Alzheimers Disease Center

Alzheimers Disease Center is a multi-speciality group practicing in Quincy, Massachusetts, specializing in the treatment of dementia, neuropsychiatry and geriatric neurology. We have the leading experts in the field of dementia, including authors of the textbook of geriatric neurology.  Our interest area is the early pre-clinical detection, prevention and treatment of Alzheimer dementia and other neuro-cognitive disorders.

We conduct several clinical trials at the Alzheimer disease center serving the south shore of Boston. The center aims to advance the field of geriatric neurology and reduce the costs of debilitating diseases such as Alzheimer disease and other related dementia. We provide preventive, diagnostic and therapeutic clinical and research services to patients with neuro-degenerative diseases. We are dedicated to providing healthcare and referral services of the highest quality. Our emphasis is on building partnerships that increase the independence and quality of life for patients with dementia.

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GAIN is a clinical trial evaluating whether an investigational oral drug is safe and can halt the progression of Alzheimer’s disease by reducing the damage caused by bacteria in the brain. Eligible study participants are being recruited at study sites around the country

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Publications

November 4-11 2020: Gerontological Society of America Annual Meeting
Four Abstracts Accepted:

#2020-11-4-1: Clinical Correlation of Cerebrospinal Fluid Total tau Levels and MMSE Score in a memory clinic. Tangal N, Nair A, Nair M. Background: Tau protein levels in cerebrospinal fluid are a biomarker of Alzheimer’s disease. We correlated MMSE severity to CSF tau levels in a large memory clinic sample. Method: We retrospectively analyzed data from patients attending a memory clinic in the south shore of Boston from 2010 to 2020, and had a lumbar puncture to obtain CSF tau levels. We correlated tau to cognitive screen data from MMSE scores, in a multivariate model including covariates of age, sex, and race. Results: 965 patients attended the memory clinic from 2010 to 2020 and had analyzable data. 711 had available MMSE scores. 131 subjects had lumbar punctures and available CSF tau levels. Univariate analyses showed that cognition as measured by MMSE total was not correlated to total tau levels in the CSF (rho=-0.07, p>0.05), but Caucasian race was inversely associated with CSF tau levels (rho= -0.217, p<0.05). In the multivariate model, tau levels in the CSF were not associated with MMSE, race, gender, or age. Conclusion: In a large memory clinic sample, CSF tau levels did not correlate to MMSE scores, age, race or gender. Link to presentation will be available here.

#2020-11-4-2: Is Immediate Recall affected by Anxiety in a memory-impaired clinic population?  Khachan H, Kanjolia M, Andrea F, Nair A
Background: It is unknown if anxiety affects performance on immediate recall testing (IR) in memory clinic patients.  Method: We performed a retrospective analysis of data from memory clinic patients from the south shore area of Boston from 2010 to 2020. Baseline anxiety screening data (GAD7) was correlated with immediate recall (IR) scores and Montreal cognitive assessment (MoCA) using Spearman correlations as the data were non normal. A multiple linear regression model analyzed association of IR to GAD7 and covariates of IR, age, gender, and race.  Hypothesis:
We hypothesized an association between IR and anxiety levels as scored on GAD7.  Results: 994 patients were evaluated in the memory clinic between 2010-2020. Patients were 58.6% female, 84.6 % White. The mean age was 70.1±14.4, IR 6.62 ± 5.4, GAD7 5.5±5.71.  On univariate analysis, IR was positively correlated to age (⍴ = 0.03, p = 0.12), and female gender (⍴ = 0.52, p = 0.24), and negatively correlated with non-Caucasian race (⍴ = – 0.11, p =0.16).IR was not significantly associated with GAD7 (⍴ = -0.03, p = 0.41). 
A multivariate model confirmed the lack of association between anxiety scores to (β = -0.03, p = 0.41) and IR scores. IR task performance was not significantly associated with any of the covariates. Conclusions:
Immediate recall task performance was not significantly associated with anxiety measured by GAD7 scores in a memory clinic population.

#202011-4-3: Does anxiety affect the clock drawing task in patients in a memory clinic?  Kanjolia M,  Khachan H, Nair A. Background: It is unknown if anxiety levels affect performance on clock drawing test (CDT) in memory clinic patients. Method: We performed a retrospective analysis of memory clinic patients in the south shore of Boston from 2010 to 2019. We correlated anxiety screen data (GAD7) to CDT scores, based on contour, numbers, and hands placement. Univariate analyses used Spearman correlation. A multivariate regression model analyzed GAD7 to covariates of CDT, age, sex, and race. Hypothesis: We hypothesized a positive  correlation between anxiety levels scored by the GAD7 and CDT. Results: 994 patients in the memory clinic between 2010-2020 had analyzable data. Patients were 58.6% female, 84.6 % White. Mean age was 70.1±14.4, CDT 1.84±1.04. CDT score correlated significantly to race (⍴= -0.16, p< 0.001) , age (⍴= -0.28, p<0.001), gender (⍴= 0.05, p=0.16), but not GAD7 (⍴= 0.05, p=0.27). Multivariate model confirmed the lack of association of anxiety scores to CDT (= 0.08, p=0.78). GAD7 scores correlated to female gender (=
-1.16, p=0.04). Conclusions: CDT scores were not affected by anxiety as measured on GAD7 scores. However, a positive correlation was shown on anxiety scores in females to CDT completion.

#202011-4-4: Does Anxiety Affect Performance on an Attention Task (digit span forward) in the MOCA Test? A clinical correlation study. Patel R, Nair A Background:  It is unknown if anxiety affects performance on Digit span forward (DSF) in memory clinic patients. Method: We performed a retrospective chart review of memory clinic patients in the south shore of Boston from 2010 to 2020. We correlated anxiety screen data (GAD7) to Digit Span Forward (DSF) scores obtained from the MoCA.  As the data were not normal, we performed univariate analyses with Spearman correlation. A multivariate regression model estimated the relationship of DSF to covariates of GAD7, age, sex, and race. Hypothesis: We hypothesized a negative correlation between anxiety levels scored by GAD7 and DSF. H0: Digit span forward DSF ~ GAD7+Age+Sex+Race Results: A chart review found 965 patients attending the memory clinic between 2010 to 2020 had analyzable data. 433 patients with available DSF and 737 had available GAD7. The patients were 58.7% female and 84.7% caucasian. The mean age was 70.1±14.4, DSF 0.8±0.4 and GAD 5.6±5.7. GAD7 correlated significantly to race (⍴=-0.25, p=<0.001), but not to gender (⍴=0.05, p=0.149), age (⍴=-0.04, p=0.3), or GAD7 (⍴=-0.018, p=0.71). There was no significant association of DSF to race, age, gender or GAD7 on the multivariate model. Conclusion: In memory clinic subjects there exists no correlation between anxiety levels scored by GAD7 and DSF performance.

July 30 2020: Alzheimer’s Association International Conference, Amsterdam

#2020-07-30-1 : Clinical Correlation of Cerebrospinal Fluid Total tau Levels and Depression as measured by PHQ9 total in a memory clinic. Pillai M, Nair A Background: Tau protein levels in cerebrospinal fluid is indicative of Alzheimer dementia. We correlated PHQ-9 screen severity of depression to CSF tau levels in a memory clinic sample. Method: We analyzed data from patients attending a memory clinic in the south shore of Boston from 2010 to 2019, and had a lumbar puncture to obtain CSF tau levels. We correlated depression screen data from PHQ9 scores. Univariate analyses used Spearman correlation. A multivariate regression model was created including covariates of age, sex, and race. Results: Depression as measured by PHQ9 total was not correlated to total tau levels in CSF. Conclusion: In a memory clinic sample, CSF tau levels did not correlate to PHQ9 scores.

July 06-08, 2020 – 6th Neurological Disorders Summit (NDS-2020), San Francisco, CA.
Chromosomal sex differences in tau levels in patients attending a memory clinic. Mehdi, S Nair S, Dr. Nair. Alzheimer’s Disease Center, United States
Background: Abnormal tau proteins can destabilize microtubules and cause an aggregation of hyperphosphorylated tau in neurodegenerative diseases like Alzheimer’s Disease (Medeiros, 2011). Two thirds of people diagnosed with dementia are women (Mielke, 2018). Understanding how sex can affect
one’s tau protein levels in the context of memory loss is important. The effect of female chromosomal sex on tau proteins is currently unknown.
Objectives: To analyze CSF tau protein variation among male and female patients attending a memory clinic. Methods: Memory clinic patients from July 2010 to July 2019 with available CSF tau results were analyzed retrospectively. Univariate and multivariate analyses of tau with sex, age, race, and education were performed. Results: From July 2010 to July 2019, 100 patients had recorded tau protein levels – mean (401.12 ± 278.15), age at first visit (71.00 ± 13.79). 56.87% of the sample were females and 88.83% were Caucasians. Univariate analyses of tau levels (Rho = -0.09 p = 0.39), race (Rho = -0.18 p = 0.07), and age after adjusting for sex, education, and race (Rho = P= 0.0001*) indicated no sex variability. A multivariate model did not show sex variability. Conclusions: Sex variation in tau protein is not present in the memory clinic patients.

 Feb. 12-13th 2020, Tau2020 International Conference, Washington, D.C.

Clinical correlation of CSF Tau in the Alzcenter.com Memory Clinic.
Nair A, Mehdi S, Nguyen C, Nair S, Alzheimer Disease Center, MA, USA
Background: We performed a retrospective chart review at the www.alzcenter.com – Alzheimer Disease Center, a suburban neurology center serving the south shore of Boston, MA to identify the clinical correlates of patients who had CSF tau measurement in the memory clinic from 2010-2019. Method: A retrospective chart review calculated demographics and memory test data from all patients evaluated in our memory clinic from 2010 to 2019 and obtaining CSF tau measurements to identify clinical correlates. As data were not normally distributed, Spearman correlation was used for univariate analyses. Regression modeling was used for multivariate analyses. Result: In univariate analyses, CSF tau was correlated to age at first clinic visit, education and amyloid PET scan results. Multivariate analyses showed a significant correlation of CSF tau levels to only to amyloid PET scan results, and not to Montreal Cognitive Assessment, Generalized Anxiety scores, gender, initial referral diagnosis, race, age, Conclusion: CSF tau correlated to amyloid PET scan results, and not to commonly used clinical measures of disease progression in a memory clinic sample.

Correlating Family History of Dementia to Age at Diagnosis.
Nair A, Nair S
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