1
|
Rai P, Sahadevan P, Mensegere AL, Issac TG, Muniz‐Terrera G, Sundarakumar JS. Rural-urban disparities in the diagnosis and treatment of hypertension and diabetes among aging Indians. Alzheimers Dement 2024; 20:2943-2951. [PMID: 38460118 PMCID: PMC11032561 DOI: 10.1002/alz.13771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Hypertension and diabetes are modifiable risk factors for dementia. We aimed to assess rural-urban disparities in the diagnosis and treatment of these conditions among aging Indians. METHODS Participants (n = 6316) were from two parallel, prospective aging cohorts in rural and urban India. Using self-report and clinical/biochemical assessments, we subdivided participants with diabetes and hypertension into undiagnosed and untreated groups. Logistic regression and Fairlie decomposition analysis were the statistical methods utilized. RESULTS There was a significant rural-urban disparity in undiagnosed hypertension (25.14%), untreated hypertension (11.75%), undiagnosed diabetes (16.94%), and untreated diabetes (11.62%). Further, sociodemographic and lifestyle factors, such as age and tobacco use were the common contributors to the disparities in both undiagnosed hypertension and undiagnosed diabetes, whereas education and body mass index (BMI) were significant contributors to the disparity in untreated hypertension. DISCUSSION Rural Indians face significant healthcare disadvantages as compared to their urban counterparts, which prompts the urgent need for strategies for equitable healthcare.
Collapse
Affiliation(s)
- Pooja Rai
- Centre for Brain ResearchIndian Institute of ScienceBangaloreIndia
| | - Pravin Sahadevan
- Centre for Brain ResearchIndian Institute of ScienceBangaloreIndia
| | | | - Thomas G. Issac
- Centre for Brain ResearchIndian Institute of ScienceBangaloreIndia
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia PreventionUniversity of EdinburghEdinburghUK
- Heritage College of Osteopathic MedicineOhio UniversityAthensOhioUSA
| | | |
Collapse
|
2
|
Tan MMC, Barbosa MG, Pinho PJMR, Assefa E, Keinert AÁM, Hanlon C, Barrett B, Dregan A, Su TT, Mohan D, Ferri C, Muniz‐Terrera G, Prina M. Determinants of multimorbidity in low- and middle-income countries: A systematic review of longitudinal studies and discovery of evidence gaps. Obes Rev 2024; 25:e13661. [PMID: 38105610 PMCID: PMC11046426 DOI: 10.1111/obr.13661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 10/03/2023] [Accepted: 10/07/2023] [Indexed: 12/19/2023]
Abstract
Multimorbidity-the coexistence of at least two chronic health conditions within the same individual-is an important global health challenge. In high-income countries (HICs), multimorbidity is dominated by non-communicable diseases (NCDs); whereas, the situation may be different in low- and middle-income countries (LMICs), where chronic communicable diseases remain prominent. The aim of this systematic review was to identify determinants (including risk and protective factors) and potential mechanisms underlying multimorbidity from published longitudinal studies across diverse population-based or community-dwelling populations in LMICs. We systematically searched three electronic databases (Medline, Embase, and Global Health) using pre-defined search terms and selection criteria, complemented by hand-searching. All titles, abstracts, and full texts were independently screened by two reviewers from a pool of four researchers. Data extraction and reporting were according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality and risk of bias assessment was performed using the Newcastle-Ottawa Scale for cohort studies. Data were summarized using narrative synthesis. The search yielded 1782 records. Of the 52 full-text articles included for review, 8 longitudinal population-based studies were included for final data synthesis. Almost all studies were conducted in Asia, with only one from South America and none from Africa. All studies were published in the last decade, with half published in the year 2021. The definitions used for multimorbidity were heterogeneous, including 3-16 chronic conditions per study. The leading chronic conditions were heart disease, stroke, and diabetes, and there was a lack of consideration of mental health conditions (MHCs), infectious diseases, and undernutrition. Prospectively evaluated determinants included socio-economic status, markers of social inequities, childhood adversity, lifestyle behaviors, obesity, dyslipidemia, and disability. This review revealed a paucity of evidence from LMICs and a geographical bias in the distribution of multimorbidity research. Longitudinal research into epidemiological aspects of multimorbidity is warranted to build up scientific evidence in regions beyond Asia. Such evidence can provide a detailed picture of disease development, with important implications for community, clinical, and interventions in LMICs. The heterogeneity in study designs, exposures, outcomes, and statistical methods observed in the present review calls for greater methodological standardisation while conducting epidemiological studies on multimorbidity. The limited evidence for MHCs, infectious diseases, and undernutrition as components of multimorbidity calls for a more comprehensive definition of multimorbidity globally.
Collapse
Affiliation(s)
- Michelle M. C. Tan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
- Global Public Health, Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaSunway CitySelangorMalaysia
- South East Asia Community Observatory (SEACO)Monash University MalaysiaSunway CitySelangorMalaysia
- Victorian Heart InstituteFaculty of Medicine, Nursing and Health Sciences, Monash University, Clayton CampusClaytonVictoriaAustralia
| | - Matheus G. Barbosa
- Psychogeriatric Unit, Department of Psychiatry, Medical SchoolUniversidade Federal de São Paulo (UNIFESP)São PauloBrazil
| | - Pedro J. M. R. Pinho
- Psychogeriatric Unit, Department of Psychiatry, Medical SchoolUniversidade Federal de São Paulo (UNIFESP)São PauloBrazil
| | - Esubalew Assefa
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT‐Africa)Addis Ababa UniversityAddis AbabaEthiopia
- Department of Economics, College of Business and EconomicsJimma UniversityJimmaEthiopia
- Department of Economics, Faculty of Arts and Social SciencesThe Open UniversityMilton KeynesUK
| | - Ana Á. M. Keinert
- Psychogeriatric Unit, Department of Psychiatry, Medical SchoolUniversidade Federal de São Paulo (UNIFESP)São PauloBrazil
| | - Charlotte Hanlon
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT‐Africa)Addis Ababa UniversityAddis AbabaEthiopia
- Global Mental Health, Centre for Global Mental Health, Institute of Psychiatry, Psychology and NeurosciencesKing's College LondonLondonUK
- Department of Psychiatry, School of Medicine, College of Health SciencesAddis Ababa UniversityAddis AbabaEthiopia
| | - Barbara Barrett
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Alexandru Dregan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaSunway CitySelangorMalaysia
- South East Asia Community Observatory (SEACO)Monash University MalaysiaSunway CitySelangorMalaysia
- Victorian Heart InstituteFaculty of Medicine, Nursing and Health Sciences, Monash University, Clayton CampusClaytonVictoriaAustralia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaSunway CitySelangorMalaysia
| | - Cleusa Ferri
- Psychogeriatric Unit, Department of Psychiatry, Medical SchoolUniversidade Federal de São Paulo (UNIFESP)São PauloBrazil
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia PreventionUniversity of Edinburgh and Western General HospitalEdinburghUK
- Department of Social Medicine, Heritage College of Osteopathic MedicineOhio UniversityAthensOhioUSA
| | - Matthew Prina
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | |
Collapse
|
3
|
Mur J, Marioni RE, Russ TC, Muniz‐Terrera G, Cox SR. Anticholinergic burden in middle and older age is associated with lower cognitive function, but not with brain atrophy. Br J Clin Pharmacol 2023; 89:2224-2235. [PMID: 36813260 PMCID: PMC10953410 DOI: 10.1111/bcp.15698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
AIMS The aim of this study is to estimate the association between anticholinergic burden, general cognitive ability and various measures of brain structural MRI in relatively healthy middle-aged and older individuals. METHODS In the UK Biobank participants with linked health-care records (n = 163,043, aged 40-71 at baseline), of whom about 17 000 had MRI data available, we calculated the total anticholinergic drug burden according to 15 different anticholinergic scales and due to different classes of drugs. We then used linear regression to explore the associations between anticholinergic burden and various measures of cognition and structural MRI, including general cognitive ability, 9 separate cognitive domains, brain atrophy, volumes of 68 cortical and 14 subcortical areas and fractional anisotropy and median diffusivity of 25 white-matter tracts. RESULTS Anticholinergic burden was modestly associated with poorer cognition across most anticholinergic scales and cognitive tests (7/9 FDR-adjusted significant associations, standardised betas (β) range: -0.039, -0.003). When using the anticholinergic scale exhibiting the strongest association with cognitive functions, anticholinergic burden due to only some classes of drugs exhibited negative associations with cognitive function, with β-lactam antibiotics (β = -0.035, PFDR < 0.001) and opioids (β = -0.026, PFDR < 0.001) exhibiting the strongest effects. Anticholinergic burden was not associated with any measure of brain macrostructure or microstructure (PFDR > 0.08). CONCLUSIONS Anticholinergic burden is weakly associated with poorer cognition, but there is little evidence for associations with brain structure. Future studies might focus more broadly on polypharmacy or more narrowly on distinct drug classes, instead of using purported anticholinergic action to study the effects of drugs on cognitive ability.
Collapse
Affiliation(s)
- Jure Mur
- Lothian Birth Cohorts Group, Department of PsychologyUniversity of EdinburghEdinburghUK
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUK
- Alzheimer Scotland Dementia Research CentreUniversity of EdinburghEdinburghUK
| | - Riccardo E. Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUK
| | - Tom C. Russ
- Alzheimer Scotland Dementia Research CentreUniversity of EdinburghEdinburghUK
- Edinburgh Dementia PreventionUniversity of EdinburghEdinburghUK
- Division of Psychiatry, Centre for Clinical Brain ScienceUniversity of EdinburghEdinburghUK
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia PreventionUniversity of EdinburghEdinburghUK
- Department of Social MedicineOhio UniversityAthensOhioUSA
| | - Simon R. Cox
- Lothian Birth Cohorts Group, Department of PsychologyUniversity of EdinburghEdinburghUK
| |
Collapse
|
4
|
Gregory S, Ritchie CW, Shannon O, Stevenson E, Blennow K, Muniz‐Terrera G. Does adherence to the Mediterranean diet have differential effects on brain health for those living within and outside of the Mediterranean region? Alzheimers Dement 2022. [DOI: 10.1002/alz.062267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | - Kaj Blennow
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg Gothenburg Sweden
| | | |
Collapse
|
5
|
Gregory S, Ritchie CW, Pullen H, Shannon O, Stevenson E, Muniz‐Terrera G. Mediterranean diet and structural neuroimaging biomarkers of Alzheimer’s and cerebrovascular disease: a systematic review. Alzheimers Dement 2022. [DOI: 10.1002/alz.059782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
6
|
Newton C, Pope M, Dounavi M, Carter SF, Muniz‐Terrera G, Henson RN, Ritchie K, Ritchie CW, O'Brien JT, Su L, Chan D. Multifactor mid‐life risk for Alzheimer’s disease associated with alterations in navigation but not episodic memory: the PREVENT‐Dementia study. Alzheimers Dement 2022. [DOI: 10.1002/alz.067235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Coco Newton
- University of Cambridge Cambridge United Kingdom
| | | | | | | | | | | | - Karen Ritchie
- Neuropsychiatry: Epidemiological and Clinical Research, INSERM, Montpellier University Montpellier France
| | - Craig W. Ritchie
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
| | | | - Li Su
- University of Cambridge Cambridge United Kingdom
- University of Sheffield Sheffield United Kingdom
| | - Dennis Chan
- University College London London United Kingdom
| |
Collapse
|
7
|
Gregory S, Blennow K, Homer NZM, Ritchie CW, Muniz‐Terrera G. Self-reported diabetes is associated with allocentric spatial processing in the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study. Eur J Neurosci 2022; 56:5917-5930. [PMID: 36103146 PMCID: PMC9828025 DOI: 10.1111/ejn.15821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 01/12/2023]
Abstract
Type 2 diabetes is a robust predictor of cognitive impairment. Impairment in allocentric processing may help identify those at increased risk for Alzheimer's disease dementia. The objective of this study was to investigate the performance of participants with and without diabetes on a task of allocentric spatial processing. This was a cross-sectional secondary data analysis study using baseline data from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study (EPAD LCS). Participants were aged 50 years and above and were free of dementia at baseline. Participants with no missing data on the variables of interest were included in this study. Our exposure variable was diabetes reported in the medical history. Our primary outcome was the Four Mountains Test (4MT), a novel task of allocentric processing. Covariates included demographics (age, sex, family history of dementia and years of education), APOEε4 carrier status, cognitive status (Clinical Dementia Rating scale), cerebrospinal fluid phosphorylated tau and amyloid-beta 1-42. Of 1324 participants (mean age = 65.95 (±7.45)), 90 had diabetes. Participants with diabetes scored 8.32 (±2.32) on the 4MT compared with 9.24 (±2.60) for participants without diabetes. In a univariate model, diabetes was significantly associated with worse 4MT total scores (β = -.92, p = .001), remaining significant in a fully adjusted model (β = -.64, p = .01). Cerebrospinal fluid phosphorylated tau was significantly higher in participants with diabetes compared with those without. Novel cognitive tests, such as the 4MT, may be appropriate to identify early cognitive changes in this high-risk group. Identifying those at greatest risk for future neurodegeneration is key to prevention efforts.
Collapse
Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Kaj Blennow
- Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgMölndalSweden,Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - Natalie Z. M. Homer
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen's Medical Research InstituteUniversity of EdinburghEdinburghUK
| | - Craig W. Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK,Ohio State UniversityColumbusOhioUSA
| |
Collapse
|
8
|
Mullin DS, Stirland LE, Welstead M, Russ TC, Luciano M, Muniz‐Terrera G. Prevalence and predictors of Motoric Cognitive Risk syndrome in a community-dwelling older Scottish population: A longitudinal observational study. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5824. [PMID: 36200618 PMCID: PMC9828770 DOI: 10.1002/gps.5824] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/29/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Motoric Cognitive Risk (MCR) is a gait-based predementia syndrome that is easy to measure and prognostic of dementia and falls. We aimed to examine the prevalence and risk factors for MCR, and assess its overlap with Mild Cognitive Impairment, Prefrailty, and Frailty, in a cohort of older Scottish adults without dementia. METHODS In this longitudinal prospective study, we classified 690 participants (mean [SD] age 76.3 [0.8] years; wave 3) of the Lothian Birth Cohort 1936 (LBC1936) into non-MCR or MCR groups. We examined their baseline (age 69.5 [0.8] years; wave 1) risk factors for MCR at waves 3, 4, and 5 (6, 9, and 12 years later respectively). RESULTS MCR prevalence rate ranged from 5.3% to 5.7% across the three waves. The presence of MCR was associated with older baseline age (6 and 9 years later), lower occupational socioeconomic status (6 years later), and worse scores in a range of tests of executive function (6, 9 and 12 years later). Approximately 46% of the MCR group also had Mild Cognitive Impairment, and almost everyone in the MCR group had either Prefrailty or Frailty. CONCLUSIONS The prevalence of MCR in this Scottish cohort is lower than the pooled global average, possibly reflecting the general good health of the LBC cohort. However, it is higher than the prevalence in two neighbouring countries' cohorts, which may reflect the younger average ages of those cohorts. Future LBC1936 research should assess the risk factors associated with MCR to validate previous findings and analyse novel predictive factors, particularly socioeconomic status.
Collapse
Affiliation(s)
- Donncha S. Mullin
- Alzheimer Scotland Dementia Research CentreUniversity of EdinburghEdinburghUK
- Edinburgh Dementia Prevention GroupUniversity of EdinburghEdinburghUK
- Division of PsychiatryCentre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- NHS LothianRoyal Edinburgh HospitalEdinburghUK
| | - Lucy E. Stirland
- Alzheimer Scotland Dementia Research CentreUniversity of EdinburghEdinburghUK
- Edinburgh Dementia Prevention GroupUniversity of EdinburghEdinburghUK
- Division of PsychiatryCentre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- NHS LothianRoyal Edinburgh HospitalEdinburghUK
| | - Miles Welstead
- Lothian Birth CohortsDepartment of PsychologyUniversity of EdinburghEdinburghUK
| | - Tom C. Russ
- Alzheimer Scotland Dementia Research CentreUniversity of EdinburghEdinburghUK
- Edinburgh Dementia Prevention GroupUniversity of EdinburghEdinburghUK
- Division of PsychiatryCentre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- NHS LothianRoyal Edinburgh HospitalEdinburghUK
- Lothian Birth CohortsDepartment of PsychologyUniversity of EdinburghEdinburghUK
| | - Michelle Luciano
- Lothian Birth CohortsDepartment of PsychologyUniversity of EdinburghEdinburghUK
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia Prevention GroupUniversity of EdinburghEdinburghUK
- Department of Social MedicineOhio UniversityAthensOhioUSA
- BrainLatUniversidad Adolfo IbanezPenalolenChile
| |
Collapse
|
9
|
Saunders TS, Gadd DA, Spires‐Jones TL, King D, Ritchie C, Muniz‐Terrera G. Associations between cerebrospinal fluid markers and cognition in ageing and dementia: A systematic review. Eur J Neurosci 2022; 56:5650-5713. [PMID: 35338546 PMCID: PMC9790745 DOI: 10.1111/ejn.15656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/08/2022] [Accepted: 03/13/2022] [Indexed: 12/30/2022]
Abstract
A biomarker associated with cognition in neurodegenerative dementias would aid in the early detection of disease progression, complement clinical staging and act as a surrogate endpoint in clinical trials. The current systematic review evaluates the association between cerebrospinal fluid protein markers of synapse loss and neuronal injury and cognition. We performed a systematic search which revealed 67 studies reporting an association between cerebrospinal fluid markers of interest and neuropsychological performance. Despite the substantial heterogeneity between studies, we found some evidence for an association between neurofilament-light and worse cognition in Alzheimer's diseases, frontotemporal dementia and typical cognitive ageing. Moreover, there was an association between cerebrospinal fluid neurogranin and cognition in those with an Alzheimer's-like cerebrospinal fluid biomarker profile. Some evidence was found for cerebrospinal fluid neuronal pentraxin-2 as a correlate of cognition across dementia syndromes. Due to the substantial heterogeneity of the field, no firm conclusions can be drawn from this review. Future research should focus on improving standardization and reporting as well as establishing the importance of novel markers such as neuronal pentraxin-2 and whether such markers can predict longitudinal cognitive decline.
Collapse
Affiliation(s)
- Tyler S. Saunders
- UK Dementia Research InstituteThe University of EdinburghEdinburghUK,Center for Discovery Brain SciencesThe University of EdinburghEdinburghUK,Center for Clinical Brain SciencesThe University of EdinburghEdinburghUK,Center for Dementia PreventionThe University of EdinburghEdinburghUK
| | - Danni A. Gadd
- Center for Genomic and Experimental Medicine, Institute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUK
| | - Tara L. Spires‐Jones
- UK Dementia Research InstituteThe University of EdinburghEdinburghUK,Center for Discovery Brain SciencesThe University of EdinburghEdinburghUK
| | - Declan King
- UK Dementia Research InstituteThe University of EdinburghEdinburghUK,Center for Discovery Brain SciencesThe University of EdinburghEdinburghUK
| | - Craig Ritchie
- Center for Clinical Brain SciencesThe University of EdinburghEdinburghUK,Center for Dementia PreventionThe University of EdinburghEdinburghUK
| | - Graciela Muniz‐Terrera
- Center for Clinical Brain SciencesThe University of EdinburghEdinburghUK,Center for Dementia PreventionThe University of EdinburghEdinburghUK
| |
Collapse
|
10
|
Mur J, Russ TC, Cox SR, Marioni RE, Muniz‐Terrera G. Association between anticholinergic burden and dementia in UK Biobank. Alzheimers Dement (N Y) 2022; 8:e12290. [PMID: 35434252 PMCID: PMC9005668 DOI: 10.1002/trc2.12290] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/11/2022] [Accepted: 03/03/2022] [Indexed: 11/20/2022]
Abstract
Background Previous studies on the relationship between anticholinergic drugs and dementia have reported heterogeneous results. This variability could be due to different anticholinergic scales and differential effects of distinct classes of drugs. Methods Using Cox proportional hazards models, we computed the association between annual anticholinergic burden (AChB) and the risk of dementia in UK Biobank with linked general practitioner prescription records between the years 2000 and 2015 (n = 171,775). Results AChB according to most anticholinergic scales (standardized odds ratio range: 1.027-1.125) and the slope of the AChB trajectory (hazard ratio = 1.094; 95% confidence interval: 1.068-1.119) were predictive of dementia. However, the association between AChB and dementia held only for some classes of drugs, especially antidepressants, antiepileptics, and antidiuretics. Discussion The heterogeneity in previous findings may partially be due to different effects for different classes of drugs. Future studies should establish differences in more detail and further examine the practicality of a general measure of AChB relating to the risk of dementia.
Collapse
Affiliation(s)
- Jure Mur
- Lothian Birth Cohorts GroupDepartment of PsychologyUniversity of EdinburghEdinburghUK
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUK
- Alzheimer Scotland Dementia Research CentreUniversity of EdinburghEdinburghUK
| | - Tom C. Russ
- Alzheimer Scotland Dementia Research CentreUniversity of EdinburghEdinburghUK
- Edinburgh Dementia PreventionUniversity of EdinburghEdinburghUK
- Division of PsychiatryCentre for Clinical Brain ScienceUniversity of EdinburghEdinburghUK
| | - Simon R. Cox
- Lothian Birth Cohorts GroupDepartment of PsychologyUniversity of EdinburghEdinburghUK
| | - Riccardo E. Marioni
- Centre for Genomic and Experimental MedicineInstitute of Genetics and CancerUniversity of EdinburghEdinburghUK
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia PreventionUniversity of EdinburghEdinburghUK
- Division of PsychiatryCentre for Clinical Brain ScienceUniversity of EdinburghEdinburghUK
| |
Collapse
|
11
|
Sundarakumar JS, Raviteja KV, Muniz‐Terrera G, Ravindranath V. Normative data for three physical frailty parameters in an aging, rural Indian population. Health Sci Rep 2022; 5:e567. [PMID: 35356805 PMCID: PMC8938919 DOI: 10.1002/hsr2.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Physical frailty is associated with multiple adverse health outcomes. Since physical characteristics markedly vary with different populations, population‐specific norms for physical frailty parameters are necessary. Such norms are lacking for the Indian population, especially for older, rural Indians. We aimed to develop normative values for three quantitative, frailty parameters—handgrip strength, “Timed Up‐and‐Go” (TUG) test time, and physical activity in an aging, rural Indian population. Methods The study sample is from an ongoing, prospective, cohort (Srinivaspura NeuoSenescence and COGnition, SANSCOG) comprised of rural, community‐dwelling, cognitively healthy, aging Indians. Subjects are recruited through area sampling strategy, from villages of Srinivaspura, Kolar district, Karnataka state, India. Three physical frailty parameters of Fried's phenotype—handgrip strength (n = 1787), TUG time (n = 1863), and physical activity (n = 1640) were assessed using digital hand dynamometry, TUG test, and General Physical Activity Questionnaire (GPAQ), respectively. Results The 10th, 25th, 50th, 75th, 90th percentiles for the three frailty parameters were: right‐hand grip strength (kg): males—13.9, 18.6, 23.8, 28.7, 33.7 and females—7.8, 10.6, 14.2, 17.9, 21.3; left‐hand grip strength (kg): males—13.3, 18.3, 23.6, 28.9, 32.9 and females—7.9, 10.5, 14.3, 17.8, 21.2; TUG time (s): males—9.1, 10.1, 11.4, 13.4, 15.5 and females—9.5, 10.7, 12.4, 14.5, 16.6; physical activity (MET‐minutes/week): males—1680; 4320; 8880; 15,840; 23,352 and females—1680; 4320; 9240; 15,120; 20,160. Discussion Our findings show that from 45 years onwards, overall grip strength decreases and TUG time increases, with women performing significantly poorer than men across all age groups, except >75 years, where no differences were seen. Physical activity did not show any consistent trend according to age or gender. Reference values for this aging, rural Indian population were substantially lower for grip strength and higher for TUG time than aging populations in several Western and other Asian countries.
Collapse
Affiliation(s)
| | - Karru V. Raviteja
- Centre for Brain Research Indian Institute of Science Bangalore India
| | | | | |
Collapse
|
12
|
Parra MA, Muniz‐Terrera G, Danso SO, Ritchie K, Ritchie CW. Memory assessment and dementia risk in the PREVENT Study. Alzheimers Dement 2021. [DOI: 10.1002/alz.055104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Graciela Muniz‐Terrera
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
- University of Edinburgh Edinburgh United Kingdom
| | | | - Karen Ritchie
- University of Edinburgh Edinburgh United Kingdom
- INSERM, Montpellier University, Neuropsychiatry: Epidemiological and Clinical Research Montpellier France
| | - Craig W. Ritchie
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
| |
Collapse
|
13
|
Ingala S, De Boer C, Masselink LA, Vergari I, Lorenzini L, Blennow K, Chételat G, Di Perri C, Ewers M, van der Flier WM, Fox NC, Gispert JD, Haller S, Molinuevo JL, Muniz‐Terrera G, Mutsaerts HJMM, Ritchie CW, Ritchie K, Schmidt M, Schwarz AJ, Vermunt L, Waldman AD, Wardlaw J, Wink AM, Wolz R, Wottschel V, Scheltens P, Visser PJ, Barkhof F. Application of the ATN classification scheme in a population without dementia: Findings from the EPAD cohort. Alzheimers Dement 2021; 17:1189-1204. [PMID: 33811742 PMCID: PMC8359976 DOI: 10.1002/alz.12292] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/11/2020] [Accepted: 12/22/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND We classified non-demented European Prevention of Alzheimer's Dementia (EPAD) participants through the amyloid/tau/neurodegeneration (ATN) scheme and assessed their neuropsychological and imaging profiles. MATERIALS AND METHODS From 1500 EPAD participants, 312 were excluded. Cerebrospinal fluid cut-offs of 1000 pg/mL for amyloid beta (Aß)1-42 and 27 pg/mL for p-tau181 were validated using Gaussian mixture models. Given strong correlation of p-tau and t-tau (R2 = 0.98, P < 0.001), neurodegeneration was defined by age-adjusted hippocampal volume. Multinomial regressions were used to test whether neuropsychological tests and regional brain volumes could distinguish ATN stages. RESULTS Age was 65 ± 7 years, with 58% females and 38% apolipoprotein E (APOE) ε4 carriers; 57.1% were A-T-N-, 32.5% were in the Alzheimer's disease (AD) continuum, and 10.4% suspected non-Alzheimer's pathology. Age and cerebrovascular burden progressed with biomarker positivity (P < 0.001). Cognitive dysfunction appeared with T+. Paradoxically higher regional gray matter volumes were observed in A+T-N- compared to A-T-N- (P < 0.001). DISCUSSION In non-demented individuals along the AD continuum, p-tau drives cognitive dysfunction. Memory and language domains are affected in the earliest stages.
Collapse
Affiliation(s)
- Silvia Ingala
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Casper De Boer
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Larissa A Masselink
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Ilaria Vergari
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Luigi Lorenzini
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,”Institut Blood and Brain @ Caen‐NormandieCyceronCaenFrance
| | - Carol Di Perri
- Centre for Dementia PreventionEdinburgh Imaging, UK Dementia Research Institute at The University of EdinburghEdinburghUK
| | - Michael Ewers
- Institute for Stroke and Dementia ResearchKlinikum der Universitat MünchenLudwig‐Maximilians‐Universitat LMUMunichGermany
| | - Wiesje M van der Flier
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Nick C Fox
- Dementia Research CentreDepartment of Neurodegenerative Disease & UK Dementia Research InstituteInstitute of NeurologyUniversity College LondonLondonUK
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
- Universitat Pompeu FabraBarcelonaSpain
| | - Sven Haller
- CIRD Centre d'Imagerie Rive DroiteGenevaSwitzerland
| | - José Luís Molinuevo
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hopsital Clínic‐IDIBAPSAlzheimer's Disease & Other Cognitive Disorders UnitBarcelonaSpain
| | - Graciela Muniz‐Terrera
- Centre for Dementia PreventionEdinburgh Imaging, UK Dementia Research Institute at The University of EdinburghEdinburghUK
| | - Henri JMM Mutsaerts
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Ghent Institute for Functional and Metabolic Imaging (GIfMI)Ghent UniversityGhentBelgium
| | - Craig W Ritchie
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Karen Ritchie
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | | | - Adam J Schwarz
- Takeda Pharmaceutical Company LtdCambridgeMassachusettsUSA
| | - Lisa Vermunt
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Adam D Waldman
- Centre for Dementia PreventionEdinburgh Imaging, UK Dementia Research Institute at The University of EdinburghEdinburghUK
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Joanna Wardlaw
- Centre for Dementia PreventionEdinburgh Imaging, UK Dementia Research Institute at The University of EdinburghEdinburghUK
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Alle Meije Wink
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | | | - Viktor Wottschel
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Philip Scheltens
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Department of Psychiatry & NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
- Institutes of Neurology and Healthcare EngineeringUniversity College LondonLondonUK
| | - the EPAD consortium
- Department of Radiology and Nuclear MedicineAmsterdam UMC Location VUmcVrije Universiteit Amsterdam, Amsterdam NeuroscienceAmsterdamthe Netherlands
| |
Collapse
|
14
|
Parra MA, Baez S, Sedeño L, Gonzalez Campo C, Santamaría‐García H, Aprahamian I, Bertolucci PHF, Bustin J, Camargos Bicalho MA, Cano‐Gutierrez C, Caramelli P, Chaves MLF, Cogram P, Beber BC, Court FA, de Souza LC, Custodio N, Damian A, de la Cruz M, Diehl Rodriguez R, Brucki SMD, Fajersztajn L, Farías GA, De Felice FG, Ferrari R, de Oliveira FF, Ferreira ST, Ferretti C, Figueredo Balthazar ML, Ferreira Frota NA, Fuentes P, García AM, Garcia PJ, de Gobbi Porto FH, Duque Peñailillo L, Engler HW, Maier I, Mata IF, Gonzalez‐Billault C, Lopez OL, Morelli L, Nitrini R, Quiroz YT, Guerrero Barragan A, Huepe D, Pio FJ, Suemoto CK, Kochhann R, Kochen S, Kumfor F, Lanata S, Miller B, Mansur LL, Hosogi ML, Lillo P, Llibre Guerra J, Lira D, Lopera F, Comas A, Avila‐Funes JA, Sosa AL, Ramos C, Resende EDPF, Snyder HM, Tarnanas I, Yokoyama J, Llibre J, Cardona JF, Possin K, Kosik KS, Montesinos R, Moguilner S, Solis PCL, Ferretti‐Rebustini REDL, Ramirez JM, Matallana D, Mbakile‐Mahlanza L, Marques Ton AM, Tavares RM, Miotto EC, Muniz‐Terrera G, Muñoz‐Nevárez LA, Orozco D, Okada de Oliveira M, Piguet O, Pintado Caipa M, Piña Escudero SD, Schilling LP, Rodrigues Palmeira AL, Yassuda MS, Santacruz‐Escudero JM, Serafim RB, Smid J, Slachevsky A, Serrano C, Soto‐Añari M, Takada LT, Grinberg LT, Teixeira AL, Barbosa MT, Trépel D, Ibanez A. Dementia in Latin America: Paving the way toward a regional action plan. Alzheimers Dement 2021; 17:295-313. [PMID: 33634602 PMCID: PMC7984223 DOI: 10.1002/alz.12202] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 12/12/2022]
Abstract
Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF.
Collapse
Affiliation(s)
- Mario Alfredo Parra
- School of Psychological Sciences and HealthGraham Hills BuildingGlasgow, G1 1QE, UK, Universidad Autónoma del CaribePrograma de PsicologíaUniversity of StrathclydeBarranquillaColombia
| | | | - Lucas Sedeño
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)Buenos AiresArgentina
| | - Cecilia Gonzalez Campo
- Cognitive Neuroscience Center (CNC)Universidad de San AndresConsejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)Buenos AiresArgentina
| | - Hernando Santamaría‐García
- Pontificia Universidad JaverianaMedical School, Physiology and Psychiatry DepartmentsMemory and Cognition Center IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Ivan Aprahamian
- Department of Internal MedicineFaculty of Medicine of JundiaíGroup of Investigation on Multimorbidity and Mental Health in Aging (GIMMA)JundiaíState of São PauloBrazil
| | - Paulo HF Bertolucci
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | - Julian Bustin
- INECO FoundationInstitute of Cognitive and Translational Neuroscience (INCYT)Favaloro UniversityBuenos AiresArgentina
| | | | - Carlos Cano‐Gutierrez
- Medical SchoolGeriatric Unit, Memory and Cognition Center‐IntellectusAging InstituteHospital Universitario San IgnacioPontificia Universidad JaverianaBogotáColombia
| | - Paulo Caramelli
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Marcia L. F. Chaves
- Neurology ServiceHospital de Clínicas de Porto Alegre e Universidade Federal do Rio Grande do SulBrazil
| | - Patricia Cogram
- Laboratory of Molecular NeuropsychiatryINECO FoundationNational Scientific and Technical Research CouncilInstitute of Cognitive and Translational Neuroscience (INCyT)Favaloro UniversityBuenos AiresArgentina
| | - Bárbara Costa Beber
- Department of Speech and Language PathologyAtlantic Fellow for Equity in Brain HealthFederal University of Health Sciences of Porto Alegre (UFCSPA)Porto AlegreBrazil
| | - Felipe A. Court
- Center for Integrative BiologyFaculty of SciencesFONDAP Center for GeroscienceBrain Health and Metabolism, Santiago, Chile, The Buck Institute for Research on AgingUniversidad Mayor, ChileNovatoCAUSA
| | | | - Nilton Custodio
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Andres Damian
- Centro Uruguayo de Imagenología Molecular (CUDIM)Centro de Medicina Nuclear e Imagenología MolecularHospital de ClínicasUniversidad de la RepúblicaMontevideoUruguay
| | - Myriam de la Cruz
- Global Brain Health Institute, University of CaliforniaSan FranciscoUSA
| | - Roberta Diehl Rodriguez
- Behavioral and Cognitive Neurology UnitDepartment of Neurology and LIM 22University of São PauloSão PauloBrazil
| | | | - Lais Fajersztajn
- Laboratory of Experimental Air Pollution (LIM05)Department of PathologySchool of MedicineGlobal Brain Health Institute, University of CaliforniaSan Francisco (UCSF)University of São PauloSão PauloSao PauloBrazil
| | - Gonzalo A. Farías
- Department Neurology and Neurosurgery North/Department of NeurosciencesCenter for Advanced Clinical Research (CICA)Faculty of MedicineUniversidad de ChileSantiagoChile
| | | | - Raffaele Ferrari
- Department of Neurodegenerative DiseaseUniversity College LondonLondonESUK
| | - Fabricio Ferreira de Oliveira
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | - Sergio T. Ferreira
- Institute of Medical Biochemistry Leopoldo de Meis & Institute of Biophysics Carlos Chagas FilhoFederal University of Rio de JaneiroRio de JaneiroRJBrazil
| | - Ceres Ferretti
- Division of NeurologyUniversity of São PauloSão PauloBrazil
| | | | | | - Patricio Fuentes
- Geriatrics Section Clinical Hospital University of Chile, Santos Dumont 999 IndependenciaSantiagoChile
| | - Adolfo M. García
- Cognitive Neuroscience Center (CNC)Faculty of EducationNational University of Cuyo (UNCuyo)Universidad de San Andres. National Scientific and Technical Research Council (CONICET)MendozaArgentina
| | | | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Instituto de PsiquiatriaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloSao PauloBrazil
| | | | | | | | - Ignacio F. Mata
- Department of Genomic MedicineLerner Research InstituteCleveland ClinicOHUSA
| | - Christian Gonzalez‐Billault
- Center for GeroscienceBrain Health and Metabolism (GERO), Santiago, Chile, and Department of Biology, Faculty of SciencesUniversity of ChileSantiagoChile
| | - Oscar L. Lopez
- Alzheimer's Disease Research CenterUniversity of PittsburghPittsburghPAUSA
| | - Laura Morelli
- Fundacion Instituto Leloir‐IIBBA‐CONICET. AveArgentina
| | - Ricardo Nitrini
- Department of NeurologyUniversity of São Paulo Medical SchoolSão PauloBrazil
| | | | - Alejandra Guerrero Barragan
- Trinity College Dublin, Dublin, Departamento de Neurologia Hospital Occidente de KennedyGlobal Brain Health InstituteUniversidad de la SabanaBogotaColombia
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN)School of PsychologyUniversidad Adolfo IbañezSantiagoChile
| | - Fabricio Joao Pio
- Department of NeurologyHospital Governador Celso RamosFlorianopolisBrazil
| | | | - Renata Kochhann
- Graduate Program in PsychologySchool of Health SciencesHospital Moinhos de VentoPontifical Catholic University of Rio Grande do Sul—PUCRS and Researcher OfficePorto AlegreBrazil
| | - Silvia Kochen
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hosp, El Cruce “N. Kirchner”, Univ. National A, Jauretche (UNAJ), F. Varela, Prov. Buenos Aires. Fac. MedicineUniv Nacional de Buenos Aires (UBA)Buenos AiresArgentina
| | - Fiona Kumfor
- Brain and Mind Centre and School of PsychologyUniversity of SydneySydneyNSWAustralia
| | - Serggio Lanata
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | - Bruce Miller
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | | | - Mirna Lie Hosogi
- Behavioral and Cognitive Unit of Department of NeurologyUniversity of São Paulo School of MedicineSao PauloBrazil
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile, Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | | | - David Lira
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Francisco Lopera
- Neuroscience Research GroupUniversidad de AntioquiaMedellínColombia
| | - Adelina Comas
- Department of Health Policy at the London School of Economics and Political ScienceLondonUK
| | | | - Ana Luisa Sosa
- Instituto Nacional de Neurología y NeurocirugíaCiudad de MéxicoMéxico
| | - Claudia Ramos
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | | | | | - Ioannis Tarnanas
- Global Brain Health Institute, University of CaliforniaSan FranciscoUSA
- Altoida Inc.HoustonTexasUSA
| | - Jenifer Yokoyama
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | | | | | - Kate Possin
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | - Kenneth S. Kosik
- Neuroscience Research Institute and Dept of Molecular Cellular and Developmental BiologyUniversity of California SantaBarbaraCaliforniaUSA
| | - Rosa Montesinos
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | - Patricia Cristina Lourdes Solis
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hosp, El Cruce “N. Kirchner”, Univ. National A, Jauretche (UNAJ), F. Varela, Prov. Buenos Aires. Fac. MedicineUniv Nacional de Buenos Aires (UBA)Buenos AiresArgentina
| | | | - Jeronimo Martin Ramirez
- Departamen de Admision Continua Adultos Hospital General La Raza Instituto Mexicano del Seguro SocialGlobal Brain Health Institute, Trinity College Dublin, DublinCiudad de MexicoMexico
| | - Diana Matallana
- Medical SchoolAging Institute and Psychiatry DepartmentPontificia Universidad Javeriana. Memory and Cognition Center‐IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Lingani Mbakile‐Mahlanza
- Global Brain Health InstituteUniversity of California San Francisco, University of BotswanaGaboroneBotswana
| | | | | | - Eliane C Miotto
- Department of NeurologyUniversity of Sao PauloSao PauloBrazil
| | | | | | - David Orozco
- Cognitive Neuroscience Development LaboratoryAxis NeurocienciasUniversidad Nacional del Sur, Cognitive Impairment and Behavior Disorders UnitBahía BlancaArgentina
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | - Olivier Piguet
- School of Psychology and Brain and Mind CentreUniversity of SydneyCamperdownNSWAustralia
| | - Maritza Pintado Caipa
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | | | - Lucas Porcello Schilling
- Department of NeurologyPontificia Universidade Catolica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil
| | - André Luiz Rodrigues Palmeira
- Santa Casa de Misericórdia de Porto Alegre, Serviço de Neurologia, Porto Alegre, BrazilHospital Ernesto DornellesServiço de Neurologia e NeurocirurgiaPorto AlegreBrazil
| | | | - Jose Manuel Santacruz‐Escudero
- Medical School and Psychiatry DepartmentMemory and Cognition Center‐ IntellectusPontificia Universidad JaverianaHospital Universitario San IgnacioBogotáColombia
| | | | - Jerusa Smid
- Department of NeurologyUniversity of Sao PauloSão PauloBrazil
| | - Andrea Slachevsky
- Neurology DepartmentGeroscience Center for Brain Health and Metabolism, Santiago, Chile, Laboratory of Neuropsychology and Clinical Neuroscience (LANNEC), Physiopathology Program‐ICBM, East Neurologic and Neurosciences Departments, Faculty of MedicineHospital del Salvador and Faculty of Medicine University of Chile. Servicio de NeurologíaDepartamento de MedicinaClínica Alemana—Universidad del DesarrolloUniversity of Chile, Neuropsychiatry and Memory Disorders clinic (CMYN)SantiagoChile
| | | | | | | | - Lea Tenenholz Grinberg
- Departments of NeurologyPathology and Global Brain Health InstituteUCSF ‐ USA, Department of PathologyUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Antonio Lucio Teixeira
- Laboratório Interdisciplinar de Investigação MédicaFaculdade de MedicinaAv. Alfredo Balena, 110Universidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Maira Tonidandel Barbosa
- Faculdade de Medicina da Universidade Federal de Minas Gerais e Faculdade deCiências Médicas de Minas GeraisBelo HorizonteBrazil
| | - Dominic Trépel
- Global Brain Health Institute (GBHI)Trinity College DublinDublin
| | - Agustin Ibanez
- Cognitive Neuroscience Center (CNC) Buenos Aires, Argentina; Universidad Autonoma del Caribe, Barranquilla, Colombia; Global Brain Health Institute (GBHI), USUniversidad de San AndresCONICETUniversidad Autonoma del CaribeUniversidad Adolfo IbanezUCSFUSA
| |
Collapse
|
15
|
Goerdten J, Carrière I, Muniz‐Terrera G. Comparison of Cox proportional hazards regression and generalized Cox regression models applied in dementia risk prediction. Alzheimers Dement (N Y) 2020; 6:e12041. [PMID: 32548239 PMCID: PMC7293996 DOI: 10.1002/trc2.12041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/23/2020] [Accepted: 05/11/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The frequently used Cox regression applies two critical assumptions, which might not hold for all predictors. In this study, the results from a Cox regression model (CM) and a generalized Cox regression model (GCM) are compared. METHODS Data are from the Survey of Health, Ageing and Retirement in Europe (SHARE), which includes approximately 140,000 individuals aged 50 or older followed over seven waves. CMs and GCMs are used to estimate dementia risk. The results are internally and externally validated. RESULTS None of the predictors included in the analyses fulfilled the assumptions of Cox regression. Both models predict dementia moderately well (10-year risk: 0.737; 95% confidence interval [CI]: 0.699, 0.773; CM and 0.746; 95% CI: 0.710, 0.785; GCM). DISCUSSION The GCM performs significantly better than the CM when comparing pseudo-R2 and the log-likelihood. GCMs enable researcher to test the assumptions used by Cox regression independently and relax these assumptions if necessary.
Collapse
Affiliation(s)
- Jantje Goerdten
- Edinburgh Dementia Prevention & Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Isabelle Carrière
- INSERMNeuropsychiatry: Epidemiological and Clinical ResearchMontpellier UniversityMontpellierFrance
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia Prevention & Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| |
Collapse
|
16
|
Stevenson EJ, Shannon OM, Minihane AM, Adamson A, Burns A, Hill T, Sniehotta F, Muniz‐Terrera G, Ritchie CW. NuBrain: UK consortium for optimal nutrition for healthy brain ageing. NUTR BULL 2020. [DOI: 10.1111/nbu.12429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- E. J. Stevenson
- Faculty of Medical Sciences Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - O. M. Shannon
- Faculty of Medical Sciences Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - A. M. Minihane
- Norwich Medical School University of East Anglia Norwich UK
| | - A. Adamson
- Faculty of Medical Sciences Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - A. Burns
- Faculty of Medical and Human Sciences University of Manchester Manchester UK
| | - T. Hill
- Faculty of Medical Sciences Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - F. Sniehotta
- Faculty of Medical Sciences Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - G. Muniz‐Terrera
- Centre for Dementia Prevention University of Edinburgh Edinburgh UK
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| | - C. W. Ritchie
- Centre for Dementia Prevention University of Edinburgh Edinburgh UK
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| |
Collapse
|
17
|
Stephan BCM, Muniz‐Terrera G, Granic A, Collerton J, Davies K, Saxby BK, Wesnes KA, Kirkwood TB, Jagger C. Longitudinal changes in global and domain specific cognitive function in the very-old: findings from the Newcastle 85+ Study. Int J Geriatr Psychiatry 2018; 33. [PMID: 28639724 PMCID: PMC5811803 DOI: 10.1002/gps.4743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Ageing is associated with changes in cognition in some, but not all domains. In young-old adults, defined as persons aged 65-84 years, baseline cognitive function has been shown to impact on cognitive trajectories. Whether similar patterns occur in the very-old, defined as persons aged 85 years and over, is not known. METHODS Longitudinal changes (5 years' follow-up) in global and domain specific cognitive function including memory, attention and speed were investigated in participants from the Newcastle 85+ Study (n = 845). At baseline, participants were grouped using Mini-Mental State Examination cut-off scores and dementia status into the following: not impaired, mildly impaired or severely impaired/dementia groups. RESULTS Only a limited number of cognitive measures showed significant decline in performance over time. Where observed, change generally occurred only in the severely impaired group. In the severely impaired group, small differences in baseline age were associated with poorer performance over time on most measures. Education was not protective against cognitive decline in any group. CONCLUSIONS There are individuals who maintain a high level of cognitive function or only show mild impairments even into their ninth decade of life. This group of successful cognitive agers may provide insight for identifying predictors of cognitive integrity in later life. In individuals with severe impairment, cognitive performance shows significant decline over time, especially in measures of attention and speed. Further work to identify those individuals at highest risk of cognitive decline is necessary to implement early support and intervention strategies in this rapidly expanding age group. © 2017 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- Blossom C. M. Stephan
- Institute of Health and SocietyNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK
| | - Graciela Muniz‐Terrera
- Centre for Dementia PreventionUniversity of Edinburgh, Royal Edinburgh HospitalEdinburghUK
| | - Antoneta Granic
- AGE Research Group, Institute of NeuroscienceNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK,NIHR Newcastle Biomedical Research Centre, and Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Joanna Collerton
- Institute of Health and SocietyNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK
| | - Karen Davies
- AGE Research Group, Institute of NeuroscienceNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK,NIHR Newcastle Biomedical Research Centre, and Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Brian K. Saxby
- Institute for AgeingNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK
| | - Keith A. Wesnes
- Department of PsychologyNorthumbria UniversityNewcastle upon TyneUK,Wesnes Cognition LimitedStreatley‐on‐ThamesUK
| | - Thomas B.L. Kirkwood
- Institute for Cell and Molecular Biosciences and Institute for AgeingNewcastle UniversityNewcastle upon TyneUK
| | - Carol Jagger
- Institute of Health and SocietyNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK
| |
Collapse
|