Dementia, clinical trials, health policy, informed consent
• 2008 – Appointed by Governor Arnold Schwarzenegger as a founding member of the Public Health Advisory Committee, California Department of Public Health, State of California
• 2007 - F.A.A.N. – Selected as a Fellow of the American Academy of Nursing – induction November 2007
• 2004 – Awarded UCI Faculty Award for outstanding faculty, University of California Irvine Extension
• 2002 – Honored with Certificate of Appreciation from California Department of Health Services, for involvement in changing the California state law concerning informed consent for research (AB2328)
• 2002 – Honored with Letter of Recognition from Judd King, Vice Provost for Research, UCOP, for involvement in changing the California state law concerning informed consent for research (AB2328)
• 1988 – Honored with induction into Sigma Theta Tau International Nursing Honor Society: Iota Lambda Chapter, University of Southern California, Charter member
• 1987 – Awarded Outstanding Faculty Service to University of Southern California, Department of Nursing
• 1987 – Awarded Outstanding Nurse Educator by the SNA (Student Nurses Association) of the University of Southern California, Department of Nursing
• 1986 – Awarded Outstanding Young Woman of America
• 1980 – Honored with induction into Sigma Theta Tau International Nursing Honor Society: Pi Chapter, University of Maryland
As a clinical researcher, I have built a program of research that provides a translational bridge between the basic and clinical sciences. Consistent with the strategies identified by the National Institute on Nursing Research to advance nursing science, my current research portfolio addresses each of the strategies as follows: 1) Strategy 1 – integrating biology and behavior, is addressed through my ongoing clinical trials and biomarker studies; 2) Strategy 2 – designing and using new technology, is addressed through a home-based assessment study that will be launched in September; 3) Strategy 3 – developing new tools, is addressed through past participation in many instrument development studies to better measure outcomes in clinical trials.
Additional research efforts include collaborative studies on elder abuse in demented persons [funded by the State of California Department of Health Services] (with a second collaborative grant being funded by the National Institute on Justice), and another collaborative project that investigates the benefit of a passive exercise regimen on the bone development and growth of premature infants. This latter project, funded by the National Institute of Nursing Research, benefited from my clinical trial design expertise, and ongoing oversight of the data and safety monitoring board for this study.
My clinical work with the cognitively impaired population led me to develop a deep interest in the area of impaired decision-making capacity, particularly as it relates to research decision-making. The pursuit of this area of interest was complimented by my robust regulatory knowledge, gained through long-term service on the university’s Institutional Review Boards and active participation as an AAHRPP site visitor. Combining these areas of expertise supported my impact on state wide health policy as I collaborated with two colleagues at the University of California San Diego to lead a state-wide initiative to modify the California Health and Safety Code. Section 24178 of the Code had severely restricted the legally authorized representative definition as it pertained to informed consent for research. After more than two years of work, involving multiple testimonies in Sacramento and expansive networking to garner support from other groups, while simultaneously debating and defeating the issues raised by activist groups, the legislation (AB2328) was signed by the governor on September 11, 2002 and became law on January 1, 2003 [Mulnard, Sundsmo, Thal, California Health and Safety Code section 24178].
Teng, E., Ringman, J.M., Ross, L.K., Mulnard, R.A., Dick, M.B., Bartzokis, G., Davies, H.D., Galasko, D., Hewitt, L., Mungas, D., Reed, B.R., Schneider, L.S., Segal-Gidan, F., Yaffe, K., and Cummings, J.L. for the Alzheimer’s Disease Research Centers of California – Depression in Alzheimer’s Disease Investigators. (2008). Diagnosing Depression in Alzheimer’s Disease With the National Institute of Mental Health Provisional Criteria. American Journal of Geriatric Psychiatry, 16, 469-477.
Mulnard, R., Bigio, E., Buckles, V., Hyman, B., Schneider, J., Galasko, D., & Rogers, J. (2007). Biospecimen Task Force Guidelines for the Alzheimer’s Disease Centers. A compilation for the National Institute on Aging; published at the following website of the National Alzheimer’s Coordinating Center –
Edwards, C., Karlawish, J., Trojanowski, J., Mulnard, R.A., Cotman, C.W., Meuser, T., Morris, J., Lunde, A., & Petersen, R. (2007). Shining a Light on AD. A video production sponsored by MetLife Foundation.
Edwards, C., Karlawish, J., Trojanowski, J., Mulnard, R.A., Cotman, C.W., Meuser, T., Morris, J., Lunde, A., & Petersen, R. (2007). Healthy Brain Aging. A video production sponsored by MetLife Foundation.
Colt, H.G., & Mulnard, R.A. (2006). Writing an application for a human subjects institutional review board. Chest, 130(5), 1605-1607.
Lu, P.H., Masterman, D.A., Mulnard, R.A., Cotman, C., Miller, B., Yaffe, K., Reback, E., Porter, V., Swerdloff, R., and Cummings, J.L. (2006). Effects of testosterone on cognition and mood in male patients with mild Alzheimer’s disease and healthy elderly men. Archives of Neurology, 63, 1-9.
Mulnard, R.A. (2005). Methodological issues in estrogen treatment trials for Alzheimer’s disease. In Meharvan Singh, Ph.D. (Ed): The Future of Estrogen and Hormone Therapy in Postmenopausal Women: What Basic Science and Clinical Studies Teach Us. Annals of the New York Academy of Sciences, 1052, 173-181.
Mulnard, R.A., Corrada, M.M., Kawas, C.H. (2004). Estrogen replacement therapy, Alzheimer’s disease and mild cognitive impairment. Current Neurology and Neuroscience Reports, 4(5), 368-373.
Grundman, M., Petersen, R.C., Ferris, S. H., Thomas, R.G., Aisen, P., Bennett, D., Foster, N., Jack, C., Galasko, D., Doody, R., Kaye, J., Sano, M., Mohs, R., Gauthier, S., Kim, H.T., Jin, S., Schultz, A.N., Schafer, K., Mulnard, R.A., van Dyck, C., Mintzer, J., Zamrini, E.Y., Cahn, D., Thal, L.J., and the Alzheimer’s Disease Cooperative Study. (2004). The ADCS Clinical Trial of Vitamin E and Donepezil HCl (Aricept) to Delay Clinical Progression from Mild Cognitive Impairment (MCI) to Alzheimer’s Disease (AD): Trial Design and Subject Baseline Characteristics. Archives of Neurology, 61(1), 59-66.
Thal, L.J., Thomas, R.G., Mulnard, R.A., Sano, M., Grundman, M., & Schneider, L. (2003). Estrogen levels do not correlate with improvement in cognition. Archives of Neurology, 60(2), 209-212.
Aisen, P.S., Berg, J.D., Craft, S., Peskind, E.R., Sano, M., Teri, L., Mulnard, R.A., Thomas, R.G., &Thal, L.J. (2003). Steroid-induced elevation of glucose in Alzheimer’s disease: Relationship to gender, apolipoprotein E genotype and cognition. Psychoneuroendocrinology, 28(1), 113-120.
Mulnard, R.A., Sundsmo, M., & Thal, L.T. (2002). California Health and Safety Code section 24178. This legislation passed on 9/11/02, and became law on 01/01/03.
Mulnard, R.A. (2001). Sensation: An overview. In K. Bronstein, C. Stewart-Amidei, J. Kunkel (Eds.) AANN's Neuroscience Nursing: Human Responses to Neurologic Dysfunction. Philadelphia: W. B. Saunders, 533-556.
Mulnard, R.A. (2001). Alterations in the special senses. In: K. Bronstein, C. Stewart-Amidei, J. Kunkel (Eds.) AANN's Neuroscience Nursing: Human Responses to Neurologic Dysfunction. Philadelphia: W. B. Saunders, 557-571.
Mulnard, R.A., Cotman, C.W., Kawas, C.H., et al., (2000). Estrogen replacement therapy for treatment of mild to moderate Alzheimer’s disease: A 1-year randomized controlled trial. JAMA, 283(8), 1007-1015.
Mulnard, R.A. (2000). Estrogen as a replacement for Alzheimer disease: Response to letters to the editor. JAMA, 284(3), 307-308.
McCleary, R., Shankle, W.R., Mulnard, R.A., & Dick, M.B. (1996). Ishihara test performance and dementia. Journal of the Neurological Sciences, 142, 93-98.
Nielson, K.A., Nolan, J.H., Berchtold, N.C., Sandman, C.A., Mulnard, R.A., & Cotman, C.W. (1996). Apolipoprotein-E genotyping of diabetic dementia patients: Is diabetes rare in Alzheimer’s disease? Journal of the American Geriatric Society,44(8), 897-904.
McCleary, R., Mulnard, R.A., & Shankle, W.R. (1996). Hysterectomy risk in dementia: Evidence from the 1986 national mortality followback survey. Alzheimer’s Research, 2(5), 181-184.
People with Dementia as Witnesses to Emotional Events
(NIH/NIJ - PI: Mosqueda; Co-Investigator: Mulnard)
Efficacy of Nicotinamide for Treatment of Alzheimer’s Disease
(National Alzheimer’s Association - PI: Schreiber; Co-Investigator: Mulnard)
A Phase II, Multicenter, Open-Label, Long-Term Treatment Study To Determine The Safety, Tolerability, And Efficacy Of AAB-001 (ELN115727) In Patients With Alzheimer’s Disease Who Participated In Study AAB-001-201
(Elan Pharmaceuticals, Inc. - PI: Mulnard)
Open Label Study of the Effect of Daily Treatment with MPC-7869 in Subjects with Dementia of the Alzheimer’s Type
(Myriad Pharmaceuticals - PI: Mulnard)
A Randomized, Double-Blind, Placebo-Controlled Trial of the Effects of Docosahexaenoic Acid (DHA) in Slowing the Progression of Alzheimer’s Disease (ADC-026)
(NIH/NIA - PI: Mulnard)
A Double-Blind, Randomized, Placebo-Controlled Study of the Efficacy, Safety and Tolerability of 8 Week Treatment of RozeremTM 8mg (QHS) in Sleep Disturbed, Community Dwelling, Mild to Moderately Severe Alzheimer’s Disease Subjects
(Takeda Research and Development, Inc. - PI: Mulnard)
Evaluation of the Safety, Tolerability, and Impact on Biomarkers of Anti-oxidant Treatment of Mild to Moderate Alzheimer’s Disease (ADC-025)
(NIH/NIA - PI: Mulnard)
Assisted Exercise in Prematurity: Effects and Mechanisms
(NIH/NINR - PI: Cooper; Co-Investigator: Mulnard)
Alzheimer’s Disease Research Center at the University of California Irvine
(NIH/NIA - PI: Cotman; EIT Core Leader: Mulnard)
ICTS - Institute for Clinical and Translational Science