About

Shana D Stites, Psy.D., M.S., M.A., is an Assistant Professor of Psychiatry at the University of Pennsylvania and a Research Associate at the Population Aging Research Center (PARC). Her research focuses on advancing diagnosis and treatment of Alzheimer’s disease dementia, with an emphasis on understanding how disease impacts individuals and their family members, and how aspects of identity such as age, gender, and race influence the disease experience. Dr. Stites aims to promote quality of life and psychological wellbeing through her work, exploring disease mechanisms and developing interventions to limit disease burdens. Her educational background includes a B.S. in Psychology from Cedar Crest College, an M.A. in Sociology from Lehigh University, an M.S. and Psy.D.. in Psychology from Chestnut Hill College. She completed her clinical training with a doctoral internship at the Corporal Michael J. Crescenz VA Medical Center and post-doctoral training at the Penn Memory Center and Department of Neurology at the University of Pennsylvania’s Perelman School of Medicine. Dr. Stites is a graduate of the National Institute on Aging’s Butler-Williams Scholars Program and has a concentration in psychological assessment and multicultural diversity in clinical practice and research.

Research topics

• Medicine
• Psychology
• Political Science
• Engineering ethics
• Philosophy
• Medical education
• Pathology
• Epistemology
• Cognitive science
• Law

Selected publications

• Learning about a heightened genetic risk for dementia: Expected stigma is greater than experienced stigma.

  Psychology and Aging · 2026-02-23

  articleOpen access1st authorCorresponding

  carrier experiential group. The largest expectation-experience gaps concerned competence and social belonging. These findings suggest that older adults overestimate the social consequences of learning they are at genetic risk for AD. Theoretically, the results add to our understanding of the disability paradox, which refers to outsiders predicting worse life outcomes for people with chronic conditions than those individuals report themselves. Our findings show similar mispredictions occur even in the absence of symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

  PublisherDOI

• Repeated Administration of Social and Structural Determinants of Health (SSDOH) Questions in an Alzheimer’s Disease Research Center: The Aging Brain Study (ABC) Life Experience Survey

  Sage Open Aging · 2026-03-01

  articleOpen access1st authorCorresponding

  Social and structural determinants of health (SSDOH) must be measured longitudinally to understand how lived experiences shape trajectories of Alzheimer's disease and related dementias (ADRD). This study evaluated the feasibility of administering an SSDOH survey to cognitively unimpaired older adults, examining response consistency, changes over time, and missing data patterns. A follow-up survey was conducted with participants in the UPenn Alzheimer's Disease Research Center clinical cohort an average of 1.7 years after the initial survey. The 225-item questionnaire covered domains including education, social networks, and stressors. At follow-up, markers of feasibility included a 60% completion rate (81 of 135 participants), high item completion (>93%), and minimal missing data (<3% missed more than 10% of data). Logistic regression identified gender, social network size, and social readjustment experiences as predictors of nonrandom missingness. Response changes between administrations were likely due to ambiguity in item phrasing, instructions, or changes in participants' experiences. Overall, repeated administration of the SSDOH survey was feasible. The response rate was reasonable but lower than expected for a volunteer research sample, suggesting multiple modes of completion may increase engagement. Repeated administration also helped identify ambiguous items and methods for improving the validity and reliability of SSDOH measures.

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• The Population Neuroscience-Dementia Syndemics Framework to better understand global sex and gender-based risk in low- and middle-income countries

  Nature Aging · 2026-01-21 · 1 citations

  article
  PublisherDOI

• Predictors of extreme future time perspective change in persons who learn an Alzheimer’s disease biomarker test result

  Aging & Mental Health · 2026-03-23

  article1st authorCorresponding

  OBJECTIVES: Future Time Perspective (FTP) refers to how individuals perceive their future. FTP can be impacted when people learn their Alzheimer's disease (AD) biomarker test result. This study aimed to understand what factors explain change in FTP after people learn their AD biomarker result and whether large FTP changes, after learning an AD biomarker test result, can be predicted by clinical and demographic characteristics. METHOD: = 4,340) screening for an AD prevention trial, completed the 10-item FTP scale pre- and post- disclosure of their amyloid test result. We conducted bivariate and multivariable analyses. We calculated FTP change between pre- and post- result disclosure to estimate bivariate mean effects for covariates. We used a mixed-effects model to estimate time-varying effects and polytomous regression to estimate the relative risk ratio (RRR) of predictors of a large FTP increase (4th quartile) or decrease (1st quartile) compared to no change (2nd and 3rd quartiles). RESULTS: = 0.005). CONCLUSION: Disclosure processes may interact with reactions to specific test results, which has implications for the wider dissemination of these diagnostics. Assessable characteristics predict large FTP changes post-biomarker disclosure, which may help identify individuals with atypical outcomes.

  PublisherDOI

• Four Common Beliefs About Patient Memory Evaluations: Who Has Them and What Modifies Them?

  American Journal of Alzheimer s Disease & Other Dementias® · 2026-05-01

  articleOpen access1st authorCorresponding

  Understanding public beliefs about patients at memory centers may inform efforts to promote early diagnosis and guide clinical discussions of Alzheimer’s disease (AD). Adults (N=3,527) read a vignette describing a fictional person at a memory center and rated the person’s condition as a mental illness, part of typical aging, and psychological or biological origins. Vignettes varied by AD biomarker result, symptom stage, and treatment availability. Participants most strongly believed that the condition was part of typical aging and biological in origin, though beliefs varied across subgroups. Black and Asian participants reported stronger beliefs than White participants that the condition was a mental illness ( β =0.39, P &lt;0.001) and psychological ( β =0.46, P &lt;0.001). Men reported stronger beliefs that the condition was a mental illness ( β =0.19, P &lt;0.001), psychological ( β =0.14, P &lt;0.001), and part of typical aging (β=-0.08, P =0.04). Biomarker positivity heightened biological and lowered psychological attributions (all P &lt;0.05). The findings offer specific insights to guide intervention.

  PublisherDOI

• Deconstructing bilingualism and its sociocultural determinants in cognitive aging and Alzheimer's disease and related dementias

  Alzheimer s & Dementia · 2026-04-01

  articleOpen access

  Despite bilingualism being highly prevalent worldwide, the role of bilingualism in cognitive aging and Alzheimer's disease and related dementias (ADRD) remains inconclusive. Gaps include whether bilingual adults show reduced ADRD risk, how cognitive decline manifests across both languages, and what considerations are needed for accurate clinical assessment and intervention. The Bilingualism, Languages and Literacy Special Interest Group, part of the Diversity and Disparities Professional Interest Area, gathered an international, interdisciplinary group of researchers to identify key methodological factors impacting the study of bilingualism in cognitive aging and ADRD. Factors identified ranged from the operationalization and measurement of bilingualism, heterogeneity of bilingual populations, inconsistent accounting of sociocultural influences, scarcity of best practices in the clinical assessment and interventions of/for bilingual adults, and limited inclusion of conceptual frameworks. Findings generated reporting recommendations designed to increase rigor, comparability, and reproducibility across studies, and provide guidance for strengthening future research involving bilingual adults.

  PublisherOA PDFDOI

• A Cross-Sectional Analysis of Change in Church Activity with Cognitive, Functional, and Mental Health among Black and White Older Adults

  Dementia and Geriatric Cognitive Disorders Extra · 2026-02-27

  articleOpen accessSenior author

  Introduction: Stable religious participation may have beneficial contributions to cognitive and mental health; however, less is known about how changes in religious participation, such as disengagement or increased engagement in church activities, affect these health outcomes and whether there are differences between racial groups. This study aimed to examine the association between changes in church activity and cognitive, functional, and mental health in older adults, and explore differences by race. Methods: Using data from the University of Pennsylvania Alzheimer’s Disease Research Center Aging Brain Cohort in 2021–2022, we examined associations between self-reported change in church activity with cognitive and functional health (Global Clinical Dementia Score [CDR] and Total CDR) and neuropsychiatric symptoms (Neuropsychiatric Inventory) in cognitively normal older adults (n = 158). We used multivariable regression analysis, controlling for self-reported age, sex, education, and social interaction, to examine differences between individuals who identified as either Black or White. Results: Controlling for covariates, Black participants who reported substantially more or less church activity in the last year had lower cognition and function (Global CDR, β = 0.19, 95% CI: [0.04, 0.34], p &lt; 0.05) and Total CDR (β = 0.30, 95% CI: [0.01, 0.58], p = 0.042), and more neuropsychiatric symptoms (β = 0.63, 95% CI: [0.02, 1.24], p &lt; 0.045). No significance was found in White older adults. Black older adults reporting major changes in church activity experienced lower cognitive, functional, and mental health. Conclusion: To explore if church activity changes could be an early sign of cognitive, functional, and mental health decline, longitudinal studies are needed.

  PublisherOA PDFDOI

• Effects of caregiving experience on expectations of becoming an Alzheimer’s disease caregiver in the future

  The Journals of Gerontology Series B · 2026-03-03

  articleOpen access1st authorCorresponding

  OBJECTIVES: Research often focuses on persons who are or have been caregivers to a person with dementia. Little is known about stigma reactions in persons who expect to care for a person with Alzheimer's disease (AD). Understanding these beliefs may help guide clinical discussions with family members of persons with AD, particularly those diagnosed in the early stages. METHODS: A sample of 3,527 adults was randomized to read a vignette describing a fictional person with either a positive or a negative AD biomarker test result. Bivariate and multivariable analyses examined associations between AD caregiver status (expected and experienced) and responses on a modified Family Stigma in Alzheimer's Disease Scale (FS-ADS). RESULTS: About 31% (n = 1,090) of participants expected to be a caregiver for a person with AD, and most (63%) had previously been a caregiver. Controlling for differences in caregiving experience and other potential confounders, participants expecting (vs. not) to be AD caregivers reported higher willingness to support, more pity, and fewer negative aesthetic attributions than participants with (vs. without) AD caregiving experience (all p < .05). DISCUSSION: Caregiving experience is a strong predictor of a person's expectations of becoming one in the future, which runs counter to observed caregiving patterns, suggesting that for most people, becoming a caregiver is unexpected. Helping individuals set more accurate expectations for future caregiving roles is essential to support planning and preparation. Specific findings may inform the content of support and education programs that could accompany disclosure of AD biomarkers and early diagnosis.

  PublisherOA PDFDOI

• Polygenic scores and baseline cognitive function in midlife

  Alzheimer s & Dementia · 2025-12-01

  articleOpen access

  BACKGROUND: Midlife is a key life-course period for understanding risk factors of cognitive decline. Despite growing evidence demonstrating polygenic contributions to age-related disease risk, less is understood about how polygenic scores (PGS) may relate to cognitive traits in middle age. In a cross-sectional analysis, we investigated how PGS for Alzheimer's disease (AD), longevity, subjective-wellbeing (based on life satisfaction and positive affect), and cognitive-function may relate to cognition in a cohort of middle-aged adults with normal cognition. METHODS: The Health and Retirement Study (HRS) is an ongoing survey in Americans aged 50 years or older. We studied a cohort of 6615 individuals from the HRS (5359 European-ancestry, 1256 African-ancestry) aged 50-56 years with normal cognition at baseline, as determined by the HRS cognitive test battery. PGS derived from genetic variants associated with traits through genome-wide association studies in independent cohorts were available for all individuals. Linear regressions adjusted for baseline age, gender, and years of education were performed separately by genetically-defined ancestral group. RESULTS: Higher baseline cognition was observed in females (European-ancestry β=0.72±0.08,p<0.001; African-ancestry β=0.46±0.18,p=0.009) and individuals with more years of education (European-ancestry β=0.39±0.02,p<0.001; African-ancestry β=0.29±0.04,p<0.001). Higher cognitive-function PGS related to higher cognition (European-ancestry β=0.19±0.04,p<0.001; African-ancestry β=0.20±0.09,p=0.024). In the European-ancestry group, the cognitive-function PGS partially mediated the relationship between education and cognition (proportion mediated in European-ancestry=0.019, CI=0.010-0.030,p<0.001; proportion mediated in African-ancestry=0.016, CI=-0.002-0.050,p=0.072). The cognitive-function PGS still partially mediated the relationship between education and cognition in a subset of the European-ancestry group matched to the African-ancestry group based on age, gender, education, and cognition (n =1256 European-ancestry, proportion mediated=0.016, CI=0.002-0.040,p=0.016). Therefore, the lack of mediation in the African-ancestry group is likely not due to smaller sample size. We did not observe associations between cognition and PGS for AD, longevity, and subjective-wellbeing in either midlife ancestral group. CONCLUSIONS: In this HRS cohort, more years of education were related to higher baseline cognition, and in individuals with European-ancestry, this relationship was partially mediated by a PGS for cognitive-function. Future directions include assessing the contribution of PGS to cognition over time, and investigating how environmental and life-course factors may moderate the association between PGS and cognition.

  PublisherOA PDFDOI

• An online vignette study of diagnostic testing: Racial and ethnic differences in Alzheimer's disease diagnosis confidence and stigma

  Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · 2025-10-01

  articleOpen access1st authorCorresponding

  INTRODUCTION: Understanding how biomarker testing affects Alzheimer's disease (AD) diagnosis confidence and AD stigma among race and ethnicity groups is essential for supporting early diagnosis and treatment. METHODS: = 3548) rated confidence in an AD diagnosis based on four diagnostic evaluations and answered questions about AD stigma based on a clinical vignette. The sample reflects response and completion rates of 53% and 91.3%, respectively. Bivariate and multivariable regression analyses were conducted. RESULTS: Black participants showed the smallest increase (11.86 points) in diagnosis confidence of all race groups when a brain scan was included in the diagnostic evaluation. AD diagnosis confidence changed across diagnostic evaluation categories based on level and type of AD stigma domain and race group. DISCUSSION: Use of brain scans in evaluations can heighten diagnosis confidence in all race groups. Yet, no group had 100% confidence in an AD diagnosis with any evaluation. Recommendations are discussed. Highlights: Confidence in an Alzheimer's disease (AD) diagnosis varies across racial groups.Within racial groups, AD diagnosis confidence differs with diagnostics.Even with cutting-edge biomarker testing, no racial group had 100% confidence in an AD diagnosis.Patient-centered care and systemic changes are needed to widen distribution of diagnostic technologies and improve access to care.

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Recent grants

• Study of Cognitive Symptoms and Future Time Perspective in Preclinical Alzheimer's Disease

  NIH · $108k · 2020–2025

• Study of Cognitive Symptoms and Future Time Perspective in Preclinical Alzheimer's Disease

  NIH · $779k · 2020–2026

Frequent coauthors

• Kristin Harkins

  University of Pennsylvania

  43 shared

• Jason Karlawish

  California University of Pennsylvania

  40 shared

• Emily A. Largent

  University of Pennsylvania

  27 shared

• Dawn Mechanic‐Hamilton

  University of Pennsylvania

  11 shared

• Andrew Peterson

  11 shared

• Justin T. Clapp

  University of Pennsylvania

  10 shared

• Rebecca T. Brown

  University of Pennsylvania

  10 shared

• Jeanine Gill

  University of Pennsylvania

  9 shared

Awards & honors

• NIA Butler-Williams Scholars Program (2020)