Suzanne Craft

Summary

Publications

  1. pmc Intranasal insulin therapy for Alzheimer disease and amnestic mild cognitive impairment: a pilot clinical trial
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, S 182, Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA
    Arch Neurol 69:29-38. 2012
  2. ncbi Insulin and Alzheimer's disease: untangling the web
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
    J Alzheimers Dis 33:S263-75. 2013
  3. pmc Intranasal insulin administration dose-dependently modulates verbal memory and plasma amyloid-beta in memory-impaired older adults
    Mark A Reger
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA
    J Alzheimers Dis 13:323-31. 2008
  4. ncbi Preserved cognition in patients with early Alzheimer disease and amnestic mild cognitive impairment during treatment with rosiglitazone: a preliminary study
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center, Research and Development Service, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA
    Am J Geriatr Psychiatry 13:950-8. 2005
  5. pmc Aerobic exercise improves cognition for older adults with glucose intolerance, a risk factor for Alzheimer's disease
    Laura D Baker
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
    J Alzheimers Dis 22:569-79. 2010
  6. doi Sex and ApoE genotype differences in treatment response to two doses of intranasal insulin in adults with mild cognitive impairment or Alzheimer's disease
    Amy Claxton
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
    J Alzheimers Dis 35:789-97. 2013
  7. pmc Cognitive response to estradiol in postmenopausal women is modified by high cortisol
    Laura D Baker
    Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
    Neurobiol Aging 33:829.e9-20. 2012
  8. pmc Effect of apolipoprotein E genotype and diet on apolipoprotein E lipidation and amyloid peptides: randomized clinical trial
    Angela J Hanson
    Geriatric Research, Veterans Affairs Puget Sound Health Care System, University of Washington School of Medicine, Seattle, Washington, USA
    JAMA Neurol 70:972-80. 2013
  9. pmc Effects of insulin and octreotide on memory and growth hormone in Alzheimer's disease
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center, VA Puget Sound Healthcare System, Seattle, WA, USA
    J Alzheimers Dis 18:595-602. 2009
  10. ncbi Insulin effects on CSF norepinephrine and cognition in Alzheimer's disease
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center GRECC, Veterans Affairs Puget Sound Health Care System, and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98108 1532, USA
    Neurobiol Aging 27:38-41. 2006

Collaborators

Detail Information

Publications47

  1. pmc Intranasal insulin therapy for Alzheimer disease and amnestic mild cognitive impairment: a pilot clinical trial
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, S 182, Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA
    Arch Neurol 69:29-38. 2012
    ..To examine the effects of intranasal insulin administration on cognition, function, cerebral glucose metabolism, and cerebrospinal fluid biomarkers in adults with amnestic mild cognitive impairment or Alzheimer disease (AD)...
  2. ncbi Insulin and Alzheimer's disease: untangling the web
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
    J Alzheimers Dis 33:S263-75. 2013
    ..Finally, we will discuss the implications of this area for AD therapeutics and prevention...
  3. pmc Intranasal insulin administration dose-dependently modulates verbal memory and plasma amyloid-beta in memory-impaired older adults
    Mark A Reger
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA
    J Alzheimers Dis 13:323-31. 2008
    ..These findings suggest that groups with different genetic risks for AD may show differential dose-response curves following intranasal insulin administration...
  4. ncbi Preserved cognition in patients with early Alzheimer disease and amnestic mild cognitive impairment during treatment with rosiglitazone: a preliminary study
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center, Research and Development Service, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA
    Am J Geriatr Psychiatry 13:950-8. 2005
    ..Authors evaluated the effects of the PPAR-gamma agonist rosiglitazone on cognition and plasma levels of the APP derivative beta-amyloid (Abeta) in humans...
  5. pmc Aerobic exercise improves cognition for older adults with glucose intolerance, a risk factor for Alzheimer's disease
    Laura D Baker
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
    J Alzheimers Dis 22:569-79. 2010
    ..Although replication in a larger sample is needed, our findings potentially have important therapeutic implications for a growing number of adults at increased risk of cognitive decline...
  6. doi Sex and ApoE genotype differences in treatment response to two doses of intranasal insulin in adults with mild cognitive impairment or Alzheimer's disease
    Amy Claxton
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
    J Alzheimers Dis 35:789-97. 2013
    ..Unlike previous studies with young adults, neither men nor women taking intranasal insulin exhibited a significant change in weight over 4 months of treatment...
  7. pmc Cognitive response to estradiol in postmenopausal women is modified by high cortisol
    Laura D Baker
    Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
    Neurobiol Aging 33:829.e9-20. 2012
    ..Our findings indicate that cognitive and physiological responses to estradiol are adversely affected by elevated stress hormone levels of cortisol in healthy postmenopausal women...
  8. pmc Effect of apolipoprotein E genotype and diet on apolipoprotein E lipidation and amyloid peptides: randomized clinical trial
    Angela J Hanson
    Geriatric Research, Veterans Affairs Puget Sound Health Care System, University of Washington School of Medicine, Seattle, Washington, USA
    JAMA Neurol 70:972-80. 2013
    ..Lipid-depleted (LD) apolipoproteins are less effective at binding and clearing Aβ, and LD Aβ peptides are more toxic to neurons. However, not much is known about the lipid states of these proteins in human cerebrospinal fluid...
  9. pmc Effects of insulin and octreotide on memory and growth hormone in Alzheimer's disease
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center, VA Puget Sound Healthcare System, Seattle, WA, USA
    J Alzheimers Dis 18:595-602. 2009
    ..0299). Thus, insulin and octreotide appear to regulate memory in older adults. APOE epsilon4 genotype modulates responses to insulin and octreotide. Finally, insulin may regulate GH levels during euglycemia...
  10. ncbi Insulin effects on CSF norepinephrine and cognition in Alzheimer's disease
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center GRECC, Veterans Affairs Puget Sound Health Care System, and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98108 1532, USA
    Neurobiol Aging 27:38-41. 2006
    ..These findings demonstrate that raising peripheral insulin levels can modulate CNS NE levels and suggest that insulin-stimulated increases in NE may modulate cognitive functions...
  11. pmc Statin users without an APOE-epsilon4 allele have increased insulin resistance
    Brian T Vanfossen
    GRECC, VA Puget Sound Health Care System, Seattle, WA 98108, USA
    J Alzheimers Dis 19:1149-53. 2010
    ..0169), and with non-users who were epsilon4- (p=0.0003) or epsilon4+ (p=0.0006). These results suggest that statin use may modulate insulin levels for individuals without an APOE epsilon4 allele...
  12. pmc Effects of aerobic exercise on mild cognitive impairment: a controlled trial
    Laura D Baker
    Departments of Psychiatry and BehavioralScience, University of Washington School of Medicine, Seattle, Washington, USA
    Arch Neurol 67:71-9. 2010
    ..To examine the effects of aerobic exercise on cognition and other biomarkers associated with Alzheimer disease pathology for older adults with mild cognitive impairment, and assess the role of sex as a predictor of response...
  13. pmc Insulin and sex interactions in older adults with mild cognitive impairment
    Brenna Cholerton
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98493, USA
    J Alzheimers Dis 31:401-10. 2012
    ..Future research will help determine whether insulin dysregulation results in differential effects on vascular function and AD pathology as a function of sex and/or APOE genotype...
  14. doi Neuropathology in the adult changes in thought study: a review
    Joshua A Sonnen
    Department of Pathology, University of Washington, Seattle, WA 98104 2420, USA
    J Alzheimers Dis 18:703-11. 2009
    ..This study examines correlations between clinical characteristics including extensive, longitudinal medication histories, and longitudinal cognitive testing against structural and biochemical features of disease...
  15. pmc Different patterns of cerebral injury in dementia with or without diabetes
    Joshua A Sonnen
    Department of Pathology, University of Washington, Seattle, USA
    Arch Neurol 66:315-22. 2009
    ..Diabetes mellitus (DM) increases the risk of dementia in the elderly. However, its underlying mechanisms, its connection with Alzheimer disease and vascular cognitive impairment, and effects of therapy remain unclear...
  16. doi Glucose levels and risk of dementia
    Paul K Crane
    Department of Medicine, University of Washington, Seattle, WA, USA
    N Engl J Med 369:540-8. 2013
    ..Diabetes is a risk factor for dementia. It is unknown whether higher glucose levels increase the risk of dementia in people without diabetes...
  17. pmc Diet intervention and cerebrospinal fluid biomarkers in amnestic mild cognitive impairment
    Jennifer L Bayer-Carter
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108, USA
    Arch Neurol 68:743-52. 2011
    ....
  18. ncbi Effects of chronic glucocorticoid administration on insulin-degrading enzyme and amyloid-beta peptide in the aged macaque
    J Jacob Kulstad
    Geriatric Research, Education, and Clinical Center, Veteran s Affairs Puget Sound Health Care System, Seattle, Washington 98108, USA
    J Neuropathol Exp Neurol 64:139-46. 2005
    ..These findings support the notion that glucocorticoids regulate IDE and provide a mechanism whereby increased glucocorticoid levels may contribute to AD pathology...
  19. ncbi Insulin dose-response effects on memory and plasma amyloid precursor protein in Alzheimer's disease: interactions with apolipoprotein E genotype
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, Veteran Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA
    Psychoneuroendocrinology 28:809-22. 2003
    ....
  20. pmc High-intensity physical activity modulates diet effects on cerebrospinal amyloid-β levels in normal aging and mild cognitive impairment
    Laura D Baker
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA
    J Alzheimers Dis 28:137-46. 2012
    ..Exercise may thus interact with diet to alter pathological processes that ultimately modify risk of Alzheimer's disease...
  21. ncbi Hyperinsulinemia provokes synchronous increases in central inflammation and beta-amyloid in normal adults
    Mark A Fishel
    Department of Neurology, University of Washington, Seattle, WA 98108, USA
    Arch Neurol 62:1539-44. 2005
    ..Hyperinsulinemia induces inflammation and is a risk factor for Alzheimer disease. Thus, insulin abnormalities may contribute to Alzheimer disease pathophysiology through effects on the inflammatory network...
  22. pmc Insulin resistance and Alzheimer-like reductions in regional cerebral glucose metabolism for cognitively normal adults with prediabetes or early type 2 diabetes
    Laura D Baker
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
    Arch Neurol 68:51-7. 2011
    ....
  23. ncbi Salivary cortisol and memory function in human aging
    Ge Li
    Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
    Neurobiol Aging 27:1705-14. 2006
    ..Previous studies have suggested that elevated glucocorticoid concentrations alter hippocampal neuronal morphology, inhibit neurogenesis, and impair cognition...
  24. pmc Session III: Mechanisms of age-related cognitive change and targets for intervention: inflammatory, oxidative, and metabolic processes
    Suzanne Craft
    Department of Psychiatry and Behavioral Sciences, University of Washington, Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound, Seattle, USA
    J Gerontol A Biol Sci Med Sci 67:754-9. 2012
    ..These presentations emphasize advances in our understanding of mechanisms and modifiers of age-related cognitive decline and provide insights into potential targets to promote cognitive health in older adults...
  25. pmc Peripheral amyloid-beta levels regulate amyloid-beta clearance from the central nervous system
    Marcos A Marques
    Geriatric Research, Education, and Clinical Center, Seattle, WA, USA
    J Alzheimers Dis 16:325-9. 2009
    ..We found that elevating peripheral Abetalevels significantly decreased [125I]-Abeta(1-40) brain clearance, thus supporting the hypothesis that peripheral Abeta levels regulate Abeta clearance from the central nervous system...
  26. pmc Effects of varying diagnostic criteria on prevalence of mild cognitive impairment in a community based sample
    Emily H Trittschuh
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
    J Alzheimers Dis 25:163-73. 2011
    ..Longitudinal follow-up will determine whether varying diagnostic criteria improves sensitivity and specificity of the MCI diagnosis as a predictor for dementia...
  27. pmc Neuropathologic correlates of cognition in a population-based sample
    Brenna Cholerton
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, 9600 Veterans Drive SW, Tacoma, WA 98493, USA
    J Alzheimers Dis 36:699-709. 2013
    ..These findings underscore that cognitive impairment is a complex convergent trait that has important implications for clinical investigation and medical management of older adults. ..
  28. ncbi Modulation of memory by insulin and glucose: neuropsychological observations in Alzheimer's disease
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Medical Center, 1660 South Columbian Way, Seattle, WA 98108, USA
    Eur J Pharmacol 490:97-113. 2004
    ..Collectively, these findings support an association among Alzheimer's disease, impaired glucose metabolism, and reduced insulin sensitivity...
  29. ncbi Pathological correlates of dementia in a longitudinal, population-based sample of aging
    Joshua A Sonnen
    Department of Pathology, University of Washington, Seattle, WA, USA
    Ann Neurol 62:406-13. 2007
    ..Our goal was to determine the independent pathological correlates associated with dementia in a typical US population...
  30. ncbi Intranasal insulin administration: a method for dissociating central and peripheral effects of insulin
    Mark A Reger
    Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, University of Washington School of Medicine, Seattle, Washington 98108, USA
    Drugs Today (Barc) 42:729-39. 2006
    ..Furthermore, intranasal insulin administration may offer a novel treatment strategy for disorders associated with central insulin abnormalities, such as diabetes and neurodegenerative diseases...
  31. ncbi Insulin resistance syndrome and Alzheimer's disease: age- and obesity-related effects on memory, amyloid, and inflammation
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98108, USA
    Neurobiol Aging 26:65-9. 2005
    ..This constellation of events may have deleterious effects on memory. Treatments focused on preventing or correcting insulin abnormalities may be of therapeutic benefit for adults with age-related memory impairment and AD...
  32. ncbi Effects of exercise and nutrition on memory in Japanese Americans with impaired glucose tolerance
    G Stennis Watson
    Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, Washington 98108, USA
    Diabetes Care 29:135-6. 2006
  33. ncbi The relationship between neuropsychological functioning and driving ability in dementia: a meta-analysis
    Mark A Reger
    Geriatric Research, Education, and Clinical Center GRECC, Veterans Affairs Puget Sound Health Care System VAPSHCS, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, WA, USA
    Neuropsychology 18:85-93. 2004
    ..Other effects were small or nonsignificant. Implications for basing driving recommendations on neuropsychological testing are discussed...
  34. pmc CSF Aβ(42) and tau in Parkinson's disease with cognitive impairment
    Thomas J Montine
    Department of Pathology, University of Washington School of Medicine, Seattle, Washington 98104, USA
    Mov Disord 25:2682-5. 2010
    ..01), whereas average CSF T-tau and P181-tau were unchanged or decreased. One-third of PD-CIND and one-half of PD-D patients had the biomarker signature of AD. Abnormal metabolism of Aβ(42) may be a common feature of PD-CIND and PD-D...
  35. ncbi Insulin resistance, inflammation, and cognition in Alzheimer's Disease: lessons for multiple sclerosis
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98108, USA
    J Neurol Sci 245:21-33. 2006
    ..Ongoing studies will determine whether thiazolidinediones improve cognitive functioning for patients with type 2 diabetes or Alzheimer's disease. Future studies are needed to examine the effects of thiazolidinediones on patients with MS...
  36. pmc Growth hormone-releasing hormone effects on brain γ-aminobutyric acid levels in mild cognitive impairment and healthy aging
    Seth D Friedman
    Department of Radiology, Seattle Children s Hospital, Seattle, Washington 98105, USA
    JAMA Neurol 70:883-90. 2013
    ..Growth hormone-releasing hormone (GHRH) has been previously shown to have cognition-enhancing effects. The role of neurotransmitter changes, measured by proton magnetic resonance spectroscopy, may inform the mechanisms for this response...
  37. pmc Apolipoprotein C-I is an APOE genotype-dependent suppressor of glial activation
    Eiron Cudaback
    Department of Pathology, University of Washington, Seattle, WA 98104, USA
    J Neuroinflammation 9:192. 2012
    ..Here we tested the hypothesis that APOE-genotype dependent innate immunomodulation may be mediated in part by apoC-I...
  38. ncbi The role of insulin resistance in the pathogenesis of Alzheimer's disease: implications for treatment
    G Stennis Watson
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
    CNS Drugs 17:27-45. 2003
    ..Based on this evidence, we propose that treatment of insulin resistance may reduce the risk or retard the development of Alzheimer's disease...
  39. doi Beneficial effect of a weight-stable, low-fat/low-saturated fat/low-glycaemic index diet to reduce liver fat in older subjects
    Kristina M Utzschneider
    Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System, Seattle, WA 98108, USA
    Br J Nutr 109:1096-104. 2013
    ..HSAT diet was a predictor of changes in lipid parameters but not liver fat. We conclude that diet composition may be an important factor in the accumulation of liver fat, with a low-fat/low-saturated fat/LGI diet being beneficial...
  40. ncbi 17beta-estradiol reduces plasma Abeta40 for HRT-naïve postmenopausal women with Alzheimer disease: a preliminary study
    Laura D Baker
    Geriatric Research, Education, and Clinical Center, the VA Puget Sound Health Care System, Seattle Tacoma, WA, USA
    Am J Geriatr Psychiatry 11:239-44. 2003
    ..The authors evaluated the effects of estrogen administration on plasma concentration of one by-product of APP processing, Abeta40, for postmenopausal women with AD...
  41. pmc The role of metabolic disorders in Alzheimer disease and vascular dementia: two roads converged
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, 98108, USA
    Arch Neurol 66:300-5. 2009
    ..Identification of such convergent factors will not only provide important insight into the causes and interdependencies of late-life dementias but will also inspire novel strategies for treating and preventing these disorders...
  42. ncbi Insulin resistance and Alzheimer's disease pathogenesis: potential mechanisms and implications for treatment
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
    Curr Alzheimer Res 4:147-52. 2007
    ..These convergent effects may impair memory and induce AD pathology. Therapeutic strategies focused on preventing or correcting insulin abnormalities may thus benefit a subset of adults with age-related memory impairment and AD...
  43. doi Insulin, cognition, and dementia
    Brenna Cholerton
    Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
    Eur J Pharmacol 719:170-9. 2013
    ....
  44. ncbi Insulin and neurodegenerative disease: shared and specific mechanisms
    Suzanne Craft
    Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Medical Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, 98108, USA
    Lancet Neurol 3:169-78. 2004
    ..We conclude by considering whether insulin dysregulation contributes to neurodegenerative disorders through disease-specific or general mechanisms...
  45. pmc Reduced hippocampal insulin-degrading enzyme in late-onset Alzheimer's disease is associated with the apolipoprotein E-epsilon4 allele
    David G Cook
    Geriatric Research, Education, and Clinical Center, Veteran Affairs Puget Sound Health Care System, Seattle, Washington 98108, USA
    Am J Pathol 162:313-9. 2003
    ..These findings show that reduced IDE expression is associated with a significant risk factor for AD and suggest that IDE may interact with APOE status to affect Abeta metabolism...
  46. ncbi Cognitive changes associated with supplementation of testosterone or dihydrotestosterone in mildly hypogonadal men: a preliminary report
    Monique M Cherrier
    Department of Psychiatry and Behavioral Sciences, University of Washington Medical School, Seattle, Washington 98108, USA
    J Androl 24:568-76. 2003
    ..Further, our results suggest that aromatization of T to E(2) may regulate verbal memory in men, whereas nonaromatizable androgens may regulate spatial memory...
  47. ncbi Insulin resistance syndrome and Alzheimer disease: pathophysiologic mechanisms and therapeutic implications
    Suzanne Craft
    Department of Psychiatry and Behavioral Sciences, Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, University of Washington School of Medicine, Seattle, WA 98108, USA
    Alzheimer Dis Assoc Disord 20:298-301. 2006
    ..These convergent effects may impair memory and induce AD pathology. Therapeutic strategies focused on preventing or correcting insulin abnormalities may thus benefit adults with age-related memory impairment and AD...