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Eliasen EH, Weihe P, Debes F, Tróndarson M, Petersen MS. 10-Year Cognitive Change in the Faroese Septuagenarian Cohort and Impact of Sociodemographic, Lifestyle, and Health Factors. J Aging Health 2024:8982643241255405. [PMID: 38819787 DOI: 10.1177/08982643241255405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
OBJECTIVES To investigate cognitive change in multiple cognitive domains in a population-based cohort of 713 Faroese older adults. METHODS Participants were cognitively tested at baseline (70-74 years) and re-evaluated after 10 years. Changes in cognitive performance and the impact of sociodemographic factors, lifestyle, and health conditions were analysed using mixed-effect models. Participants free from dementia were studied in separate analyses. RESULTS A significant decline over 10 years was observed in most of the neuropsychological tests. People living in rural areas, married or cohabiting people, people without professional education, slightly older persons, smokers, teetotalers, and people with heart disease and abnormal electrocardiogram (ECG) had a steeper decline in cognitive ability. Conflicting results were found for sex and people with myocardial infarction (MI). DISCUSSION There are modifiable factors that contribute to cognitive decline which should be addressed in future public health efforts.
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Affiliation(s)
- Eina H Eliasen
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
- Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Pál Weihe
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
- Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
- Center of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Fróði Debes
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Marjun Tróndarson
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Maria Skaalum Petersen
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
- Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
- Center of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
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Brain J, Kafadar AH, Errington L, Kirkley R, Tang EY, Akyea RK, Bains M, Brayne C, Figueredo G, Greene L, Louise J, Morgan C, Pakpahan E, Reeves D, Robinson L, Salter A, Siervo M, Tully PJ, Turnbull D, Qureshi N, Stephan BC. What's New in Dementia Risk Prediction Modelling? An Updated Systematic Review. Dement Geriatr Cogn Dis Extra 2024; 14:49-74. [PMID: 39015518 PMCID: PMC11250535 DOI: 10.1159/000539744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/07/2024] [Indexed: 07/18/2024] Open
Abstract
Introduction Identifying individuals at high risk of dementia is critical to optimized clinical care, formulating effective preventative strategies, and determining eligibility for clinical trials. Since our previous systematic reviews in 2010 and 2015, there has been a surge in dementia risk prediction modelling. The aim of this study was to update our previous reviews to explore, and critically review, new developments in dementia risk modelling. Methods MEDLINE, Embase, Scopus, and Web of Science were searched from March 2014 to June 2022. Studies were included if they were population- or community-based cohorts (including electronic health record data), had developed a model for predicting late-life incident dementia, and included model performance indices such as discrimination, calibration, or external validation. Results In total, 9,209 articles were identified from the electronic search, of which 74 met the inclusion criteria. We found a substantial increase in the number of new models published from 2014 (>50 new models), including an increase in the number of models developed using machine learning. Over 450 unique predictor (component) variables have been tested. Nineteen studies (26%) undertook external validation of newly developed or existing models, with mixed results. For the first time, models have also been developed in low- and middle-income countries (LMICs) and others validated in racial and ethnic minority groups. Conclusion The literature on dementia risk prediction modelling is rapidly evolving with new analytical developments and testing in LMICs. However, it is still challenging to make recommendations about which one model is the most suitable for routine use in a clinical setting. There is an urgent need to develop a suitable, robust, validated risk prediction model in the general population that can be widely implemented in clinical practice to improve dementia prevention.
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Affiliation(s)
- Jacob Brain
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, UK
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Aysegul Humeyra Kafadar
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, UK
| | - Linda Errington
- Walton Library, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Rachael Kirkley
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eugene Y.H. Tang
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ralph K. Akyea
- PRISM Group, Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Manpreet Bains
- Nottingham Centre for Public Health and Epidemiology, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | | | - Leanne Greene
- Exeter Clinical Trials Unit, Department of Health and Community Sciences, University of Exeter Medical School, Exeter, UK
| | - Jennie Louise
- Women’s and Children’s Hospital Research Centre and South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Catharine Morgan
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Eduwin Pakpahan
- Department of Mathematics, Physics and Electrical Engineering, Northumbria University, Newcastle upon Tyne, UK
| | - David Reeves
- School for Health Sciences, University of Manchester, Manchester, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Amy Salter
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Mario Siervo
- School of Population Health, Curtin University, Perth, WA, Australia
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Phillip J. Tully
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, NSW, Australia
| | - Deborah Turnbull
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Nadeem Qureshi
- PRISM Group, Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Blossom C.M. Stephan
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, UK
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Eliasen EH, Weihe P, Debes F, Tróndarson M, Petersen MS. 10-Year Follow-up of the Original Faroese Septuagenarian Cohort: Focus on Frailty and Association With All-cause Mortality. Gerontol Geriatr Med 2023; 9:23337214231167980. [PMID: 37077430 PMCID: PMC10108422 DOI: 10.1177/23337214231167980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 04/21/2023] Open
Abstract
Little is known about the health status of Faroese people reaching high age. The purpose of this study was to elucidate the health status of older adults in a small-scale society with emphasis on frailty and all-cause mortality. In this 10-year follow-up study, 347 Faroese citizens aged 80 to 84 from the Faroese Septuagenarian cohort participated. A detailed health examination was conducted, in addition to self-reported questionnaire. We constructed a 40-item Frailty Index (FI) to assess frailty. Survival and mortality risks were analyzed using Kaplan-Meier curves and Cox proportional hazard model. Median FI score was 0.28 ranging from 0.09 to 0.7; 71 (21%) individuals were least frail, 244 (67%) moderately frail, and 41 (12%) were most frail. Frailty and sex were statistically significantly associated with mortality; being male was associated with hazard ratio (HR) of 4.05 [CI 1.73, 9.48], and being most frail with HR of 6.2 [CI 1.84, 21.3]. Classification of octogenarians as least/moderately frail may be an opportunity to initiate interventions to prevent or delay frailty in this population stratum.
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Affiliation(s)
- Eina H. Eliasen
- The Faroese Hospital System, Tórshavn, Faroe Islands
- University of the Faroe Islands, Tórshavn, Faroe Islands
- Eina H. Eliasen, Department of Occupational Medicine and Public Health, the Faroese Hospital System, Sigmundargøta 5, Tórshavn, FO-100, Faroe Islands.
| | - Pál Weihe
- The Faroese Hospital System, Tórshavn, Faroe Islands
- University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Fróði Debes
- The Faroese Hospital System, Tórshavn, Faroe Islands
| | | | - Maria Skaalum Petersen
- The Faroese Hospital System, Tórshavn, Faroe Islands
- University of the Faroe Islands, Tórshavn, Faroe Islands
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Zhou J, Lee S, Wong WT, Waleed KB, Leung KSK, Lee TTL, Wai AKC, Liu T, Chang C, Cheung BMY, Zhang Q, Tse G. Gender-specific clinical risk scores incorporating blood pressure variability for predicting incident dementia. J Am Med Inform Assoc 2021; 29:335-347. [PMID: 34643701 DOI: 10.1093/jamia/ocab173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The present study examined the gender-specific prognostic value of blood pressure (BP) and its variability in the prediction of dementia risk and developed a score system for risk stratification. MATERIALS AND METHODS This was a retrospective, observational population-based cohort study of patients admitted to government-funded family medicine clinics in Hong Kong between January 1, 2000 and March 31, 2002 with at least 3 blood pressure measurements. Gender-specific risk scores for dementia were developed and tested. RESULTS The study consisted of 74 855 patients, of whom 3550 patients (incidence rate: 4.74%) developed dementia over a median follow-up of 112 months (IQR= [59.8-168]). Nonlinear associations between diastolic/systolic BP measurements and the time to dementia presentation were identified. Gender-specific dichotomized clinical scores were developed for males (age, hypertension, diastolic and systolic BP and their measures of variability) and females (age, prior cardiovascular, respiratory, gastrointestinal diseases, diabetes mellitus, hypertension, stroke, mean corpuscular volume, monocyte, neutrophil, urea, creatinine, diastolic and systolic BP and their measures of variability). They showed high predictive strengths for both male (hazard ratio [HR]: 12.83, 95% confidence interval [CI]: 11.15-14.33, P value < .0001) and female patients (HR: 26.56, 95% CI: 14.44-32.86, P value < .0001). The constructed gender-specific scores outperformed the simplified systems without considering BP variability (C-statistic: 0.91 vs 0.82), demonstrating the importance of BP variability in dementia development. CONCLUSION Gender-specific clinical risk scores incorporating BP variability can accurately predict incident dementia and can be applied clinically for early disease detection and optimized patient management.
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Affiliation(s)
- Jiandong Zhou
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Sharen Lee
- Cardiovascular Analytics Group, Laboratory of Cardiovascular Physiology, Hong Kong, China
| | - Wing Tak Wong
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Khalid Bin Waleed
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen, Shenzhen, China
| | - Keith Sai Kit Leung
- Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Teddy Tai Loy Lee
- Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Abraham Ka Chung Wai
- Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Carlin Chang
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong, China
| | - Bernard Man Yung Cheung
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.,Kent and Medway Medical School, Canterbury, UK
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