Methods: Audio recordings of an animal...

The search for early biomarkers of mild cognitive impairment (MCI) has been central to the Alzheimer’s Disease (AD) and dementia research community in recent years. To identify MCI status at the earliest possible point, recent studies have shown that linguistic markers such as word choice, utterance and sentence structures can potentially serve as...

Background: Cerebrovascular disease is a common cause of dementia in older adults, and potentially preventable with early intervention. Oxylipins are produced from the oxidation of long-chain polyunsaturated fatty acids (PUFA) possessing potent vascular effects. Oxylipins generated from the cytochrome P450 pathway are enzymatically converted to di...

Introduction: Physical activities (PA) may lead to improved cognition in mild cognitive impairment (MCI), Alzheimer's disease (AD), and dementia. The mechanisms mediating potential PA effects are unknown. Assessment of PA effects on relevant biomarkers may provide insights into mechanisms underlying potential PA effects on cognition. Methods: We...

Introduction: Multinutrient approaches may produce more robust effects on brain health through interactive qualities. We hypothesized that a blood-based nutritional risk index (NRI) including three biomarkers of diet quality can explain cognitive trajectories in the multidomain Alzheimer prevention trial (MAPT) over 3-years. Methods: The NRI inc...

BACKGROUND Current clinical trial assessment methodology relies on a combination of self-report measures, cognitive and physical function tests, and biomarkers. This methodology is limited by recall bias and recency effects in self-report and by assessments that are brief, episodic, and clinic-based. Continuous monitoring of ecologically valid meas...