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Royall, Donald R Jr.

School of Medicine
Psychiatry
(210) 567-1255
royall@uthscsa.edu

Objectives: clinical /translational geriatric research with special interests in geriatric assessment, the cognitive correlates of functional outcomes, executive function, and dementing illnesses.

Appointments Education Expertise Teaching Publications Grants

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

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 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. 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 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.

Royall DR. Insular Alzheimer disease pathology and the psychometric correlates of mortality Cleve Clin J Med 2008 Mar;75 Su:97-99.

Royall DR, Palmer RF, Chiodo LK, Polk MJ, S Markides K, Hazuda H. Clock-drawing potentially mediates the effect of depression on mortality: replication in three cohorts Int J Geriatr Psychiatry 2008 Feb;.

Kochunov P, Thompson PM., Coyle T, Lancaster JL, Kochunov V, Royall DR, Mangine F, Riviere D, Fox P. Relationship among neuroimaging indices of cerebral health during normal aging Human Brain Mapping 2008 Jan;29:36-45.

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.

Book Chapter

Royall DR. Exercise Diabetes and Cognition. In: Spirduso WW, Poon LW, Chodzko-Zajko W(eds). Aging, Exercise, and Cognition Volume II: Exercise and its Mediating Effects on Cognition. 2008. p. 183-196.

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).

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).

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. 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).

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, 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, Vidoni ED, Honea RA, Burns JM. Imaging Dementia: The Cognitive Correlates of Functional Status; 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).

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).

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).

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).

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).

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).

Royall DR, Palmer RF, Wong K, Urehara J, White L. Insular Neurofibrillary Tangle Counts are Specifically Associated with the Rate of Age-Related QTc Changes in Older Adults: The Honolulu-Asia Aging Study; 2008 Jan. (International Congress on Alzheimers Disease (ICAD). Chicago, IL, 2008).

Royall DR, Palmer RF, Wong K, Urehara J, White L. Insular Neurofibrillary Tangle Counts are Specifically Associated with the Rate of Age-Related Heart Rate Changes in Older Adults: The Honolulu-Asia Aging Study; 2008 Jan. (International Congress on Alzheimers Disease (ICAD). Chicago, IL, 2008).

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.

Royall DR. Is disability required for dementia case-finding? Int J Geriatr Psychiatry 2008 Feb;23(2):224-225.

Royall DR. Slippery slopes J Gerontol A Biol Sci Med Sci 2008 Jan;63(1):107-108.

Federal
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
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	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	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
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	9/2011 - 8/2013
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.

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	Psychology (Magna Cum Laude)	Texas A&M University/College Station San Antonio , TX
1980	BS	Biology (Magna Cum Laude)	Texas A&M University/College Station San Antonio , TX

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-4 Geropsychiatry Seminar
Course Director - PGY-4 Psychiatry Didactic Seminar. Co-taught with Jeffrey Cordes, MD
1/1995 - Present	PGY-3-4 Clinical Geropsychiatry Seminar
Course Director - Topics in Geropsychiatry delivered to PGY-III & IV Psychiatry residents rotating through Geropsychiatry
1/1992 - Present	Individual Instruction	University of Texas Health Science Center at San Antonio

Faculty

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Royall, Donald R Jr.

Research Interest: Dementia Phenomenology

Research Interest: Health Services Research

Research Interest: Psychometrics

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Journal Article

Book Chapter

Abstract

Review Article

Other

Federal

Private

State