Royall, Donald R Jr.School of Medicine |
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Objectives: clinical /translational geriatric research with special interests in geriatric assessment, the cognitive correlates of functional outcomes, executive function, and dementing illnesses. |
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| 10/2009 - Present | Professor; Department of Family & Community Medicine | University of Texas Health Science Center at San Antonio, Family & Community Medicine, San Antonio, TX |
| 1/2000 - Present | Professor; Department of Medicine | University of Texas Health Science Center at San Antonio, Medicine, San Antonio, TX |
| 1/2000 - Present | Professor; Department of Psychiatry | University of Texas Health Science Center at San Antonio, Psychiatry, San Antonio, TX |
| 1/1994 - Present | Geriatric Psychiatry Consultant | Air Force Village Retirement Community, Psychiatry, San Antonio, TX |
| 1/1994 - Present | Director of Research | Freedom House Foundation, San Antonio, TX |
| 1/1990 - Present | Faculty/Staff Physician | Audie L. Murphy VA Hospital Geriatric Research Education and Clinical Care Program (GRECC), Psychiatry, San Antonio, TX |
| Year | Degree | Discipline | Institution |
| 1990 | Residency | Residency in Psychiatry | Johns Hopkins Hospital Baltimore , MD |
| 1987 | Residency | Residency in Internal Medicine | Johns Hopkins Hospital Baltimore , MD |
| 1985 | Internship | Internship in Internal Medicine | Johns Hopkins Hospital Baltimore , MD |
| 1984 | MD | Psychiatry | University of Texas Medical School at Houston Houston , TX |
| 1980 | BS | Biology (Magna Cum Laude) | Texas A&M University/College Station San Antonio , TX |
| 1980 | BS | Psychology (Magna Cum Laude) | Texas A&M University/College Station San Antonio , TX |
Research Interest: Dementia Phenomenology- Clinical phenomenology of dementia concentrating on frontal executive control functions and related clinical phenomena. |
Research Interest: Health Services Research- Concentrating on the cognitive correlates of functional status, forensic capacity, and need for services across diagnostic groups. Also on the ability of qualitative assessment to cost-effectively target dementia subgroups for evaluation. |
Research Interest: Psychometrics- Clinical assessment strategies (e.g. for dementia): Concentrating on the development of bedside measures for the assessment of executive control [The Executive Interview (EXIT25) *Royall 1992, 1995, The Executive Interview Spanish Translation (EXIT-S) *Royall 1995, The Telephone Executive Assessment Scale (TEXAS), CLOX: An Executive Clock Drawing Task *Royall 1995] and qualitative assessment of dementia phenomenology [Qualitative Evaluation of Dementia (QED) *Royall 1992, 1995. |
Research Technical Expertise- Longitudinal data analysis, latent variable models, Structural Equation Models, Growth Curve and Growth Mixture Models, Clinical Trials, neuroimaging studies |
| Date | Description | Institution | # Students |
| 7/2008 - Present | Individual Instruction | UTHSCSA | |
| 1/2000 - Present | Post Graduate Rotation Supervision | ALMVAH MS/R | |
| 1/1999 - Present | PGY-3 Psychiatry: Neurobiology | ||
| Course Director - PGY-3 Psychiatry Didactic Semeinar. Co-taught with Jeff Cordes, MD | |||
| 1/1997 - Present | PGY-1 Medicine/PGY-2 Psychiatry: Clinical Geropsychiatry Seminar | ||
| Course Director - Topics in Geropsychiatry to PGY-1 Medicine/PGY-2 Psychiatry residents rotating in Geriatrics | |||
| 1/1997 - Present | Post Graduate Rotation Supervision | ALMVAH MS/R | |
| 1/1995 - Present | PGY-3-4 Clinical Geropsychiatry Seminar | ||
| Course Director - Topics in Geropsychiatry delivered to PGY-III & IV Psychiatry residents rotating through Geropsychiatry | |||
| 1/1995 - Present | PGY-4 Geropsychiatry Seminar | ||
| Course Director - PGY-4 Psychiatry Didactic Seminar. Co-taught with Jeffrey Cordes, MD | |||
| 1/1992 - Present | Individual Instruction | University of Texas Health Science Center at San Antonio | |
Journal Article |
| Royall DR, Palmer RF. Validation of a latent construct for dementia case-finding in Mexican-Americans Journal of Alzheimers Disease in press. |
| Royall DR, Palmer R, Chiodo LK, Polk M. Towards an Aging Specific Cognitive Phenotype: The Freedom House Study Experimental Aging Research, in press. |
| Schillerstrom JE, Birkenfeld EM, Yu AS, Goldstein DJ, Royall DR. Neuropsychological correlates of performance based functional status in elder Adult Protective Services (APS) referrals for capacity assessments Journal of Elder Abuse and Neglect 2013 Jan;25:294-304. |
| Royall DR, Palmer RF. Alzheimer pathology does not mediate the association between depressive symptoms and subsequent cognitive decline Alzheimers Disease & Dementia 2013 Jan;9:318-325. |
| Royall DR, Palmer RF, Vidoni ED, Honea RA. The Default Mode Network may be the key substrate of depression related cognitive changes Journal of Alzheimers Disease 2013 Jan;34:547-560. |
| Royall DR, Palmer RF, White LR, Petrovitch H, Ross GW, Masaki K. Modeling regional vulnerability to Alzheimer pathology Neurobiology of Aging 2012 Aug;33(08):1556-1563. |
| Royall DR, Palmer RF, OBryant SE. Validation of a Latent Variable Representing the Dementing Process J Alzheimers Dis 2012 Jun;30:639-649. |
| Royall DR, Palmer RF. Getting Past "g": testing a new model of dementing processes in persons without dementia J Neuropsychiatry Clin Neurosci 2012 Jan;24(1):37-46. |
| Royall DR, Palmer R, Chiodo LK, Polk MJ. Depressive symptoms predict longitudinal change in executive control but not memory Int J Geriatr Psychiatry 2012 Jan;27(01):89-96. |
| Royall DR, Palmer RF. Estimating the temporal evolution of Alzheimers Disease pathology with autopsy data Journal of Alzheimers Disease 2012 Jan;32:23-32. |
| Royall DR, Palmer RF, Vidoni ED, Honea RA, Burns JM. The Default Mode Network and Related Right Hemisphere Structures may be the Key Substrates of Dementia J Alzheimers Dis 2012 Jan;32:467-478. |
| King AE, Mintz J, Royall DR. Meta-analysis of (123) I-MIBG cardiac scintigraphy for the diagnosis of Lewy body-related disorders Mov Disord 2011 Jun;26(7):1218-1224. |
| Romn GC, Salloway S, Black SE, Royall DR, Decarli C, Weiner MW, Moline M, Kumar D, Schindler R, Posner H. Randomized, placebo-controlled, clinical trial of donepezil in vascular dementia: differential effects by hippocampal size Stroke 2010 Jun;41(6):1213-1221. |
| Kochunov P, Coyle T, Lancaster J, Robin D, Hardies J; Kochunov V, Bartzokies G, Stanley J; Royall DR, Schlosser A, Null M, Fox P. Processing speed is correlated with cerebral health markers in the frontal lobes as quantified by neuro-imaging NeuroImage 2010 Jan;49:1190-1199. |
| Kochunov P, Robin DA, Royall DR, Coyle T, Lancaster J, Kochunov V, Schlosser AE, Fox PT. Can structural MRI indices of cerebral integrity track cognitive trends in executive control function during normal maturation and adulthood? Hum Brain Mapp 2009 Aug;30(8):2581-2594. |
| Kochunov P, Ramage AE, Lancaster JL, Robin DA, Narayana S, Coyle T, Royall DR, Fox P. Loss of cerebral white matter structural integrity tracks the gray matter metabolic decline in normal aging Neuroimage 2009 Mar;45(1):17-28. |
| Royall DR, Romn GC, Cordes JA, Velez A, Edwards A, Schillerstrom JS. Sertraline improves executive function in patients with vascular cognitive impairment Journal of Neuropsychiatry and Clinical Neurosciences 2009 Jan;21:445-454. |
| Fuller CD, Schillerstrom JE, Jones WE, Boersma M, Royall DR, Fuss M. Prospective Evaluation of Pretreatment Executive Cognitive Impairment and Depression in Patients Referred for Radiotherapy Int J Radiat Oncol Biol Phys 2008 Oct;72(2):529-533. |
| Schillerstrom JE, Rickenbacker D, Joshi KG, Royall DR. Executive function and capacity to consent to a noninvasive research protocol Am J Geriatr Psychiatry 2007 Feb;15(2):159-162. |
| Royall DR, Rauch R, Roman GC, Cordes JA, Polk MJ. MRI findings associated with impairment on the Executive Interview (EXIT25) Experimental Aging Research 2001 Jan;27:293-308. |
| Royall DR, Cordes J, Polk M. Executive control and the comprehension of medical information by elderly retirees Exp Aging Res 1997 Jan;23(4):301-313. |
| Gallo JJ, Royall DR, Anthony JC. Risk factors for the onset of depression in middle age and later life Soc Psychiatry Psychiatr Epidemiol 1993 Jul;28(3):101-108. |
Abstract |
| Royall DR, Palmer RF. The Biomarkers of Dementia Severity Vary Widely by Ethnicity: A Latent Variable Approach; 2013 Jul. (2013 Alzheimers Association International Conference (AAIC). Boston, MA. July 17, 2013). |
| Salazar R, Shuham WJ, Royall DR. Frequency of Neuropsychiatric Symptoms in Hispanics with Alzheimers Disease; 2013 Jul. (2013 Alzheimers Association International Conference (AAIC). Boston, MA. July 17, 2013). |
| Salazar R, Royall DR, Palmer RF. Neuropsychiatric Symptoms in Community Dwelling Mexican-Americans: results from the Hispanic EPESE Study; 2013 Jul. (2013 Alzheimers Association International Conference (AAIC). Boston, MA. July 17, 2013). |
| Royall DR, Palmer RF. Ethnicity Specific Pathways between Biomarkers and Cognition: A Latent Variable Approach; 2013 Jul. (2013 Alzheimers Association International Conference (AAIC). Boston, MA. July 15, 2013). |
| Palmer RF, Royall DR. Future Dementia Status is Almost Entirely Explained by the Latent Variable ds Baseline and Change; 2013 Jul. (2013 Alzheimers Association International Conference (AAIC). Boston, MA. July 17, 2013). |
| Royall DR. The Pseudodementia of Pseudodepression''; 2013 Jul. (Journal of Nutrition, Health & Aging; vol. 17, no. S1). |
| Hall J, Edwards M, Hobson Balldin V, Strutt A, Pavlik V, Marquez de la Plata C, Cullum CM, Lacritz L, Reisch J, Massman P, Royall D, Barber R, Younes S, Weichmann A, OBryant SE. Normative data for Mexican Americans on tasks of executive and physiometric functions: The Texas Mexican American Normative Studies; 2012 Nov. (Archives of Clinical Neuropsychology; vol. 27). |
| Hobson-Balldin V, Menon C, Younes S, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum CM, Lacritz L, Reisch J, Massman P, Royall D, Barber R, OBryant SE. Normative performance on the RBANS in a multi-ethnic bilingual cohort: The Texas Mexican American Normative Studies; 2012 Nov. (Archives of Clinical Neuropsychology; vol. 27). |
| Edwards M, Hobson-Balldin V, Hall J, Strutt A, Pavlik V, Maruquez de la Plata C, Cullum CM, Lacritz L, Reisch J, Massman P, Barber R, Royall D, Younes S, & OBryant SE. Mexican American normative references on tasks of memory and language: The Texas Mexican American Normative Studies; 2012 Nov. (Archives of Clinical Neuropsychology; vol. 27). |
| Royall DR, Palmer RF. Latent Variables Offer a Cost-Effective Approach to Dementia Case Finding; 2012 Jul. (Alzheimers and Dementia; vol. 8, no. Sup). |
| Royall DR, Palmer RF. Latent Variables Offer an Unbiased Approach to Dementia Case Finding; 2012 Jul. (Alzheimers and Dementia; vol. 8, no. Sup). |
| Velez CE, Salazar R, Royall DR. Screening for Mild Cognitive Impairment and Alzheimers Dementia by Telephone Using the Alzheimers Questionnaire; 2012 Mar. (Meeting of the American Directors Association. San Antonio, TX, March 9, 2012). |
| Allman RM, Sawyer P, Crowe M, Roth DL, Royall DR. Prognostic significance of CLOX cognitive phenotypes on mortality and function; 2011 Nov. (64th Annual Meeting of the Gerontological Society of America, Boston, MA, November 18-22, 2011). |
| Xiao G, Barber R, Reisch J, Doody R, Fairchild T, Adams P, Royall DR, Wilhelmsen K, Diaz-Arrastia R, OBryant S, and the TARC Investigators. Developing and Validating of Diagnostic Algorithm for Alzheimers Disease; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. S). |
| OBryant S, Xiao G, Barber R, Hall J, Doody R, Reisch J, Fairchild T, Adams P, Royall DR, Wilhelmsen K, Diaz-Arrastia R, and the TARC Investigators. Refinement and Expansion of the Texas Alzheimers Research Consortium Serum-Based Diagnostic Algorithm for Alzheimers Disease; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Doody R, Chan W, Barber R, Ballantyne C, Pavlik V, OBryant S, Darby E, Diaz-Arrastia R, Fairchild T, Royall DR, Adams P, and the TARC Investigators. Inflammatory Biomarkers in the Texas Alzheimers Research Consortium (TARC) Cohort; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Royall DR, Doody R, Barber R, Palmer RF, OBryant S, Reisch J, Fairchild T, Adams P, and the TARC Investigators. The Cognitive Correlates of Functional Status: A New Approach to Dementia; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Royall DR, Palmer RF, White L. Tangles are Distributed Across Two Temporally and Spatially Distinct Populations; 2011 Jul. (Alzheimer''s and Dementia; vol. 7, no. Sup). |
| Royall DR, Palmer RF, White LR. Modeling the Temporal Evolution of Alzheimers pathology with Autopsy Data; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Royall DR, Palmer RF, Vidoni ED, Honea RA, Burns JM. The Default Mode Network and Related Right Hemisphere Structures may be the Key Substrates of Dementia; 2011 Jul. (Alzheimer''s and Dementia; vol. 7, no. Sup). |
| Royall DR, Palmer RF, Vidoni ED, Honea RA, Burns JM. Imaging Dementia: The Cognitive Correlates of Functional Status; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Doody R, Chan W, Ballantyne C, Pavlik V, Barber R, OBryant S, Darby E, Diaz-Arrastia R, Fairchild T, Royall DR, Adams P, and the TARC Investigators. Biomarkers Associated with Cardiovascular Risk in the Texas Alzheimers Research Consortium (TARC) Cohort: LpPla2 and Homocysteine; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Barber R, OBryant S, Reisch J, Doody R, Fairchild T, Adams P, Royall DR, Diaz-Arrastia R, and the TARC Investigators. Serum Granulocyte Colony Stimulating Factor and Alzheimers Disease; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Dentino A, Hall J, Barber R, Doody R, Royall DR, OBryant S, and the TARC Investigators. The Impact of Depression on Cognition Varies by APOE4 Status; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Wilhelmsen K, Chase S, Griffin N, Diaz-Arrastia R, Barber R, Royall DR, OBryant S, Doody R, Fairchild T, Rosenberg RN, Adams P, Reisch J, and the TARC Investigators. Genome-Wide Association Scan Replication for Bio-marker Endophenotypes of Alzheimers Disease; 2011 Jul. (Alzheimers and Dementia; vol. 7, no. Sup). |
| Royall DR, Palmer RF, White LR. Modeling regional vulnerability to Alzheimer pathology; 2010 May. (8th Annual Center for Biomedical Neuroscience Research Symposium. UTHSCSA, San Antonio, TX, May 2010). |
| Palmer RF, Mouton CP, Royall DR, Markides KS , Espino DV. Polypharmacy Predicts MMSE Decline Over 12 Years: Data From the Hispanic EPESE study; 2010 Feb. (63rd Annual Meeting of the Gerontological Society of America. New Orleans, LA, November, 2010). |
| King A, Royall DR. Executive Impairment and Global Cognitive Function are Associated with Decreased Sleep Efficiency but not Sleep-Related Breathing Events in Patients Seen at VA Memory Clinic; 2010 Jan. (SLEEP 2010 24th Annual Meeting of the Associated Professional Sleep Societies. January, 2010). |
| Royall DR, Palmer RF. Towards an Aging Specific Cognitive Phenotype: The Freedom House Study; 2009 Jan. (20th Annual Meeting of the American Neuropsychiatric Association. San Antonio, TX February 30, 2009). |
| Schillerstrom JE, Shuler A, Royall DR. Clock Drawing Phenotypes and Disability in Elders; 2009 Jan. (20th Annual Meeting of the American Neuropsychiatric Association. San Antonio, TX February 20, 2009). |
| Horton MS, Schillerstrom JE, Earthman BS, Joshi KG, SCHILLERSTROM TL, Velez AM, Royall DR. Prevalence of executive impairment on a general medicine ward; 2003 Jan. (Journal of the American Geriatrics Society; vol. 51). |
Review Article |
| Royall DR. Fortress Brain Medical Hypotheses 2013 Jan;80:118-121. |
| Palmer RF, Royall DR. Missing data? Plan on it! J Am Geriatr Soc 2010 Oct;58:343-348. |
| Schillerstrom JE, Royall DR, Palmer R. Depression, disability and intermediate pathways: a review of longitudinal studies in elders Journal of Geriatric Psychiatry and Neurology 2008 Sep;21(3):183-197. |
Other |
| Royall DR. The Ethics of Evidence are not Evidence of Ethics Journal of the American Geriatrics Society 2013 Jan;61. |
| Royall DR, Parr J, Parr VB. What did you expect? Int J Geriatr Psychiatry 2011 Dec;26(12):1319-1320. |
| Royall DR. The quest for biomarkers of Alzheimers disease J Am Geriatr Soc 2011 Feb;59(2):377-378. |
| Royall DR. A Tangled Web The Journal of Neuroscience 2010 Jan;. |
| Royall DR. Visuospatial impairment and mortality J Am Geriatr Soc 2009 May;57(5):932-933. |
| Royall DR. In regard to Fuller et al Int J Radiat Oncol Biol Phys 2008 Sep;72(1):301-301. |
| Royall DR. Measurement of meaningful treatment effects in CADASIL Lancet Neurol 2008 Aug;7(8):673-674. |
Federal |
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| Funding Agency | NHLB, NIA |
| Title | Insular Autonomic Function in Depression |
| Status | Active |
| Period | 9/2008 - 8/2013 |
| Role | Principal Investigator |
| Grant Detail | The major goals of this project are to demonstrate whether insular blood flow mediates depressions association with mortality. |
Private |
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| Funding Agency | |
| Title | Open Label Study of the Effect of Daily Treatment with MPC-7869 in Subjects with Dementia of the Alzheimers Type |
| Status | Active |
| Period | 2/2007 - Present |
| Role | Principal Investigator |
| Grant Detail | A Phase III multi-center clinical trial. |
| Funding Agency | |
| Title | The Effect of Passive Immunization on the Progression of Alzheimers Disease: LY2062430 Versus Placebo |
| Status | Active |
| Period | 9/2009 - Present |
| Role | Principal Investigator |
| Grant Detail | |
| Funding Agency | |
| Title | A Randomized Controlled Trial to Assess the Efficacy of a Medical Food in Patients with Mild to Moderate Alzheimers Disease Medication |
| Status | Active |
| Period | - Present |
| Role | Principal Investigator |
| Grant Detail | Industry Sponsored clinical trial. |
| Funding Agency | Eisai |
| Title | BAN2401-G000-201 A Placebo-controlled, Double-blind, Parallel-group, Bayesian Adaptive Randomization Design and Dose Regimen-finding Study to Evaluate Safety, Tolerability and Efficacy of BAN2401 in Subjects With Early Alzheimers Disease |
| Status | Active |
| Period | 2/2013 - 2/2029 |
| Role | Co-Investigator |
| Grant Detail | |
| Funding Agency | American Cancer Society |
| Title | Neuroprotective Properties of Memantine in Elders Receiving Chemotherapy |
| Status | Complete |
| Period | 1/2009 - 12/2012 |
| Role | Co-Investigator |
| Grant Detail | A 6-month, randomized, double blind, placebo controlled trial determining the prophylactic benefit of memantine for preventing cognitive decline, functional decline, and decreased stimulated cortical response in elders receiving chemotherapy. |
| Funding Agency | Forrest Labs |
| Title | An Open Label Pilot Study of Memantines Effects on Executive Function in patients with Mild Cognitive Impairment (MCI). |
| Status | Active |
| Period | 9/2008 - 8/2012 |
| Role | Principal Investigator |
| Grant Detail | Investigator initiated clinical trial. |
State |
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| Funding Agency | State of Texas/The Texas Council on Alzheimer`s Disease |
| Title | Genetic and Biomarker Study of Alzheimer`s Disease (Texas Alzheimer`s Research Consortium)(Second Biennium). |
| Status | Active |
| Period | 8/2013 - 2/2014 |
| Role | Principal Investigator |
| Grant Detail | Discover the genetic and biological markers that would lead to the better undersatnding of what causes AD and find ways to an earlier diagnosis before evident clinical symptoms. |
| Funding Agency | State of Texas /The Texas Council on Alzheimers Disease |
| Title | Genetic and Biomarker Study of Alzheimers Disease (Texas Alzheimers Research Consortium) |
| Status | Complete |
| Period | 9/2009 - 8/2011 |
| Role | Principal Investigator |
| Grant Detail | The major goals of this project are to study the longitudinal history and biomarkers associated with the transition to clinical Alzheimers disease. This award funds the 2009-2011 biennium. |