2006 T. Franklin Williams Scholar Recipients

Diana Kerwin, MD

“The Association Between Body Mass, Body Fat Distribution and Vascular Risk Factors on Functional MRI and Cognitive Performance in Postmenopausal Women”

Medical College of Wisconsin

Dr. Diana R. Kerwin is Assistant Professor of Medicine, in the Division of Geriatrics/Gerontology at the Medical College of Wisconsin, Milwaukee, Wisconsin. She obtained here medical doctorate from the Medical College of Wisconsin and completed residency training at Northwestern University Memorial Hospital in Chicago. She was named the John A Hartford Chief Resident for Geriatric Programs and completed fellowship training in geriatrics at Northwestern University Medical School. Dr. Kerwin is a board certified internist and geriatrician, specializing in the diagnosis and treatment of dementia as the clinic director of the Geriatric Memory Disorders Clinic. Dr. Kerwin is currently involved in the Women’s Health Initiative Memory Study, as well as several clinical trials investigating new therapies for dementia. Dr. Kerwin’s research focuses on identifying risk factors for dementia in women and is investigating the effects of body weight on cognition. Dr. Kerwin was awarded 2003 “Young Investigator Award” by the Alzheimer’s Association and the 2004 “Dr. Judith Stitt Faculty Scholar Award” by the Wisconsin Women’s Health Foundation for her work in identifying risk factors for Alzheimer disease in women.

Research Abstract

2006 T. Franklin Williams Scholar
Diana Kerwin, MD

Obesity has been suggested as a risk factor for Alzheimer disease in older women 1,2, and with poorer cognitive function in men 2 – 4 but not in women. 4,5 Obesity may be protective in women possibly related to endogenous estrogens. 6 – 9 A cross – sectional analysis of the Women’s Health Initiative (WHI) showed increasing body mass index (BMI) was associated with decreased cognitive scores and increasing abdominal girth appeared protective. It is not clear how obesity effects cognition and if the effects are direct or indirectly through vascular risk factors, inflammation, hormone levels or the presence of APOE4 genotype.

Objectives: To determine the relationship between obesity and cognitive function.

Hypothesis 1 : BMI effects recognition in postmenopausal women through 3 mechanisms that contribute to AD risk: 1) vascular risk factors and disease, 2) endogenous hormone levels 3) increased inflammation.

Hypothesis 2: The presence of APOE4 genotype will be associated with poorer cognitive function in women with vascular risk factors.

Design, Setting and Participants: This is a cross – sectional study of postmenopausal women, >65 years of age, enrolled at MCW in the Women’s Health Initiative Study of Cognitive Aging (WHISCA). Participants have completed an annual, standardized neuropsychological battery and health status questionnaire.

Methods: Obtain informed consent and measurements of blood pressure, weight, height, waist and hip circumference. Measurements of fasting lipids, glucose, homocysteine, CRP, IL – 1, IL – 6, estradiol and APOE4 genotype.

Analysis: Differences in baseline demographic and clinical factors, grouped by BMI will be assessed using chi – squared and analyses of variance. Correlation coefficients and multivariate analysis will be used to determine the relationship between domain – specific cognitive function, BMI, waist – hip ratio, vascular risk and inflammatory markers, estradiol and APOE4.

Significance : This study will determine domain – specific cognitive effects of body weight in older women, the effect of vascular risk factors, inflammatory markers, endogenous hormones and the effect of APOE4 status.

 

The recipient, selected by an academic selection committee composed of nationally prominent academic physicians, will receive a $75,000 grant over a two-year period. The award must be matched by support (either from the applicant’s home institution or a grant-making agency) that provides for 75% protected time for research. Research findings are presented at the American Geriatrics Society Annual Scientific Meeting at the conclusion of the recipient’s grant.

 

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