Jeffrey Kaye

Oregon Health & Science University | OHSU · Department of Neurology

Background Agitation is one of the most challenging behaviors exhibited by people with cognitive decline, causing distress in caregivers, earlier placement into long‐term care and faster disease progression. In order to better manage agitated behaviors in people with cognitive decline, it is important to identify associated factors. The MODERATE (M...

Background Life‐space mobility can be a behavioral indicator of loneliness. This study examined the association between life‐space mobility measured with motion sensors and weekly vs. annually reported loneliness. Methods Participants were older adults who lived alone. Passive infrared motion sensors were placed in the bathroom, bedroom, kitchen,...

The SHARP-Caregiver (SHARP-CG) study evaluated the feasibility of adapting SHARP to family caregivers of care partners with mild cognitive impairment or early-stage dementia. SHARP-CG assigned 7 triads (n=21) to Group A or B. Triads had a family caregiver (age >40), their care partner (age >40), and a support person (age >18). Caregivers and suppor...

Androgen deprivation therapy (ADT) for prostate cancer (PC) increases the risk of physical and cognitive decline as well as side effects impacting quality of life. However, we lack a holistic understanding of the timing and spectrum of ADT-related side effects. Thus, we evaluated the feasibility of using home-based, continuous passive monitoring of...

Spousal care dyads’ in-home activity and routines are typically captured through self-report. Remote passive sensing offers a sensitive, continuous, and ecologically-valid method of assessment that increases the ability to detect patterns of daily activities and function; however, there are challenges of deploying these technologies among dyads in...

Behavioral and psychological symptoms are common among older adults with apathy, depression and anxiety being the most prevalent. Identifying factors associated with such symptoms may help mitigate them. The study, Monitoring Apathy, Depression and Anxiety Using Technology Evaluations, aimed to identify indoor environmental quality factors that may...

Poor sleep quality has been associated with worse cognition performance. As sleep quality is multidimensional, examining separate factors captured by the PROMIS™ Sleep Disturbance 8b scale, insomnia, and sleep dissatisfaction, may provide greater insight into aspects most pertinent to cognitive health. Herein, we evaluated the associations between...

Background Socially isolated individuals tend to have less access to cognitively stimulating activities, which could adversely impact their cognitive health. The Internet-Based Conversational Engagement Clinical Trial (I-CONECT) intervention was designed to deliver online conversation sessions to socially isolated older old adults to prevent cognit...

Introduction The vast majority of studies on aging, cognition, and dementia focus on non-Hispanic white subjects. This paper adds to the extant literature by providing insight into the African American aging experience. Here we describe the study design and baseline characteristics of the African American Dementia and Aging Project (AADAPt) study,...

Behavioral intervention studies often lack sufficiently sensitive and frequent measurements to observe an effect. Remote passive sensing offers a highly sensitive, continuous, and ecologically valid method of assessment that increases the ability to detect changes in the daily activities and function of those being monitored. To be most effectively...

Background Plasma neurofilament light chain (NfL) is a blood biomarker of neurodegeneration, including Alzheimer’s disease. However, its usefulness may be influenced by common conditions in older adults, including amyloid-β (Aβ) deposition and cardiometabolic risk factors like hypertension, diabetes mellitus (DM), impaired kidney function, and obes...

Importance Older adults with lower intake and tissue levels of long-chain ω-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA; 20:5) and docosahexaenoic acid (DHA; 22:6) have more brain white matter lesions (WMLs), an association suggesting that small-vessel ischemic disease, a major contributor to the development of dementia, includ...

Importance The lack of an in vivo measure for α-synuclein (α-syn) pathology until recently has limited thorough characterization of its brain atrophy pattern, especially during early disease stages. Objective To assess the association of state-of-the-art cerebrospinal fluid (CSF) seed amplification assays (SAA) α-syn positivity (SAA α-syn+) with m...

The Behavioral Risk Factor Surveillance System (BRFSS) is a randomized national U.S. telephone survey administered by state health departments. This study aimed to identify how Black/African Americans understand BRFSS caregiver and cognitive decline surveys and terminology to inform health messaging that centers the Black/African American experienc...

Objectives. The vast majority of studies on aging, cognition, and dementia focus on non-Hispanic white subjects. This paper adds to the extant literature by providing insight into the African American aging experience. Here we describe the study design and baseline characteristics of the African American Dementia and Aging Project (AADAPt) study, w...

Alzheimer's disease (AD) is a neurodegenerative disease that commonly causes dementia. Identifying biomarkers for the early detection of AD is an emerging need, as brain dysfunction begins two decades before the onset of clinical symptoms. To this end, we reanalyzed untargeted metabolomic mass spectrometry data from 905 patients enrolled in the AD...

We introduce a novel framework for the classification of functional data supported on nonlinear, and possibly random, manifold domains. The motivating application is the identification of subjects with Alzheimer’s disease from their cortical surface geometry and associated cortical thickness map. The proposed model is based upon a reformulation of...

Background Functional connectivity (FC) biomarkers play a crucial role in the early diagnosis and mechanistic study of Alzheimer’s disease (AD). However, the identification of effective FC biomarkers remains challenging. In this study, we introduce a novel approach, the spatiotemporal graph convolutional network (ST-GCN) combined with the gradient-...

Background and Objectives Two exploratory 6-month pilots of triadic walking with culturally celebratory social reminiscence in gentrifying neighborhoods tested feasibility and health impact among normal and mildly cognitively impaired (MCI) older Black adults. Research Design and Methods Fourteen triads walked 1-mile 3x/week, using a navigational...

Background Polygenic effects have been proposed to account for some disease phenotypes; these effects are calculated as a polygenic risk score (PRS). This score is correlated with Alzheimer’s disease (AD)-related phenotypes, such as biomarker abnormalities and brain atrophy, and is associated with conversion from mild cognitive impairment (MCI) to...

BACKGROUND Caring for a family member with dementia is costly. Here we examine costs related to caregiving from surveys collected during a behavioral intervention study, Support via TEchnology: Living and Learning with Advancing AD (STELLA) a telehealth-based intervention. OBJECTIVE To understand relationships between behavioral symptoms and out-o...

Background Caring for a family member living with dementia is costly. A major contributor to care demands, and therefore to the costs, are the behavioral symptoms of dementia. Here, we examine the feasibility of ascertaining costs related to caregiving from weekly web-based surveys collected during a telehealth-based behavioral intervention study—S...

Background A common challenge for individuals caring for people with Alzheimer disease and related dementias is managing the behavioral and psychological symptoms of dementia (BPSD). Effective management of BPSD will increase the quality of life of people living with dementia, lessen caregivers’ burden, and lower health care cost. Objective In thi...

BACKGROUND A common challenge for individuals caring for people with Alzheimer disease and related dementias is managing the behavioral and psychological symptoms of dementia (BPSD). Effective management of BPSD will increase the quality of life of people living with dementia, lessen caregivers’ burden, and lower health care cost. OBJECTIVE In thi...

Background Social isolation has been linked to an increased risk of cognitive decline and incident dementia. Socially isolated individuals tend to lack access to cognitively stimulating activities. This may adversely impact their cognitive health. The Internet‐Based Conversational Engagement Clinical Trial (I‐CONECT) was designed to deliver online...

Background Frontotemporal Dementia (FTD) patients are geographically dispersed and often have behavioral and/or motor deficits that limit access to in‐person clinical trials and research. To address these participation barriers, we investigated the feasibility of installing in‐home sensor technologies to remotely assess everyday functioning in FTD....

Background Early detection and precise monitoring of cognitive and functional decline in persons with Alzheimer’s Disease (AD) in clinical trials is a high priority. Unfortunately, early detection and monitoring of the subtle and slow changes of disease with conventional cognitive testing and self‐report questionnaires has been fraught with poor se...

Background Troubling behavioral symptoms such as mood changes or agitation are highly prevalent during the course of Alzheimer’s disease and related dementias (ADRD). Effective management is dependent upon understanding the causes and precipitants of behavioral symptoms. The objective of our studies is to evaluate the role of the physical ambient e...

Background More nuanced data collection beyond pre/post measures can detect real‐time changes in activity levels, sleep, and other factors that may signal transition in cognitive health. Method Nine Black adults (n = 4 healthy, mean age 71.1; n = 5 mildly cognitively impaired (MCI), mean age 79.2) tested the feasibility of adding digital biomarker...

Background MRI‐visible perivascular spaces (mrPVS) in the brain, typically found in white matter and assumed to be pathologically enlarged though historically considered a benign finding, have been more recently associated with normal aging as well as with various disease states, including traumatic brain injury, sleep apnea, Alzheimer’s Disease (A...

Background 50% of US adults living with Alzheimer’s disease and related dementias (ADRD) never receive a formal diagnosis. This compromises the wellbeing of persons living with ADRD and their care partners, increases health services utilization, and the costs‐of‐care. Wider screening and assessment for ADRD may increase access to supportive care th...

Background Social isolation has been linked to an increased risk of cognitive decline and incident dementia. Socially isolated individuals tend to lack access to cognitively stimulating activities. This may adversely impact their cognitive health. The Internet‐Based Conversational Engagement Clinical Trial (I‐CONECT) was designed to deliver online...

Background Early detection and precise monitoring of cognitive and functional decline in persons with Alzheimer’s Disease (AD) in clinical trials is a high priority. Unfortunately, early detection and monitoring of the subtle and slow changes of disease with conventional cognitive testing and self‐report questionnaires has been fraught with poor se...

Background List learning and memory tests are frequently used to evaluate older adults for late life cognitive disorders, such as Alzheimer’s disease. The Word List subtest of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery has been widely‐used in clinical research, including clinical trials, to ide...

Background List learning and memory tests are frequently used to evaluate older adults for Mild Cognitive Impairment and Alzheimer’s disease. One such test, the Word List subtest of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), has been widely‐used in clinical trials track such disorders. However, data is lacking on the am...

Background Daily activity patterns of life‐space mobility can serve as indicators for loneliness and subsequent cognitive change. Assessment of life‐space mobility often uses self‐reported data, and the measurement intervals are often less frequent than needed to capture change over time. This study examined whether the life‐space mobility changed...

Background Older Black adults facing gentrification may engage less in neighborhood walking and social opportunities because of gentrification’s effect on mental health. Reminiscence therapy promotes coping which mediates negative feelings, improves mood and emotional well‐being, and improves depressive symptoms. Method The Sharing History Through...

Background The Uniform Data Set Neuropsychological Battery, Version 3 (UDSv3) was designed for face‐to‐face assessment of cognition within Alzheimer’s Disease Research Centers (ADRCs) in the USA. However, there are many reasons research participants may be unable to meet face‐to‐face for assessments. This inter‐ADRC, multi‐site study will validate...

Background MRI‐visible perivascular spaces (mrPVS) in the brain, typically found in white matter and assumed to be pathologically enlarged though historically considered a benign finding, have been more recently associated with normal aging as well as with various disease states, including traumatic brain injury, sleep apnea, Alzheimer’s Disease (A...

In-home digital technology affords the opportunity for more precise and ecologically valid assessments of daily activity engagement. However, concerns about loss of privacy can hinder recruitment, especially within communities already underrepresented in research. Literature on effective, culturally tailored recruitment strategies is limited. Herei...

The impact of cancer and cancer treatment on older adults’ day-to-day health and functioning remains poorly characterized. Therefore, we evaluated the feasibility of using home-based, continuous passive monitoring of daily life functioning plus symptom surveys in older adults with multiple myeloma (MM). We assessed accrual, uptake of passive monito...

Minoritized and marginalized older adults face multifaceted barriers that could prevent them from participating in aging research, including but not limited to not having access to research opportunities, time and transportation constraints, lack of trust with health care providers and researchers, and language barriers. When the research projects...

Remote assessment of cognitive function is increasingly of interest for monitoring cognitive decline. Additional advantages of remote monitoring are more frequent assessments and the examination of change over time, which may yield more sensitive indicators of cognitive status. This concept was tested in DETECT-AD (Digital Evaluations and Technolog...

UNSTRUCTURED Behavioral intervention studies often lack sufficiently sensitive and frequent measurements to observe an effect. Remote passive sensing offers a highly sensitive, continuous, and ecologically-valid method of assessment that increases the ability to detect change in daily activities and function of those being monitored. To be most eff...

The READyR Program assesses and targets everyday routines of care dyads (older adults with cognitive impairment and their co-habiting partners) using in-home sensors and video-conference sessions in order to understand future care needs, and promote greater well-being. This study aimed to evaluate the feasibility, acceptability, and pilot test of e...

Behavioral symptoms are highly prevalent during the course of cognitive decline associated with dementia. Studies have shown that the social environment may affect these symptoms. Data sources examining the effect of environment come from two ongoing studies: 1) MOnitoring DEmentia-Related Agitation Using Technology Evaluations (MODERATE), focusing...

Background and Objectives Social isolation is a risk factor for cognitive decline and dementia. We conducted a randomized controlled clinical trial (RCT) of enhanced social interactions, hypothesizing that conversational interactions can stimulate brain functions among socially isolated older adults without dementia. We report topline results of th...

Background Deep learning has shown potential in various scientific domains but faces challenges when applied to complex, high-dimensional multi-omics data. Alzheimer's Disease (AD) is a neurodegenerative disorder that lacks targeted therapeutic options. This study introduces the Circular-Sliding Window Association Test (c-SWAT) to improve the class...

Importance Increased white matter hyperintensity (WMH) volume is a common magnetic resonance imaging (MRI) finding in both autosomal dominant Alzheimer disease (ADAD) and late-onset Alzheimer disease (LOAD), but it remains unclear whether increased WMH along the AD continuum is reflective of AD-intrinsic processes or secondary to elevated systemic...

Background Measuring function with passive in-home sensors has the advantages of real-world, objective, continuous, and unobtrusive measurement. However, previous studies have focused on 1-person homes only, which limits their generalizability. Objective This study aimed to compare the life space activity patterns of participants living alone with...

BACKGROUND Apathy, depression, and anxiety are prevalent neuropsychiatric symptoms experienced by older adults. Early detection, prevention, and intervention may improve outcomes. OBJECTIVE To demonstrate feasibility of deploying online weekly questionnaires inquiring of participants’ behavioral symptoms and an in-home technology platform measurin...

Background Apathy, depression, and anxiety are prevalent neuropsychiatric symptoms experienced by older adults. Early detection, prevention, and intervention may improve outcomes. Objective We aim to demonstrate the feasibility of deploying web-based weekly questionnaires inquiring about the behavioral symptoms of older adults with normal cognitio...

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Policymakers have recognized the urgent need to create AI data protections, yet the interests of older adults have thus far not been well represented. We report peoples’ perspectives on small AI companion robots for older adults, along with attendant issues related to facial expression and conversation data collection and sharing. Data are from a c...

Background Troubling behavioral symptoms such as mood changes or agitation are highly prevalent during the course of Alzheimer’s disease and related dementias (ADRD). Effective management is dependent upon understanding the causes and precipitants of behavioral symptoms. The objective of our studies is to evaluate the role of the physical ambient e...

Background As Alzheimer’s disease (AD) prevalence rises, the development of effective screening tools is necessary to aid in earlier AD diagnosis. In the USA, Hispanic and Non‐Hispanic Black adults are at a disproportionately higher risk of developing dementia than non‐Hispanic whites but are poorly represented in AD research. A digital assessment...

Limited ancestral diversity has impaired our ability to detect risk variants more prevalent in non-European ancestry groups in genome-wide association studies (GWAS). We constructed and analyzed a multi-ancestry GWAS dataset in the Alzheimer Disease (AD) Genetics Consortium (ADGC) to test for novel shared and ancestry-specific AD susceptibility loc...

Background The gold standard method for assessing the efficacy of dementia treatments, the Alzheimer’s Disease (AD) Assessment Scale‐Cognitive Subscale (ADAS‐Cog), has limitations of use based on the level of cognitive decline of a patient, the need for an in‐person evaluation, and the sampling of a time point in the patient experience. However, me...

Background Outcome measures available for use in Alzheimer’s disease (AD) clinical trials are limited in ability to detect gradual changes. Measures of everyday function and cognition assessed unobtrusively at home using embedded sensing and computing generated “digital biomarkers” (DBs) have been shown to be ecologically valid and to improve effic...

We propose a new approach, called as functional deep neural network (FDNN), for classifying multidimensional functional data. Specifically, a deep neural network is trained based on the principal components of the training data which shall be used to predict the class label of a future data function. Unlike the popular functional discriminant analy...

Aging is a significant contributor to changes in sleep patterns, which has compounding consequences on cognitive health. A modifiable factor contributing to poor sleep is inadequate and/or mistimed light exposure. However, methods to reliably and continuously collect light levels long-term in the home, a necessity for informing clinical guidance, a...

Widespread cognitive test screening as part of tele-public health initiatives necessitates a test that is self-administered online and automatically scored, with no clinician effort. The feasibility of unsupervised cognitive screening is unclear. We adapted the Self-Administered Tasks Uncovering Risk of Neurodegeneration (SATURN) to make it suitabl...

Background and Objective Care partners of people living with dementia require support to knowledgeably navigate decision making about how and when to use monitoring technologies for care purposes. We conducted a pilot study of a novel self-administered intervention, “Let’s Talk Tech,” for people living with mild dementia and their care partners. Th...

(1) Background: The development of assistive technologies has become a key solution to reduce caregiver burden. The objective of this study was to survey caregivers on perceptions and beliefs about the future of modern technology in caregiving. (2) Methods: Demographics and clinical caregiver characteristics were collected via an online survey alon...

Objective Given growing interest in companion robots to mitigate loneliness, large-scale studies are needed to understand peoples’ perspectives on the use of robots to combat loneliness and attendant ethical issues. This study examines opinions about artificial companion (AC) robots regarding deception with dementia and impact on loneliness. Metho...

BACKGROUND Measuring function with passive in-home sensors has the advantages of real-world, objective, continuous, and unobtrusive measurement. However, previous studies have focused on 1-person homes only, which limits their generalizability. OBJECTIVE This study aimed to compare the life space activity patterns of participants living alone with...

BACKGROUND Describing changes in health and behavior that precede and follow a sentinel health event, like a cancer diagnosis, is challenging because of a lack of longitudinal, objective measurements that are collected frequently enough to capture varying trajectories of change leading up to and following the event. A continuous passive assessment...

Background Describing changes in health and behavior that precede and follow a sentinel health event, such as a cancer diagnosis, is challenging because of the lack of longitudinal, objective measurements that are collected frequently enough to capture varying trajectories of change leading up to and following the event. A continuous passive assess...

Octogenarians are the fastest growing segment of the population worldwide, but are often excluded from pharmacological intervention trials. Slowing cognitive decline and delaying the onset of dementia even for a few years among this age group could reduce prevalent dementia significantly. Behavioral intervention targeting the older old, which can b...

Voluntary, self-administered online assessment platforms have gained popularity in monitoring cognition and lifestyle behaviors. This study used the AARP Staying Sharp online brain health assessment platform to estimate the progression of a cognitive composite and correlate it with six modifiable lifestyle behaviors (physical activity, diet, sleep,...

Amyloid (Aβ) clearance is disturbed in late‐onset Alzheimer’s disease (AD), and a local relationship between Aβ clearance and gray (GM) and white matter (WM) perivascular spaces (PVS) is presumed. Most in vivo primate work has focused on MRI‐visible PVS in WM, described as pathological and enlarged, while nearly all in vivo mechanistic work in anim...

Among prominent unmet needs of the Alzheimer’s disease and related dementia (ADRD) research community is the ability to leverage opportunities to improve the assessments of persons with and at risk for ADRD. This vision can be realized by providing the tools and infrastructure to transform dementia assessment using remote sensing and digital techno...

Remote delivery of dementia caregiver interventions can decrease delivery costs, and make it more feasible to provide evidence-based interventions to caregivers across the country. As the science behind remote delivery develops, new technologies and their applications can ensure preservation of important intervention components and principles, as w...

The out-of-pocket costs to care for individuals living with dementia are high, and is exacerbated by the expense of managing behavioral and psychological symptoms of dementia (BPSD) (e.g., depression, irritability). STELLA (Support via TEchnology: Living and Learning with Advancing AD) is a telehealth-based intervention that provides a personalized...

Mobility features are important for health. In this study, we quantified in-home mobility and explored potential health and environmental correlates. Participants included community-dwelling older adults living alone (n=139). Two indoor mobility features were developed (frequency; interdaily stability) using passive, room-level (bathroom; bedroom;...

Timely and objective knowledge regarding behavioral and psychological symptoms (BPS) in older adults with cognitive impairment or dementia residing in the community setting is challenging to obtain. The Monitoring Dementia-Related Agitation using Technology Evaluation (MODERATE) Study aims to identify longitudinal changes of agitation and related s...

Many people living with Alzheimer’s disease and related dementias (ADRD) never receive a formal disease diagnosis. This compromises wellbeing and increases health services utilization and care costs. Wider screening and assessment for ADRD may increase access to supportive care, improve allocation of medical care, and foster interventions that prev...

Background: For older adults in community settings, predicting undesired outcomes (needing higher levels of care or death) is important for advancing preventative care and achieving successful aging. We examined whether a combination of baseline characteristics (demographic, clinical) and a continuous digital measure of general mobility and social...

Background: Home-based sensor technologies can detect information on daily activities, such as sleep, activity level, and time spent together. This is relevant information for care partners of individuals with cognitive impairment as it can detect early changes in daily activities and cognition. The challenge is how to present thousands of data po...

Background: Among prominent unmet needs of the Alzheimer's disease and related dementia (ADRD) research community is the ability to leverage opportunities to improve the assessments of persons with and at risk for ADRD. This vision can be realized by providing the tools and infrastructure to transform dementia assessment using remote sensing and d...