I am a practicing clinical neuropsychologist with dual appointments in the Departments of Neurology at Brigham and Women’s Hospital (BWH) and Massachusetts General Hospital (MGH). I am also the Co-Director of the Center for Alzheimer Research and Treatment (CART) at BWH, the Clinical Core Lead of the Harvard Aging Brain Study and the Director of the Neuropsychology as well as the Outreach, Recruitment and Engagement Core of the Massachusetts Alzheimer’s Disease Research Center at MGH. I have published over 100 peer-reviewed manuscripts in the area of normal aging and the early detection of cognitive decline in normal older adults who have biomarker evidence of preclinical Alzheimer’s Disease (AD).
I have been involved in the clinical assessment of patients and the supervision of clinical fellows in the Division of Cognitive and Behavioral Neurology at BWH for over 24 years. My specialty is in geriatric neuropsychology and the evaluation of high functioning elders. As a result, physicians have referred patients to me from all over the world.
Over the course of my career, I have had the wonderful opportunity to collaborate with colleagues such as Reisa Sperling MD, Keith Johnson MD and Kirk Daffner MD. They recognized my unique expertise that allowed me to make several distinct contributions to the fields of normal aging and AD. These contributions have had clinical relevance as well as shaped cognitive outcome measures in current AD prevention trials.
The first major contribution was furthering the understanding of cognitive reserve and the development of an IQ-Adjusted Method (Rentz et al 2004; 2007) for assessing cognition in patients with a high ability level. This method allows for the detection of early cognitive impairments that would otherwise go undetected using standard neuropsychological normative data, thus obscuring early diagnosis and treatment. Understanding the influence of cognitive reserve in preclinical AD (Rentz et al, 2010; 2017) has also had important implications for decisions regarding treatment effects in AD Prevention Trials.
The second contribution has been the development of sensitive cognitive tests (Face Name Associative Memory Exam, FNAME) and cognitive composites (Primary Alzheimer Cognitive Composite, PACC) as outcome measures for AD Prevention Trials. Tackling how to measure cognitive change in otherwise, cognitively normal older adults has been a major conundrum in the AD field. I have had the privilege of guiding the discussion about clinically sensitive cognitive tests and the value of combining these assessments within a clinical composite for the first ever Prevention Trial in AD. Over the past few years, with the help of talented junior faculty, we have determined that these cognitive composites are sensitive to decline in biomarker positive individuals (Mormino, E et al 2015; 2016; 2017 and Papp KV et al 2014; 2015; 2016; 2017). I have also had the privilege of exploring Subjective Cognitive Decline (SCD) as a patient-oriented outcome measure (Amariglio RE et al 2015; 2016; 2017); have acted as a leader in an International Working Group and have been an invited speaker on this subject at international conferences.
The third major contribution has been the use of computerized technology to administer cognitive tests for use in clinical trials and exploring the feasibility of performing these tests in the home environment when individuals cannot come to the clinic (Rentz et al 2016; 2017). I am currently working on the development of digital pen technology for detecting deficits in cognitive processing and decision-making that may be sensitive to early cognitive decline in neurodegenerative diseases. I have begun to partner with PCP and geriatric practices, with the help of two BWH behavioral neurologists and the Alzheimer’s Association, to develop a lecture series and to determine the usefulness of digital technology for conducting easy to administer cognitive tests in the PCP environment for dementia assessment.
In the past 2 years, I have had the privilege of developing a Community Service Outreach Initiative that provides education about Alzheimer’s disease and clinical trials in underserved Black and Hispanic communities in the Boston area. We have partnered with the NAACP Health Committee, Religious Leaders and State Representatives and are making efforts to reduce disparities in health care and increase opportunities for clinical trial participation.
Finally, and most importantly, I have had the privilege of mentoring and training the next generation of neuropsychologists for both clinical practice and clinical research. Several of these trainees have gone on to join the faculty at Harvard (Pam Friedman PsyD, Meghan Searl PhD, Kim Wilmett PhD), and two have received NIA K23 and Alzheimer’s Association awards as well as promotions to Assistant Professor (Rebecca Amariglio, PhD and Kathryn Papp, PhD). One research trainee (Elizabeth Mormino, PhD) has been asked to join the faculty of Stanford University and to head their research efforts in normal aging and preclinical Alzheimer’s disease. The privilege of mentoring these remarkable women and observing their growing reputation in the national and international arena will always be my most treasured legacy.