Rush University Medical Center

About: Rush University Medical Center is a healthcare organization based out in Chicago, Illinois, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 13915 authors who have published 29027 publications receiving 1379216 citations. The organization is also known as: Rush Presbyterian St. Luke's Medical Center.

Preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty.

Abstract: This guideline supersedes a prior one from 2007 on a similar topic. The work group evaluated the available literature concerning various aspects of patient screening, risk factor assessment, and prophylactic treatment against venous thromboembolic disease (VTED), as well as the use of postop

Educational attainment and cognitive decline in old age

Abstract: Risk of dementia and Alzheimer disease (AD) in old age is reduced in persons with higher levels of educational attainment compared to those with lower levels.1–4 This finding is due in part to the well-established correlation of education with cognitive test performance at all ages. Thus, persons with more schooling, relative to those with less, are likely to begin old age at a higher level of cognitive function and so would need to experience more cognitive decline before reaching a level of impairment meeting dementia criteria. Another way in which education might influence risk of dementia is by a correlation with late life cognitive decline, the primary clinical manifestation of AD. Consistent with this idea, several studies have reported an association of higher educational attainment with reduced cognitive decline.5–23 However, this research is mostly based on change between two measurement points. Although this approach can provide an estimate of rate of change in cognitive function, it has a fundamental limitation: even with statistical adjustments, change in function between two time points is hard to securely distinguish from level of function at either point.24 This limitation is especially telling when the predictor of interest is highly correlated with the outcome as in the present case. Importantly, therefore, such studies are not well positioned to separate the estimate of education’s correlation with cognitive decline from its strong correlation with level of cognition. Assessment of cognition at three or more points in time permits separation of initial level of cognition from rate of change, but fewer of these studies have been published and their findings on the relation of higher educational attainment to cognitive decline have been mixed.12,17,19,21,25–28 Other factors may be contributing to this inconsistency. For example, education has been quantified in different ways (e.g., categorically vs continuously, linearly vs nonlinearly) and its association with cognitive decline may be modified by other variables (e.g., preexisting cognitive impairment, practice effects, race/ethnicity). In the present study, we test the hypothesis that higher level of education is associated with reduced rate of cognitive decline in old age using data from the Chicago Health and Aging Project, a longitudinal population-based study of aging and AD. Participants are more than 6,000 older African American and white residents of a community on the south side of Chicago. At approximately 3-year intervals for up to 14 years, they completed four brief tests of cognitive performance from which a previously established composite measure of global cognition was derived. We used mixed-effects models to characterize person-specific paths of cognitive change and to test the relation of education to initial level of cognition and annual rate of change. In subsequent analyses, we examined other socioeconomic indicators and tested whether the association of education with change in cognitive function was modified by race, cognitive impairment, or repeated exposure to the cognitive tests.

Cerebral Amyloid Angiopathy Pathology and Cognitive Domains in Older Persons

Abstract: Cerebral amyloid angiopathy (CAA) is common in older persons,1,2 and in a small number, particularly when severe, has been related to serious adverse neurological conditions, most commonly hemorrhage.3 CAA has also been implicated in dementia,4 infarcts,5 and more recently brain microbleeds.6 A general role for CAA in cognitive impairment in aging is controversial. Indeed, CAA has been related to one of the main causes of dementia, Alzheimer's disease (AD) pathology,7–9 yet little data are available on the relation of CAA to cognitive impairment, the principal clinical manifestation of AD.3,10–12 Further, we are not aware of any previously published study of the relation of CAA to different cognitive domains. A better understanding of the relation of common neuropathology such as CAA to a common and disabling condition of aging, cognitive impairment, may impact future research in aging. In this study, we tested the hypothesis that CAA pathology is associated with specific cognitive domains in older community-dwelling women and men, with and without dementia. We used data from the Religious Orders Study, an ongoing epidemiologic clinical-pathologic study of aging and dementia. In more than 400 autopsied persons, we describe characteristics of CAA data, including frequency and distribution of pathology, inter-relations of severity scores across brain regions, and associations with relevant variables, including AD pathology. We then examine associations of CAA severity with 5 different cognitive domains and global cognition proximate-to-death, in analyses controlling for AD pathology and other covariates.