Northern Light Mercy Hospital

BACKGROUND: Chronic pain has emerged as a disease in itself, affecting a growing number of people. Effective patient-provider communication is central to good pain management because pain can only be understood from the patient's perspective. We aimed to develop a user-centered tool to improve patient-provider communication about chronic pain and assess its feasibility in real-world settings in preparation for further evaluation and distribution. METHODS: To identify and prioritize patient treatment goals for chronic pain, strategies to improve patient-provider communication about chronic pain, and facilitate implementation of the tool, we conducted nominal group technique meetings and card sorting with patients with chronic pain and experienced providers (n = 12). These findings informed the design of the PainAPP tool. Usability and beta-testing with patients (n = 38) and their providers refined the tool and assessed its feasibility, acceptability, and preliminary impact. RESULTS: Formative work revealed that patients felt neither respected nor trusted by their providers and focused on transforming providers' negative attitudes towards them, whereas providers focused on gathering patient information. PainAPP incorporated areas prioritized by patients and providers: assessing patient treatment goals and preferences, functional abilities and pain, and providing patients tailored education and an overall summary that patients can share with providers. Beta-testing involved 38 patients and their providers. Half of PainAPP users shared their summaries with their providers. Patients rated PainAPP highly in all areas. All users would recommend it to others with chronic pain; nearly all trusted the information and said it helped them think about my treatment goals (94%), understand my chronic pain (82%), make the most of my next doctor's visit (82%), and not want to use opioids (73%). Beta-testing revealed challenges delivering the tool and summary report to patients and providers in a timely manner and obtaining provider feedback. CONCLUSIONS: PainAPP appears feasible for use, but further adaptation and testing is needed to assess its impact on patients and providers. TRIAL REGISTRATION: This study was approved by the University of New England Independent Review Board for the Protection of Human Subjects in Research (012616-019) and was registered with ClinicalTrials.gov (protocol ID: NCT03425266) prior to enrollment. The trial was prospectively registered and was approved on February 7, 2018.

BACKGROUND: Total knee arthroplasty (TKA) is a commonly performed procedure to alleviate pain and improve functional limitations caused by end-stage joint damage. Effective management of postoperative pain following TKA is crucial to the prevention of complications and enhancement of recovery. Adductor canal blocks (ACB) with conventional bupivacaine (CB) provide adequate analgesia after TKA, but carry a risk of rebound pain following block resolution. Liposomal bupivacaine (LB) is an extended-release local anesthetic that can provide up to 72 h of pain relief. The objective of this study was to compare postoperative outcomes between ACBs using LB and CB after TKA. METHODS: This single institution, prospective, randomized, clinical trial enrolled patients scheduled for TKA. Participants were randomized to receive ACB with either LB or CB. Pain scores up to 72 h postoperatively were assessed as the primary outcome. Opioid consumption and length of stay were evaluated as secondary outcomes. RESULTS: A total of 80 patients were enrolled. Demographic and clinical characteristics were similar between the two groups. LB group showed significantly lower cumulative opioid use during the 72 h evaluated (P = 0.016). There were no differences in pain scores or length of stay between the groups. CONCLUSION: The study demonstrated that LB ACBs led to significantly lower opioid consumption in the days following TKA without affecting pain scores or length of stay. This finding has important implications for improving postoperative outcomes and reducing opioid use in TKA patients. Previous studies have reported inconsistent results regarding the benefits of LB, highlighting the need for further research. TRIAL REGISTRATION: This project was retrospectively registered with clinicaltrials.gov ( NCT05635916 ) on 2 December 2022.

BACKGROUND: Cervical artery dissection and subsequent ischemic stroke is the most serious safety concern associated with cervical spinal manipulation. METHODS: We evaluated the association between cervical spinal manipulation and cervical artery dissection among older Medicare beneficiaries in the United States. We employed case-control and case-crossover designs in the analysis of claims data for individuals aged 65+, continuously enrolled in Medicare Part A (covering hospitalizations) and Part B (covering outpatient encounters) for at least two consecutive years during 2007-2015. The primary exposure was cervical spinal manipulation; the secondary exposure was a clinical encounter for evaluation and management for neck pain or headache. We created a 3-level categorical variable, (1) any cervical spinal manipulation, 2) evaluation and management but no cervical spinal manipulation and (3) neither cervical spinal manipulation nor evaluation and management. The primary outcomes were occurrence of cervical artery dissection, either (1) vertebral artery dissection or (2) carotid artery dissection. The cases had a new primary diagnosis on at least one inpatient hospital claim or primary/secondary diagnosis for outpatient claims on at least two separate days. Cases were compared to 3 different control groups: (1) matched population controls having at least one claim in the same year as the case; (2) ischemic stroke controls without cervical artery dissection; and (3) case-crossover analysis comparing cases to themselves in the time period 6-7 months prior to their cervical artery dissection. We made each comparison across three different time frames: up to (1) 7 days; (2) 14 days; and (3) 30 days prior to index event. RESULTS: The odds of cervical spinal manipulation versus evaluation and management did not significantly differ between vertebral artery dissection cases and any of the control groups at any of the timepoints (ORs 0.84 to 1.88; p > 0.05). Results for carotid artery dissection cases were similar. CONCLUSION: Among Medicare beneficiaries aged 65 and older who received cervical spinal manipulation, the risk of cervical artery dissection is no greater than that among control groups.

Purpose: Unicompartmental knee arthroplasty (UKA) is an established option for treating isolated unicompartmental knee osteoarthritis (OA), but controversies still exist about patient selection, indications, perioperative management and alignment goals. This survey was designed to understand the current trends of experienced arthroplasty knee surgeons performing UKA. Methods: to assess global tendencies in the utilization of UKA. A link to the survey was shared with all ESSKA (European Society for Sports Traumatology, Knee Surgery and Arthroscopy) members. The questionnaire consisted of free and multiple-choice questions and was divided into four sections: demographic information, the surgical activity of the respondents, indications for surgery and postoperative alignment goals. Results: A total of 138 ESSKA members from 34 different countries completed the survey. A total of 81 % of the responders performed fewer than 50 UKAs per year; 53 % of UKAs represented less than 20 % of their knee replacements; 71 % used mainly or only fixed-bearing implants; 81 % performed UKA in a shorter time compared to TKA; and 61 % and 72 % were interested in custom-made UKA and robotics, respectively. Thirty-six percent considered a minimum postoperative alignment of 0° for medial UKA, and 32 % considered 10° as the maximum valgus deformity for lateral UKA. Fifty-five percent had no minimum age cut-off, 47 % had no BMI cut-off, and 57 % believed TKA was better than UKA in knees with concomitant high-grade patellofemoral OA. Approximately 50 % of the surgeons desired a coronal alignment that was the same as the predegeneration alignment. Conclusion: A high level of agreement was reached regarding the following: preference for fixed-bearing UKAs, lower surgical time for UKA compared to TKA, interest in custom-made and robotic UKAs, no age and weight cut-off, TKA preferred in the presence of patellofemoral OA, and a final alignment goal of the predegenerative state both for medial and lateral. There was no agreement regarding length of stay, rehabilitation protocol, preoperative varus and valgus cut-off values, and treatment in cases of absence of anterior cruciate ligament or previous osteotomy.

Food pantries have the potential to promote nutrition through public health interventions and several novel approaches have been adopted. Prior to implementing new efforts, an important first step is understanding the receptivity and capacity of food pantries to adopt innovative strategies ultimately designed to improve health outcomes related to diet among the clients they serve. This is particularly important in rural areas, given the gap in research on several factors including food pantries’ organizational capacity, operations, personnel, and interest in distributing nutritious foods. We conducted a descriptive study based on a survey administered to 274 food pantry directors in Maine, a largely rural state to learn about their experiences, perceptions, as well as their pantry’s policies, practices, and capacity. Data were collected via an online 29-item questionnaire for those with email and through a paper and pencil version for those without email access. This study achieved a 69% response rate and the findings revealed variability in terms of practices, policy, capacity and food availability. Yet, despite these differences, respondents indicated a fairly consistent desire to provide balanced, nutritious meals. This suggests that pantry directors in Maine recognize the need for nutritious food and may be willing to adopt nutrition interventions.

PURPOSE: The aim of this meta-analysis was to to determine the influence of obesity on patient outcome and implant survivorship after primary unicompartmental knee arthroplasty (UKA). METHODS: A PRISMA systematic review was conducted by searching the Medline (PubMed), EMBASE, and Cochrane electronic databases to identify clinical studies investigating the effect of obesity on outcomes after UKA. Data were collected on aspecifically designed extraction form. Methodological quality was assessed using the Methodological Index for Nonrandomized Studies score. Quantitative meta-analysis was carried out using RevMan 5.4 software. RESULTS: ). Pooled analysis showed no statistically significant difference in Knee Society Score (KSS) pain in the obese (n.s.) and the severely obese (n.s.) group compared to the non-obese group, while the KSS function score was lower in the severely obese (P = 0.0002) compared to the obese (P = 0.06) and the non-obese group. Postoperative Oxford Knee Score (OKS) was lower in the obese group (P = 0.01) but not in the severely obese group (P = 0.16). Postoperative Range of Motion (ROM) was comparable in the obese and non-obese group (P = 0.16). Implant survival at 10 years follow-up was significantly lower in the obese (82.5-95.3%; P < 0.0001) and the severely obese group (87.5-93.8%; P < 0.0001) thanthe non-obese group (83.6-98.6%). CONCLUSION: Obesity and severe obesity were associated with significantly higher revision and lower implant survival rates. Obesity did not influence clinical and most functional outcomes after UKA, whereas KSS function score was significantly lower only for the severely obese patient group. LEVEL OF EVIDENCE: III, meta-analysis.

BACKGROUND We report the case of a patient undergoing a colonoscopy during which pressure applied on the abdomen by a nurse assisting in the procedure caused an extraluminal mesenteric tear. Mesenteric tears can be life-threating and need to be managed appropriately. This is the first case reported in the literature describing abdominal counter-pressure applied in the endoscopic procedure room as the cause of traumatic bowel injury. CASE REPORT A 72-year-old woman presented for a screening colonoscopy. Advancement of the colonoscope became so difficult that the procedure was temporarily aborted. To reduce looping of the colonoscope, the nurse assistant applied a forceful two-handed counter-pressure maneuver upon the abdomen to help the endoscopist advance the colonoscope to the cecum. After the procedure, the patient complained of abdominal pain and nausea. A CT scan of the abdomen showed a hematoma abutting the anterior abdominal wall. Unfortunately, laparoscopic surgery was hastily recommended over conservative medical management. Approximately 500 mL of old blood was evacuated. The patient survived postoperative complications, including pneumonia, respiratory failure, and sepsis. CONCLUSIONS Mesenteric tears are a rare but potentially life-threatening complication of colonoscopy. Post-colonoscopy patients with severe nausea, abdominal pain and/or distention, who fail to demonstrate free air in the abdomen, should have a CT scan with i.v. contrast to assess their condition. Hemodynamically stable patients should be managed with serial vitals and bedside observations, laboratory tests, imaging studies, fluid replenishment, and medication, to avoid unnecessary high-risk surgery. Abdominal counter-pressure applied safely during colonoscopy can reduce the risk of injury inherent in the procedure.

In recent years, the maritime sector has become increasingly interested in environmental sustainability issues, leading to the development of innovative technologies and materials. Seldom these solutions were analyzed with a life cycle approach and, when this has been done, the studies have been carried out without a reproducible methodology. The lack of a standardized methodology based on Life Cycle Assessment prevents a fair comparison between studies carried out on different vessels or technological solutions. As a result, determining whether the new solution or the new material employed is more sustainable than the prior one is difficult. The aim of the project was to develop a Product Category Rules (PCR), i.e. the standard that defines the rules for the publication of environmental labels based on Life Cycle Assessment (LCA) studies, based on ISO 14044 and ISO 14025, that could be used on a wide variety of vessel categories. This work presents the approach adopted for the development of the PCR, in order to produce comparable outcomes among different investigations. This article also includes an LCA analysis of a boat that represents one of the standard’s fields of application’s extremes, in order to confirm and verify our approach’s applicability. Indeed, we conducted a through investigation of a racing sailing boat built in composite material, whose components are all made by recyclable and recycled materials, i.e., a thermoplastic matrix filled with linen natural fibers.

Background: Quantitative pupillometry has been proposed as an objective means to diagnose acute sports-related concussion (SRC). Objective: To assess the diagnostic accuracy of a smartphone-based quantitative pupillometer in the acute diagnosis of SRC. Methods: Division I college football players had baseline pupillometry including pupillary light reflex (PLR) parameters of maximum resting diameter, minimum diameter after light stimulus, percent change in pupil diameter, latency of pupil constriction onset, mean constriction velocity, maximum constriction velocity, and mean dilation velocity using a smartphone-based app. When an SRC occurred, athletes had the smartphone pupillometry repeated as part of their concussion testing. All combinations of the seven PLR parameters were tested in machine learning binary classification models to determine the optimal combination for differentiating between non-concussed and concussed athletes. Results: 93 football athletes underwent baseline pupillometry testing. Among these athletes, 11 suffered future SRC and had pupillometry recordings repeated at the time of diagnosis. In the machine learning pupillometry analysis that used the synthetic minority oversampling technique to account for the significant class imbalance in our dataset, the best-performing model was a random forest algorithm with the combination of latency, maximum diameter, minimum diameter, mean constriction velocity, and maximum constriction velocity PLR parameters as feature inputs. This model produced 91% overall accuracy, 98% sensitivity, 84.2% specificity, area under the curve (AUC) of 0.91, and an F1 score of 91.6% in differentiating between baseline and SRC recordings. In the machine learning analysis prior to oversampling of our imbalanced dataset, the best-performing model was k-nearest neighbors using latency, maximum diameter, maximum constriction velocity, and mean dilation velocity to produce 82% accuracy, 40% sensitivity, 87% specificity, AUC of 0.64, and F1 score of 24%. Conclusions: Smartphone pupillometry in combination with machine learning may provide fast and objective SRC diagnosis in football athletes.

» Obesity is a public health concern, with 41.9% of the US population classified as obese. Obesity increases the risk of chronic disease, type II diabetes, cardiovascular diseases, etc., leading to increased morbidity and mortality. Obesity has been identified as an independent risk factor of postoperative complications, including infection and impaired wound healing, following elective surgery. In total joint arthroplasty, it has been well elucidated that obese patients are predisposed to higher rates of postoperative complications, longer hospital stays, and increased cost of stay.» Obesity is influenced by the interplay between many societal, behavioral, and socioeconomic factors and requires a multidisciplinary approach to treatment. The patient's care team should be well versed in nutritional counseling, behavioral health counseling, medication management, and surgery to allow for a comprehensive approach.» Orthopaedic surgeons, dietitians, nutritionists, weight-loss physicians, and bariatric surgeons all play a critical role in treating this patient population. This review highlights the roles of these practitioners in developing an interdisciplinary framework to help patients with hip and knee arthritis lose weight before joint replacement surgery. Not only will this afford more patients the quality-of-life benefits that come with a hip or knee replacement but will also serve to decrease the complication rates associated with this patient cohort.» The aim of this review was to educate orthopaedic surgeons on various strategies that can be used to best optimize these patients for successful joint replacement surgery.

Objective: There is significant variation in out-of-hospital cardiac arrest (OHCA) outcomes between different regions. We sought to evaluate outcomes of OHCA patients in the interfacility transfer (IFT) setting, between critical care transport (LifeFlight) and community Emergency Medical Services (EMS), in the state of Maine. Methods: This was a retrospective analysis of our institution's electronic medical record and the Maine EMS database. Data were collected from January 1, 2019, to December 31, 2021. Only adult OHCA encounters requiring an IFT for definitive post-cardiac-arrest care were included. Demographics, EMS agency, IFT vital signs, targeted temperature management (TTM) medications, cerebral performance category (CPC) scores, survival to discharge, and other descriptive variables were collected. Results: = 0.036). LifeFlight was associated with more epinephrine (0.034) and norepinephrine (<0.001) use. Only 37% of IFTs had physician orders, with none (0.0%) of them defining vital sign targets. No difference in survival to discharge or CPC scores was observed between LifeFlight and other EMS agencies. No significant variation in comorbidities or vital signs was observed. Conclusions: There was no difference in survival to discharge or CPC scores between LifeFlight and ad hoc EMS agency. LifeFlight was associated with more TTM and vasopressor utilization during IFT. Most IFT encounters did not have dedicated physician orders, and none of the orders included vital sign targets.

OBJECTIVES: Objectively measuring pain sensitivity has not been easy in primary care clinics. A sphygmomanometer test (a sensory test that measures an individual's nociceptive response to pressure using a standard blood pressure cuff) has recently been established to test pain sensitivity. Here, we examined the feasibility of using the sphygmomanometer test with chronic pain patients. DESIGN: Population, observational study. SETTINGS: A community hospital multidisciplinary Pain Center and a private nonprofit university. SUBJECTS: Healthy controls and chronic pain patients were recruited. METHODS: All subjects underwent four pain sensitivity tests: a pressure algometer test, a cold pressure test, a heat sensitivity test, and a sphygmomanometer test. Participants then completed four established surveys for evaluating depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), fatigue (Fatigue Severity Scale), and pain catastrophizing (Pain Catastrophizing Scale). RESULTS: Although pain patients had significantly higher levels of depression, anxiety, fatigue, and pain catastrophizing, as well as reported pain scores, no significant differences in pain sensitivity were detected via any of the pain sensitivity tests. In the control but not the patient group, results from all pain sensitivity tests including the sphygmomanometer test were significantly correlated with each other. Unlike other pain sensitivity tests, the sphygmomanometer test did not correlate with measures of depression, anxiety, fatigue, or pain catastrophizing characteristics. CONCLUSIONS: Our results indicate the unique characteristics of the sphygmomanometer test as a pain sensitivity test, particularly when utilized for individuals with chronic pain. Multiple pain sensitivity tests that assess various sensory modalities are needed to evaluate pain sensitivities in chronic pain patients.

Abstract Sleep disturbances in Alzheimer’s disease (AD) are stressful for patients and families. This review provides an update on the efficacy of melatonin and other interventions for nighttime sleep disturbances in AD patients, building on the original Alzheimer’s disease Cooperative Study trial, the first large trial for sleep disturbance in AD. The initial multicenter, randomized, placebo‐controlled study investigated the effects of two melatonin formulations – 2.5 mg sustained‐release (ML2.5SR) and 10 mg immediate‐release (ML10) –compared to placebo (PLA) in 157 participants. The primary outcomes, measured via wrist‐actigraphy, indicated no significant changes; however, secondary outcomes suggested improvement in sleep quality with ML2.5SR. This suggests the efficacy of melatonin in AD may be related to time and exposure rather than dosage, as sustained‐release formulations showed a greater trend for efficacy than immediate. Melatonin’s antioxidant properties have been shown to be neuroprotective, balancing Aβ production and clearance, but have been equivocal in reducing sleep disturbances. Recent research has demonstrated actigraphy to be an imperfect method for measuring sleep and wakefulness, misclassifying asleep time as awake in people with AD, and overestimating sleep in others. Combined with the subjective nature and poor compliance with sleep diaries in the ADCS study, methodological questions as to how to do large studies of sleep in people with AD arose. Updated studies have looked at melatonin in comparison to interventions like bright‐light therapy and other drugs. Circadian rhythm disturbances are common in AD, and different therapies have been trialed to improve sleep onset, duration, and quality. There has also been updated information regarding the efficacy of different measure to accurately record sleep including EEG and polysomnography. We analyzed studies in the 20 years since the ADCS trial was published. Our findings, while mixed, suggest that melatonin may be more effective improving sleep outcomes in AD, than reported in the ADCS paper‐ particularly when used in conjunction with other interventions. Suggestions for further study include finding a new way to objectively gather sleep data in a large trial so that another multicenter trial looking several sustained release formulations and other interventions may be attempted.

The patient with anterior instability of the shoulder and substantial glenoid bone loss presents a challenging situation to the surgeon. Most often, this phenomenon occurs in young patients, when it is even more crucial that the surgeon choose the procedure with the greatest chance of success. The ideal surgical treatment for any orthopaedic condition is safe, pragmatic, inexpensive, and proven to be effective in both clinical and biomechanical studies. Distal tibia allograft (DTA) was first introduced approximately 10 years ago as a surgical technique to address shoulder instability in the setting of glenoid bone loss. Although Latarjet remains a reliable option, mounting evidence has demonstrated that DTA delivers comparable or improved rates of stability and patient-reported outcomes. Although the cost of DTA remains a consideration, its lower risk of complications and proven success has established this as a technique that rivals the traditional gold standard.

α-Gal syndrome (AGS) is an allergy to meat and other products derived from non-primate mammals resulting from development of IgE antibodies against the oligosaccharide galactose-α,1,3-galactose (α-Gal). Sensitivity to α-Gal is linked to tick bites, particularly bites from Amblyomma americanum (lone star tick). Recent studies demonstrate early failure of bioprosthetic valves in the setting of chronic inflammation following exposure to animal-derived surgical implants. We report a case of AGS associated with restenosis of prior bovine pericardium used for a common femoral patch angioplasty requiring reoperation.

Introduction: Splenic hemangioma is a rare vascular tumor of the spleen. Typically asymptomatic, these lesions can present with rupture and hemoperitoneum. Clinical Findings: We report the case of a patient with no previous abdominal surgery that presented with symptoms and imaging consistent with small bowel obstruction (SBO), and an incidental finding of a splenic lesion. Main diagnoses, therapeutic interventions, and outcomes: At diagnostic laparoscopy, a ruptured splenic hemangioma was identified, with obstructive ileus due to hemoperitoneum. The patient subsequently underwent splenectomy to prevent recurrent bleeding. Conclusions: Splenic hemangiomas are rare vascular neoplasms of the spleen, which can be complicated by rupture. While obstructive ileus is a common post-operative phenomenon, it is rarely seen in association with vascular anomalies. This case represents a rare presentation of small bowel obstruction, highlighting the utility of diagnostic laparoscopy in patients with no previous abdominal surgery.

Summary Northern Lights offers CO2 transport and storage as a service. Monitoring the storage complex throughout the phases of CO2-injection – pre-injection, active injection and post-injection is key to ensure safe and reliable operation. Northern Lights has developed in-house CO2 monitoring dashboards, with intuitive interfaces, which allows for daily cross-disciplinary monitoring of CO2 injection in the storage complex. This allows us to confirm safe storage in the targeted hydraulic unit, and to demonstrate the success of effective and safe CO2 storage.

Abstract In this case–case control study, we identified receipt of β-lactam antibiotics and older age as independently associated with increased infection risk with ESBL-producing Escherichia coli among residents aged 20–88 years in a rural Maine hospital system where the infection prevalence of antibiotic-resistant E. coli is low.

An open label trial had suggested that a comprehensive micronutrient supplement, Empower Plus Advanced, in combination with Fish Oil, would be helpful in reducing symptom burden in adults diagnosed with bipolar disorder. We designed a double-blinded, randomized, controlled feasibility trial to explore the parameters necessary to mount a large-scale clinical trial. We aimed to enroll 97 participants and randomize in a 3:2 ratio to Vitamins or Placebo. We recruited patients from a family medicine residency clinic in Maine who were diagnosed in the electronic health record as having bipolar disorder. Diagnoses were confirmed via psychiatric interview or chart review (for obvious cases). The primary outcome measures were changes on the clinical global impressions scale (CGI), changes on the UKU Side Effects Scale, and changes in medications doses. A total of 69 patients were actually randomized and data were analyzed for 49 patients. The cost per participant was higher than expected due to increased regulatory requirements imposed by our Institutional Review Board (IRB) related to concerns about the hazards of micronutrient supplementation for psychiatric patients. In non-parametric chi-square analysis, significantly more patients in the Vitamin group improved on the CGI over the course of their participation in the study (p = 0.04). However, in parametric analysis the average improvement was not statistically significant between the two groups. All patients showed significant improvement over time in CGI (p = 0.0001) with statistically significant reductions in medication doses and side effects. The only adverse events occurring more among the Intervention group were nausea and loose stools but were not statistically significant. We suspect the benefits of closer surveillance, medication adjustment (mostly reduction), and human contact overshadowed the potential benefits of micronutrients. Future studies would do well to use a four-month lead-in period during which medications can be adjusted and participants can decide if they are willing to take vitamins for an extended time. Our data suggest that primary care patients with bipolar disorder would fare better on lower medications doses and more frequent visits. Further clinical trials are warranted. The Foundation for Excellence in Mental Health.

Abstract Background Disease‐modifying treatments for Alzheimer’s disease and related dementias (ADRD) will be most effective early in the disease process. Clinical use of these therapies will require practical, widely accessible biomarkers. Plasma‐based protein biomarkers hold promise for identifying core AD pathology, but this complex disease likely requires other markers to identify people at highest risk of progression to dementia. Studies support eye exams as a synergistic strategy since retinal imaging would be cost effective, but significant hurdles remain. The timing and subtypes of retinal biomarkers have not yet been determined and the identification of ADRD‐specific biomarkers independent of common ocular diseases is challenging. Here, we introduce a new program, Model‐EyeD, to evaluate the eye as an accessible biomarker in the mouse model and human subjects. Method For familial AD and mixed dementia, we have backcrossed the APP SAA knock‐in allele (humanized Abeta with Swedish, Artic, Austrian, mutations) from C57BL/6J (B6) to genetically diverse NZO/HILtJ (prone to obesity and diabetes), and WSB/EiJ (susceptible to cerebrovascular deficits) strains. To study late‐onset AD (LOAD), we are using strains created by the IU/JAX/PITT MODEL‐AD Center, including the common 677C&gt;T variant in methylene tetrahydrofolate reductase gene ( Mthfr 677C&gt;T ), a cardiovascular and cerebrovascular risk factor. A battery of ocular assays (pattern electroretinograms, fluorescence angiography, optical coherence tomography) are performed on four to 24 months old male and female mice. Results are being compared to MRI, PET/CT, cognition and blood biomarkers. Result Unlike previous transgenic amyloid models, B6. APP SAA and WSB. APP SAA mice show no retinal amyloid deposition or retinal vascular deficits at 12 months. NZO (in the absence of amyloid deposition) show retinopathy lesions (cotton wool spots, vascular leakage), suggesting NZO. APP SAA are ideal to study interactions between metabolic syndrome retinopathy and mixed dementia. Young B6. Mthfr 677C&gt;T mice show cerebral and retinal vascular deficits. Aging studies are ongoing. Results will be confirmed in human subjects with clinical and biomarker‐confirmed AD and mixed AD/small vessel vascular disease. Conclusion Our extensive collection of genetically diverse mouse models, coupled with our alignment to data from human subjects, show promise in developing eye‐based protocols to identify early stages of different clinical phenotypes of ADRD in humans.