Talking to newly appointed PBS Assistant Professor of Clinical Science Lauren Rutter is like seeing a scientific career take shape before your eyes. Rutter explains the evolution of her interests, how one experience has built on another, both broadening the scope of her work and bringing it into focus around a single question: how symptoms of depression and anxiety interact with the cognitive decline that leads to dementia and Alzheimer’s disease.
Growing evidence suggests that depression in older adults is a risk factor for cognitive decline and Alzheimer’s disease, potentially acting through perceived stress. “Right now,” Rutter explains, “a lot of work shows they’re connected. But it’s still not known if depression and anxiety are a precursor, an actual cause, an early warning sign, or a consequence that manifests itself earlier than other symptoms. What’s interesting to me though is that anxiety and depression set people up to have higher risk profile for dementia and Alzheimer’s, and the cognitive impairments in these conditions, and can look similar to dementia as people age.”
Rutter has been a research scientist in PBS with her own lab since 2019. Now, as she takes on her new role as an assistant professor, she is also, as of August 15, the recipient of a five-year grant from the National Institute on Aging. Specifically designed for developing expertise on aging-related issues, the grant is a career development award which puts the necessary supports in place to lead her to the next stage of her career as “an independently funded researcher on the interplay of depression and pathological aging.”
Stepping stones to a career
As a graduate student in clinical psychology at Boston University, Rutter was interested in the classification of depression and anxiety, the concurrence and common symptoms that characterize these disorders, as well as how they might affect social cognition. In her dissertation she looked at the way people with depressive disorders vs. anxiety disorders judged emotional faces and whether a particular drug (oxytocin) could enhance the ability of each group to read facial expressions. In the end, she felt the scope and generalizability of the research was limited by the small pool of clinical participants. She wanted to study larger samples, to scale up the size of her dataset from dozens of participants to tens of thousands. And she soon realized you can create the technology to do this in the form of tests that anyone can use to measure their moods or cognition within minutes, a couple of times a day, what she calls “scalable citizen science.”
Following graduate school, Rutter completed an internship and postdoctoral fellowship at McLean Hospital in Belmont, MA, the largest psychiatric facility for Harvard Medical School and a leading research center. Here, she first began to study aging and expand her research, as well as to explore the technology she sought. She did clinical work and research in the Division of Geriatric Psychiatry at McLean and was part of the hospital’s Institute for Technology in Psychiatry, where she focused on developing accurate assessments of emotion sensitivity, processing speed, memory, and executive functioning that could be completed on a remote device. “I wanted them to be brief cognitive tests that could be done in your daily life,” says Rutter. “I think a lot of testing that is long and expensive can also be skewed. If you are having a bad day on the day of your testing, the results might reflect that. A regular daily test of functioning over time in your day-to-day life is likely to be more accurate than a single, longer test at a testing center.”
Rutter and her postdoctoral mentor, who developed the assessment platform “TestMyBrain,” have since been able to evaluate the accuracy and validity of the test in hundreds of thousands of people, confirming that it is a valid measure of reaction time, executive functioning, and attentional control.
IU opens new frontiers
Since arriving at IU, Rutter has expanded her interests even further. She has formed new collaborations with researchers in informatics, who are using social media to measure how people use certain kinds of language online that may be associated with depression and aging. She is a co-investigator on the grant of her PBS Clinical Science colleague Lorenzo Lorenzo-Luaces, in which they conduct text-based analysis of social media posts to understand how adolescents’ language on social media might relate to their mental health and can predict the presence of depression and anxiety.
Rutter has also developed collaborations with people in the College of Arts and Sciences sociology department and IU Bloomington School of Public Health. Key to her work is PBS colleague and social neuroscience professor Anne Krendl, who is the primary mentor on the mentorship team for her grant. Krendl’s work on the role of social networks in Alzheimer’s disease is also proving useful and relevant to Rutter’s in many ways.
“Coming to IU has really expanded what I’m interested in and what I do. I value the collaborations that I’ve developed at IU,” she says. “I love the psych department here and am very happy to be able to stay here.”
Ultimately, she brings this new wealth of collaborations and influences to bear on the work of her current grant: teasing out the pathways and mechanisms by which depression and Alzheimer’s are connected. And she foresees the difference this research will make in people’s lives.
“I think we are likely to find that depression can speed up the rate at which a person who is already experiencing some degree of cognitive problems will transition to Alzheimer’s,” she notes. “Alzheimer’s is progressive, meaning that once it starts, it worsens and there’s no going back. But the rate at which people will stay in a phase of mild cognitive impairment before it becomes severe can vary. By treating the depression, we may be able to slow down the progression of Alzheimer’s. Sadly, there’s not too much one can currently do about cognitive decline once it’s reached a certain point. But depression is very treatable.”
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