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Objective Previous research has suggested that depressive symptoms may be associated with telomere length; however, findings have been mixed, and few studies have sought to generalize the results beyond samples of white individuals. The present study, conducted from August 2013 through August 2015, sought to examine the relationship between depressive symptoms and leukocyte telomere length in a large (N = 2,710), multiethnic sample (African American, white, Hispanic) and to determine if this relationship differed across ethnic/racial groups. Analyses were based on data taken from the Dallas Heart Study, a recent epidemiologic-style, population-based study of adults from Dallas County, Texas. Methods Depressive symptoms were measured using the Quick Inventory of Depressive Symptomatology, and leukocyte telomere length was measured using a quantitative polymerase chain reaction technique. Analyses of the relationship between depressive symptoms and telomere length were conducted using multiple linear regression models. Results Among the whole sample, there was no significant relationship between depressive symptoms and telomere length in either a basic (β = -0.025, P = .190) or an adjusted (β = -0.015, P = .443) model. However, among non-Hispanic white participants, depressive symptoms were significantly associated with telomere length in both basic (β = -0.083, P = .014) and adjusted (β = -0.066, P = .049) models. Conclusions These findings suggest that ethnic/racial identification may be a factor in the relationship between depressive symptoms and telomere length and could impact the generalizability of previous research.

Background/Aims: Few studies have examined predictors of reversion from mild cognitive impairment (MCI) to normal cognition. We sought to identify baseline predictors of reversion, using the National Alzheimer's Coordinating Center Uniform Data Set, by comparing MCI individuals who reverted to normal cognition to those who progressed to dementia. Methods: Participants (n = 1,208) meeting MCI criteria were evaluated at the baseline visit and 3 subsequent annual visits. Clusters of baseline predictors of MCI reversion included demographic/genetic data, global functioning, neuropsychological functioning, medical health/dementia risk score, and neuropsychiatric symptoms. Stepwise logistic regression models identified predictors of MCI reversion per cluster, which were then entered into a final comprehensive model to find overall predictor(s). Results: At 2 years, 175 (14%) reverted to normal cognition, 612 (51%) remained MCI, and 421 (35%) progressed to dementia, with sustained diagnoses at 3 years. Significant variables associated with MCI reversion were younger age, being unmarried, absence of APOE ε4 allele, lower CDR-SOB score, and higher memory/language test scores. Conclusion: A relatively sizable proportion of MCI individuals reverted to normal cognition, which is associated with multiple factors previously noted. Findings may enhance MCI prognostic accuracy and increase precision of early intervention studies of dementia.

This study constituted the first step in the psychometric development of a self-report screening instrument for risk of opioid medication misuse among chronic pain patients. A 26-item instrument, the Pain Medication Questionnaire (PMQ), was constructed based on suspected behavioral correlates of opioid medication misuse, which heretofore have received limited empirical investigation. The PMQ was administered to 184 patients at an interdisciplinary pain treatment center. Reliability coefficients for the PMQ were found to be of moderate but acceptable strength. Construct and concurrent validity were examined through correlation of PMQ scores to measures of substance abuse, physical and psychological functioning, and physicians' risk assessments. To explore high and low cutoff points for misuse risk, subgroups were formed according to the upper and lower thirds of PMQ scores and compared on validity measures. Higher PMQ scores were associated with history of substance abuse, higher levels of psychosocial distress, and poorer functioning. Future psychometric analyses will consider predictive validity and examine shortened versions of the instrument.

Objective: The objective was to evaluate whether the Multidimensional Pain Inventory (MPI) is effective for predicting response to interdisciplinary treatment in a heterogeneous group of patients with chronic pain. Changes in patients' profiles to a predominantly adaptive coping status after treatment also were assessed. Design: A prospective study was conducted of patients with an array of pain conditions. A standard evaluation battery, including measures of self-reported pain and disability, psychosocial functioning, helpfulness of the program, and medication use, was used for all patients before and after treatment. The MPI status of patients was evaluated and differential response to treatment was assessed. Methods: Sixty-five consecutive patients with chronic pain were evaluated before and immediately after participation in an interdisciplinary pain treatment program. This heterogeneous pain-condition cohort was also differentiated on the basis of the MPI to evaluate potential differential response to treatment. Results: Results revealed significant improvement among these patients with chronic pain when a comprehensive interdisciplinary pain-management program was administered. This improvement was seen across the variety of outcomes evaluated, including narcotic medication use. Most important, the MPI subgroup classification did not significantly predict the degree of positive treatment outcome; all subgroups improved. Conclusions: Although there were major differences in psychosocial functioning before treatment, the MPI was not found to significantly predict response to interdisciplinary treatment in a heterogeneous group of patients with chronic pain. Thus, a comprehensive interdisciplinary treatment program may achieve its full effectiveness across a wide array of pain/disability-related outcome variables, regardless of initial MPI profile categorization.

Objective: To develop a total or composite score for the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery. Method: CERAD total scores were obtained by summing scores from the individual CERAD subtests (excluding the Mini-Mental State Examination [MMSE]) into a total composite (maximum score = 100). The method of tabulating the total score was constructed using normal controls (NCs; n = 424) and patients with AD (n = 835) from the CERAD registry database. The utility of the total score was further tested in independent samples of mild AD (n = 95), mild cognitive impairment (MCI; n = 60), and NC (n = 95) subjects. Results: The CERAD total score was highly accurate in differentiating NC and AD subjects in the CERAD registry. Age, gender, and education effects were observed, and demographic correction scores were derived through multiple regression analysis. Demographically corrected CERAD total scores showed excellent test-retest reliability across samples ( r = 0.95) and were highly correlated with the MMSE ( r = 0.89) and Clinical Dementia Rating Scale ( r = −0.83) in mixed AD and NC samples and with the Blessed Dementia Rating Scale in an AD sample ( r = −0.40). The CERAD total score was highly accurate in differentiating independent samples of NC, MCI, and AD subjects. Conclusion: Results provide support for the validity of a Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) total score that can be used along with the normative data to provide an index of overall level of cognitive functioning from the CERAD neuropsychological battery.