Amy Byers, PhD, MPH

Professor In Residence

Division of Geriatrics

Dr. Byers is Professor of Psychiatry & Behavioral Sciences with a joint appointment in the Department of Medicine, Division of Geriatrics. She is an epidemiologist with a background in aging research, methods, and biostatistics. Her research focuses on the epidemiology of late-life mental health and employs advanced epidemiological and biostatistical techniques to determine the incidence, prevalence, risk factors, and outcomes of late-life mental health disorders with the objective of reducing the burden of these disorders by informing long-term clinical care. Dr. Byers has been heavily involved in research to determine nationally representative estimates of psychiatric disorders and health care utilization among older community-dwelling adults. As a clinical epidemiologist studying geropsychiatry with an expertise in mathematical epidemiology, Dr. Byers is involved in the application of advanced methodology to address complex clinical questions at the intersection of physical and mental health in aging adults.

Dr. Byers has been funded by several agencies, including NIH (i.e., NIMH, NIA, and NIMHD), Department of Defense, and VA. She is PI of the first VA R01-level grant longitudinally investigating suicide and suicidal behavior at a national level in older U.S. Veterans. Dr. Byers’ NIH-funded research program currently focuses on suicide and suicide-related outcomes and prevalence and incidence of dementia among older Veterans and individuals reentering the community from incarceration. Leveraging national databases, Dr. Byers has built large longitudinal cohorts to study how complex and salient risk factors, such as comorbidities, polypharmacy, and history of incarceration, contribute to late-life suicide and related disorders and will lead to targeted late-life risk assessment tools. Dr. Byers has been awarded a Genius Award from UCSF’s Older Americans Independence Center to provide innovative methodologic advancements to estimate associations of suicide risk linked to specific medications.

Education
Research Fellowship, - Geriatric Psychiatry, Cornell University
BA, - Anthropology, Scripps College
MPH, - Chronic Disease Epidemiology, Yale University
PhD, - Epidemiology of Aging, Yale University
Websites
Publications
  1. Growdon ME, Jing B, Morris EJ, Deardorff WJ, Boscardin WJ, Byers AL, Boockvar KS, Steinman MA. Which older adults are at highest risk of prescribing cascades? A national study of the gabapentinoid-loop diuretic cascade. Journal of the American Geriatrics Society 2024. PMID: 38547357


  2. Hwong AR, Barry LC, Li Y, Byers AL. Comorbidities, healthcare use, and contact with healthcare transition services in older veterans after incarceration. Journal of the American Geriatrics Society 2024. PMID: 38525526


  3. Zaman T, Bravata DM, Byers A, Krebs E, Leonard S, Austin C, Sandbrink F, Hasin DS, Keyhani S. A national study of clinical discussions about cannabis use among Veteran patients prescribed opioids. Journal of cannabis research 2024. PMID: 38493111


  4. Jeffers AM, Glantz S, Byers AL, Keyhani S. Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. Journal of the American Heart Association 2024. PMID: 38415581


  5. Travis KJ, Huang AJ, Maguen S, Inslicht S, Byers AL, Seal KH, Gibson CJ. Military Sexual Trauma and Menopause Symptoms Among Midlife Women Veterans. Journal of general internal medicine 2023. PMID: 37957529


  6. Morin RT, Li Y, Karel MJ, Consolino T, Hwong A, Clark R, Byers AL. Comorbidity profiles in older patients last seen by mental health prior to suicide attempt. Aging & mental health 2023. PMID: 37545400


  7. Sirey JA, Pepin R, Aizenstein H, Taylor WD, Forester B, Okereke O, Byers AL, Bruce ML. Advanced Research Institute (ARI): Supporting the Geriatric Mental Health Research Pipeline. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2023. PMID: 37620206


  8. Kelly JD, Leonard S, Boscardin WJ, Hoggatt KJ, Lum EN, Austin CC, Byers A, Tien PC, Austin PC, Bravata DM, Keyhani S. Comparative mRNA booster effectiveness against death or hospitalization with COVID-19 pneumonia across at-risk US Veteran populations. Nature communications 2023. PMID: 37221198


  9. Ruderman MA, Byers AL, Bauer MS, Stolzmann K, Miller CJ, Connolly SL, Kim B. One-Year All-Cause Mortality and Delivery of the Collaborative Chronic Care Model in General Mental Health Clinics. Psychiatric services (Washington, D.C.) 2023. PMID: 37016822


  10. Kuffel RL, Morin RT, Covinsky KE, Boscardin WJ, Lohman MC, Li Y, Byers AL. Association of Frailty With Risk of Suicide Attempt in a National Cohort of US Veterans Aged 65 Years or Older. JAMA psychiatry 2023. PMID: 36811913


  11. Zaman T, Bravata DM, Byers AL, Krebs EE, Leonard SJ, Sandbrink F, Barker W, Keyhani S. A national population-based study of cannabis use and correlates among U.S. veterans prescribed opioids in primary care. BMC psychiatry 2023. PMID: 36927526


  12. Barry LC, Steffens DC, Covinsky KE, Conwell Y, Boscardin J, Li Y, Byers AL. High Risk of Substance Use Disorder-Related Outcomes in Veterans Released from Correctional Facilities in Mid to Late Life. Journal of general internal medicine 2023. PMID: 36781577


  13. Rustagi AS, Byers AL, Brown JK, Purcell N, Slatore CG, Keyhani S. Lung Cancer Screening Among U.S. Military Veterans by Health Status and Race and Ethnicity, 2017-2020: A Cross-Sectional Population-Based Study. AJPM focus 2023. PMID: 37790642


  14. Goldstein LA, Jakubowski KP, Huang AJ, Seal KH, Maguen S, Inslicht SS, Byers AL, Gibson CJ. Lifetime history of interpersonal partner violence is associated with insomnia among midlife women veterans. Menopause (New York, N.Y.) 2023. PMID: 36753121


  15. Clark R, Kuffel RL, Neylan TC, Maguen S, Li Y, Boscardin WJ, Byers AL. Posttraumatic stress disorder, suicide, and unintended overdose death in later life: A national cohort study of veterans aged 50 and older. Journal of the American Geriatrics Society 2022. PMID: 36573640


  16. Keyhani S, Leonard S, Byers AL, Zaman T, Krebs E, Austin PC, Moss-Vazquez T, Austin C, Sandbrink F, Bravata DM. Association of a Positive Drug Screening for Cannabis With Mortality and Hospital Visits Among Veterans Affairs Enrollees Prescribed Opioids. JAMA network open 2022. PMID: 36525274


  17. Sullivan JL, Simons KV, Mills WL, Hilgeman MM, Freytes IM, Morin RT, Bower ES, Clark R, Byers AL. A Paucity of Data on Veterans 65 and Older and Risk of Suicide: A Systematic Review. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2022. PMID: 36494291


  18. Dolsen EA, Nishimi K, LeWinn KZ, Byers AL, Tripp P, Woodward E, Khan AJ, Marx BP, Borsari B, Jiha A, Neylan TC, O'Donovan A. Identifying correlates of suicide ideation during the COVID-19 pandemic: A cross-sectional analysis of 148 sociodemographic and pandemic-specific factors. Journal of psychiatric research 2022. PMID: 36252348


  19. Kelly JD, Leonard S, Hoggatt KJ, Boscardin WJ, Lum EN, Moss-Vazquez TA, Andino R, Wong JK, Byers A, Bravata DM, Tien PC, Keyhani S. Incidence of Severe COVID-19 Illness Following Vaccination and Booster With BNT162b2, mRNA-1273, and Ad26.COV2.S Vaccines. JAMA 2022. PMID: 36156706


  20. Byers AL, Li Y, Barnes DE, Boscardin WJ, Peltz CB, Yaffe K. TBI and risk of death in military veterans over 14 years: Injury severity, timing, and cause of death. Journal of psychiatric research 2022. PMID: 36257114


  21. Dolsen EA, Byers AL, Flentje A, Goulet JL, Jasuja GK, Lynch KE, Maguen S, Neylan TC. Sleep disturbance and suicide risk among sexual and gender minority people. Neurobiology of stress 2022. PMID: 36164391


  22. Gibson CJ, Li Y, Jasuja GK, Keyhani S, Byers AL. Long-term Psychoactive Medications, Polypharmacy, and Risk of Suicide and Unintended Overdose Death Among Midlife and Older Women Veterans. Journal of general internal medicine 2022. PMID: 36042093


  23. Portacolone E, Byers A, Halpern J, Barnes DE. Addressing suicide risk in patients living with dementia during the COVID-19 pandemic and beyond. TO REMOVE 2022. PMID: 35365827


  24. Hargrave AS, Maguen S, Inslicht SS, Byers AL, Seal KH, Huang AJ, Gibson CJ. Veterans Health Administration Screening for Military Sexual Trauma May Miss Over Half of Cases Among Midlife Women Veterans. Women's health issues : official publication of the Jacobs Institute of Women's Health 2022. PMID: 35821182


  25. Blanken A, Gibson CJ, Li Y, Huang AJ, Byers AL, Maguen S, Inslicht S, Seal K. Racial/ethnic disparities in the diagnosis and management of menopause symptoms among midlife women veterans. Menopause (New York, N.Y.) 2022. PMID: 35796560


  26. Kuffel RL, Byers AL, Williams B, Fortinsky R, Li Y, Ruderman MA, Barry LC. Prevalence of dementia and mild cognitive impairment before incarceration. TO REMOVE 2022. PMID: 35212389


  27. Wray CM, Vali M, Walter LC, Christensen L, Chapman W, Austin PC, Byers AL, Keyhani S. Examining the association of social risk with heart failure readmission in the Veterans Health Administration. BMC health services research 2021. PMID: 34445974


  28. Günak MM, Barnes DE, Yaffe K, Li Y, Byers AL. Risk of Suicide Attempt in Patients With Recent Diagnosis of Mild Cognitive Impairment or Dementia. JAMA psychiatry 2021. PMID: 33760039


  29. Martinez S, Yaffe K, Li Y, Byers AL, Peltz CB, Barnes DE. Agent Orange Exposure and Dementia Diagnosis in US Veterans of the Vietnam Era. JAMA neurology 2021. PMID: 33492338


  30. Leng Y, Byers AL, Barnes DE, Peltz CB, Li Y, Yaffe K. Traumatic Brain Injury and Incidence Risk of Sleep Disorders in Nearly 200,000 US Veterans. Neurology 2021. PMID: 33658328


  31. Gibson CJ, Li Y, Jasuja GK, Self KJ, Seal KH, Byers AL. Menopausal Hormone Therapy and Suicide in a National Sample of Midlife and Older Women Veterans. Medical care 2021. PMID: 33438886


  32. Wray CM, Byers AL. Methodological Progress Note: Classification and Regression Tree Analysis. Volume 15. Journal of hospital medicine 2020. PMID: 32195654


  33. Byers AL, Li Y, Barnes DE, Seal KH, Boscardin WJ, Yaffe K. A national study of TBI and risk of suicide and unintended death by overdose and firearms. Brain injury 2019. PMID: 31822136


  34. Morin RT, Li Y, Mackin RS, Whooley MA, Conwell Y, Byers AL. Comorbidity Profiles Identified in Older Primary Care Patients Who Attempt Suicide. Volume 67 of Issue 12. Journal of the American Geriatrics Society 2019. PMID: 31469184


  35. Wray CM, Vali M, Walter LC, Lopez L, Austin PC, Byers A, Keyhani S. Examining the Utility of 30-day Readmission Rates and Hospital Profiling in the Veterans Health Administration. Journal of hospital medicine 2019. PMID: 30794141


  36. Dismuke-Greer CE, Gebregziabher M, Byers AL, Taber D, Axon N, Yaffe K, Egede LE. Comorbid TBI-depression costs in veterans: a chronic effect of neurotrauma consortium (CENC) study. Brain injury 2018. PMID: 30403538


  37. Gibson CJ, Li Y, Inslicht SS, Seal KH, Byers AL. Gender Differences in Cardiovascular Risk Related to Diabetes and Posttraumatic Stress Disorder. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2018. PMID: 30314941


  38. Lai AX, Kaup AR, Yaffe K, Byers AL. High Occurrence of Psychiatric Disorders and Suicidal Behavior Across Dementia Subtypes. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2018. PMID: 30392777


  39. Barnes DE, Byers AL, Gardner RC, Seal KH, Boscardin WJ, Yaffe K. Association of Mild Traumatic Brain Injury With and Without Loss of Consciousness With Dementia in US Military Veterans. JAMA neurology 2018. PMID: 29801145


  40. Byers AL, Lui LY, Vittinghoff E, Covinsky KE, Ensrud KE, Taylor B, Yaffe K. Burden of Depressive Symptoms Over 2 Decades and Risk of Nursing Home Placement in Older Women. Journal of the American Geriatrics Society 2018. PMID: 30094824


  41. Barry LC, Steffens DC, Covinsky KE, Conwell Y, Li Y, Byers AL. Increased Risk of Suicide Attempts and Unintended Death Among Those Transitioning From Prison to Community in Later Life. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2018. PMID: 30146371


  42. Bertenthal D, Yaffe K, Barnes DE, Byers AL, Gibson CJ, Seal KH. Do postconcussive symptoms from traumatic brain injury in combat veterans predict risk for receiving opioid therapy for chronic pain? Brain injury 2018. PMID: 29985653


  43. Gardner RC, Byers AL, Barnes DE, Li Y, Boscardin J, Yaffe K. Mild TBI and risk of Parkinson disease: A Chronic Effects of Neurotrauma Consortium Study. Neurology 2018. PMID: 29669907


  44. Seal KH, Bertenthal D, Barnes DE, Byers AL, Gibson CJ, Yaffe K. Traumatic Brain Injury and Receipt of Prescription Opioid Therapy for Chronic Pain in Iraq and Afghanistan Veterans: Do Clinical Practice Guidelines Matter? The journal of pain : official journal of the American Pain Society 2018. PMID: 29597083


  45. Byers AL, Lai AX, Nelson C, Yaffe K. Predictors of Mental Health Services Use Across the Life Course among Racially-Ethnically Diverse Adults. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2017. PMID: 28774787


  46. Seal KH, Bertenthal D, Barnes DE, Byers AL, Strigo I, Yaffe K. Association of Traumatic Brain Injury With Chronic Pain in Iraq and Afghanistan Veterans: Effect of Comorbid Mental Health Conditions. Archives of physical medicine and rehabilitation 2017. PMID: 28455190


  47. Kaup AR, Byers AL, Falvey C, Simonsick EM, Satterfield S, Ayonayon HN, Smagula SF, Rubin SM, Yaffe K. Trajectories of Depressive Symptoms in Older Adults and Risk of Dementia. JAMA psychiatry 2016. PMID: 26982217


  48. Beristianos MH, Maguen S, Neylan TC, Byers AL. TRAUMA EXPOSURE AND RISK OF SUICIDAL IDEATION AMONG ETHNICALLY DIVERSE ADULTS. Volume 33 of Issue 6. Depression and anxiety 2016. PMID: 26992150


  49. Beristianos MH, Maguen S, Neylan TC, Byers AL. Trauma Exposure and Risk of Suicidal Ideation Among Older Adults. Volume 24 of Issue 8. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2016. PMID: 27067069


  50. Byers AL, Lai AX, Arean P, Nelson JC, Yaffe K. Mental Health Service Use Across the Life Course Among Adults With Psychiatric Disorders and Prior Suicidal Behavior. Psychiatric services (Washington, D.C.) 2016. PMID: 26766753


  51. Kargel JS, Leonard GJ, Shugar DH, Haritashya UK, Bevington A, Fielding EJ, Fujita K, Geertsema M, Miles ES, Steiner J, Anderson E, Bajracharya S, Bawden GW, Breashears DF, Byers A, Collins B, Dhital MR, Donnellan A, Evans TL, Geai ML, Glasscoe MT, Green D, Gurung DR, Heijenk R, Hilborn A, Hudnut K, Huyck C, Immerzeel WW, Liming J, Jibson R, Kääb A, Khanal NR, Kirschbaum D, Kraaijenbrink PD, Lamsal D, Shiyin L, Mingyang L, McKinney D, Nahirnick NK, Zhuotong N, Ojha S, Olsenholler J, Painter TH, Pleasants M, Pratima KC, Yuan QI, Raup BH, Regmi D, Rounce DR, Sakai A, Donghui S, Shea JM, Shrestha AB, Shukla A, Stumm D, van der Kooij M, Voss K, Xin W, Weihs B, Wolfe D, Lizong W, Xiaojun Y, Yoder MR, Young N. Geomorphic and geologic controls of geohazards induced by Nepal's 2015 Gorkha earthquake. Volume 351 of Issue 6269. Science (New York, N.Y.) 2015. PMID: 26676355


  52. Poelke G, Ventura MI, Byers AL, Yaffe K, Sudore R, Barnes DE. Leisure activities and depressive symptoms in older adults with cognitive complaints. Volume 28 of Issue 1. International psychogeriatrics 2015. PMID: 26299193


  53. Yaffe K, Nettiksimmons J, Yesavage J, Byers A. Sleep Quality and Risk of Dementia Among Older Male Veterans. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2015. PMID: 25794635


  54. Beristianos MH, Yaffe K, Cohen B, Byers AL. PTSD and Risk of Incident Cardiovascular Disease in Aging Veterans. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2014. PMID: 25555625


  55. Barnes DE, Kaup A, Kirby KA, Byers AL, Diaz-Arrastia R, Yaffe K. Traumatic brain injury and risk of dementia in older veterans. Neurology 2014. PMID: 24966406


  56. Byers AL, Yaffe K. Depression and dementias among military veterans. Alzheimer's & dementia : the journal of the Alzheimer's Association 2014. PMID: 24924668


  57. Yaffe K, Hoang TD, Byers AL, Barnes DE, Friedl KE. Lifestyle and health-related risk factors and risk of cognitive aging among older veterans. Alzheimer's & dementia : the journal of the Alzheimer's Association 2014. PMID: 24924664


  58. Meziab O, Kirby KA, Williams B, Yaffe K, Byers AL, Barnes DE. Prisoner of war status, posttraumatic stress disorder, and dementia in older veterans. Alzheimer's & dementia : the journal of the Alzheimer's Association 2014. PMID: 24924674


  59. Byers AL, Covinsky KE, Neylan TC, Yaffe K. Chronicity of posttraumatic stress disorder and risk of disability in older persons. JAMA psychiatry 2014. PMID: 24647756


  60. Hoang TD, Byers AL, Barnes DE, Yaffe K. Alcohol consumption patterns and cognitive impairment in older women. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2014. PMID: 24862680


  61. Mackin RS, Nelson JC, Delucchi K, Raue P, Byers A, Barnes D, Satre DD, Yaffe K, Alexopoulos GS, Arean PA. Cognitive outcomes after psychotherapeutic interventions for major depression in older adults with executive dysfunction. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2013. PMID: 24378255


  62. Zeki Al Hazzouri A, Vittinghoff E, Byers A, Covinsky K, Blazer D, Diem S, Ensrud KE, Yaffe K. Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women. The journals of gerontology. Series A, Biological sciences and medical sciences 2013. PMID: 24097423


  63. Byers AL, Vittinghoff E, Lui LY, Hoang T, Blazer DG, Covinsky KE, Ensrud KE, Cauley JA, Hillier TA, Fredman L, Yaffe K. Twenty-year depressive trajectories among older women. Archives of general psychiatry 2012. PMID: 23026957


  64. Byers AL, Covinsky KE, Barnes DE, Yaffe K. Dysthymia and depression increase risk of dementia and mortality among older veterans. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2012. PMID: 21597358


  65. Barnes DE, Yaffe K, Byers AL, McCormick M, Schaefer C, Whitmer RA. Midlife vs late-life depressive symptoms and risk of dementia: differential effects for Alzheimer disease and vascular dementia. Archives of general psychiatry 2012. PMID: 22566581


  66. Byers AL, Arean PA, Yaffe K. Low use of mental health services among older Americans with mood and anxiety disorders. Psychiatric services (Washington, D.C.) 2012. PMID: 22227762


  67. Byers AL, Yaffe K. Depression and risk of developing dementia. Nature reviews. Neurology 2011. PMID: 21537355


  68. Byers AL, Yaffe K, Covinsky KE, Friedman MB, Bruce ML. High occurrence of mood and anxiety disorders among older adults: The National Comorbidity Survey Replication. Archives of general psychiatry 2010. PMID: 20439830


  69. Sheeran T, Byers AL, Bruce ML. Depression and increased short-term hospitalization risk among geriatric patients receiving home health care services. Volume 61 of Issue 1. Psychiatric services (Washington, D.C.) 2010. PMID: 20044423


  70. Byers AL, Levy BR, Kasl SV, Bruce ML, Allore HG. Heritability of depressive symptoms: a case study using a multilevel approach. Volume 18 of Issue 4. International journal of methods in psychiatric research 2009. PMID: 19757480


  71. Gallo WT, Brand JE, Teng HM, Leo-Summers L, Byers AL. Differential Impact of Involuntary Job Loss on Physical Disability Among Older Workers Does Predisposition Matter? Volume 31 of Issue 3. Research on aging 2009. PMID: 19924265


  72. Byers AL, Sheeran T, Mlodzianowski AE, Meyers BS, Nassisi P, Bruce ML. Depression and risk for adverse falls in older home health care patients. Volume 1 of Issue 4. Research in gerontological nursing 2008. PMID: 20077999


  73. Byers AL, Levy BR, Allore HG, Bruce ML, Kasl SV. When parents matter to their adult children: filial reliance associated with parents' depressive symptoms. Volume 63 of Issue 1. The journals of gerontology. Series B, Psychological sciences and social sciences 2008. PMID: 18332193


  74. Walke LM, Byers AL, Tinetti ME, Dubin JA, McCorkle R, Fried TR. Range and severity of symptoms over time among older adults with chronic obstructive pulmonary disease and heart failure. Volume 167 of Issue 22. Archives of internal medicine 2007. PMID: 18071174


  75. Bruce ML, Brown EL, Raue PJ, Mlodzianowski AE, Meyers BS, Leon AC, Heo M, Byers AL, Greenberg RL, Rinder S, Katt W, Nassisi P. A randomized trial of depression assessment intervention in home health care. Volume 55 of Issue 11. Journal of the American Geriatrics Society 2007. PMID: 17916119


  76. Fried TR, Van Ness PH, Byers AL, Towle VR, O'Leary JR, Dubin JA. Changes in preferences for life-sustaining treatment among older persons with advanced illness. Volume 22 of Issue 4. Journal of general internal medicine 2007. PMID: 17372799


  77. Walke LM, Byers AL, Gallo WT, Endrass J, Fried TR. The association of symptoms with health outcomes in chronically ill adults. Volume 33 of Issue 1. Journal of pain and symptom management 2007. PMID: 17196907


  78. Fried TR, Byers AL, Gallo WT, Van Ness PH, Towle VR, O'Leary JR, Dubin JA. Prospective study of health status preferences and changes in preferences over time in older adults. Volume 166 of Issue 8. Archives of internal medicine 2006. PMID: 16636215


  79. Walke LM, Byers AL, McCorkle R, Fried TR. Symptom assessment in community-dwelling older adults with advanced chronic disease. Volume 31 of Issue 1. Journal of pain and symptom management 2006. PMID: 16442480


  80. Fried TR, Bradley EH, O'Leary JR, Byers AL. Unmet desire for caregiver-patient communication and increased caregiver burden. Volume 53 of Issue 1. Journal of the American Geriatrics Society 2005. PMID: 15667377


  81. Byers AL, Allore H, Gill TM, Peduzzi PN. Application of negative binomial modeling for discrete outcomes: a case study in aging research. Volume 56 of Issue 6. Journal of clinical epidemiology 2003. PMID: 12873651


  82. Yaffe K, Haan M, Byers A, Tangen C, Kuller L. Estrogen use, APOE, and cognitive decline: evidence of gene-environment interaction. Neurology 2000. PMID: 10822435