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Godard-Sebillotte C, Navani S, Hacker G, Vedel I. Considering inequities in national dementia strategies: breadth, depth, and scope. Int J Equity Health 2024; 23:75. [PMID: 38627768 PMCID: PMC11022480 DOI: 10.1186/s12939-024-02166-8] [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: 12/08/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Considering that dementia is an international public health priority, several countries have developed national dementia strategies outlining initiatives to address challenges posed by the disease. These strategies aim to improve the care, support, and resources available to meet the needs of persons living with dementia and their care partners and communities. Despite the known impact of social determinants of health on dementia risk, care, and outcomes, it is unclear whether dementia strategies adequately address related inequities. This study aimed to describe whether and how national dementia strategies considered inequities associated with social determinants of health. METHODS We conducted an environmental scan of the national dementia strategies of countries that are part of the Organisation for Economic Cooperation and Development (OECD). Included strategies had to be accessible in English or French. Sub-national or provincial plans were excluded. We synthesised information on strategies' considerations of inequity through a thematic analysis. RESULTS Of the 15 dementia strategies that met inclusion criteria, 13 mentioned at least one inequity (M = 2.4, median = 2, range:0-7) related to Race/Ethnicity; Religion; Age; Disability; Sexual Orientation/Gender Identity; Social Class; or Rurality. Age and disability were mentioned most frequently, and religion most infrequently. Eleven strategies included general inequity-focused objectives, while only 5 had specific inequity-focused objectives in the form of tangible percentage changes, deadlines, or allocated budgets for achieving equity-related goals outlined in their strategies. CONCLUSIONS Understanding if and how countries consider inequities in their dementia strategies enables the development of future strategies that adequately target inequities of concern. While most of the strategies mentioned inequities, few included tangible objectives to reduce them. Countries must not only consider inequities at a surface-level; rather, they must put forth actionable objectives that intend to lessen the impact of inequities in the care of all persons living with dementia.
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Affiliation(s)
- Claire Godard-Sebillotte
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Department of Medicine, Division of Geriatrics, McGill University, Montreal, QC, Canada.
| | - Sanjna Navani
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Georgia Hacker
- The Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Isabelle Vedel
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Department of Family Medicine, McGill University, Montreal, QC, Canada
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Jafari E, Abuloha S, Alshehri A, Eljilany I, Aroza R, Guo J, Shao H. Racial/Ethnic Disparities in Use of Angiotensin II Receptor Type 2/4 Stimulatory Vs. Inhibitory Antihypertensive Among Hypertensive Adults in the USA. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01970-w. [PMID: 38498117 DOI: 10.1007/s40615-024-01970-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/25/2024] [Accepted: 03/01/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES Studies showed angiotensin II type 2 receptor/angiotensin II type 4 receptor (AT2R/AT4R) stimulatory antihypertensive was associated with a lower risk of dementia and cognitive impairment compared to the inhibitory one. This study aimed to identify the racial and ethnic differences in using these agents among the USA adults with hypertension. METHODS A cross-sectional study was conducted using data from the Medical Expenditure Panel Survey (MEPS, 2016-2019). Individuals with a diagnosis of hypertension or self-reported hypertension and without dementia or Alzheimer's disease diagnosis were included in the analysis. We applied two multivariable logistic regressions to compare racial/ethnic differences in AT2R/AT4R stimulatory antihypertensive use and AT2R/AT4R inhibitory antihypertensive use, adjusting for covariates. RESULTS Twenty-four thousand five hundred eighty-one individuals with hypertension and without dementia or Alzheimer's disease were identified. Among non-Hispanic Whites, 72.39% were using AT2R/AT4R inhibitory antihypertensive agents, vs. 66.97% using AT2R/AT4R stimulatory antihypertensive agents. In contrast, both non-Hispanic Black and Asian Americans were using more AT2R/AT4R stimulatory agents than inhibitory ones (16.40% vs. 12.16% and 4.79% vs. 3.43%, respectively). Compared to non-Hispanic White, non-Hispanic Black (OR 1.980, 95% CI 1.839-2.132) and non-Hispanic Asian Americans (OR 1.545, 95% CI 1.356-1.761) were significantly associated with higher odds of prescribing AT2R/AT4R stimulatory agents, while Hispanics (OR 0.744, 95% CI 0.685-0.808) were associated with lower odds of prescribing AT2R/AT4R inhibitory agents compared to non-Hispanic Whites. CONCLUSIONS The results showed that the high-dementia risk populations like non-Hispanic Black and Asian American races are proportionally prescribed with higher use of low-dementia risk antihypertensive agents, compared to non-Hispanic Whites.
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Affiliation(s)
- Eissa Jafari
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Pharmacy Practice, College of Pharmacy, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Sumaya Abuloha
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Clinical Pharmacy and Pharmacy Practice, College of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Alaa Alshehri
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Islam Eljilany
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Cutaneous Oncology and Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
| | - Rupal Aroza
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky, Lexington, KY, USA
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Center for Drug Evaluation and Safety (CoDES), University of Florida, Gainesville, FL, USA
| | - Hui Shao
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA.
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
- Emory Global Diabetes Research Center of Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA.
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Benge JF, Aguirre A, Scullin MK, Kiselica A, Hilsabeck RC, Paydarfar D, Thomaz E, Douglas M. Digital Methods for Performing Daily Tasks Among Older Adults: An Initial Report of Frequency of Use and Perceived Utility. Exp Aging Res 2024; 50:133-154. [PMID: 36739553 DOI: 10.1080/0361073x.2023.2172950] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/22/2023] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Digital technologies permit new ways of performing instrumental activities of daily living (iADLs) for older adults, but these approaches are not usually considered in existing iADL measures. The current study investigated how a sample of older adults report using digital versus analog approaches for iADLs. METHOD 248 older adults completed the Digital and Analog Daily Activities Survey, a newly developed measure of how an individual performs financial, navigation, medication, and other iADLs. RESULTS The majority of participants reported regularly using digital methods for some iADLs, such as paying bills (67.7%) and using GPS (67.7%). Low digital adopters were older than high adopters (F(2, 245) = 12.24, p < .001), but otherwise the groups did not differ in terms of gender, years of education, or history of neurological disorders. Participants who used digital methods relatively more than analog methods reported greater levels of satisfaction with their approach and fewer daily errors. CONCLUSIONS Many older adults have adopted digital technologies for supporting daily tasks, which suggests limitations to the validity of current iADL assessments. By capitalizing on existing habits and enriching environments with new technologies, there are opportunities to promote technological reserve in older adults in a manner that sustains daily functioning.
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Affiliation(s)
- Jared F Benge
- Department of Neurology, University of Texas at Austin, Austin, TX, USA
- Mulva Clinic for the Neurosciences, University of Texas at Austin, Austin, TX, USA
| | - Alyssa Aguirre
- Department of Neurology, University of Texas at Austin, Austin, TX, USA
- Mulva Clinic for the Neurosciences, University of Texas at Austin, Austin, TX, USA
| | - Michael K Scullin
- Department of Psychology and Neurosciences, Baylor University, Waco, TX, USA
| | - Andrew Kiselica
- Department of Health Psychology, University of Missouri, Columbia, MO, USA
| | - Robin C Hilsabeck
- Department of Neurology, University of Texas at Austin, Austin, TX, USA
- Mulva Clinic for the Neurosciences, University of Texas at Austin, Austin, TX, USA
| | - David Paydarfar
- Department of Neurology, University of Texas at Austin, Austin, TX, USA
- Mulva Clinic for the Neurosciences, University of Texas at Austin, Austin, TX, USA
| | - Edison Thomaz
- Department of Electrical and Computer Engineering, University of Texas at Austin, Austin, TX, USA
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Vandenbroucke JP, Sørensen HT, Rehkopf DH, Gradus JL, Mackenbach JP, Glymour MM, Galea S, Henderson VW. Report on the Joint Workshop on the Relations between Health Inequalities, Ageing and Multimorbidity, Iceland, May 3-4, 2023. Clin Epidemiol 2024; 16:9-22. [PMID: 38259327 PMCID: PMC10801289 DOI: 10.2147/clep.s443152] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
This paper is a summary of key presentations from a workshop in Iceland on May 3-4, 2023 arranged by Aarhus University and with participation of the below-mentioned scientists. Below you will find the key messages from the presentations made by: Professor Jan Vandenbroucke, Department of Clinical Epidemiology, Aarhus University, Emeritus Professor, Leiden University; Honorary Professor, London School of Hygiene & Tropical Medicine, UKProfessor, Chair Henrik Toft Sørensen, Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, DenmarkProfessor David H. Rehkopf, Director, the Stanford Center for Population Health Sciences, Stanford University, CA., USProfessor Jaimie Gradus, Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USProfessor Johan Mackenbach, Emeritus Professor, Department of Public Health, Erasmus University Rotterdam, HollandProfessor, Chair M Maria Glymour, Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, Massachusetts, USProfessor, Dean Sandro Galea, School of Public Health, Boston University, Boston, Massachusetts, USProfessor Victor W. Henderson, Departments of Epidemiology & Population Health and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, US; Department of Clinical Epidemiology, Aarhus University, Aarhus, DK.
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Affiliation(s)
- Jan P Vandenbroucke
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Leiden University, Leiden, Netherlands
- London School of Hygiene & Tropical Medicine, London, UK
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Aarhus University Hospital, Aarhus, Denmark
| | - David H Rehkopf
- Stanford Center for Population Health Sciences, Stanford University, CA, USA
| | - Jaimie L Gradus
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Rotterdam, Rotterdam, Holland
| | - M Maria Glymour
- Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, MA, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | - Victor W Henderson
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Departments of Epidemiology & Population Health and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA
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Jünemann K, Engels A, Marie D, Worschech F, Scholz DS, Grouiller F, Kliegel M, Van De Ville D, Altenmüller E, Krüger THC, James CE, Sinke C. Increased functional connectivity in the right dorsal auditory stream after a full year of piano training in healthy older adults. Sci Rep 2023; 13:19993. [PMID: 37968500 PMCID: PMC10652022 DOI: 10.1038/s41598-023-46513-1] [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: 06/03/2022] [Accepted: 11/02/2023] [Indexed: 11/17/2023] Open
Abstract
Learning to play an instrument at an advanced age may help to counteract or slow down age-related cognitive decline. However, studies investigating the neural underpinnings of these effects are still scarce. One way to investigate the effects of brain plasticity is using resting-state functional connectivity (FC). The current study compared the effects of learning to play the piano (PP) against participating in music listening/musical culture (MC) lessons on FC in 109 healthy older adults. Participants underwent resting-state functional magnetic resonance imaging at three time points: at baseline, and after 6 and 12 months of interventions. Analyses revealed piano training-specific FC changes after 12 months of training. These include FC increase between right Heschl's gyrus (HG), and other right dorsal auditory stream regions. In addition, PP showed an increased anticorrelation between right HG and dorsal posterior cingulate cortex and FC increase between the right motor hand area and a bilateral network of predominantly motor-related brain regions, which positively correlated with fine motor dexterity improvements. We suggest to interpret those results as increased network efficiency for auditory-motor integration. The fact that functional neuroplasticity can be induced by piano training in healthy older adults opens new pathways to countervail age related decline.
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Affiliation(s)
- Kristin Jünemann
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Anna Engels
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Damien Marie
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- CIBM Center for Biomedical Imaging, MRI UNIGE, University of Geneva, Geneva, Switzerland
| | - Florian Worschech
- Center for Systems Neuroscience, Hannover, Germany
- Institute of Music Physiology and Musicians' Medicine, Hannover University of Music, Drama and Media, Hannover, Germany
| | - Daniel S Scholz
- Institute of Medical Psychology, University of Lübeck, Lübeck, Germany
- Department of Musicians' Health, University of Music Lübeck, Lübeck, Germany
| | - Frédéric Grouiller
- CIBM Center for Biomedical Imaging, MRI UNIGE, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Dimitri Van De Ville
- Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Eckart Altenmüller
- Center for Systems Neuroscience, Hannover, Germany
- Institute of Music Physiology and Musicians' Medicine, Hannover University of Music, Drama and Media, Hannover, Germany
| | - Tillmann H C Krüger
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Clara E James
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Christopher Sinke
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
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Heng NYW, Rittman T. Understanding ethnic diversity in open dementia neuroimaging data sets. Brain Commun 2023; 5:fcad308. [PMID: 38025280 PMCID: PMC10667030 DOI: 10.1093/braincomms/fcad308] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/22/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
Ethnic differences in dementia are increasingly recognized in epidemiological measures and diagnostic biomarkers. Nonetheless, ethnic diversity remains limited in many study populations. Here, we provide insights into ethnic diversity in open-access neuroimaging dementia data sets. Data sets comprising dementia populations with available data on ethnicity were included. Statistical analyses of sample and effect sizes were based on the Cochrane Handbook. Nineteen databases were included, with 17 studies of healthy groups or a combination of diagnostic groups if breakdown was unavailable and 12 of mild cognitive impairment and dementia groups. Combining all studies on dementia patients, the largest ethnic group was Caucasian (20 547 participants), with the next most common being Afro-Caribbean (1958), followed by Asian (1211). The smallest effect size detectable within the Caucasian group was 0.03, compared to Afro-Caribbean (0.1) and Asian (0.13). Our findings quantify the lack of ethnic diversity in openly available dementia data sets. More representative data would facilitate the development and validation of biomarkers relevant across ethnicities.
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Affiliation(s)
- Nicholas Yew Wei Heng
- Department of Neurosciences, University of Cambridge, Herchel Smith building, Cambridge Biomedical Campus, Robinson Way, Cambridge CB2 0SZ, UK
| | - Timothy Rittman
- Department of Neurosciences, University of Cambridge, Herchel Smith building, Cambridge Biomedical Campus, Robinson Way, Cambridge CB2 0SZ, UK
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Borelli WV, Formoso CR, Bieger A, Ferreira PL, Zimmer ER, Pascoal TA, Chaves MLF, Castilhos RM. Race‐related population attributable fraction of preventable risk factors of dementia: A Latino population‐based study. Alzheimers Dement (Amst) 2023; 15:e12408. [PMID: 36968620 PMCID: PMC10031750 DOI: 10.1002/dad2.12408] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/27/2022] [Accepted: 01/19/2023] [Indexed: 03/24/2023]
Abstract
Background Risk factors for dementia have distinct frequency and impact in relation to race. Our aim was to identify differences in modifiable risk factors of dementia related to races and estimate their population attributable fraction (PAF). Methods An epidemiological cohort was used to estimate the prevalence of 10 modifiable risk factors for dementia among five races—White, Black, Brown, Asian, and Indigenous. Sample weighting was used to estimate the prevalence and PAF of each risk factor in each race. Results A total of 9070 individuals were included. Overall adjusted PAF was the lowest in Indigenous (38.9%), and Asian individuals (41.2%). Race‐related prevalence of individual risk factors was widely variable in our population, but hearing loss was the most important contributor to the overall PAF in all races. Conclusions Public policies aiming to reduce preventable risk factors for dementia should take into consideration the race of the target populations. HIGHLIGHTS Preventable risk factors for dementia vary according to race. Hearing loss presented the highest prevalence among all races studied. Indigenous and Asian individuals presented the lowest population attributable fractions. Black and Brown individuals were more vulnerable to social determinants.
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Affiliation(s)
- Wyllians Vendramini Borelli
- Pharmacology and Therapeutics Research ProgramUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
- Cognitive and Behavioral Neurology CenterNeurology ServiceHospital de Clínicas de Porto Alegre (HCPA)Porto AlegreBrazil
| | - Carolina Rodrigues Formoso
- Cognitive and Behavioral Neurology CenterNeurology ServiceHospital de Clínicas de Porto Alegre (HCPA)Porto AlegreBrazil
- Faculty of MedicineUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
| | - Andrei Bieger
- Faculty of MedicineUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
- Department of BiochemistryInstitute of Health SciencesUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
| | | | - Eduardo R. Zimmer
- Pharmacology and Therapeutics Research ProgramUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
| | | | - Marcia Lorena Fagundes Chaves
- Cognitive and Behavioral Neurology CenterNeurology ServiceHospital de Clínicas de Porto Alegre (HCPA)Porto AlegreBrazil
- Faculty of MedicineUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
| | - Raphael Machado Castilhos
- Cognitive and Behavioral Neurology CenterNeurology ServiceHospital de Clínicas de Porto Alegre (HCPA)Porto AlegreBrazil
- Faculty of MedicineUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
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Roche-Dean M, Baik S, Moon H, Coe NB, Oh A, Zahodne LB. Paid Care Services and Transitioning out of the Community Among Black and White Older Adults With Dementia. J Gerontol B Psychol Sci Soc Sci 2023; 78:S91-S100. [PMID: 36075074 PMCID: PMC10010476 DOI: 10.1093/geronb/gbac117] [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: 02/08/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Paid care provided in the home includes important support services for older adults with dementia such as cleaning and personal care assistance. By reducing unmet needs, these services could delay the transition to residential long-term care, but access may differ across racial groups. This study examined the relationship between paid care and transitioning out of the community among Black and White older adults with dementia. METHODS Using data from 303 participants (29.4% Black) with probable dementia in the 2011 National Health and Aging Trends Study, competing risk hazards models estimated the association between receiving paid care at baseline and the probability of transitioning out of the community over 8 years (through 2019). Covariate selection was guided by the Andersen model of health care utilization. RESULTS Paid care was associated with lower risk of transitioning out of the community (subhazard ratios [SHR] = 0.70, 95% CI [0.50, 0.98]). This effect was similar after controlling for predisposing factors and most prominent after controlling for enabling and need for services factors (SHR = 0.65, 95% CI [0.44, 0.95]). There was no racial difference in the use of paid care despite evidence of greater care needs in Blacks. Furthermore, Black participants were less likely to transition out of the community than Whites. DISCUSSION Paid care services may help delay transitions out of the community. Future research should seek to explain racial differences in access to and/or preferences for home-based, community-based, and residential care.
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Affiliation(s)
- Maria Roche-Dean
- Bronson School of Nursing, Western Michigan University, 1903 West Michigan Avenue, Kalamazoo, MI 49008-5345, USA
| | - Sol Baik
- University of Virginia Weldon Cooper Center for Public Service, University of Virginia, 2400 Old Ivy Rd, Charlottesville, VA 22903, USA
| | - Heehyul Moon
- Kent School of Social Work and Family Science, University of Louisville, 2217 S. 3rd st., Louisville, KY 40292, USA
| | - Norma B Coe
- Department of Medical Ethics and Health Policy, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Anna Oh
- San Francisco VA Health Care System, 4150 Clement Street, San Francisco, CA 94121, USA
- Department of Social and Behavioral Sciences, University of California San Francisco, 490 Illinois St., Floor 12 San Francisco, CA 94143, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, USA
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Huang AR, Roth DL, Cidav T, Chung SE, Amjad H, Thorpe RJ, Boyd CM, Cudjoe TK. Social isolation and 9-year dementia risk in community-dwelling Medicare beneficiaries in the United States. J Am Geriatr Soc 2023; 71:765-773. [PMID: 36628523 PMCID: PMC10023331 DOI: 10.1111/jgs.18140] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [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: 06/10/2022] [Revised: 09/26/2022] [Accepted: 10/26/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Social isolation can influence whether older adults develop dementia. We examine the association between social isolation and incident dementia among older adults in a nationally representative sample of community dwelling older adults in the United States (U.S.). We also investigate whether this association varies by race and ethnicity. METHODS Data (N = 5022) come from the National Health and Aging Trends Study, a longitudinal and nationally representative cohort of older adults in the U.S. A composite measure of social isolation was used to classify older adults as socially isolated or not socially isolated at baseline. Demographic and health factors were measured at baseline via self-report. Dementia was measured at each round of data collection. Discrete-time proportional hazard time-to-event models were used to assess the association between social isolation and incident dementia over 9 years (2011-2020). RESULTS Of 5022 older adults, 1172 (23.3%) were socially isolated, and 3850 (76.7%) were not socially isolated. Adjusting for demographic and health factors, being socially isolated (vs. not socially isolated) was associated with a 1.28 (95% CI: 1.10-1.49) higher hazard of incident dementia over 9 years. There was no statistically significant difference by race and ethnicity. CONCLUSION Social isolation among older adults is associated with greater dementia risk. Elucidating the pathway by which social isolation impacts dementia may offer meaningful insights for the development of novel solutions to prevent or ameliorate dementia across diverse racial and ethnic groups.
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Affiliation(s)
- Alison R. Huang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David L. Roth
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tom Cidav
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shang-En Chung
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Halima Amjad
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Roland J. Thorpe
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cynthia M. Boyd
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Shvedko AV, Versolker Y, Edelstein OE. Translation and Validation of the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) Questionnaire among the General Israeli Population. Int J Environ Res Public Health 2023; 20:2622. [PMID: 36767987 PMCID: PMC9915287 DOI: 10.3390/ijerph20032622] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The need to promote awareness of dementia prevention is broadly emphasized in Israel. Currently, there is no valid version of a Hebrew questionnaire to assess attitudes and beliefs related to dementia prevention. This study aimed to translate and validate the MCLHB-DRR questionnaire among the general Israeli population. METHODS A total sample of 328 participants between the ages of 50-83 years (mean = 58.7, SD = 6.9) were included in this study. Participants completed the online translated MCLHB-DRR questionnaire. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were conducted to assess the questionnaire's validity. Internal consistency was assessed using Cronbach's alpha. RESULTS The EFA analysis revealed a seven-factor model with 27 items. One item related to perceived barriers and two items related to perceived severity were deleted. The CFA analysis confirmed a good model fit with the deleted items (χ2/df = 2.146, CFI = 0.930, TLI = 0.916, RMSEA = 0.049). Cronbach's alpha values ranged from 0.61 to 0.92. CONCLUSIONS The Hebrew MCLHB-DRR questionnaire is a valid and reliable measurement tool for assessing attitudes and beliefs related to health behaviours and lifestyle changes for dementia risk reduction in Israeli adults over the age of 50.
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Lipnicki DM, Lam BCP, Mewton L, Crawford JD, Sachdev PS. Harmonizing Ethno-Regionally Diverse Datasets to Advance the Global Epidemiology of Dementia. Clin Geriatr Med 2023; 39:177-190. [PMID: 36404030 PMCID: PMC9767705 DOI: 10.1016/j.cger.2022.07.009] [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] [Indexed: 11/23/2022]
Abstract
Understanding dementia and cognitive impairment is a global effort needing data from multiple sources across diverse ethno-regional groups. Methodological heterogeneity means that these data often require harmonization to make them comparable before analysis. We discuss the benefits and challenges of harmonization, both retrospective and prospective, broadly and with a focus on data types that require particular sorts of approaches, including neuropsychological test scores and neuroimaging data. Throughout our discussion, we illustrate general principles and give examples of specific approaches in the context of contemporary research in dementia and cognitive impairment from around the world.
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Affiliation(s)
- Darren M Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia.
| | - Ben C P Lam
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia; Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia
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Bonnechère B, Liu J, Thompson A, Amin N, van Duijn C. Does ethnicity influence dementia, stroke and mortality risk? Evidence from the UK Biobank. Front Public Health 2023; 11:1111321. [PMID: 37124771 PMCID: PMC10140594 DOI: 10.3389/fpubh.2023.1111321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/29/2022] [Accepted: 03/10/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction The number of people with dementia and stroke is increasing worldwide. There is increasing evidence that there are clinically relevant genetic differences across ethnicities. This study aims to quantify risk factors of dementia, stroke, and mortality in Asian and black participants compared to whites. Methods 272,660 participants from the UK Biobank were included in the final analysis, among whom the vast majority are white (n = 266,671, 97.80%), followed by Asian (n = 3,790, 1.35%), and black (n = 2,358, 0.84%) participants. Cumulative incidence risk was calculated based on all incident cases occurring during the follow-up of the individuals without dementia and stroke at baseline. We compared the allele frequency of variants in Asian and black participants with the referent ethnicity, whites, by chi-square test. Hierarchical cluster analysis was used in the clustering analysis. Significance level corrected for the false discovery rate was considered. Results After adjusting for risk factors, black participants have an increased risk of dementia and stroke compared to white participants, while Asians has similar odds to the white. The risk of mortality is not different in blacks and white participants but Asians have a decreased risk. Discussion The study provides important insights into the potential differences in the risk of dementia and stroke among different ethnic groups. Specifically, the study found that black individuals had a higher incidence of dementia and stroke compared to white individuals living in the UK. These findings are particularly significant as they suggest that there may be underlying factors that contribute to these differences, including genetic, environmental, and social factors. By identifying these differences, the study helps to inform interventions and policies aimed at reducing the risk of dementia and stroke, particularly among high-risk populations.
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Affiliation(s)
- Bruno Bonnechère
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, Diepenbeek, Belgium
| | - Jun Liu
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Alexander Thompson
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Najaf Amin
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Cornelia van Duijn
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- *Correspondence: Cornelia van Duijn,
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Kim J, Yon DK, Choi KY, Lee JJ, Kim N, Lee KH, Kim JG. Novel diagnostic tools for identifying cognitive impairment using olfactory-stimulated functional near-infrared spectroscopy: patient-level, single-group, diagnostic trial. Alzheimers Res Ther 2022; 14:39. [PMID: 35260170 PMCID: PMC8905807 DOI: 10.1186/s13195-022-00978-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/08/2022] [Indexed: 11/17/2022]
Abstract
Introduction Basic studies suggest that olfactory dysfunction and functional near-infrared spectroscopy (fNIRS) can be used as tools for the diagnosis of mild cognitive impairment (MCI); however, real-world evidence is lacking. We investigated the potential diagnostic efficacy of olfactory-stimulated fNIRS for early detection of MCI and/or Alzheimer disease (AD). Methods We conducted a patient-level, single-group, diagnostic interventional trial involving elderly volunteers (age >60 years) suspected of declining cognitive function. Patients received open-label olfactory-stimulated fNIRS for measurement of oxygenation difference in the orbitofrontal cortex. All participants underwent amyloid PET, MRI, Mini-Mental State Examination (MMSE), and Seoul Neuropsychological Screening Battery (SNSB). Results Of 97 subjects, 28 (28.9%) were cognitively normal, 32 (33.0%) had preclinical AD, 21 (21.6%) had MCI, and 16 (16.5%) had AD. Olfactory-stimulated oxygenation differences in the orbitofrontal cortex were associated with cognitive impairment; the association was more pronounced with cognitive severity. Olfactory-stimulated oxygenation difference was associated with MMSE (adjusted β [aβ] 1.001; 95% CI 0.540−1.463), SNSB language and related function (aβ, 1.218; 95% CI, 0.020−2.417), SNSB memory (aβ, 1.963; 95% CI, 0.841−3.084), SNSB frontal/executive function (aβ, 1.715; 95% CI, 0.401−3.029) scores, standard uptake value ratio from amyloid PET (aβ, −10.083; 95% CI, −19.063 to −1.103), and hippocampal volume from MRI (aβ, 0.002; 95% CI, 0.001−0.004). Olfactory-stimulated oxygenation difference in the orbitofrontal cortex was superior in diagnosing MCI and AD (AUC, 0.909; 95% CI, 0.848−0.971), compared to amyloid PET (AUC, 0.793; 95% CI, 0.694−0.893) or MRI (AUC, 0.758; 95% CI, 0.644−0.871). Discussion Our trial showed that olfactory-stimulated oxygenation differences in the orbitofrontal cortex detected by fNIRS were associated with cognitive impairment and cognitive-related objectives. This novel approach may be a potential diagnostic tool for patients with MCI and/or AD. Trial registration CRIS number, KCT0006197. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-00978-w.
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Bergeron CD, Robinson MT, Willis FB, Albertie ML, Wainwright JD, Fudge MR, Parfitt FC, Crook JE, Ball CT, Lucas JA. Testing an Alzheimer's Disease Educational Approach in Two African American Neighborhoods in Florida. J Racial Ethn Health Disparities 2022; 9:2283-2290. [PMID: 34647272 PMCID: PMC9005559 DOI: 10.1007/s40615-021-01165-7] [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: 07/19/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/29/2022]
Abstract
African Americans experience a significantly greater burden of Alzheimer's disease (AD) compared to non-Hispanic White Americans. Raising awareness and increasing knowledge of AD within African American communities is an important step towards addressing these disparities. The purpose of this study was to assess the effectiveness of two approaches to sharing AD knowledge with community residents. Using a quasi-experimental design, African American participants were recruited through community partners and local resources in two comparable neighborhoods in Duval County, Florida, which formed the intervention and the comparison groups for this study. The identical 40-min educational lecture was provided to both groups. In the intervention community, the lecture was followed by focus group sessions modeled after the Dementia Friendly America toolkit. In the comparison community, the lecture was followed by a social event where participants could interact informally with the speaker and dementia outreach staff. A brief quantitative survey assessing AD knowledge was administered to participants in both groups before the education session, immediately after the lecture, and 2 months later. Results indicate that both groups improved their knowledge scores at immediate post-test. Scores for both groups declined at 2-month follow-up, but the comparison group's scores declined more precipitously than the intervention group's scores (p = 0.0.21). These results suggest that conducting focus groups and interviews following a lecture on AD may help better retain AD knowledge over time.
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Affiliation(s)
- Caroline D Bergeron
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Maisha T Robinson
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Floyd B Willis
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Monica L Albertie
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Jolita D Wainwright
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Michelle R Fudge
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Francine C Parfitt
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Julia E Crook
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Colleen T Ball
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - John A Lucas
- Alzheimer's Disease Research Center, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA.
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Brayne C, Moffitt TE. The limitations of large-scale volunteer databases to address inequalities and global challenges in health and aging. Nat Aging 2022; 2:775-783. [PMID: 37118500 PMCID: PMC10154032 DOI: 10.1038/s43587-022-00277-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/02/2022] [Indexed: 04/30/2023]
Abstract
Large-scale volunteer databanks (LSVD) have emerged from the recognized value of cohorts, attracting substantial funding and promising great scientific value. A major focus is their size, with the implicit and sometimes explicit assumption that large size (thus power) creates generalizability. We contend that this is open to challenge. In the context of aging and age-related disease research, LSVD typically have limitations such as healthy volunteer, white ethnicity and high-education biases, and they omit early and late life stages critical for understanding aging. Their outputs are heavily focused on biomedical pathways of single chronic diseases. LSVD outputs increasingly dominate the funding and the publication landscapes. This Perspective discusses LSVD limitations and calls for more transparent reporting in LSVD research, as well as a greater reflection on the value of LSVD in relation to resources consumed. We invite funders and researchers to examine whether LSVD do actually contribute knowledge needed for our acute global health challenges including inequalities.
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Affiliation(s)
- Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK.
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Promenta Centre, University of Oslo, Oslo, Norway
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Brain J, Tully PJ, Turnbull D, Tang E, Greene L, Beach S, Siervo M, Stephan BCM. Risk factors for dementia in the context of cardiovascular disease: A protocol of an overview of reviews. PLoS One 2022; 17:e0271611. [PMID: 35862400 PMCID: PMC9302739 DOI: 10.1371/journal.pone.0271611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Dementia is a major public health priority. Although there is abundant evidence of an association between dementia and poor cardiovascular health, findings have been inconsistent and uncertain in identifying which factors increase dementia risk in those with cardiovascular disease. Indeed, multiple variables including sociodemographic, economic, health, lifestyle and education may indicate who is at higher vs. lower dementia risk and could be used in prediction modelling. Therefore, the aim of this review is to synthesise evidence on the key risk factors for dementia in those with a history of cardiovascular disease.
Methods
This is an overview of reviews protocol, registered on PROSPERO (CRD42021265363). Four electronic databases including MEDLINE, EMBASE, PsycINFO, and the Cochrane Database of Systematic Reviews will be searched. Studies will be included if they are systematic reviews and/or meta-analyses that have investigated the risk of incident dementia (all-cause and subtypes including Alzheimer’s disease and vascular dementia) in people with a history of coronary heart disease, heart failure, atrial fibrillation, hypertension, hyperlipidaemia, and vascular stiffness. Study selection will be completed by two independent researchers according to the eligibility criteria, and conflicts resolved by a third reviewer. References will be exported into Covidence for title and abstract sifting, full-text review, and data extraction. Methodological quality will be assessed using the AMSTAR-2 criteria and confidence of evidence will be assessed using the GRADE classification. This overview of reviews will follow PRISMA guidelines. If there is sufficient homogeneity in the data, the results will be pooled, and a meta-analysis conducted to determine the strength of association between each risk factor and incident all-cause dementia and its subtypes for each cardiovascular diagnoses separately.
Discussion
We will create a comprehensive summary of the key risk factors linking cardiovascular diseases to risk of incident dementia. This knowledge is essential for informing risk predictive model development as well as the development of risk reduction and prevention strategies.
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Affiliation(s)
- Jacob Brain
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, United Kingdom
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Phillip J. Tully
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, Australia
| | - Deborah Turnbull
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Eugene Tang
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Leanne Greene
- Clinical Trials Unit, College of Medicine and Health, University of Exeter, St Luke’s Campus, Exeter, United Kingdom
- * E-mail:
| | - Sarah Beach
- University of Nottingham Libraries, University of Nottingham, King’s Meadow Campus, Nottingham, United Kingdom
| | - Mario Siervo
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, United Kingdom
| | - Blossom C. M. Stephan
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, United Kingdom
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Chu CS, Liang CS, Tsai SJ, Bai YM, Su TP, Chen TJ, Chen MH. Bacterial pneumonia and subsequent dementia risk: A nationwide cohort study. Brain Behav Immun 2022; 103:12-8. [PMID: 35390468 DOI: 10.1016/j.bbi.2022.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/17/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Bacterial pneumonia is associated with an increased risk of dementia. However, the association between different pathogens of bacterial pneumonia and the risk of dementia remains unclear. METHODS Using the Taiwan National Health Insurance Research Database, we recruited 11,712 patients with bacterial pneumonia and 11,120 controls between 1997 and 2012 and followed them up until the end of 2013. A diagnosis of dementia, Alzheimer's disease (AD), vascular dementia (VaD), and unspecified dementia were identified during the follow-up period. Cox regression analyses were performed with adjustments for confounders. Sensitivity analysis was conducted to exclude patients with prodromal dementia. RESULTS Patients with bacterial pneumonia were more likely to develop dementia (hazard ratio [HR]: 2.83, 95% confidence interval [CI]: 2.53-3.18), AD (HR: 2.44, 95% CI: 1.65-3.61), VaD (HR: 4.15, 95% CI: 3.20-5.38), and unspecified dementia (HR: 2.62, 95% CI: 2.29-3.00) compared with controls after adjusting for potential confounders. Subgroup pathogen analyses showed that the HR of AD was 3.85 (1.66-8.96) for Hemophilus, and the HR of VaD was 5.40 for Staphylococcus. The risks of dementia and VaD were associated with repeated hospitalization due to bacterial pneumonia in a dose-dependent manner. Sensitivity analyses after exclusion of the first three years or first five years of observation and after exclusion case enrollment before 2010 or 2008 showed consistent findings. CONCLUSION Different pathogens are associated with different risks of AD, VaD, and unspecified dementia. Further studies are necessary to investigate the underlying mechanisms of bacterial pneumonia and dementia.
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Hamadelseed O, Elkhidir IH, Skutella T. Psychosocial Risk Factors for Alzheimer's Disease in Patients with Down Syndrome and Their Association with Brain Changes: A Narrative Review. Neurol Ther 2022; 11:931-953. [PMID: 35596914 PMCID: PMC9338203 DOI: 10.1007/s40120-022-00361-9] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/28/2022] [Indexed: 12/02/2022] Open
Abstract
Several recent epidemiological studies attempted to identify risk factors for Alzheimer’s disease. Age, family history, genetic factors (APOE genotype, trisomy 21), physical activity, and a low level of schooling are significant risk factors. In this review, we summarize the known psychosocial risk factors for the development of Alzheimer’s disease in patients with Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. We completed a comprehensive review of the literature on PubMed, Google Scholar, and Web of Science about psychosocial risk factors for Alzheimer’s disease, for Alzheimer’s disease in Down syndrome, and Alzheimer’s disease in Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. Alzheimer’s disease causes early pathological changes in individuals with Down syndrome, especially in the hippocampus and corpus callosum. People with Down syndrome living with dementia showed reduced volumes of brain areas affected by Alzheimer’s disease as the hippocampus and corpus callosum in association with cognitive decline. These changes occur with increasing age, and the presence or absence of psychosocial risk factors impacts the degree of cognitive function. Correlating Alzheimer’s disease biomarkers in Down syndrome and cognitive function scores while considering the effect of psychosocial risk factors helps us identify the mechanisms leading to Alzheimer’s disease at an early age. Also, this approach enables us to create more sensitive and relevant clinical, memory, and reasoning assessments for people with Down syndrome.
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Affiliation(s)
- Osama Hamadelseed
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, University of Heidelberg, Im Neuenheimer Feld 307, 69120, Heidelberg, Germany.
| | - Ibrahim H Elkhidir
- Faculty of Medicine, University of Khartoum, Alqasr St., Khartoum, Sudan
| | - Thomas Skutella
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, University of Heidelberg, Im Neuenheimer Feld 307, 69120, Heidelberg, Germany
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Bothongo PL, Jitlal M, Parry E, Waters S, Foote IF, Watson CJ, Cuzick J, Giovannoni G, Dobson R, Noyce AJ, Mukadam N, Bestwick JP, Marshall CR. Dementia risk in a diverse population: A single-region nested case-control study in the East End of London. The Lancet Regional Health - Europe 2022; 15:100321. [PMID: 35558994 PMCID: PMC9088197 DOI: 10.1016/j.lanepe.2022.100321] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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