Elizabeth Sara England-Kennedy

Dr. Elizabeth Sara England-Kennedy

orcid

Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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7 November 2024 in Healthcare
Verified
Journal Article
Open access
PDF file
Sri BanerjeeSri Banerjee
Sri Banerjee
Jagdish KhubchandaniJagdish Khubchandani
Jagdish Khubchandani
Elizabeth Sara England-KennedyElizabeth Sara England-Kennedy
Elizabeth Sara England-Kennedy
Rhonda Eve McIntyreRhonda Eve McIntyre
Rhonda Eve McIntyre
KKKaren Kopera-Frye
Karen Kopera-Frye
KAVITA BatraKAVITA Batra
KAVITA Batra
Background/Objectives: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality in the United States (U.S.), with rates varying by disease severity, comorbidities, and sociodemographic factors. Cognitive impairment has been independently associated with increased mortality, but has not been well studied in relation to COPD despite being a frequently overlooked comorbidity in COPD patients. The purpose of this nationwide study was to assess the relationship between low cognitive performance and the risk of mortality among older adults with COPD while adjusting for major sociodemographic and health-related characteristics. Methods: This study utilized the 1999–2002 National Health and Nutrition Examination Survey (NHANES) and the respiratory mortality data of noninstitutionalized US adults aged over 65 years. Survival curves showing the combined effect of cognitive decline and COPD using the Kaplan–Meier product-limit method to estimate the percent survival of the subject at each point in time were used. Results: The final sample included 2013 older adults, with 39.1% showing low cognitive performance and 12.7% having COPD. Those with low cognitive performance were older, less educated, had lower income, were more likely to be racial/ethnic minorities, and had a history of cardiovascular diseases (CVD); they were also more likely to have COPD or chronic kidney disease (CKD). The adjusted hazard ratio for respiratory-related mortality risk was highest for individuals with both COPD and low cognitive performance (hazards ratio = 8.53), people with COPD alone also had a higher respiratory-related mortality risk (hazards ratio = 4.92), but low cognitive performance alone did not significantly increase respiratory-related mortality risk. Conclusions: These findings provide clearer insights into how cognitive impairment affects mortality risk in older adults with COPD and we discuss potential strategies to address this dual chronic health challenge effectively.

14 May 2026 in Brain Sciences
Verified
Journal Article
Open access
PDF file
LBLiahm Blank
Liahm Blank
JKJoshua Khorsandi
Joshua Khorsandi
Elizabeth Sara England-KennedyElizabeth Sara England-Kennedy
Elizabeth Sara England-Kennedy
Sri BanerjeeSri Banerjee
Sri Banerjee
KKKaren Kopera-Frye
Karen Kopera-Frye
KAVITA BatraKAVITA Batra
KAVITA Batra
Daylight Saving Time (DST) creates abrupt, externally imposed circadian disruptions that can impair sleep regulation, hormonal balance, cognitive performance, and emotional stability. Although these effects are known in the general population, individuals with chronic mental illness, whose circadian systems are often intrinsically dysregulated, may face increased neuropsychological consequences. This comprehensive review synthesizes evidence from chronobiology, psychiatry, neuroscience, and population health to examine how DST-related circadian misalignment impacts cognitive functioning, mood regulation, suicidality risk, and symptom exacerbation across psychological disorders such as depression, anxiety disorders, bipolar disorder, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, and psychotic disorders. Following the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines, a search of PubMed, PsycINFO, Scopus, and Google Scholar was conducted to identify studies published from 2000–2026 examining DST, circadian rhythm disruption, neuropsychological outcomes, and chronic mental illness. Empirical, theoretical, and mechanistic studies were included to ensure comprehensive synthesis. Across conditions, DST, particularly spring forward transitions, is associated with increased sleep disturbance, impaired executive functioning, reduced attention and working memory, heightened emotional reactivity, increased depressive symptoms, elevated risk of manic episodes, and short-term increases in suicidality. Neurobiological mechanisms include altered melatonin secretion, cortisol dysregulation, Hypothalamus Pituitary Axis (HPA-axis) activation, and clock-gene desynchrony. DST may function as a modifiable negative environmental influence capable of affecting neuropsychological functioning in vulnerable populations. These findings underscore the need for clinical awareness, preventive strategies, and policy reconsiderations, including calls to eliminate seasonal time changes. Standardizing DST-related research outcomes and expanding longitudinal, multi-site studies will be essential for advancing this emerging field.

14 September 2025 in Brain Sciences
Verified
Journal Article
Open access
PDF file
Jagdish KhubchandaniJagdish Khubchandani
Jagdish Khubchandani
Elizabeth Sara England-KennedyElizabeth Sara England-Kennedy
Elizabeth Sara England-Kennedy
Sri BanerjeeSri Banerjee
Sri Banerjee
KKKaren Kopera-Frye
Karen Kopera-Frye
KAVITA BatraKAVITA Batra
KAVITA Batra
Background: Diabetes is a leading cause of death globally and is strongly associated with aging-related conditions, such as cognitive decline. Both diabetes and cognitive impairment share overlapping biological mechanisms, including vascular damage and insulin resistance. While each condition independently affects health outcomes, the impact of their coexistence on mortality risk among older Hispanic adults remains understudied. This study aimed to examine the impact of the combination of diabetes and low cognitive performance on mortality risk among this marginalized population. Methods: Data were drawn from 636 Hispanic adults aged 60 years and older who participated in NHANES 1999–2002, with mortality follow-up through 2019. Cox proportional hazards models were used to estimate hazard ratios (HRs) for all-cause mortality, adjusting for sociodemographic and health-related variables. Results: Among participants, 23.3% had diabetes, and 54.9% had low cognitive performance. The combination of diabetes and low cognitive performance was associated with a significantly elevated risk of all-cause mortality (HR = 2.36; 95% CI: 1.70–3.28). No statistically significant increase in mortality risk was observed for either condition alone (i.e. diabetes or cognitive impairment). Conclusions: Coexisting diabetes and cognitive impairment in older Hispanic adults were associated with more than a twofold increase in mortality risk. These findings underscore the need for culturally appropriate, interdisciplinary strategies to address the dual burden of diabetes and cognitive decline in aging minority populations.

5 November 2024 in The Evidence
Verified
Journal Article
Open access
Akshaya BhagavathulaAkshaya Bhagavathula
Akshaya Bhagavathula
Jagdish KhubchandaniJagdish Khubchandani
Jagdish Khubchandani
Elizabeth Sara England-KennedyElizabeth Sara England-Kennedy
Elizabeth Sara England-Kennedy
APAyana Pai
Ayana Pai
SSSushil Sharma
Sushil Sharma
BackgroundThe COVID-19 pandemic caused profound socioeconomic disruption in addition to claiming millions of lives worldwide. Beyond the infection-related mortality, a chronic and morbid condition known as “Long-COVID” is now getting increasing attention. Scholars and clinicians around the world are still trying to ascertain which COVID-19 variants could be linked with long-COVID mostly from clinic or healthcare facility-based studies. MethodsWe conducted a nationwide assessment in the U.S. using an infodemiological analysis to explore COVID-19 variants potentially linked with long-COVID. Long-COVID search-related data were collected from Google Trends from January 1st, 2020 to January 10th, 2023 (the peak phase of the pandemic in the U.S.). Variants prevalent in this period were analyzed in relation to the searches on long-COVID. ResultsA total of 2.2 million x 107 online searches for long-COVID were observed during the analytic period. The highest average searches recorded were during the Omicron variant surge followed by the surge of the Alpha variant. Given these findings and reports from clinical studies, Delta or original/wild variants are most likely associated with the occurrence of long-COVID symptoms among the U.S population. ConclusionsDelta or original wild variants may have the highest tendency to cause long-COVID symptoms in the general public. Additional population-based surveillance studies are needed to validate infodemiology methods on Long-COVID prevalence and occurrence.