Research Topics
| D R RoyallSummaryAffiliation: University of Texas Health Science Center Country: USA Publications
Research Grants
| Collaborators
|
Detail Information
Publications
Insular Alzheimer's disease pathology as a cause of "age-related" autonomic dysfunction and mortality in the non-demented elderlyDonald R Royall
Department of Psychiatry, South Texas Veterans Health System Audie L Murphy Division GRECC and the University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284 7792, United
Med Hypotheses 67:747-58. 2006..If true, then preclinical AD pathology should be considered as a possible explanation for arrhythmia/fall related morbidity and mortality in non-demented elderly persons...
Fortress brainDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, USA
Med Hypotheses 80:118-21. 2013..This suggests a defense in depth of a structure, the brain, that is inherently vulnerable to invasion along its neural networks...
The default mode network and related right hemisphere structures may be the key substrates of dementiaDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, USA
J Alzheimers Dis 32:467-78. 2012..The latent variable d localizes to elements of the default mode network and related structures in the R hemisphere...- Estimating the temporal evolution of Alzheimer's disease pathology with autopsy dataDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, USA
J Alzheimers Dis 32:23-32. 2012..The mediation effect of cognitive change on both AD lesion models effectively dates them within the period of cognitive surveillance. Additional analyses could lead to an improved understanding of lesion propagation in AD... - Modeling regional vulnerability to Alzheimer pathologyDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX 78284 7792, USA
Neurobiol Aging 33:1556-63. 2012..This is the first application of LGC models to spatially-ordered data. The result is a quantification of the interindividual variation in the interregional vulnerability to Alzheimer's disease lesions... - Validation of a latent variable representing the dementing processDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX 78229 3900, USA
J Alzheimers Dis 30:639-49. 2012..Our approach results in "error free" continuous variables. This suggests that δ can serve as a dementia specific endophenotype. As a result, future studies may be able to associate δ with inflammatory and genetic biomarkers... - Getting Past "g": testing a new model of dementing processes in persons without dementiaDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, USA
J Neuropsychiatry Clin Neurosci 24:37-46. 2012..These results have implications for the clinical assessment of dementia and suggest that functional status should assume a more important role... - Clock-drawing potentially mediates the effect of depression on mortality: replication in three cohortsDonald R Royall
Department of Psychiatry, The South Texas Veterans Health System Audie L Murphy Division GRECC and the University of Texas Health Science Center, San Antonio, TX, USA
Int J Geriatr Psychiatry 23:821-9. 2008..Previously studies have associated visuospatial tasks, particularly 'clock-drawing', with mortality. We sought to determine whether clock-drawing also mediates the association between depressive symptoms and mortality... - Normal rates of cognitive change in successful aging: the freedom house studyDonald R Royall
Department of Psychiatry, University of Texas Health Science Center, San Antonio 78284 7792, USA
J Int Neuropsychol Soc 11:899-909. 2005..Nonverbal measures appear to be particularly well suited for the prediction of age-related functional decline. These observations are relevant to the definition and diagnosis of "dementing" conditions... - Sertraline improves executive function in patients with vascular cognitive impairmentDonald R Royall
Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229 3900, USA
J Neuropsychiatry Clin Neurosci 21:445-54. 2009..Our findings suggest that sertraline may have both statistical and clinically meaningful effects on executive control function in ischemic cerebrovascular disease. The authors discuss the implications for future clinical trials... - Executive control mediates memory's association with change in instrumental activities of daily living: the Freedom House StudyDonald R Royall
Department of Psychiatry, South Texas Veterans Health System Audie L Murphy Division Geriatric Research, Education and Clinical Center, and the University of Texas Health Science Center, San Antonio, Texas 78284, USA
J Am Geriatr Soc 53:11-7. 2005..To assess the relative independent contribution of changes in executive control function (ECF) and memory to changes in functional status... - Prevalence and patterns of executive impairment in community dwelling Mexican Americans: results from the Hispanic EPESE StudyDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX 78284 7792, USA
Int J Geriatr Psychiatry 19:926-34. 2004..We have determined the prevalence of cognitive impairment and impaired ECF in a community dwelling Mexican American elderly population, and their associations with functional status... - Misclassification is likely in the assessment of mild cognitive impairmentDonald R Royall
Department of Psychiatry, South Texas Veterans Health System Audie L Murphy Division GRECC and University of Texas Health Science Center, San Antonio, TX 78284, USA
Neuroepidemiology 23:185-91. 2004..Isolated ECF impairment is not consistent with the natural history of preclinical Alzheimer's disease, suggests other conditions, and can be disabling, independently of age and/or memory loss... - Location, location, location!Donald R Royall
Division of Aging and Geriatric Psychiatry, The University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900, Mail Code 7792, United States
Neurobiol Aging 28:1481-2; discussion 1483. 2007 - Cognitive predictors of mortality in elderly retirees: results from the Freedom House studyDonald R Royall
Department of Psychiatry, South Texas Veterans Health System Audie L Murphy Division GRECC and the University of Texas Health Science Center, San Antonio, TX 78284 7792, USA
Am J Geriatr Psychiatry 15:243-51. 2007..The objective of this longitudinal cohort study was to study the cognitive domains associated with five-year longitudinal survival among healthy, well-educated, noninstitutionalized elderly... - Depression and mortality in elders referred for geriatric psychiatry consultationDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
J Am Med Dir Assoc 8:318-21. 2007..The association between depressive symptoms and mortality was assessed in a 7-year longitudinal follow-up of subjects referred for geropsychiatric consultation... - The cognitive correlates of functional status: a review from the Committee on Research of the American Neuropsychiatric AssociationDonald R Royall
Department of Psychiatry, UTHSCSA, 7703 Floyd Curl Drive, San Antonio, TX 78229 3900, USA
J Neuropsychiatry Clin Neurosci 19:249-65. 2007..Better integration of cognitive and functional assessments would offer greater clinical utility. However, psychometric batteries may have to be redesigned to maximize their capacity to capture the variance in functional outcomes... - Insular Alzheimer disease pathology and the psychometric correlates of mortalityDonald R Royall
Department of Psychiatry, South Texas Veterans Health System Audie L Murphy Division, Geriatric Research Education and Clinical Center, San Antonio, TX, USA
Cleve Clin J Med 75:S97-9. 2008..Thus, AD pathology should be considered as a possible explanation for autonomic morbidity and mortality in nondemented elderly persons... - Asymmetric insular function predicts positional blood pressure in nondemented elderlyDonald Royall
Department of Psychiatry, The University of Texas Health Science Center, 7703 Floyd Curl Dr, Mail Code 7792, San Antonio, TX 78229 3900, USA
J Neuropsychiatry Clin Neurosci 21:173-80. 2009..This subset had significantly increased positional drops in systolic blood pressure. While these data cannot address Alzheimer's disease as the specific cause, this possibility is being investigated in other cohorts... - Depressive symptoms predict longitudinal change in executive control but not memoryDonald R Royall
Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
Int J Geriatr Psychiatry 27:89-96. 2012..Depression in non-demented persons has been identified as a possible risk factor for incident Alzheimer's disease (AD)... - Executive control and the validity of survey dataDonald R Royall
Departments of Psychiatry Medicine and Pharmacology, The University of Texas Health Sciences Center at San Antonio, Texas 78229, USA
Int J Geriatr Psychiatry 19:696-8. 2004 - Frontal systems impairment in major depressionD R Royall
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78264 7792, USA
Semin Clin Neuropsychiatry 4:13-23. 1999..This should cause doctors to reconsider their approach to depression. Treatment for the cognitive aspects of depression may be needed to ensure improvement in functional domains... - Validation of a Spanish translation of the CLOX for use in Hispanic samples: the Hispanic EPESE studyDonald R Royall
Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284 7792, USA
Int J Geriatr Psychiatry 18:135-41. 2003..We investigated a Spanish language translation of CLOX: an executive CDT, in a community sample of Hispanic elders... - Decline in learning ability best predicts future dementia type: the Freedom House StudyDonald R Royall
Department of Psychiatry, University of Texas Health Science Center, San Antonio, Texas 78284 7792, USA
Exp Aging Res 29:385-406. 2003..Serial administrations of memory tests may help identify nondemented persons at greater or lesser risk for conversion to frank dementia in the near-term... - Executive dyscontrol in normal aging: normative data, factor structure, and clinical correlatesDonald R Royall
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284, USA
Curr Neurol Neurosci Rep 3:487-93. 2003..Moreover, associations with functional status should not be casually extrapolated from regional frontal clinical correlations, particularly with the dorsolateral prefrontal cortex... - CLOX: an executive clock drawing taskD R Royall
Department of Psychiatry, University of Texas, Health Science Center at San Antonio, 78284 7792, USA
J Neurol Neurosurg Psychiatry 64:588-94. 1998..To describe a clock drawing task (CLOX) designed to elicit executive impairment and discriminate it from non-executive constructional failure... - Declining executive control in normal aging predicts change in functional status: the Freedom House StudyDonald R Royall
Department of Psychiatry, South Texas Veterans Health System Audie L Murphy Division GRECC, and the University of Texas Health Science Center, San Antonio, Texas 78284, USA
J Am Geriatr Soc 52:346-52. 2004..To assess the contribution of executive control function (ECF) to functional status... - Frontal MRI findings associated with impairment on the Executive Interview (EXIT25)D R Royall
Departments of Psychiatry, Medicine, and Pharmacology, South Texas Veterans Health System, Geriatric Research, Education and Clinical Center GRECC, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
Exp Aging Res 27:293-308. 2001..This conclusion is consistent with earlier functional neuroimaging studies associating EXIT25 performance with left mesiofrontal perfusion... - Severe dysosmia is specifically associated with Alzheimer-like memory deficits in nondemented elderly retireesD R Royall
Department of Psychiatry, The Audie L Murphy VA Geriatric Research Education Clinical Center and University of Texas Health Science Center at San Antonio, Tex, 78229 3900, USA
Neuroepidemiology 21:68-73. 2002.... - Executive cognitive impairment: a novel perspective on dementiaD R Royall
Department of Psychiatry, South Texas Veterans Health System Audie L Murphy Division GRECC, San Antonio, TX, USA
Neuroepidemiology 19:293-9. 2000..The total number of dementia cases may be much greater than previously thought and we are likely to be selectively missing cases with reversible causes of ECF impairment... - Correlates of disability among elderly retirees with "subclinical" cognitive impairmentD R Royall
Department of Psychiatry, University of Texas Health Science Center, San Antonio 78284 7792, USA
J Gerontol A Biol Sci Med Sci 55:M541-6. 2000..We assessed the effects of impaired Executive Control Function (ECF) on Instrumental Activities of Daily Living (IADL) and level of care among noninstitutionalized elderly retirees with "subclinical" cognitive impairment... - Clock drawing is sensitive to executive control: a comparison of six methodsD R Royall
Department of Psychiatry, South Texas Veterans Health System Audie L Murphy Division GRECC, San Antonio, USA
J Gerontol B Psychol Sci Soc Sci 54:P328-33. 1999..68) and MMSE scores (R2 = .72). Clock drawing draws upon both executive and general cognitive resources. CLOX explains incrementally more variance in ECF than other CDTs... - Executive control function: a review of its promise and challenges for clinical research. A report from the Committee on Research of the American Neuropsychiatric AssociationDonald R Royall
The University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229 3900, USA
J Neuropsychiatry Clin Neurosci 14:377-405. 2002..The prevalence and severity of ECF deficits in many disorders remain to be determined, and treatment has been attempted in only a few disorders. Much more research in these areas is necessary... - Mexican-American ethnicity and cognitive function: findings from an elderly southwestern samplePeter L Heller
Departments of Neuropsychiatry and Behavioral Science, Texas Tech University Health Sciences Center, El Paso, TX, USA
J Neuropsychiatry Clin Neurosci 18:350-5. 2006..The authors conclude that a dependable and clinically meaningful negative association exists between Mexican-American ethnicity and late-life cognitive function in this region that is mediated by as yet unmeasured variables... - Relationship between white matter fractional anisotropy and other indices of cerebral health in normal aging: tract-based spatial statistics study of agingP Kochunov
Research Imaging Center, University of Texas Health Science Center at San Antonio, Research Imaging Center, 7703 Floyd Curl Drive, San Antonio, TX 78284, USA
Neuroimage 35:478-87. 2007..These data are consistent with the hypothesis that late-myelinating regions of the brain bear the brunt of age-related degenerative changes... - Loss of cerebral white matter structural integrity tracks the gray matter metabolic decline in normal agingP Kochunov
Research Imaging Center, University of Texas Health Science Center, San Antonio, 78284, USA
Neuroimage 45:17-28. 2009..Specifically, age-related WM degradation in the thinly myelinated association tracts appears to track the decreases in global and regional rates of glucose uptake... - Prevalence of executive impairment in patients seen by a psychiatry consultation serviceJason E Schillerstrom
Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
Psychosomatics 44:290-7. 2003..Because impairment of executive function has been specifically associated with behavioral and functional disability, routine assessment of executive function should be integrated into psychiatric case management... - Clock drawing phenotypes in community-dwelling African Americans and Caucasians: results from the University of Alabama at Birmingham study of agingJason E Schillerstrom
Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
Neuroepidemiology 28:175-80. 2007..The aim of this study was to describe the prevalence of these phenotypes in community-dwelling African American and Caucasian elders... - Prospective evaluation of pretreatment executive cognitive impairment and depression in patients referred for radiotherapyClifton D Fuller
Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
Int J Radiat Oncol Biol Phys 72:529-33. 2008.... - Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementiaGustavo C Roman
Department of Medicine Neurology, University of Texas HSC at San Antonio and the Audie Murphy Veterans Administration Hospital, Mail Code 7883, 7703 Floyd Curl Drive, San Antonio, TX 78229 3900, USA
J Neurol Sci 226:81-7. 2004..It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This category explicitly excludes isolated cognitive dysfunctions such as those mentioned above... - Depression, disability and intermediate pathways: a review of longitudinal studies in eldersJason E Schillerstrom
Department of Psychiatry The University of Texas Health Seience Center, San Antonio, TX 78229, USA
J Geriatr Psychiatry Neurol 21:183-97. 2008.... - Executive function in self-neglecting adult protective services referrals compared with elder psychiatric outpatientsJason E Schillerstrom
University of Texas Health Science Center at San Antonio, TX 78229, USA
Am J Geriatr Psychiatry 17:907-10. 2009.... - Missing data? Plan on it!Raymond F Palmer
Department of Family and Community Medicine, University of Texas Health Science Center, San Antonio, Texas 78284, USA
J Am Geriatr Soc 58:S343-8. 2010..How the purposeful planning of missing data in research designs can reduce subject burden, improve data quality and statistical power, and manage costs is then described... - An empiric approach to level of care determinations: the importance of executive measuresDonald R Royall
Department of Psychiatry, University of Texas Health Science, San Antonio, TX 78229-3900, USA
J Gerontol A Biol Sci Med Sci 60:1059-64. 2005..CONCLUSIONS: Executive control function appears to be most responsible for the effect of cognition on level of care. Young adult norms may be most relevant when the effects of cognitive impairment on functional status are assessed... - A diagnostic dilemma: is "Alzheimer's dementia" Alzheimer's disease, vascular dementia, or both?Gustavo C Roman
University of Texas Health Science Center at San Antonio and the Audie L Murphy Veterans Hospital, San Antonio, Texas, USA
Lancet Neurol 3:141. 2004 - Prevalence, course, and risk factors for executive impairment in patients hospitalized on a general medicine serviceJason E Schillerstrom
Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, USA
Psychosomatics 46:411-7. 2005..The prevalence of executive impairment on general medicine services is high. Although improvement in executive function occurs during hospitalization, many patients remained impaired... - The impact of medical illness on executive functionJason E Schillerstrom
Department of Psychiatry, University of Texas Health Science Center at San Antonio, TX 78229, and the Geriatric Research Education and Clinical Center, Audie L Murphy Division, South Texas Veterans Health Administration, USA
Psychosomatics 46:508-16. 2005..The changes in functional status associated with executive impairment as well as pathophysiology and treatment strategies are also discussed... - Pathological determinants of the transition to clinical dementia in Alzheimer's diseaseDonald R Royall
Departments of Psychiatry, Medicine, and Pharmacology, South Texas Veterans' Health System, Audie L. Murphy Division GRECC, University of Texas Health Science Center, San Antonio, Texas, USA
Exp Aging Res 28:143-62. 2002..A22, A23, and A39 provide major afferents to other frontal systems and have previously been implicated in very early clinical Alzheimer's disease... - Back to the future of mental capacity assessmentDonald R Royall
Department of Psychiatry, The Audie Murphy VA Geriatric Research, Education and Clinical Center, University of Texas Health Science Center, San Antonio, TX, USA
J Am Geriatr Soc 50:1884-5. 2002 - Executive function and capacity to consent to a noninvasive research protocolJason E Schillerstrom
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA
Am J Geriatr Psychiatry 15:159-62. 2007..This study measured the association between executive function and decision-making capacity in subjects consenting to a noninvasive research protocol... - Not all clock-drawing tasks are the sameDonald R Royall
J Am Geriatr Soc 50:1166-7. 2002 - Mild cognitive impairment and functional statusDonald R Royall
J Am Geriatr Soc 54:163-5. 2006 - Re: De Jager, CA, et al. Sensitivity and specificity of neuropsychological tests for mild cognitive impairment, vascular cognitive impairment and Alzheimer's diseaseDonald R Royall
Psychol Med 34:761-2. 2004 - Double jeopardyDonald R Royall
Chest 130:1636-8. 2006 - Pet peevesDonald R Royall
J Am Geriatr Soc 52:1218. 2004 - In regard to fuller et AlDonald R Royall
Int J Radiat Oncol Biol Phys 72:301. 2008 - Alzheimer disease as a vascular disorder: nosological evidenceDonald R Royall
Stroke 33:2147-8; author reply 2147-8. 2002 - Geriatric depression and chronic medical disease: another world of hurtDonald R Royall
J Am Geriatr Soc 50:969-70. 2002 - Slippery slopesDonald R Royall
J Gerontol A Biol Sci Med Sci 63:107; author reply 107-8. 2008 - Pathological determinants of dementia in Alzheimer's disease (AD)Donald R Royall
Exp Aging Res 29:107-10. 2003 - Donepezil's effects remain uncertainDonald R Royall
J Am Geriatr Soc 52:843-4; author reply 845-6. 2004 - The "subsyndromal" syndromes of agingDonald R Royall
J Am Geriatr Soc 52:463-5. 2004 - The new "silent" epidemicDonald R Royall
J Am Geriatr Soc 52:1212-3. 2004 - The emperor has no clothes: dementia treatment on the eve of the aging eraDonald R Royall
J Am Geriatr Soc 53:163-4. 2005 - Catie's lessonsDonald R Royall
J Am Geriatr Soc 55:636-7. 2007 - ECF impairment is commonDonald R Royall
Age Ageing 33:206-7; author reply 207. 2004 - Is disability required for dementia case-finding?Donald R Royall
Int J Geriatr Psychiatry 23:224-5. 2008
Research Grants
- Dyspraxia and Autonomic Control in Very Early ADDonald Royall; Fiscal Year: 2004..Some dementia treatments are known to reduce HRV, and possibly mortality as well. Alternatively, some psychotropics may increase arrhythmia-related mortality, possibly via a central mechanism. ..
- Insular AD Pathology and Autonomic FunctionDonald Royall; Fiscal Year: 2006..Autonomic dysfunction could provide a sensitive indicator of future AD dementia conversion risk, while interventions against supraventricular bradyarrhythmias may decrease mortality in the earlier stages of AD. ..
- VAS-COG 2007Donald Royall; Fiscal Year: 2007..Many vascular cognitive disorders are preventable and potentially reversible. VAS-COG will provide a forum in which information on these important conditions can be exchanged and disseminated. ..
- Insular Autonomic Function in DepressionDonald R Royall; Fiscal Year: 2010..Minorities may be disporportionately at risk. Moreover, insular dysfunction could explain recent reports of increased mortality in eldely patients receiving several types of psychotropic medications. ..