Nun Study Research Articles

Neuropathologic Changes of Alzheimer's Disease and Related Dementias: Relevance to Future Prevention.

Decedents with late-life dementia are often found at autopsy to have vascular pathology, cortical Lewy bodies, hippocampal sclerosis, and/or TDP-43 encephalopathy alone or with concurrent Alzheimer's disease (AD) lesions. Nonetheless, it is commonly believed that AD neuropathologic changes (NC) are the dominant or exclusive drivers of late-life dementia. Assess associations of end-of-life cognitive impairment with any one or any combination of five distinct NC. Assess impairment prevalence among subjects having natural resistance to each type of NC. Brains from 1,040 autopsied participants of the Honolulu-Asia Study, the Nun Study, and the 90 + Study were examined for NC of AD, Lewy body dementia, microvascular brain injury, hippocampal sclerosis, and limbic predominate TDP-43 encephalopathy. Associations with impairment were assessed for each NC and for NC polymorbidity (variable combinations of 2-5 concurrent NC). Among 387 autopsied decedents with severe cognitive impairment, 20.4% had only AD lesions (ADNC), 25.3% had ADNC plus 1 other NC, 11.1% had ADNC plus 2 or more other NC, 28.7% had no ADNC but 1-4 other NC, and 14.5% had no/negligible NC. Combinations of any two, three, or four NC were highly frequent among the impaired. Natural resistance to ADNC or any other single NC had a modest impact on overall cohort impairment levels. Polymorbidity involving 1-5 types of concurrent NC is a dominant neuropathologic feature of AD and related dementias. This represents a daunting challenge to future prevention and could explain failures of prior preventive intervention trials and of efforts to identify risk factors.

Evaluation of the natural history of disease by combining incident and prevalent cohorts: application to the Nun Study.

The Nun study is a well-known longitudinal epidemiology study of aging and dementia that recruited elderly nuns who were not yet diagnosed with dementia (i.e., incident cohort) and who had dementia prior to entry (i.e., prevalent cohort). In such a natural history of disease study, multistate modeling of the combined data from both incident and prevalent cohorts is desirable to improve the efficiency of inference. While important, the multistate modeling approaches for the combined data have been scarcely used in practice because prevalent samples do not provide the exact date of disease onset and do not represent the target population due to left-truncation. In this paper, we demonstrate how to adequately combine both incident and prevalent cohorts to examine risk factors for every possible transition in studying the natural history of dementia. We adapt a four-state nonhomogeneous Markov model to characterize all transitions between different clinical stages, including plausible reversible transitions. The estimating procedure using the combined data leads to efficiency gains for every transition compared to those from the incident cohort data only.

The Association Between Emotional Expressivity in Autobiographies from Early Adulthood and the Risk of Dementia in the Context of Written Language Skills.

Risk factors for dementia, such as Alzheimer's disease, are complex and span a lifetime. Exploring novel factors, such as characteristics of writing, may provide insight into dementia risk. To investigate the association between emotional expressivity and risk of dementia in the context of a previously identified risk factor, written language skills. The Nun Study recruited 678 religious sisters aged 75 + years. Of these, 149 U.S.-born participants had archived autobiographies handwritten at a mean age of 22 years. The autobiographies were scored for frequency of emotion word usage and language skills (e.g., idea density). The association of emotional expressivity and a four-level composite variable (combining high/low emotional expressivity and high/low idea density) with dementia was assessed using logistic regression models adjusted for age, education, and apolipoprotein E. Within the composite variable, odds of dementia increased incrementally, with opposing effects of emotional expressivity across the two idea density levels. Compared to the referent category (low emotional expressivity/high idea density), the risk of dementia increased in those with high emotional expressivity/high idea density (OR = 2.73, 95% CI = 1.05-7.08), while those with low emotional expressivity/low idea density had the highest risk (OR = 18.58, 95% CI = 4.01-86.09). Dementia risk is better captured by inclusion of multiple measures relating to characteristics of writing. Emotional expressivity may be protective when individuals are at increased risk due to poor written language skills (i.e., low idea density), but detrimental when not at risk (i.e., high idea density). Our findings indicate that emotional expressivity is a contextually-dependent novel risk factor for dementia.

Positive impact of cognitive reserve on the dynamics of selected cognitive functions in a 3-month follow-up of adult Poles

https://orcid.org/0000-0003-3383-0353 Introduction: David Snowden’s 25-year longitudinal Nun Study has contributed to the ongoing interest in the relationship between cognitive reserve and cognitive performance in adults. The term “cognitive reserve” refers to the capital of knowledge and skills. Greater cognitive reserve accounts for good baseline cognitive status of adults and may translate into successful aging. Therefore, research was undertaken to assess the role of cognitive reserve and age in shaping the results of tests assessing cognitive functions and self-report methods. Methods: The study was conducted among adult Poles (N = 80) and involved two measurements (at baseline and after 3 months). The cognitive reserve index included self-report data on past and present involvement in various areas of life, years of occupational activity, level of formal education and occupational status. Each of these categories was scored. Cognitive functions were assessed twice using verbal fluency tests, the Wechsler Adult Intelligence Scale – Revised (WAIS-R) subtests, the Zoo Map subtest, the Trail Making Test (TMT), self-report tools such as the Dysexecutive Questionnaire – Self (DEX-S) and the Prospective and Retrospective Memory Questionnaire (PRMQ), as well as the Beck Depression Inventory (BDI-II). Results: Age was negatively correlated with test results, while greater cognitive reserve contributed to better outcomes, which was observed both at baseline and follow-up. The same assessments performed separately for the group of younger (≤55 years of age) and older (≥56 years) adults revealed the negative effect of age in the older group, with less pronounced positive effect of cognitive reserve. Discussion: The results correspond to previous findings. Attention, cognitive flexibility, working memory and planning abilities deteriorate with age. High levels of cognitive reserve account for improvement of these functions both at baseline and at 3 months. However, age, the negative role of which is particularly evident in individuals aged ≥56 years, is the strongest determinant of task performance. Conclusions: The relationship between deteriorated cognitive functions and the protective role of cognitive reserve may vary at different stages of adulthood. Adverse effects of age on cognitive abilities are more pronounced, while the protective effects of cognitive reserve cease in individuals aged ≥56 years. This may indicate that in the presence of other unfavourable factors, such as multimorbidity, cognitive reserve has no significant impact on the ageing trajectory.

Non Formal Education and Poverty Reduction in Tanzania: A Case Study of Catholic Nuns’ Institutions in Kilimanjaro Region

This paper is based on a study that examines how Catholic Nun’s institutions (CNIs) use non formal education (NFE) to reduce poverty in Kilimanjaro Region, Tanzania. The article analyzes how CNIs provide NFE to bring about social development in Kilimanjaro communities. The study employed the theory of Constructivism to ascertain participatory and collaborative methods as principles of teaching youths and adults in CNIs. The study revealed that after attainment of independence in Tanzania, missionary institutions were also obliged to adhere to government's education policy and regulations in their running of educational institutions. Such changes made CNIs form another way of providing non-formal education. Furthermore, due to technological advancement, the changes in teaching methodology ushered in the use of Information and Communication Technology (ICT). This caused CNIs to face lack of qualified and enough teachers. Lack of NFE therefore is the source of missing self-employment and confidence to create new skills for reducing poverty. The study concludes that NFE provided by CNIs in Kilimanjaro communities have been supportive to social development. The study insists that CNIs should upgrade their provision of non-formal education which can bring economic changes and facilitate the achievement of high standards of life in Kilimanjaro and elsewhere.

Autophagy and Herpesvirus: A collaboration Contributing to Alzheimer's Disease.

Since the 1960s viral pathogenesis researchers have considered herpesviruses as an underlying factor for Alzheimer's disease (AD). We reported molecular interactions between herpes simplex virus type 1 (HSV-1) and the amyloid precursor protein (APP), the parent of amyloid plaques pathognomonic for AD (Sapute-Krishnan et al., 2003 and 2006; Chen et al., 2011, Bearer and Wu, 2019). Furthermore, others report biochemical interactions between HSV-1 and autophagy. Using several brain banks for specimens of four brain regions in post-mortems of individuals with and without cognitive impairment prior to death. Readhead et al. 2018 found molecular-genetic evidence linking activity of 6 different human herpesviruses to AD, including HSV-1, HSV-2, HHN6, HHN7, VZV and CMV to AD. Of these, HHN6, a common virus causing a minor childhood illness thought to be a nuisance, emerged as most significant. Using a quantitative trait loci approach, a network of candidate AD-associated genes were found that correlated with viral load and activity. These ontology networks did not specifically consider autophagy genes. Our hypothesis is that viral replication and egress highjacks cellular membrane systems and thereby alters autophagic function. Those individuals carrying genetic variations that protect against this dynamic will be less vulnerable to cognitive impairment despite viral load, or viral load will be diminished. Here we first prepared lists of autophagy genes (ATG), including 180 we uniquely identified through machine learning, as well as lists from publications (Mitzushima, 2019) and websites (Autophagy Gene List, Tanpaku.org). We applied software developed by Readhead et al. 2018, available through Synapse.com, to expression and sequence data from post-mortem brains obtained from publications and public sites hosted by Alzheimer's Center brain banks. We first determined ATG expression levels correlating with either non-AD (<1 plaque per section, Braak<3, and no dementia, or pre-clinical AD, defined as Braak III-IV with no cognitive impairment. Virtually all ATG were down-regulated in pre-clinical compared to non-AD controls. Next we searched the list of quantitative trait loci (QTL) that correlated with increased viral load and activity for ATG genes from 300+ brains in the Nun's Study brain bank (ROSMAP) and the Mount Sinai Brain Bank (MSBB). Lastly, we correlated those ATG-associated QTL with expression levels of these genes in control and preclinical AD (Liang et al. 2007, 2008 and 2010). We found that decreased ATG expression due to single nucleotide polymorphisms correlate with viral load and AD. This study suggests autophagy is a novel mechanism linking herpesvirus to AD, which may aid in finding new diagnostic and therapeutic targets. Since HHV6 is a common infection of childhood, infecting nearly 100% of humans, identifying genetic vulnerabilities to persistence and progression will be critically important for prevention of adult AD.

Modifiable psychosocial risk factors and delayed onset of dementia in older populations: analysis of two prospective US cohorts

ObjectivePreventing Alzheimer’s dementia (AD) fundamentally equates to delaying onset. Thus, we quantified associations of modifiable, psychosocial risk factors to years of delayed onset of dementia.DesignTwo prospective cohorts (n=2860) with negative...

Cognitive Reserve and Mild Cognitive Impairment: Predictors and Rates of Reversion to Intact Cognition vs Progression to Dementia.

Background and ObjectivesLittle is known about the effect of education or other indicators of cognitive reserve on the rate of reversion from mild cognitive impairment (MCI) to normal cognition (NC) or the relative rate (RR) of reversion from MCI to NC vs progression from MCI to dementia. Our objectives were to (1) estimate transition rates from MCI to NC and dementia and (2) determine the effect of age, APOE, and indicators of cognitive reserve on the RR of reversion vs progression using multistate Markov modeling.MethodsWe estimated instantaneous transition rates between NC, MCI, and dementia after accounting for transition to death across up to 12 assessments in the Nun Study, a cohort study of religious sisters aged 75+ years. We estimated RRs of reversion vs progression for age, APOE, and potential cognitive reserve indicators: education, academic performance (high school grades), and written language skills (idea density, grammatical complexity).ResultsOf the 619 participants, 472 were assessed with MCI during the study period. Of these 472, 143 (30.3%) experienced at least one reverse transition to NC, and 120 of the 143 (83.9%) never developed dementia (mean follow-up = 8.6 years). In models adjusted for age group and APOE, higher levels of education more than doubled the RR ratio of reversion vs progression. Novel cognitive reserve indicators were significantly associated with a higher adjusted RR of reversion vs progression (higher vs lower levels for English grades: RR ratio = 1.83; idea density: RR ratio = 3.93; and grammatical complexity: RR ratio = 5.78).DiscussionKnowledge of frequent reversion from MCI to NC may alleviate concerns of inevitable cognitive decline in those with MCI. Identification of characteristics predicting the rate of reversion from MCI to NC vs progression from MCI to dementia may guide population-level interventions targeting these characteristics to prevent or postpone MCI and dementia. Research on cognitive trajectories would benefit from incorporating predictors of reverse transitions and competing events, such as death, into statistical modeling. These results may inform the design and interpretation of MCI clinical trials, given that a substantial proportion of participants may experience improvement without intervention.

Assessing L2 Portuguese writing: idea density and sentence complexity

Abstract: Idea density and grammatical complexity were proposed as writing assessment parameters by Snowdon et al. (1996) and by Kemper et al. (2001) in the Nun Study (Snowdon 2001). The same parameters are used here to assess advanced Portuguese L2 writing in a learning context (C1/C2) in order to confirm them as valid assessment measures in a L2. Quality in writing is expected to translate into lexical precision and richness as well as sentence complexity. Results confirmed that reading has an influence on writing quality, insofar as the students who usually read are the ones who got the highest scores in both parameters. Results were nevertheless highly variable due to the heterogeneity of the group of participants. Both measures, idea density and grammatical complexity, were found to be correlated in two writing tasks, a synthesis and a writing prompt, which led to the conclusion that participants who write with lexical precision and richness also produce higher complexity sentences regardless of language and writing task variability. Keywords: idea density; grammatical complexity; assessing writing; Portuguese L2. Keywords: dyslexia; educational measurement; learning disabilities; validation study; psychometrics.

A densidade de ideias e a complexidade gramatical na avaliação da produção escrita em português L2

Advanced L2 written production assessment is difficult to quantify as are learning goals established for this competence in the same level. Correction is not enough. Quality in writing is expected to translate into lexical precision and richness, as well as sentence complexity. In order to measure these characteristics of sophisticated writing, Idea Density and Grammatical Complexity are proposed as assessment parameters as they were explored by Snowdon et al. (1996) and by Kemper et al. (2001) in the Nun Study (Snowdon 2001). Its adoption to the advanced Portuguese L2 learning context (C1/C2) underlied the study of sentences produced in two writing tasks: a synthesis and a writing prompt. First, results were highly variable due to the heterogeneity of the group of participants. Both measures were found to be correlated in both writing tasks, which led to the conclusion that participants who write with lexical precision and richness also produce higher complexity sentences. Lastly, the results confirmed that reading has an influence on writing quality, insofar as the students who usually read as the ones who got the highest scores in both parameters.

Embracing Age: How Catholic Nuns Became Models of Aging Well by Anna I. Corwin

Reviewed by: Embracing Age: How Catholic Nuns Became Models of Aging Well by Anna I. Corwin Richard P. Johnson, PhD Embracing Age: How Catholic Nuns Became Models of Aging Well. By Anna I. Corwin. Newark, NJ: Rutgers University Press, 2021. Pp. xiv + 188. $120; $29.95; $0 (pdf and epub). Anna Corwin's book, Embracing Age invites us to ponder some very important questions: What does it mean to be old? What is the meaning in diminishment? How can we all "do" this human process of aging best? C. escorts us through her comprehensive research and intriguing narrative that showcases a deeper understanding of what it means to be fully human in one's later years. Through her lens of scientific anthropology, C. focuses upon a specific convent of Catholic nuns. C.'s findings create a fascinating, albeit somewhat academic, report of a way of aging that generates greater positive outcomes than is seen in the general population. The genius of her report sheds new light on how it is possible to embrace aging and flourish in the process. In the past two decades American Catholic nuns have been heralded as models of successful aging, perhaps prompted by the curious findings of investigator David Snowden in the "Nun Study." That study found nuns with the biological markers of Alzheimer's Dementia (AD) strangely showed only minor signs of the serious cognitive, emotional, and behavioral decline usually associated with AD. These findings prompted an avalanche of research looking at why and how the special "convent culture" of Catholic nuns provides a setting for aging well. C.'s anthropological work goes deep into this "convent culture" and gives a more panoramic answer to the question: what do Catholic nuns have that the general population might need to know about aging? C.'s thorough research looked at a range of factors that former studies of positive aging identified as contributing to improved aging, including: consistent nutrition, higher education, help with self-care tasks, greater linguistic [End Page 275] facility, positive emotions association with longevity, positive association toward the wider world, and others. C. found that while these factors certainly contributed to higher quality of aging, they neither individually nor collectively provided the key to why nuns better performed the "tasks" leading to more positive and meaningful aging. The central thesis of C.'s engaging work is that the nuns' attitudes about aging contrast with the prevalent mainstream American model. Her research confirms that nuns subscribe to a fundamentally different definition of what it means to be a valuable person. The very structure of the language they speak shapes an alternative worldview around aging. C.'s research shows that that the nuns, even in the last stages of life, believed that their lives were highly meaningful, purposeful, and worthwhile. C. finds no traces of ageism among the nuns, a ubiquitous prejudice in the wider American culture. Indeed, C. reports that there appears little, if any, negative judgment about aging. She writes persuasively that care in the convent seems blind to age and describes interaction among and between ages as "mutual, ongoing and dynamic" (42). Elder nuns are neither segregated nor stigmatized; indeed, their presence in the fullness of the flow of the convent is pervasive. The "convent culture" emphasizes the importance of prayer as a connection to the sacred, a way of communicating inner needs that encourages mutual support and feeling embraced by God. C. sees the emphasis on prayer as both a means for interpersonal connection among the nuns and also as a tool for creating and maintaining a personal relationship with God. Prayer and contemplation are known positive practices that promote mental and physical health, claims C. God is now proximate: not distant, but available and loving, which consequently fills the nuns "with the emotions of love, safety, and the knowledge that they were cared for by a benevolent companion" (109). C. finds, finally, that prayer allows the nuns to meet death in complete poverty through the freedom of self-abandonment. A series of theological insights help explain the nuns' approach to aging. First, the virtues of equanimity and acceptance with which the nuns approach old age are cultivated and informed by...

Positive Psychology: Not a ‘Just Be Happy’ Approach to Physician Wellness in 2020

Positive Psychology: Not a ‘Just Be Happy’ Approach to Physician Wellness in 2020

A Bayesian hierarchical change point model with parameter constraints.

Alzheimer's disease is the leading cause of dementia among adults aged 65 or above. Alzheimer's disease is characterized by a change point signaling a sudden and prolonged acceleration in cognitive decline. The timing of this change point is of clinical interest because it can be used to establish optimal treatment regimens and schedules. Here, we present a Bayesian hierarchical change point model with a parameter constraint to characterize the rate and timing of cognitive decline among Alzheimer's disease patients. We allow each patient to have a unique random intercept, random slope before the change point, random change point time, and random slope after the change point. The difference in slope before and after a change point is constrained to be nonpositive, and its parameter space is partitioned into a null region (representing normal aging) and a rejection region (representing accelerated decline). Using the change point time, the estimated slope difference, and the threshold of the null region, we are able to (1) distinguish normal aging patients from those with accelerated cognitive decline, (2) characterize the rate and timing for patients experiencing cognitive decline, and (3) predict personalized risk of progression to dementia due to Alzheimer's disease. We apply the approach to data from the Religious Orders Study, a national cohort study of aging Catholic nuns, priests, and lay brothers.

Cognitive and Psychopathological Profile on Catholic Nuns in Puerto Rico: An exploratory study

Introduction: The vocation of Catholic nun has spread virtually throughout the world for hundreds of years. The purpose of this pioneer nun study in Puerto Rico is to generate a comprehensive cognitive and psychopathological profile in a particular sample that usually shares a similar environment and lifestyle. Even though, nuns have been studied in the United States and other parts of the world, no known study conducted with Puerto Rican nuns has been found in local academic databases explored in the last ten years using the subject keywords (i.e., Puerto Rican Nuns) in data search. Method: The sample consists of 25 female catholic nuns, residents in Puerto Rico, with a median age of 60.96 years old (SD= 17.594; RANGE= 61). A Non-probability sampling method was utilized to retrieve the participants. Instruments: Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Beck Hopelessness Inventory (BHS), Symptom Checklist 90-R and Folstein Mini-Mental State Examination (MMSE). Findings: Significant findings among BDI-II results (t=2.377, p&lt;.05), BHS results (t=34.671, p&lt;.05) and Mini-mental examination (t=16.613, p&lt;.05). An ANOVA was conducted evaluate significant differences among the subscales of the 90-Symptom Checklist Significant differences were found. Conclusion: Results suggest that symptoms of psychopathology are present predominantly at a minimal level. However, mild to moderate results were also found. Nuns in the sample showed high cognitive functioning and were capable of performing the tasks assigned. Future research may include a bigger sample and comparisons among cloistered and apostolic nuns. A mixed methodology is suggested.

Liesbeth Corens, Confessional Mobility and English Catholics in Counter-Reformation Europe

Over the last twenty years, there has been a surge in research exploring early modern English and Irish Catholicism in exile on the Continent. Complementing the seminal in-depth studies of Catholicism at home, produced by John Bossy or, more recently, by Michael Questier, the pioneering works of scholars such as Claire Walker or Caroline Bowden opened up new avenues in the study of exiled English and Irish nuns, a field which remained nearly unexplored till then. The Who Were the Nuns? projec...

Multilingualism and Dementia Risk: Longitudinal Analysis of the Nun Study.

Multilingualism is associated with enhanced executive function and may thus prevent cognitive decline and reduce the risk of dementia. To determine whether multilingualism is associated with delayed onset or reduced risk of dementia. Dementia was diagnosed in the Nun Study, a longitudinal study of religious sisters aged 75+ years. Multilingualism was self-reported. Dementia likelihood was determined in 325 participants using discrete-time survival analysis; sensitivity analyses (n = 106) incorporated additional linguistic measures (idea density and grammatical complexity). Multilingualism did not delay the onset of dementia. However, participants speaking four or more languages (but not two or three) were significantly less likely to develop dementia than monolinguals (OR = 0.13; 95% CI = 0.01, 0.65, adjusted for age, apolipoprotein E, and transition period). This significant protective effect of speaking four or more languages weakened (OR = 0.53; 95% CI = 0.06, 4.91) in the presence of idea density in models adjusted for education and apolipoprotein E. Linguistic ability broadly was a significant predictor of dementia, although it was written linguistic ability (specifically idea density) rather than multilingualism that was the strongest predictor. The impact of language on dementia may extend beyond number of languages spoken to encompass other indicators of linguistic ability. Further research to identify the characteristics of multilingualism most salient for risk of dementia could clarify the value, target audience, and design of interventions to promote multilingualism and other linguistic training as a strategy to reduce the risk of dementia and its individual and societal impacts.

First person profile: Leslie Bernstein, PhD: An epidemiologist known for her groundbreaking discoveries about breast cancer, Dr. Bernstein continues to push the field forward.

First person profile: Leslie Bernstein, PhD: An epidemiologist known for her groundbreaking discoveries about breast cancer, Dr. Bernstein continues to push the field forward.

Analysis of combined incident and prevalent cohort data under a proportional mean residual life model.

The Nun Study, a longitudinal study to examine risk factors for the progression of dementia, consists of subjects who were already diagnosed with dementia (ie, prevalent cohort) and those who do not have dementia (ie, incident cohort) at study enrollment. When assessing the risk factors' effects on the survival time from dementia diagnosis until death, utilizing data from both cohorts supports more efficient statistical inference because the two cohorts provide valuable complementary information. A major challenge in analyzing the combined cohort data is that the prevalent cases are not representative of the target population. Moreover, the dates of dementia diagnosis are not ascertained for the prevalent cohort in the Nun Study. Hence, the survival time for the prevalent cohort is only partially observed from study enrollment until death or censoring, with the time from dementia diagnosis to study enrollment missing. In this paper, we propose an efficient estimation method that uses both incident and prevalent cohorts under the proportional mean residual life model. By assuming proportionality of the mean residual life time with covariates in the incident cohort, we can utilize the natural relationship between the mean residual life function and the hazard function of the survival time measured from enrollment until death for the prevalent cohort. We evaluate the efficiency gain from using the combined cohort data through simulations and demonstrate that the proposed method is valid and efficient.

TDP-43 Neuropathologic Associations in the Nun Study and the Honolulu-Asia Aging Study.

Transactive response binding protein-43 (TDP-43) cytoplasmic neuronal and glial aggregates (pathologic TDP-43) have been described in multiple brain diseases. We describe the associations between neuropathologically confirmed TDP-43 and cognition in two population-based cohorts: the Nun Study (NS) and the Honolulu-Asia Aging Study (HAAS). In the HAAS, there was a significant association between hippocampal sclerosis (HS) and TDP-43 (OR = 11.04, p < 0.0001, 95% CI 3.57-34.13). In the NS, there were significant associations between TDP-43 and HS (OR = 16.44, p > 0.001 95%, CI 7.10-38.00) and Alzheimer's disease (AD) severity (OR = 1.74, p = 0.009, 95% CI 1.15-2.64). When cognitive scores were added to the model, HS remained significant but the other variables were not. When HS was removed from the model, the overall model remained significant and the associations between cognitive performance and TDP-43 (OR = 2.11, p = 0.022, 95% CI 1.11-4.02) were significant. In the NS, there was a significant association between cognitive performance and TDP-43 (OR 1.94 p = 0.005, 95% CI 1.22-3.09) (HS remained significant, but AD did not). When HS was removed from the model, only CERAD was significant (OR = 2.43 p < 0.001, 95% CI 1.58-3.74). These results support a consistent association between pathologic TDP-43, HS, and the development of cognitive impairment in two large studies of brain aging, while the relationship between AD pathology and TDP-43 may vary according to cohort-specific features.

Writing the History of Women Religious Today: Possibilities and Problems

Deirdre Raftery Studies • volume 107 • number 427 Writing the History of Women Religious Today: Possibilities and Problems Deirdre Raftery In 1987, Irish historian Catríona Clear wrote: ‘Nuns have suffered the fate of historical marginalisation’. Now, over thirty years later, it is worth considering the degree to which this situation has changed. Do scholars recognise the many possibilities for research on women religious? And, if so, what problems do they encounter when they embark on projects that draw on the archives of women religious? This special issue of Studies reflects the fact that there has been significant growth in this area of historical resarch. The papers here are all drawn from the 2017 conference of the History of Women Religious – Britain and Ireland (H-WRBI), which I had the pleasure of convening at the School of Education, University College Dublin (UCD). The conference theme was ‘Sources and the History of Women Religious’, and delegates attended from the USA, Canada, Spain, Israel, Germany and the Netherlands. The H-WBRI is a research network that, despite its name, attracts scholars from around the world, all of whom are undertaking historical research in areas including biographical studies of nuns, congregational histories, studies of monastic life and explorations of women religious in education and healthcare. When I first hosted a H-WRBI conference at UCD back in 2014, it became very clear to me that this research field was finally ‘taking off’in Ireland. Irish scholarship was very well represented, and the 2014 conference resulted in a book, Education, Identity and Women Religious: Convents, Classrooms and Colleges.1 This book added to existing scholarship by Catríona Clear, Mary Peckham Magray, Margaret MacCurtain, Phil Kilroy and Máire Kealy.2 Most recently, Jacinta Prunty has published a major study of the Irish monasteries, asylums and reformatories of the Sister of Our Lady of Refuge. In Galway, scholars including Bronagh Ann McShane and Marie Louise Coolahan are working on women religious in early modern Ireland, while at UCD my own doctoral and post-doctoral researchers are examining many aspects of the history of convent education, and together we have worked with UCD Digital 262 Writing the History of Women Religious Today: Possibilities and Problems Archive to develop several online projects to showcase the importance of congregational collections. There are many possibilities for using the archives of women religious in research. The 1980s saw American scholars drawing on novitiate records, as they developed a major study of ageing and the effects of Alzheimer’s disease. Known widely as the ‘Nun Study’, this research was conducted with the cooperation of living members of the Schools Sisters of Notre Dame (SSND) in seven US provinces, who agreed that, after death, their brains would be donated to the study. Communities of sisters form a relatively homogenous group, and are therefore an ideal population for medical research. A breakthrough moment in the research came when the team located autobiographical essays by the sisters in the archives. These essays had been written when the women first entered the novitiate and, together with other archival data, helped to inform the researchers of the pattern of study the sisters had maintained over their lifespan. Further, by studying the handwriting samples of deceased sisters whose brain tissue had been examined, the team were able to conclude that a lack of ‘linguistic density’ in writing was a strong predictor of the risk of Alzheimer’s disease in later life. While the main value of the Nun Study was its contribution to the medical understanding of aging and of quality of life, it also served to remind congregations of the purposes to which researchers may be able to put their records: we simply do not know how archival records will be used in the future. Other possibilities for research drawing on the archives of women religious include studies of education and healthcare, while the experiences of sisters as missionaries has only recently begun to attract attention. Scholarly studies of sisters as global travellers have benefited from the rich travel journals that some nineteenth and early twentieth century sisters kept. In my own work, I have used the theoretical framework of transnationalism to explore how Irish sisters...