…In her research, she focuses on the characterization and early identification of Alzheimer’s disease and dementia with Lewy bodies, as well as the reduction of health-care disparities in minority elders. Dr. Tsuang is concerned that the pandemic is widening digital health-care divides between white and minority Americans, which may increase race-related mental and cognitive health disparities. She is working to address these disparities using mobile-health tools and machine-learning methods.

In a study funded by the UW Garvey Institute for Brain Health Solutions, Dr. Tsuang is comparing pen-and-paper, telephone, online, and mobile-health assessment methods to identify the most effective, feasible, and participant-preferred way(s) of remotely assessing cognitive and mental health symptoms in older black Americans. Dr. Tsuang anticipates enrolling 9 participants by the end of May.

Dr. Tsuang has also applied National Institutes of Health (NIH)-funded machine-learning methods in VA’s electronic health-record system to identify individuals who are at high risk for developing dementia. In this work, she has found differences in health risk factors between white and black Americans, higher rates of underdiagnosis for blacks, and evidence that this method can establish risk scores to improve the diagnosis of dementia in black Americans. She is preparing an R01 submission with SIBCR’s assistance to validate the model, perform related focus groups in blacks, and explore future implementation of a dementia-identification workflow in primary-care settings. Her goal is to improve the diagnosis and delivery of cognitive and mental health services in ethnic-minority elders.

Dr. Tsuang’s work is funded by the UW, NIH, and VISN-20/GRECC Clinical Demonstration Projects

….where she studied mechanisms of blood-brain barrier dysfunction in Alzheimer’s disease. Shelly then completed her postdoctoral fellowship under the mentorship of Dr. Kelly Jordan-Sciutto, PhD, and Reynold Panettieri, MD, at the University of Pennsylvania. Her studies focused on neuroinfl ammatory responses to HIV infection, glutamate excitotoxicity, and environmental toxicants. During her postdoctoral training, Shelly was awarded a 2-year T32 fellowship and a 1-year F32 fellowship from NIEHS to study mechanisms by which air pollution contributes to brain dysfunction. Shelly began her current position at the VA in June of 2016. Her long-term research goals aim to characterize novel aspects of communication between the brain and the immune system, with a particular focus on how the blood-brain barrier regulates neuroimmune communication in health and in pathological states that are considered to be risk factors for Alzheimer’s disease. Shelly’s current work focuses on serum amyloid A (SAA), which is a protein that is produced in high quantities by the liver and secreted into blood following acute infl ammatory stimuli, and is also elevated in chronic infl ammatory diseases. Shelly and her collaborators have recently shown that SAA can cross the intact blood brain barrier, suggesting that there is a transporter that facilitates the entry of circulating SAA into the brain. Further, SAA can inhibit the clearance of Alzheimer’s disease-associated proteins from the brain, which suggests that SAA overproduction during infl ammation could contribute to Alzheimer’s disease progression. Shelly is currently the principal investigator on an ADRC Junior Investigator pilot project award which aims to assess the causal role of SAA in AD. She is also the principal investigator on an R21 from NIEHS which aims to investigate SAA as a mediator of communication in the lung-liver-brain axis following ozone exposure. Ozone is a widespread component of air pollution, and ozone exposure has been linked to cognitive decline and Alzhiemer’s disease in human epidemiological studies. However, the mechanisms by which ozone causes neurological dysfunction are unknown. Using a mouse model of whole body ozone exposure, Shelly’s future work will characterize cognitive and neurobehavioral defi cits that are caused by acute and chronic ozone exposure paradigms, and the associations of behavioral outcomes with SAA overproduction. By developing a better understanding of how environmental factors contribute to CNS dysfunction from a systemic perspective, Dr. Erickson hopes to identify novel therapeutic targets for the prevention and treatment of age-associated cognitive decline and dementia.