About

Ting-Ling Chang, D.D.S., is a Health Sciences Clinical Professor and the Chair of the Section of Prosthodontics at the UCLA School of Dentistry. She serves as the residency program director for both Maxillofacial Prosthetics and Advanced Prosthodontics. Dr. Chang joined the UCLA faculty in 1998 and maintains a private practice limited to implant prosthodontics and maxillofacial prosthetic rehabilitation. She is a Diplomate of the American Board of Prosthodontics. Her research interests include cleft lip and palate rehabilitation, implant biomechanics, maxillofacial prosthetics, and patient-centered outcome studies. Dr. Chang has contributed to the field through her teaching, research, and clinical activities, including her role as course chair for advanced removable prosthodontics and removable partial dentures, as well as her involvement in maxillofacial prosthodontic consultations at UCLA.

Research topics

• Medicine
• Genetics
• Biology
• Psychiatry
• Virology
• Pathology
• Evolutionary biology
• Environmental health
• Emergency medicine
• Internal medicine

Selected publications

• Advancing precision health discovery in a genetically diverse health system

  Cell · 2026-03-27

  articleOpen access

  Linking genetic data with electronic health records in hospital biobanks promises to advance precision medicine, but limited ancestral diversity constrains discovery and generalizability. We analyzed 93,936 participants from the UCLA ATLAS Community Health Initiative to inform disease prevalence and genetic risk across five continental and 36 fine-scale ancestry groups. We discovered numerous unreported gene-phenotype associations, including FN3K with intestinal disaccharidase deficiency in Europeans and admixed Americans. Polygenic scores (PGS) robustly predicted common diseases, with effects markedly diminished in non-Europeans. Furthermore, we reduced the pronounced European bias in curated clinical variants using computational predictors, uncovering unreported disease-gene associations, including ANKZF1 and peripheral vascular disease in African Americans. Longitudinal data revealed that semaglutide efficacy varies across ancestries, is associated with PGS for type 2 diabetes, and is modulated by genetic variation in PTPRU. These findings illustrate how ancestrally diverse biobanks from a single health system yield robust disease associations and pharmacogenomic insights.

  PublisherDOI

• Increased dementia diagnosis and workup in primary care with a bilingual screening tool integrated in the electronic health record

  Journal of Alzheimer s Disease · 2026-04-15

  articleOpen accessSenior authorCorresponding

  BackgroundAlzheimer's disease (AD) affects over 10% of adults aged 65 and older. Black and Hispanic/Latino individuals experience 1.5-2.0 times higher prevalence than White individuals, yet AD remains underdiagnosed, particularly in non-White populations. Common screening tools such as the Mini-Mental State Examination and Montreal Cognitive Assessment are limited by time burden and cultural sensitivity.ObjectiveTo evaluate the impact of integrating a brief dementia screening tool (DST) into the electronic health record (EHR) on diagnosis, evaluation, and treatment in primary care.MethodsThe DST, developed by the University of California Alzheimer's Disease Centers and the California Department of Public Health, takes under five minutes and includes a three-question patient form, optional informant questionnaire, and Mini-Cog. It was translated and culturally adapted for Spanish-speaking patients and embedded in the EHR. Patients aged ≥60 in a diverse Los Angeles County family medicine clinic completed the DST before annual wellness visits. We conducted a pre-post study comparing patients without prior dementia diagnoses during pre-intervention (February 2021-August 2022) and post-intervention (January 2023-June 2024) periods. Primary outcome was new dementia diagnosis; secondary outcomes included medications, referrals, labs, and imaging.ResultsAmong 1515 eligible patients post-intervention, 1249 completed screening. New dementia diagnoses increased from 0.75% pre-DST to 2.45% among those screening positive (adjusted OR 2.99; p = 0.01). Dementia medications, laboratory orders, and specialty referrals significantly increased; imaging did not.ConclusionsA brief, culturally adapted DST integrated into primary care improved dementia diagnosis, evaluation, and treatment.

  PublisherDOI

• Sparse Foundation Models for Continous-Time EHRs

  Research Square · 2026-02-10

  preprintOpen access
  PublisherOA PDFDOI

• Broad repetitive transcranial magnetic stimulation (rTMS) of the precuneus in Alzheimer's disease: A rationale and study design

  Alzheimer s & Dementia Translational Research & Clinical Interventions · 2025-01-01 · 2 citations

  articleOpen access

  INTRODUCTION: Brain network dysfunction, particularly within the default mode network (DMN), is an increasingly apparent contributor to the clinical progression of Alzheimer's disease (AD). Repetitive transcranial magnetic stimulation (rTMS) can target key DMN hubs, maintain signaling function, and delay or improve clinical outcomes in AD. Here, we present the rationale and design of a study using off-the-shelf equipment and the latest clinical evidence to expand on prior rTMS work and reduce participant burden in the process. METHODS: We will conduct a two-stage trial of large-coil rTMS targeting the precuneus (a key hub in the DMN affected by AD) in 54 participants with mild to moderate Alzheimer's Clinical Syndrome focused primarily on determining tolerability and feasibility and secondarily focused on determining short-term efficacy for memory. The first stage will involve 5 to 10 participants receiving open-label active treatment to refine the protocol. The following second stage will consist of a 1:1 randomized, double-blind, sham-controlled clinical trial to study feasibility and tolerability while exploring target engagement and short-term efficacy for memory. Participants will undergo 16 total rTMS brain stimulation sessions over the course of 5 weeks. A full course of open-label active treatment will be offered as an extension to the sham group after unblinding. Outcomes will focus on completion rates and adverse events to demonstrate feasibility and tolerability. Further exploratory outcomes will include neuropsychological assessments, electroencephalography, neuroimaging, and blood biomarkers to demonstrate the feasibility of collection and explore preliminary changes in these measures. RESULTS: We anticipate this treatment is feasible and tolerable and may show evidence of target engagement and clinical improvement. DISCUSSION: Should we achieve expected positive outcomes in feasibility and tolerability, this will justify future work focusing on clear demonstrations of clinical efficacy and biomarker engagement, as well as enhancement of generalizability and scalability. Highlights: Induction-to-maintenance repetitive transcranial magnetic stimulation (rTMS) of the precuneus is a promising treatment for Alzheimer's disease (AD), though recent methods require intensive personalization.We propose here a trial design of precuneus rTMS in mild-to-early-moderate AD dementia using exclusively off-the-shelf equipment and protocol modifications to reduce participant burden.Our two novel modifications from prior work are (1) using a larger rTMS coil, and (2) consolidating the induction phase of treatment.This trial focuses primarily on tolerability and feasibility while exploring clinical measures of efficacy and biomarkers of target engagement.Our trial is registered at ClinicalTrials.gov NCT06597942.

  PublisherOA PDFDOI

• Broad‐coil Repetitive Transcranial Magnetic Stimulation (rTMS) of the Precuneus in Alzheimer’s Disease

  Alzheimer s & Dementia · 2025-12-01

  articleOpen access

  BACKGROUND: Brain network dysfunction, particularly within the default mode network (DMN), is an increasingly apparent manifestation of Alzheimer's Disease (AD) progression. Repetitive transcranial magnetic stimulation (rTMS) can target key DMN hubs, maintain signaling function, and delay or improve clinical outcomes in AD. We present here the rationale, design, and preliminary open-label data of a study using off-the-shelf equipment and the latest clinical evidence to expand on prior rTMS work and reduce participant burden in the process. METHODS: We are conducting a two-stage trial of large-coil rTMS targeting the precuneus (a key hub in the DMN affected by AD) in 54 participants with mild to moderate Alzheimer's Clinical Syndrome focused primarily on determining tolerability and feasibility and secondarily studying short-term efficacy for episodic memory. The currently active first stage involves 5-10 participants receiving open-label treatment for protocol refinement. The subsequent stage will consist of a 1:1 randomized, double-blind, sham controlled clinical trial to study feasibility and tolerability while exploring target engagement and short-term efficacy for memory. Participants will undergo 16 total rTMS brain stimulation sessions over the course of 5 weeks. A full open-label extension treatment course will be offered to the sham group after unblinding. Outcomes focus on completion rates and adverse events to demonstrate feasibility and tolerability. Further exploratory outcomes will include neuropsychological assessments, electroencephalography (EEG), neuroimaging, and blood biomarkers to demonstrate feasibility of collection and explore preliminary changes in these measures. RESULTS: We anticipate this treatment is feasible and tolerable and may show evidence of target engagement and clinical improvement. We plan to present current preliminary open-label data as analyzed at AAIC. CONCLUSION: Should we achieve expected positive outcomes in feasibility and tolerability, this will justify future work focusing on clear demonstrations of clinical efficacy and biomarker engagement, as well as enhancement of generalizability and scalability. TRIAL REGISTRATION: Clinicaltrials.gov NCT06597942.

  PublisherOA PDFDOI

• Identifying common disease trajectories of Alzheimer’s disease with electronic health records

  EBioMedicine · 2025-07-01 · 3 citations

  articleOpen accessSenior author

  BACKGROUND: Alzheimer's disease (AD) is a leading cause of dementia and an escalating public health concern. Although recent research has identified multiple AD risk factors, most studies examine isolated comorbidities rather than complex, sequential progressions. In this study, we sought to identify multi-step trajectories culminating in AD by analysing longitudinal electronic health records (EHRs). METHODS: We analysed data from 24,473 patients in the University of California Health Data Warehouse (UCHDW). A Fine-Gray subdistribution hazard model identified temporally associated diagnoses, from which we constructed diagnostic trajectories. We employed dynamic time warping and k-means clustering to group similar trajectories, and network analyses to characterize their common structures. Causal inferences were explored using the Greedy Equivalence Search algorithm. Validation in the UCHDW included association tests and comparison to control groups. We further validated our findings in the All of Us Research Program, a diverse, nationally representative cohort. FINDINGS: After filtering, 5762 patients contributed 6794 unique AD progression trajectories, revealing four major trajectory clusters: mental health, encephalopathy, mild cognitive impairment, and vascular disease. These clusters differed significantly in demographic and clinical features. Approximately 26% of edges showed consistent directional ordering (e.g., hypertension → depressive episode → AD). In an independent population, these multi-step trajectories conferred greater AD risk than single diagnoses alone. Our validation in the All of Us cohort confirmed the reproducibility of these trajectory patterns in a more diverse population. INTERPRETATION: Our findings demonstrate the value of examining sequential diagnostic patterns in AD pathogenesis. Multi-step progressions reveal potential latent contributors to AD, offering pathways for risk stratification, early detection, and targeted interventions. FUNDING: This study was supported by the National Institutes of Health, National Institute on Aging, the National Science Foundation, the Hillblom and Fineberg Foundations, and the California Department of Public Health.

  PublisherOA PDFDOI

• 112. BROAD REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) OF THE PRECUNEUS IN ALZHEIMER’S DISEASE: A RATIONALE AND STUDY DESIGN

  American Journal of Geriatric Psychiatry · 2025-07-15

  article
  PublisherDOI

• Advancing Precision Health Discovery in a Genetically Diverse Health System

  medRxiv · 2025-06-12 · 1 citations

  preprintOpen access

  Summary Linking genetic data with electronic health records in hospital biobanks promises to advance precision medicine, but limited ancestral diversity constrains discovery and generalizability. We analyzed 93,936 participants from the UCLA ATLAS Community Health Initiative to inform disease prevalence and genetic risk across five continental and 36 fine-scale ancestry groups. We discovered numerous unreported gene-phenotype associations, including FN3K with intestinal disaccharidase deficiency in Europeans and admixed Americans. Polygenic scores (PGS) robustly predicted common diseases, with effects markedly diminished in non-Europeans. Furthermore, we reduced the pronounced European bias in curated clinical variants using computational predictors, uncovering unreported disease-gene associations, including ANKZF1 and peripheral vascular disease in AFR. Longitudinal data revealed that semaglutide efficacy varies across ancestries, is associated with PGS for type 2 diabetes, and is modulated by genetic variation in PTPRU . These findings illustrate how ancestrally diverse biobanks from a single health system yield robust disease associations and pharmacogenomic insights.

  PublisherOA PDFDOI

• Lysosomal proteomics reveals mechanisms of neuronal APOE4-associated lysosomal dysfunction

  Autophagy · 2025-10-17 · 6 citations

  articleOpen access

  : Aβ-β-amyloid; AD-Alzheimer disease; APMS-affinity purification mass spectrometry; APOE-apolipoprotein E; APP-amyloid beta precursor protein; BafA1-bafilomycin A1; CMA-chaperone-mediated autophagy; COP-coatomer; ER-endoplasmic reticulum; ERAD-endoplasmic reticulum-associated degradation; ERGIC-endoplasmic reticulum-Golgi intermediate compartment; FCCP-carbonyl cyanide p-trifluoromethoxyphenylhydrazone; GABA-gamma-aminobutyric acid; GFP-green fluorescent protein; GPI-glycerophosphoinositol; GPN-glycyl-L-phenylalanine 2-naphthylamide; HA-hemagglutinin protein tag; iPSC-induced pluripotent stem cells; LAMP1-lysosomal associated membrane protein 1; LGALS3BP-galectin 3 binding protein; LysoIP-lysosomal immunoprecipitation; MAPT-microtubule associated protein tau; MR-CTSB-magic red cathepsin B; MS-mass spectrometry; NFT-neurofibrillary tangles; PCA-principal component analysis; PLA-proximity ligation assay; PSEN1-presenilin 1; PSEN2-presenilin 2; p-MAPT/Tau-phospho-MAPT/tau; ROS-reactive oxygen species; RT-qPCR-reverse transcriptase quantitative polymerase chain reaction; SEM-standard error of the mean; siRNA-short interfering RNA; SRCR-scavenger receptor cysteine-rich domain; TMED-transmembrane p24 trafficking protein; TMEM192-transmembrane protein 192.

  PublisherDOI

• Enhancing Early Dementia Detection in Primary Care with a Culturally Tailored Bilingual EHR Screening Tool

  Alzheimer s & Dementia · 2025-12-01

  articleOpen accessSenior author

  BACKGROUND: Alzheimer's disease (AD) affects over 10% of individuals aged 65 and older, with Black and Hispanic/Latino individuals experiencing a 1.5-2.0 times higher prevalence than white individuals. Despite these disparities, AD remains underdiagnosed, particularly in non-white populations. Current dementia screening tools, such as the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), face challenges in time efficiency, accessibility, and cultural sensitivity. This study aimed to implement a brief dementia screening tool integrated into the electronic health record (EHR) and evaluate its impact on diagnosis, workup, and treatment in a diverse family medicine clinic in Los Angeles County. METHOD: The dementia screening tool (DST), developed collaboratively by the University of California Alzheimer's Disease Centers and the California Department of Public Health, was designed to be brief (<5 minutes) and adaptable. It includes a three-question patient questionnaire, an informant input option, and the Mini-Cog assessment. To enhance accessibility, the tool was translated and culturally adapted for Spanish-speaking patients. Patients aged 60+ completed the DST before their annual wellness visits, with results integrated into the EHR. This pre-post intervention study compared patients aged 60+ without a prior dementia diagnosis during the pre-intervention (February 2016-August 2022) and post-intervention (September 2022-June 2023) periods. Outcomes included new dementia diagnoses, medications, specialty referrals, labs, and imaging. RESULT: The DST was implemented, screening 996 patients in 10 months. Screening led to 35 specialty care referrals and 15 new dementia diagnoses. New diagnoses increased from 4.17% pre-DST to 4.80% post-DST all (OR 2.10, p = 0.02) and 6.43% among those screening positive (OR 2.57, p = 0.04). Dementia medication prescriptions rose from 2.93% pre-DST to 4.94% in the post-DST all group, reaching 6.87% among those who screened positive. Specialty referrals were more frequent post-DST all (9.13%) and even higher among those screening positive (14.16%). Post-DST, all secondary outcomes significantly improved, including increased use of diagnostic labs and imaging studies. CONCLUSION: Integrating a brief, culturally sensitive DST into primary care significantly improved dementia diagnosis rates, workup, referrals, and treatment. These findings highlight the potential for broader implementation of the DST to enhance dementia care and address health disparities in diverse populations.

  PublisherOA PDFDOI

Frequent coauthors

• Daniel H. Geschwind

  Center for Autism and Related Disorders

  40 shared

• J. Kenneth Baillie

  Roslin Institute

  21 shared

• Günter U. Höglinger

  Munich Cluster for Systems Neurology

  17 shared

• Alexis Brice

  Sorbonne Université

  15 shared

• Alexandra Dürr

  Sorbonne Université

  15 shared

• Bogdan Paşaniuc

  University of California, Los Angeles

  12 shared

• Laura Molina‐Porcel

  Consorci Institut D'Investigacions Biomediques August Pi I Sunyer

  12 shared

• Andrea Ganna

  Institute for Molecular Medicine Finland

  12 shared

Education

• BS

  Stanford University

• MD, PhD

  University of Wisconsin Madison

• MD, PhD, Neurology

  University of California, Los Angeles

  2020

Awards & honors

• Teaching Award, UCLA School of Dentistry, Class 2004
• Teaching Award, UCLA School of Dentistry, Class 2006
• The Academy of Excellent Educators, inaugural member, UCLA S…
• The 2016 Distinguished Teaching Award