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Galvin JE, Cummings JL, Benea ML, de Moor C, Allegri RF, Atri A, Chertkow H, Paquet C, Porter VR, Ritchie CW, Sikkes SAM, Smith MR, Grassi CM, Rubino I. Generating real-world evidence in Alzheimer's disease: Considerations for establishing a core dataset. Alzheimers Dement 2024. [PMID: 38706421 DOI: 10.1002/alz.13785] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/18/2024] [Accepted: 02/12/2024] [Indexed: 05/07/2024]
Abstract
Ongoing assessment of patients with Alzheimer's disease (AD) in postapproval studies is important for mapping disease progression and evaluating real-world treatment effectiveness and safety. However, interpreting outcomes in the real world is challenging owing to variation in data collected across centers and specialties and greater heterogeneity of patients compared with trial participants. Here, we share considerations for observational postapproval studies designed to collect harmonized longitudinal data from individuals with mild cognitive impairment or mild dementia stage of disease who receive therapies targeting the underlying pathological processes of AD in routine practice. This paper considers key study design parameters, including proposed aims and objectives, study populations, approaches to data collection, and measures of cognition, functional abilities, neuropsychiatric status, quality of life, health economics, safety, and drug utilization. Postapproval studies that capture these considerations will be important to provide standardized data on AD treatment effectiveness and safety in real-world settings.
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Affiliation(s)
- James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, Florida, USA
| | - Jeffrey L Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada, USA
| | | | | | - Ricardo F Allegri
- Instituto de Investigaciones Neurológicas Fleni, Buenos Aires, Argentina
- Departamento de Neurociencias, Universidad De La Costa (CUC), Barranquilla, Atlántico, Colombia
| | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, USA
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital - Main Campus, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Howard Chertkow
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Claire Paquet
- Université de Paris GHU AP-HP Nord Lariboisière Hospital, Paris, France
| | - Verna R Porter
- Pacific Brain Health Center, Pacific Neuroscience Institute, Santa Monica, California, USA
- Saint John's Cancer Institute, Santa Monica, California, USA
| | | | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam, The Netherlands
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Gregory S, Griffiths A, Jennings A, Malcomson FC, Matu J, Minihane AM, Muniz-Terrera G, Ritchie CW, Parra-Soto S, Stevenson E, Townsend R, Ward NA, Shannon O. Adherence to the Eatwell Guide and cardiometabolic, cognitive and neuroimaging parameters: an analysis from the PREVENT dementia study. Nutr Metab (Lond) 2024; 21:21. [PMID: 38594677 PMCID: PMC11005234 DOI: 10.1186/s12986-024-00794-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The Eatwell guide reflects the UK government's recommendations for a healthy and balanced diet. Previous research has identified associations between healthy eating patterns and both cardiovascular and brain health, although there is little evidence specifically focusing on the Eatwell Guide. To date no research has investigated associations between the Eatwell Guide and risk for future dementia. METHODS Data from the PREVENT dementia cohort study baseline visit was used in this analysis. Binary and graded Eatwell Guide scores (BEWG, GEWG) were created from a self-reported Food Frequency Questionnaire. The CAIDE score was included as the primary outcome measure to represent risk for future Alzheimer's disease. Secondary outcome measures included cardiometabolic health measures and brain health measures. Generalised additive models were run in R. RESULTS A total of 517 participants were included in the analysis, with a mean BEWG score of 4.39 (± 1.66) (out of a possible 12 points) and GEWG score of 39.88 (± 6.19) (out of a possible 60 points). There was no significant association between either Eatwell Guide score and the CAIDE score (BEWG β: 0.07, 95% confidence interval (CI): -0.07, 0.22; GEWG β: 0.02, 95% CI: -0.02, 0.06) or any measures of brain health. There was a significant association between higher GEWG score and lower systolic and diastolic blood pressure and body mass index (BMI) (systolic β: -0.24, 95% CI: -0.45, -0.03; diastolic β: -0.16, 95% CI: -0.29, -0.03; BMI β: -0.09, 95% CI: -0.16, -0.01). CONCLUSIONS Although not directly associated with the CAIDE score, the Eatwell Guide dietary pattern may be beneficial for dementia prevention efforts through the modification of hypertension and obesity, which are both known risk factors for dementia. Future work could replicate these findings in other UK-based cohorts as well as further development of Eatwell Guide scoring methodologies.
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Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Outpatient Department 2, Western General Hospital, Crewe Road South, Edinburgh, EH42XU, UK.
| | | | - Amy Jennings
- Norwich Medical School, University of East Anglia, Norwich, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Fiona C Malcomson
- Human Nutrition & Exercise Research Centre, Faculty of Medicine Sciences, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Jamie Matu
- School of Health, Leeds Beckett University, Leeds, UK
| | | | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Outpatient Department 2, Western General Hospital, Crewe Road South, Edinburgh, EH42XU, UK
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Outpatient Department 2, Western General Hospital, Crewe Road South, Edinburgh, EH42XU, UK
- Scottish Brain Sciences, Edinburgh, UK
| | - Solange Parra-Soto
- Department of Nutrition and Public Health, Universidad del Bío-Bío, 3780000, Chillan, Chile
- School of Cardiometabolic and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Emma Stevenson
- Human Nutrition & Exercise Research Centre, Faculty of Medicine Sciences, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- School of Biomedical, Nutritional and Sport Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Rebecca Townsend
- School of Biomedical, Nutritional and Sport Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Nicola Ann Ward
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Oliver Shannon
- Human Nutrition & Exercise Research Centre, Faculty of Medicine Sciences, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
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3
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Newton C, Pope M, Rua C, Henson R, Ji Z, Burgess N, Rodgers CT, Stangl M, Dounavi M, Castegnaro A, Koychev I, Malhotra P, Wolbers T, Ritchie K, Ritchie CW, O'Brien J, Su L, Chan D. Entorhinal-based path integration selectively predicts midlife risk of Alzheimer's disease. Alzheimers Dement 2024; 20:2779-2793. [PMID: 38421123 PMCID: PMC11032581 DOI: 10.1002/alz.13733] [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: 08/02/2023] [Revised: 01/03/2024] [Accepted: 01/17/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Entorhinal cortex (EC) is the first cortical region to exhibit neurodegeneration in Alzheimer's disease (AD), associated with EC grid cell dysfunction. Given the role of grid cells in path integration (PI)-based spatial behaviors, we predicted that PI impairment would represent the first behavioral change in adults at risk of AD. METHODS We compared immersive virtual reality (VR) PI ability to other cognitive domains in 100 asymptomatic midlife adults stratified by hereditary and physiological AD risk factors. In some participants, behavioral data were compared to 7T magnetic resonance imaging (MRI) measures of brain structure and function. RESULTS Midlife PI impairments predicted both hereditary and physiological AD risk, with no corresponding multi-risk impairment in episodic memory or other spatial behaviors. Impairments associated with altered functional MRI signal in the posterior-medial EC. DISCUSSION Altered PI may represent the transition point from at-risk state to disease manifestation in AD, prior to impairment in other cognitive domains.
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Affiliation(s)
- Coco Newton
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Marianna Pope
- Department of PsychiatryUniversity of CambridgeCambridgeUK
- Cambridgeshire and Peterborough NHS Foundation TrustCambridgeUK
| | - Catarina Rua
- Wolfson Brain Imaging CentreUniversity of CambridgeCambridgeUK
| | - Richard Henson
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Zilong Ji
- Institute of Cognitive NeuroscienceUCLLondonUK
| | | | | | - Matthias Stangl
- Jane and Terry Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesCaliforniaUSA
- Department of Biomedical EngineeringBoston UniversityBostonMassachusettsUSA
| | | | | | - Ivan Koychev
- Department of PsychiatryWarneford HospitalOxford UniversityOxfordUK
| | | | - Thomas Wolbers
- German Centre for Neurodegenerative Diseases (DZNE)MagdeburgGermany
| | | | - Craig W. Ritchie
- Centre for Dementia PreventionWestern General HospitalUniversity of EdinburghEdinburghUK
| | - John O'Brien
- Department of PsychiatryUniversity of CambridgeCambridgeUK
- Cambridgeshire and Peterborough NHS Foundation TrustCambridgeUK
| | - Li Su
- Department of PsychiatryUniversity of CambridgeCambridgeUK
- Sheffield Institute for Translational NeuroscienceUniversity of SheffieldSheffieldUK
| | - Dennis Chan
- Department of PsychiatryUniversity of CambridgeCambridgeUK
- Institute of Cognitive NeuroscienceUCLLondonUK
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Saunders S, Haider F, Ritchie CW, Muniz Terrera G, Luz S. Longitudinal observational cohort study: Speech for Intelligent cognition change tracking and DEtection of Alzheimer's Disease (SIDE-AD). BMJ Open 2024; 14:e082388. [PMID: 38548356 PMCID: PMC10982798 DOI: 10.1136/bmjopen-2023-082388] [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: 11/22/2023] [Accepted: 02/19/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION There is emerging evidence that speech may be a potential indicator and manifestation of early Alzheimer's disease (AD) pathology. Therefore, the University of Edinburgh and Sony Research have partnered to create the Speech for Intelligent cognition change tracking and DEtection of Alzheimer's Disease (SIDE-AD) study, which aims to develop digital speech-based biomarkers for use in neurodegenerative disease. METHODS AND ANALYSIS SIDE-AD is an observational longitudinal study, collecting samples of spontaneous speech. Participants are recruited from existing cohort studies as well as from the National Health Service (NHS)memory clinics in Scotland. Using an online platform, participants record a voice sample talking about their brain health and rate their mood, anxiety and apathy. The speech biomarkers will be analysed longitudinally, and we will use machine learning and natural language processing technology to automate the assessment of the respondents' speech patterns. ETHICS AND DISSEMINATION The SIDE-AD study has been approved by the NHS Research Ethics Committee (REC reference: 23/WM/0153, protocol number AC23046, IRAS Project ID 323311) and received NHS management approvals from Lothian, Fife and Forth Valley NHS boards. Our main ethical considerations pertain to the remote administration of the study, such as taking remote consent. To address this, we implemented a consent process, whereby the first step of the consent is done entirely remotely but a member of the research team contacts the participant over the phone to consent participants to the optional, most sensitive, elements of the study. Results will be presented at conferences, published in peer-reviewed journals and communicated to study participants.
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Affiliation(s)
| | - Fasih Haider
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Craig W Ritchie
- Department of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Scottish Brain Sciences, Edinburgh, UK
| | - Graciela Muniz Terrera
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
- Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Saturnino Luz
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh School of Molecular Genetic and Population Health Sciences, Edinburgh, UK
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Frisoni GB, Festari C, Massa F, Cotta Ramusino M, Orini S, Aarsland D, Agosta F, Babiloni C, Borroni B, Cappa SF, Frederiksen KS, Froelich L, Garibotto V, Haliassos A, Jessen F, Kamondi A, Kessels RP, Morbelli SD, O'Brien JT, Otto M, Perret-Liaudet A, Pizzini FB, Vandenbulcke M, Vanninen R, Verhey F, Vernooij MW, Yousry T, Boada Rovira M, Dubois B, Georges J, Hansson O, Ritchie CW, Scheltens P, van der Flier WM, Nobili F. European intersocietal recommendations for the biomarker-based diagnosis of neurocognitive disorders. Lancet Neurol 2024; 23:302-312. [PMID: 38365381 DOI: 10.1016/s1474-4422(23)00447-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 02/18/2024]
Abstract
The recent commercialisation of the first disease-modifying drugs for Alzheimer's disease emphasises the need for consensus recommendations on the rational use of biomarkers to diagnose people with suspected neurocognitive disorders in memory clinics. Most available recommendations and guidelines are either disease-centred or biomarker-centred. A European multidisciplinary taskforce consisting of 22 experts from 11 European scientific societies set out to define the first patient-centred diagnostic workflow that aims to prioritise testing for available biomarkers in individuals attending memory clinics. After an extensive literature review, we used a Delphi consensus procedure to identify 11 clinical syndromes, based on clinical history and examination, neuropsychology, blood tests, structural imaging, and, in some cases, EEG. We recommend first-line and, if needed, second-line testing for biomarkers according to the patient's clinical profile and the results of previous biomarker findings. This diagnostic workflow will promote consistency in the diagnosis of neurocognitive disorders across European countries.
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Affiliation(s)
- Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland; Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Cotta Ramusino
- Unit of Behavioral Neurology and Dementia Research Center (DRC), IRCCS Mondino Foundation, Pavia, Italy
| | - Stefania Orini
- Alzheimer's Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Dag Aarsland
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway; UK Dementia Research Institute, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele of Cassino, Cassino, Italy
| | - Barbara Borroni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Continuity of Care and Frailty, ASST Spedali Civili, Brescia, Italy
| | - Stefano F Cappa
- Centro Ricerca sulle Demenze, IRCCS Mondino Foundation, Pavia, Italy; University Institute for Advanced Studies (IUSS), Pavia, Italy
| | - Kristian S Frederiksen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocenter and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland; CIBM Center for Biomedical Imaging, Geneva, Switzerland
| | | | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Anita Kamondi
- National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary; Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Roy Pc Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands; Radboud UMC Alzheimer Center and Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands; Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Silvia D Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Markus Otto
- Department of Neurology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | | | - Francesca B Pizzini
- Department of Diagnostic and Public Health, Verona University Hospital, Verona University, Verona, Italy
| | - Mathieu Vandenbulcke
- Department of Neurosciences, KU Leuven, Leuven, Belgium; Department of Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - Ritva Vanninen
- University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology-Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Meike W Vernooij
- Department of Epidemiology and Department of Radiology and Nuclear Medicine Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Tarek Yousry
- Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK
| | - Mercè Boada Rovira
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Bruno Dubois
- Institut de La Mémoire et de La Maladie d'Alzheimer, Neurology Department, Salpêtrière Hospital, Assistance Publique-Hôpital de Paris, Paris, France; Sorbonne University, Paris, France
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Western General Hospital, University of Edinburgh, Edinburgh, UK; Brain Health Scotland, Edinburgh, UK
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, Netherlands; Amsterdam Neuroscience-Neurodegeneration, Amsterdam, Netherlands; Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Netherlands
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Shah SN, Dounavi ME, Malhotra PA, Lawlor B, Naci L, Koychev I, Ritchie CW, Ritchie K, O’Brien JT. Dementia risk and thalamic nuclei volumetry in healthy midlife adults: the PREVENT Dementia study. Brain Commun 2024; 6:fcae046. [PMID: 38444908 PMCID: PMC10914447 DOI: 10.1093/braincomms/fcae046] [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: 07/26/2023] [Revised: 12/31/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
A reduction in the volume of the thalamus and its nuclei has been reported in Alzheimer's disease, mild cognitive impairment and asymptomatic individuals with risk factors for early-onset Alzheimer's disease. Some studies have reported thalamic atrophy to occur prior to hippocampal atrophy, suggesting thalamic pathology may be an early sign of cognitive decline. We aimed to investigate volumetric differences in thalamic nuclei in middle-aged, cognitively unimpaired people with respect to dementia family history and apolipoprotein ε4 allele carriership and the relationship with cognition. Seven hundred participants aged 40-59 years were recruited into the PREVENT Dementia study. Individuals were stratified according to dementia risk (approximately half with and without parental dementia history). The subnuclei of the thalamus of 645 participants were segmented on T1-weighted 3 T MRI scans using FreeSurfer 7.1.0. Thalamic nuclei were grouped into six regions: (i) anterior, (ii) lateral, (iii) ventral, (iv) intralaminar, (v) medial and (vi) posterior. Cognitive performance was evaluated using the computerized assessment of the information-processing battery. Robust linear regression was used to analyse differences in thalamic nuclei volumes and their association with cognitive performance, with age, sex, total intracranial volume and years of education as covariates and false discovery rate correction for multiple comparisons. We did not find significant volumetric differences in the thalamus or its subregions, which survived false discovery rate correction, with respect to first-degree family history of dementia or apolipoprotein ε4 allele status. Greater age was associated with smaller volumes of thalamic subregions, except for the medial thalamus, but only in those without a dementia family history. A larger volume of the mediodorsal medial nucleus (Pfalse discovery rate = 0.019) was associated with a faster processing speed in those without a dementia family history. Larger volumes of the thalamus (P = 0.016) and posterior thalamus (Pfalse discovery rate = 0.022) were associated with significantly worse performance in the immediate recall test in apolipoprotein ε4 allele carriers. We did not find significant volumetric differences in thalamic subregions in relation to dementia risk but did identify an interaction between dementia family history and age. Larger medial thalamic nuclei may exert a protective effect on cognitive performance in individuals without a dementia family history but have little effect on those with a dementia family history. Larger volumes of posterior thalamic nuclei were associated with worse recall in apolipoprotein ε4 carriers. Our results could represent initial dysregulation in the disease process; further study is needed with functional imaging and longitudinal analysis.
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Affiliation(s)
- Sita N Shah
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
| | - Maria-Eleni Dounavi
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
| | - Paresh A Malhotra
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, London SW7 2AZ, UK
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin D02 PX31, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin D02 X9W9, Ireland
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin D02 PX31, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin D02 X9W9, Ireland
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
| | - Craig W Ritchie
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Karen Ritchie
- Institute de Neurosciences de Montpellier, INSERM, Montpellier 34093, France
| | - John T O’Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
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7
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Buller-Peralta I, Gregory S, Low A, Dounavi ME, Bridgeman K, Ntailianis G, Lawlor B, Naci L, Koychev I, Malhotra P, O'Brien JT, Ritchie CW, Muniz-Terrera G. Comprehensive allostatic load risk index is associated with increased frontal and left parietal white matter hyperintensities in mid-life cognitively healthy adults. Sci Rep 2024; 14:573. [PMID: 38177228 PMCID: PMC10766612 DOI: 10.1038/s41598-023-49656-3] [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: 09/14/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024] Open
Abstract
To date, there is a considerable heterogeneity of methods to score Allostatic Load (AL). Here we propose a comprehensive algorithm (ALCS) that integrates commonly used approaches to generate AL risk categories and assess associations to brain structure deterioration. In a cohort of cognitively normal mid-life adults (n = 620, age 51.3 ± 5.48 years), we developed a comprehensive composite for AL scoring incorporating gender and age differences, high quartile approach, clinical reference values, and current medications, to then generate AL risk categories. Compared to the empirical approach (ALES), ALCS showed better model fit criteria and a strong association with age and sex. ALSC categories were regressed against brain and white matter hyperintensity (WMH) volumes. Higher AL risk categories were associated with increased total, periventricular, frontal, and left parietal WMH volumes, also showing better fit compared to ALES. When cardiovascular biomarkers were removed from the ALSC algorithm, only left-frontal WMHV remained associated with AL, revealing a strong vascular burden influencing the index. Our results agree with previous evidence and suggest that sustained stress exposure enhances brain deterioration in mid-life adults. Showing better fit than ALES, our comprehensive algorithm can provide a more accurate AL estimation to explore how stress exposure enhances age-related health decline.
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Affiliation(s)
- Ingrid Buller-Peralta
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK.
| | - Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Katie Bridgeman
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Georgios Ntailianis
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, GBHI Office Room 0.60, Lloyd Building Trinity College Dublin, Dublin 2, Ireland
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, GBHI Office Room 0.60, Lloyd Building Trinity College Dublin, Dublin 2, Ireland
| | - Ivan Koychev
- Department of Psychiatry, Warneford Hospital, Oxford University, Warneford Ln, Headington, Oxford, OX3 7JX, UK
| | - Paresh Malhotra
- Department of Brain Sciences, Imperial College London, Burlington Danes, The Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
- Scottish Brain Sciences, Gyleview House, 3 Redheughs Rigg, South Gyle, Edinburgh, EH12 9DQ, UK
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
- Ohio University Heritage College of Osteopathic Medicine, 191 W Union St, Athens, OH, 45701, USA
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Dubbelman MA, Postema MC, Jutten RJ, Harrison JE, Ritchie CW, Aleman A, de Jong FJ, Schalet BD, Terwee CB, van der Flier WM, Scheltens P, Sikkes SAM. What's in a score: A longitudinal investigation of scores based on item response theory and classical test theory for the Amsterdam Instrumental Activities of Daily Living Questionnaire in cognitively normal and impaired older adults. Neuropsychology 2024; 38:96-105. [PMID: 37676135 DOI: 10.1037/neu0000914] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE We aimed to investigate whether item response theory (IRT)-based scoring allows for a more accurate, responsive, and less biased assessment of everyday functioning than traditional classical test theory (CTT)-based scoring, as measured with the Amsterdam Instrumental Activities of Daily Living Questionnaire. METHOD In this longitudinal multicenter study including cognitively normal and impaired individuals, we examined IRT-based and CTT-based score distributions and differences between diagnostic groups using linear regressions, and investigated scale attenuation. We compared change over time between scoring methods using linear mixed models with random intercepts and slopes for time. RESULTS Two thousand two hundred ninety-four participants were included (66.6 ± 7.7 years, 54% female): n = 2,032 (89%) with normal cognition, n = 93 (4%) with subjective cognitive decline, n = 79 (3%) with mild cognitive impairment, and n = 91 (4%) with dementia. At baseline, IRT-based and CTT-based scores were highly correlated (r = -0.92). IRT-based scores showed less scale attenuation than CTT-based scores. In a subsample of n = 1,145 (62%) who were followed for a mean of 1.3 (SD = 0.6) years, IRT-based scores declined significantly among cognitively normal individuals (unstandardized coefficient [B] = -0.15, 95% confidence interval, 95% CI [-0.28, -0.03], effect size = -0.02), whereas CTT-based scores did not (B = 0.20, 95% CI [-0.02, 0.41], effect size = 0.02). In the other diagnostic groups, effect sizes of change over time were similar. CONCLUSIONS IRT-based scores were less affected by scale attenuation than CTT-based scores. With regard to responsiveness, IRT-based scores showed more signal than CTT-based scores in early disease stages, highlighting the IRT-based scores' superior suitability for use in preclinical populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Mark A Dubbelman
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | - Merel C Postema
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | - Roos J Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - John E Harrison
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | | | - André Aleman
- Department of Neurosciences, University Medical Center Groningen, University of Groningen
| | | | | | | | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | - Sietske A M Sikkes
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
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9
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Bader I, Bader I, Lopes Alves I, Vállez García D, Vellas B, Dubois B, Boada M, Marquié M, Altomare D, Scheltens P, Vandenberghe R, Hanseeuw B, Schöll M, Frisoni GB, Jessen F, Nordberg A, Kivipelto M, Ritchie CW, Grau-Rivera O, Molinuevo JL, Ford L, Stephens A, Gismondi R, Gispert JD, Farrar G, Barkhof F, Visser PJ, Collij LE. Recruitment of pre-dementia participants: main enrollment barriers in a longitudinal amyloid-PET study. Alzheimers Res Ther 2023; 15:189. [PMID: 37919783 PMCID: PMC10621165 DOI: 10.1186/s13195-023-01332-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND The mismatch between the limited availability versus the high demand of participants who are in the pre-dementia phase of Alzheimer's disease (AD) is a bottleneck for clinical studies in AD. Nevertheless, potential enrollment barriers in the pre-dementia population are relatively under-reported. In a large European longitudinal biomarker study (the AMYPAD-PNHS), we investigated main enrollment barriers in individuals with no or mild symptoms recruited from research and clinical parent cohorts (PCs) of ongoing observational studies. METHODS Logistic regression was used to predict study refusal based on sex, age, education, global cognition (MMSE), family history of dementia, and number of prior study visits. Study refusal rates and categorized enrollment barriers were compared between PCs using chi-squared tests. RESULTS 535/1856 (28.8%) of the participants recruited from ongoing studies declined participation in the AMYPAD-PNHS. Only for participants recruited from clinical PCs (n = 243), a higher MMSE-score (β = - 0.22, OR = 0.80, p < .05), more prior study visits (β = - 0.93, OR = 0.40, p < .001), and positive family history of dementia (β = 2.08, OR = 8.02, p < .01) resulted in lower odds on study refusal. General study burden was the main enrollment barrier (36.1%), followed by amyloid-PET related burden (PCresearch = 27.4%, PCclinical = 9.0%, X2 = 10.56, p = .001), and loss of research interest (PCclinical = 46.3%, PCresearch = 16.5%, X2 = 32.34, p < .001). CONCLUSIONS The enrollment rate for the AMYPAD-PNHS was relatively high, suggesting an advantage of recruitment via ongoing studies. In this observational cohort, study burden reduction and tailored strategies may potentially improve participant enrollment into trial readiness cohorts such as for phase-3 early anti-amyloid intervention trials. The AMYPAD-PNHS (EudraCT: 2018-002277-22) was approved by the ethical review board of the VU Medical Center (VUmc) as the Sponsor site and in every affiliated site.
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Affiliation(s)
- Ilse Bader
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, 1081 HV, Amsterdam, The Netherlands.
| | - Ilona Bader
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
| | - Isadora Lopes Alves
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
- Brain Research Center, 1081 GN, Amsterdam, The Netherlands
| | - David Vállez García
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
| | - Bruno Vellas
- Gérontopole of Toulouse, University Hospital of Toulouse (CHU-Toulouse), 31300, Toulouse, France
- UMR INSERM 1027, University of Toulouse III, 31062, Toulouse, France
| | - Bruno Dubois
- Institute of Memory and Alzheimer's Disease (IM2A) and Brain Institute, Salpetriere Hospital, Sorbonne University, 75013, Paris, France
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Daniele Altomare
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, 1081 HV, Amsterdam, The Netherlands
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Leuven Brain Institute, KU Leuven, 3001, Louvain, Belgium
| | - Bernard Hanseeuw
- Institute of Neuroscience, Université Catholique de Louvain, 1200, Brussels, Belgium
- Department of Neurology, Clinique Universitaires Saint-Luc, 1200, Brussels, Belgium
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02155, USA
- WELBIO Department, WEL Research Institute, Avenue Pasteur, 6, 1300, Wavre, Belgium
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, 405 30, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30, Gothenburg, Sweden
- Dementia Research Centre, Queen Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, 1205, Geneva, Switzerland
- Geneva Memory Center, Geneva University Hospitals, 1205, Geneva, Switzerland
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), 53127, Bonn, Germany
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, 171 77, Stockholm, Sweden
- Theme Inflammation, Karolinska University Hospital, Stockholm, 171 77, Sweden
- Theme Aging, Karolinska University Hospital, Stockholm, 171 77, Sweden
| | - Miia Kivipelto
- Kuopio University Hospital, 70210, Kuopio, Finland
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, 171 77, Stockholm, Sweden
- Imperial College London, London, SW7 2AZ, UK
| | | | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005, Barcelona, Spain
- H. Lundbeck A/S, 2500, Copenhagen, Denmark
| | - Lisa Ford
- Janssen Research and Development, Titusville, NJ, 08560, USA
| | | | | | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005, Barcelona, Spain
| | - Gill Farrar
- GE Healthcare, Pharmaceutical Diagnostics, Amersham, HP7 9LL, UK
| | - Frederik Barkhof
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
- Institutes of Neurology and Healthcare Engineering, UCL, London, WC1N 3BG, UK
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, 1081 HV, Amsterdam, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, 6229 ER, The Netherlands
| | - Lyduine E Collij
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, 221 00, Malmö, Sweden
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10
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Gregory S, Blennow K, Ritchie CW, Shannon OM, Stevenson EJ, Muniz-Terrera G. Mediterranean diet is associated with lower white matter lesion volume in Mediterranean cities and lower cerebrospinal fluid Aβ 42 in non-Mediterranean cities in the EPAD LCS cohort. Neurobiol Aging 2023; 131:29-38. [PMID: 37572525 DOI: 10.1016/j.neurobiolaging.2023.07.012] [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: 02/09/2023] [Revised: 07/12/2023] [Accepted: 07/15/2023] [Indexed: 08/14/2023]
Abstract
The Mediterranean diet (MedDiet) has been associated with better brain health and reduced incidence of dementia. Few studies have compared the effects of the MedDiet in early Alzheimer's disease or compared the effects of the diet within and outside of the Mediterranean region. The Mediterranean diet adherence screener (MEDAS) and MEDAS continuous scores were calculated at the baseline visit of the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study (n = 1625). The scores were included in linear regression models to test for associations with hippocampal volume, log-transformed white matter lesion volume, cerebrospinal fluid pTau18, and Aβ42. Higher MEDAS scores were associated with lower log-transformed white matter lesion volume (β: -0.07, standard error [SE]: 0.02, p < 0.001). This association was only seen in the Mediterranean region (β: -0.12, SE: 0.03, p < 0.001). In the non-Mediterranean region, higher MEDAS continuous scores were associated with lower cerebrospinal fluid Aβ42 (β: -68.30, SE: 14.32, p < 0.001). More research is needed to understand the differences in the associations seen with the MedDiet and Alzheimer's disease biomarkers in different European regions.
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Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Scottish Brain Sciences, Edinburgh, UK
| | - Oliver M Shannon
- Faculty of Medical Sciences, Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Emma J Stevenson
- Faculty of Medical Sciences, Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Department of Social Medicine, Ohio University, Athens, OH, USA
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11
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Dounavi ME, Mak E, Swann P, Low A, Muniz-Terrera G, McKeever A, Pope M, Williams GB, Wells K, Lawlor B, Naci L, Malhotra P, Mackay C, Koychev I, Ritchie K, Su L, Ritchie CW, O’Brien JT. Differential association of cerebral blood flow and anisocytosis in APOE ε4 carriers at midlife. J Cereb Blood Flow Metab 2023; 43:1672-1684. [PMID: 37132287 PMCID: PMC10581239 DOI: 10.1177/0271678x231173587] [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: 08/08/2022] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 05/04/2023]
Abstract
Cerebral hemodynamic alterations have been observed in apolipoprotein ε4 (APOE4) carriers at midlife, however the physiological underpinnings of this observation are poorly understood. Our goal was to investigate cerebral blood flow (CBF) and its spatial coefficient of variation (CoV) in relation to APOE4 and a measure of erythrocyte anisocytosis (red blood cell distribution width - RDW) in a middle-aged cohort. Data from 563 participants in the PREVENT-Dementia study scanned with 3 T MRI cross-sectionally were analysed. Voxel-wise and region-of-interest analyses within nine vascular regions were run to detect areas of altered perfusion. Within the vascular regions, interaction terms between APOE4 and RDW in predicting CBF were examined. Areas of hyperperfusion in APOE4 carriers were detected mainly in frontotemporal regions. The APOE4 allele differentially moderated the association between RDW and CBF, an association which was more prominent in the distal vascular territories (p - [0.01, 0.05]). The CoV was not different between the considered groups. We provide novel evidence that in midlife, RDW and CBF are differentially associated in APOE4 carriers and non-carriers. This association is consistent with a differential hemodynamic response to hematological alterations in APOE4 carriers.
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Affiliation(s)
- Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Peter Swann
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Anna McKeever
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Marianna Pope
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Guy B Williams
- Department of Clinical Neurosciences and Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Katie Wells
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Brian Lawlor
- Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Lorina Naci
- Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Paresh Malhotra
- Division of Brain Science, Imperial College Healthcare NHS Trust, UK
| | - Clare Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - John T O’Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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12
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Graham M, Farina F, Ritchie CW, Lawlor B, Naci L. Fear of Dementia and the Obligation to Provide Aggregate Research Results to Study Participants-ADDENDUM. Camb Q Healthc Ethics 2023; 32:1. [PMID: 36825784 DOI: 10.1017/s0963180123000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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13
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Newton C, Pope M, Rua C, Henson R, Ji Z, Burgess N, Rodgers CT, Stangl M, Dounavi ME, Castegnaro A, Koychev I, Malhotra P, Wolbers T, Ritchie K, Ritchie CW, O’Brien J, Su L, Chan D. Path integration selectively predicts midlife risk of Alzheimer's disease. bioRxiv 2023:2023.01.31.526473. [PMID: 36778428 PMCID: PMC9915680 DOI: 10.1101/2023.01.31.526473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The entorhinal cortex (EC) is the first cortical region to exhibit neurodegeneration in Alzheimer's disease (AD), associated with EC grid cell dysfunction. Given the role of grid cells in path integration, we predicted that path integration impairment would represent the first behavioural change in adults at-risk of AD. Using immersive virtual reality, we found that midlife path integration impairments predicted both hereditary and physiological AD risk, with no corresponding impairment on tests of episodic memory or other spatial behaviours. Impairments related to poorer angular estimation and were associated with hexadirectional grid-like fMRI signal in the posterior-medial EC. These results indicate that altered path integration may represent the transition point from at-risk state to disease onset in AD, prior to impairment in other cognitive domains.
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Affiliation(s)
- Coco Newton
- Department of Psychiatry, University of Cambridge; Cambridge, UK
| | - Marianna Pope
- Department of Psychiatry, University of Cambridge; Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust; Cambridge, UK
| | - Catarina Rua
- Wolfson Brain Imaging Centre, University of Cambridge; Cambridge, UK
| | - Richard Henson
- Department of Psychiatry, University of Cambridge; Cambridge, UK
| | - Zilong Ji
- Institute of Cognitive Neuroscience, UCL; London, UK
| | - Neil Burgess
- Institute of Cognitive Neuroscience, UCL; London, UK
| | | | - Matthias Stangl
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California; Los Angeles, USA
| | | | | | - Ivan Koychev
- Department of Psychiatry, Oxford University; Oxford, UK
| | - Paresh Malhotra
- Department of Brain Sciences, Imperial College London; London, UK
| | - Thomas Wolbers
- German Centre for Neurodegenerative Diseases (DZNE); Magdeburg, Germany
| | - Karen Ritchie
- Inserm, Institut de Neurosciences; Montpellier, France
| | - Craig W. Ritchie
- Centre for Dementia Prevention, University of Edinburgh; Edinburgh, UK
| | - John O’Brien
- Department of Psychiatry, University of Cambridge; Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust; Cambridge, UK
| | - Li Su
- Department of Psychiatry, University of Cambridge; Cambridge, UK
| | - Dennis Chan
- Institute of Cognitive Neuroscience, UCL; London, UK
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14
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Gregory S, Saunders S, Ritchie CW. The ethics of revolution in Alzheimer's research - Authors' reply. Lancet Healthy Longev 2023; 4:e62. [PMID: 36738745 DOI: 10.1016/s2666-7568(23)00004-1] [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] [Received: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatient Department 2, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK.
| | - Stina Saunders
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatient Department 2, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatient Department 2, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK; Brain Health Scotland, Edinburgh, UK
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15
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Gregory S, Pullen H, Ritchie CW, Shannon OM, Stevenson EJ, Muniz-Terrera G. Mediterranean diet and structural neuroimaging biomarkers of Alzheimer's and cerebrovascular disease: A systematic review. Exp Gerontol 2023; 172:112065. [PMID: 36529364 DOI: 10.1016/j.exger.2022.112065] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 08/09/2022] [Revised: 11/23/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Previous studies have demonstrated an association between adherence to the Mediterranean diet (MedDiet) and better cognitive performance, lower incidence of dementia and lower Alzheimer's disease biomarker burden. The aim of this systematic review was to evaluate the evidence base for MedDiet associations with hippocampal volume and white matter hyperintensity volume (WMHV). We searched systematically for studies reporting on MedDiet and hippocampal volume or WMHV in MedLine, EMBASE, CINAHL and PsycInfo. Searches were initially carried out on 21st July 2021 with final searches run on 23rd November 2022. Risk of bias was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Of an initial 112 papers identified, seven papers were eligible for inclusion in the review reporting on 21,933 participants. Four studies reported on hippocampal volume, with inconclusive or no associations seen with MedDiet adherence. Two studies found a significant association between higher MedDiet adherence and lower WMHV, while two other studies found no significant associations. Overall these results highlight a gap in our knowledge about the associations between the MedDiet and AD and cerebrovascular related structural neuroimaging findings.
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Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - Hannah Pullen
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Brain Health Scotland, UK.
| | - Oliver M Shannon
- Faculty of Medical Sciences, Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, UK.
| | - Emma J Stevenson
- Faculty of Medical Sciences, Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, UK.
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Social Medicine, Ohio University, OH, USA.
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16
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Heneghan A, Deng F, Wells K, Ritchie K, Muniz-Terrera G, Ritchie CW, Lawlor B, Naci L. Modifiable Lifestyle Activities Affect Cognition in Cognitively Healthy Middle-Aged Individuals at Risk for Late-Life Alzheimer's Disease. J Alzheimers Dis 2023; 91:833-846. [PMID: 36502318 DOI: 10.3233/jad-220267] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND It is now acknowledged that Alzheimer's disease (AD) processes are present decades before the onset of clinical symptoms, but it remains unknown whether lifestyle factors can protect against these early AD processes in mid-life. OBJECTIVE We asked whether modifiable lifestyle activities impact cognition in middle-aged individuals who are cognitively healthy, but at risk for late life AD. Participants (40-59 years) completed cognitive and clinical assessments at baseline (N = 206) and two years follow-up (N = 174). METHODS Mid-life activities were measured with the Lifetime of Experiences Questionnaire. We assessed the impact of lifestyle activities, known risk factors for sporadic late-onset AD (Apolipoprotein E ɛ4 allele status, family history of dementia, and the Cardiovascular Risk Factors Aging and Dementia score), and their interactions on cognition. RESULTS More frequent engagement in physically, socially, and intellectually stimulating activities was associated with better cognition (verbal, spatial, and relational memory), at baseline and follow-up. Critically, more frequent engagement in these activities was associated with stronger cognition (verbal and visuospatial functions, and conjunctive short-term memory binding) in individuals with family history of dementia. Impaired visuospatial function is one of the earliest cognitive deficits in AD and has previously associated with increased AD risk in this cohort. Additionally, conjunctive memory functions have been found impaired in the pre-symptomatic stages of AD. CONCLUSION These findings suggest that modifiable lifestyle activities offset cognitive decrements due to AD risk in mid-life and support the targeting of modifiable lifestyle activities for the prevention of AD.
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Affiliation(s)
- Amy Heneghan
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Feng Deng
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Katie Wells
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Karen Ritchie
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK.,INSERM and University of Montpellier, Montpellier, France
| | | | - Craig W Ritchie
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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17
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Pead E, Thompson AC, Grewal DS, McGrory S, Robbins CB, Ma JP, Johnson KG, Liu AJ, Hamid C, Trucco E, Ritchie CW, Muniz G, Lengyel I, Dhillon B, Fekrat S, MacGillivray T. Retinal Vascular Changes in Alzheimer's Dementia and Mild Cognitive Impairment: A Pilot Study Using Ultra-Widefield Imaging. Transl Vis Sci Technol 2023; 12:13. [PMID: 36622689 PMCID: PMC9838583 DOI: 10.1167/tvst.12.1.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Indexed: 01/10/2023] Open
Abstract
Purpose Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer's dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging. Methods UWF images from 103 participants (28 with Alzheimer's dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity. Results Participants with Alzheimer's dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching. Conclusions Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer's disease. Translational Relevance This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential.
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Affiliation(s)
- Emma Pead
- VAMPIRE Project, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Atalie C. Thompson
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Dilraj S. Grewal
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Sarah McGrory
- VAMPIRE Project, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Cason B. Robbins
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Justin P. Ma
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Kim G. Johnson
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Andy J. Liu
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Charlene Hamid
- Edinburgh Clinical Research Facility, The University of Edinburgh, Edinburgh, UK
| | - Emanuele Trucco
- VAMPIRE Project, Computer Vision and Image Processing, Computing (SSE), The University of Dundee, Dundee, UK
| | - Craig W. Ritchie
- Edinburgh Dementia Prevention, The University of Edinburgh, Edinburgh, UK
| | - Graciela Muniz
- Department of Social Medicine, Ohio University, Athens, OH, USA
| | - Imre Lengyel
- The Welcome-Wolfson Institute for Experimental Medicine, School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, UK
| | - Baljean Dhillon
- VAMPIRE Project, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK,Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
| | - Sharon Fekrat
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Tom MacGillivray
- VAMPIRE Project, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
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18
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Saleh RNM, Hornberger M, Ritchie CW, Minihane AM. Hormone replacement therapy is associated with improved cognition and larger brain volumes in at-risk APOE4 women: results from the European Prevention of Alzheimer's Disease (EPAD) cohort. Alzheimers Res Ther 2023; 15:10. [PMID: 36624497 PMCID: PMC9830747 DOI: 10.1186/s13195-022-01121-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/08/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The risk of dementia is higher in women than men. The metabolic consequences of estrogen decline during menopause accelerate neuropathology in women. The use of hormone replacement therapy (HRT) in the prevention of cognitive decline has shown conflicting results. Here we investigate the modulating role of APOE genotype and age at HRT initiation on the heterogeneity in cognitive response to HRT. METHODS The analysis used baseline data from participants in the European Prevention of Alzheimer's Dementia (EPAD) cohort (total n= 1906, women= 1178, 61.8%). Analysis of covariate (ANCOVA) models were employed to test the independent and interactive impact of APOE genotype and HRT on select cognitive tests, such as MMSE, RBANS, dot counting, Four Mountain Test (FMT), and the supermarket trolley test (SMT), together with volumes of the medial temporal lobe (MTL) regions by MRI. Multiple linear regression models were used to examine the impact of age of HRT initiation according to APOE4 carrier status on these cognitive and MRI outcomes. RESULTS APOE4 HRT users had the highest RBANS delayed memory index score (P-APOE*HRT interaction = 0.009) compared to APOE4 non-users and to non-APOE4 carriers, with 6-10% larger entorhinal (left) and amygdala (right and left) volumes (P-interaction= 0.002, 0.003, and 0.005 respectively). Earlier introduction of HRT was associated with larger right (standardized β= -0.555, p=0.035) and left hippocampal volumes (standardized β= -0.577, p=0.028) only in APOE4 carriers. CONCLUSION HRT introduction is associated with improved delayed memory and larger entorhinal and amygdala volumes in APOE4 carriers only. This may represent an effective targeted strategy to mitigate the higher life-time risk of AD in this large at-risk population subgroup. Confirmation of findings in a fit for purpose RCT with prospective recruitment based on APOE genotype is needed to establish causality.
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Affiliation(s)
- Rasha N M Saleh
- Norwich Medical School, University of East Anglia, Norwich, UK.
| | | | - Craig W Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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19
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Udeh‐Momoh CT, Sindi S, Lee P, Zheng B, Robb C, Giannakopoulou P, Toopchiani ST, Watermeyer TJ, Ritchie CW, Middleton LT. Sex differences in Actigraph‐estimated versus Self‐reported sleep quality and Alzheimer’s disease neuropathology among cognitively‐unimpaired older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.065741] [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)
- Chinedu T. Udeh‐Momoh
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London London United Kingdom
| | - Shireen Sindi
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London London United Kingdom
| | - Pei‐Yu Lee
- Imperial College London London United Kingdom
| | - Bang Zheng
- Imperial College London London United Kingdom
| | | | | | | | - Tamlyn J Watermeyer
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh Edinburgh United Kingdom
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20
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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
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21
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Lorenzini L, Orso B, García DV, Pontillo G, Ingala S, Haller S, Blennow K, Frisoni GB, Chetelat G, Payoux P, Martinez‐Lage P, Ewers M, Waldman A, Ritchie CW, Gispert JD, Visser PJ, Mutsaerts H, Tijms BM, Wink AM, Barkhof F. Concerted alterations of functional connectivity and WM integrity in relationship to early amyloid deposition. Alzheimers Dement 2022. [DOI: 10.1002/alz.063910] [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)
- Luigi Lorenzini
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Beatrice Orso
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location VuMC, Vijre Universiteit Amsterdam Amsterdam Netherlands
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa Genova Italy
| | - David Vállez García
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, location VUmc Amsterdam Netherlands
| | - Giuseppe Pontillo
- Department of Advanced Biomedical Sciences, University “Federico II” Naples Italy
- Department of Electrical Engineering and Information Technology, University of Naples “Federico II” Naples Italy
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Sven Haller
- University of Geneva, Faculty of Medicine Geneva Switzerland
- Uppsala University Uppsala Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
| | - Giovanni B Frisoni
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli Brescia Italy
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals Geneva Switzerland
| | - Gael Chetelat
- Normandie University, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen‐Normandie, Cyceron Caen France
| | | | | | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Adam Waldman
- Imperial College London London United Kingdom
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
| | - Craig W. Ritchie
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
| | - Juan Domingo Gispert
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina Madrid Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
| | - Pieter Jelle Visser
- Alzheimer Centrum Limburg, Maastricht University Maastricht Netherlands
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience Campus, VU University Medical Center Amsterdam Netherlands
| | - Henk‐Jan Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University Ghent Belgium
| | - Betty M. Tijms
- Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Alle Meije Wink
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center Amsterdam Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- UCL Institute of Neurology London United Kingdom
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22
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Lorenzini L, Ingala S, Collij LE, Wottschel V, Haller S, Blennow K, Frisoni GB, Chetelat G, Payoux P, Martinez‐Lage P, Ewers M, Waldman A, Wardlaw JM, Ritchie CW, Gispert JD, Mutsaerts H, Visser PJ, Scheltens P, Tijms BM, Barkhof F, Wink AM. Functional eigenvector centrality dynamics are related to amyloid deposition in preclinical Alzheimer’s Disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.063850] [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)
- Luigi Lorenzini
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | | | - Viktor Wottschel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center Amsterdam Netherlands
| | - Sven Haller
- University of Geneva, Faculty of Medicine Geneva Switzerland
- Uppsala University Uppsala Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
| | - Giovanni B Frisoni
- University Hospitals of Geneva Geneva Switzerland
- Laboratory of Alzheimer’s Neuroimaging and Epidemiology (LANE) Brescia Italy
| | - Gael Chetelat
- Normandie University, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen‐Normandie, Cyceron Caen France
| | - Pierre Payoux
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS Toulouse France
| | - Pablo Martinez‐Lage
- Center for Research and Advanced Therapies, CITA‐Alzheimer Foundation San Sebastian Spain
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Adam Waldman
- Imperial College London London United Kingdom
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
- University of Edinburgh Edinburgh United Kingdom
| | - Craig W. Ritchie
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
| | - Juan Domingo Gispert
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER‐BBN) Madrid Spain
| | - Henk‐Jan Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University Ghent Belgium
| | - Pieter Jelle Visser
- Karolinska Institutet Stockholm Sweden
- Alzheimer Centrum Limburg, Maastricht University Maastricht Netherlands
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience Campus, VU University Medical Center Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Betty M. Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Frederik Barkhof
- UCL Institutes of Neurology and Healthcare Engineering London United Kingdom
- Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Alle Meije Wink
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center Amsterdam Netherlands
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23
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García DV, Collij LE, Mastenbroek SE, Alves IL, Gispert JD, Ritchie CW, Boada M, Marquié M, Grau‐Rivera O, Fauria K, Scheltens P, Vandenberghe R, Hanseeuw BJ, Schöll M, Frisoni GB, Boecker H, Jessen F, Wolz R, Grootoonk S, Stephens AW, Buckley CJ, Ford L, Visser PJ, Farrar G, Barkhof F. First results of the AMYPAD Prognostic and Natural History Study: amyloid‐PET Centiloid predicts cognitive functioning in a pre‐dementia population. Alzheimers Dement 2022. [DOI: 10.1002/alz.067114] [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)
| | | | - Sophie E Mastenbroek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, De Boelelaan 1117 Amsterdam Netherlands
| | | | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
| | | | - Mercè Boada
- Fundació ACE. Barcelona Alzheimer Treatment & Research Center Barcelona Spain
| | - Marta Marquié
- Fundació ACE. Barcelona Alzheimer Treatment & Research Center Barcelona Spain
| | - Oriol Grau‐Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
| | | | | | | | | | | | - Henning Boecker
- German Center for Neurodegenerative Diseases (DZNE) Bonn Germany
| | | | | | | | | | | | - Lisa Ford
- Janssen Research and Development Titusville NJ USA
| | | | - Gill Farrar
- GE Healthcare, Pharmaceutical Diagnostics Amersham United Kingdom
| | - Frederik Barkhof
- Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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24
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MacLeod T, Baksh MR, Filho OCDS, Govia I, Robledo LMG, Kowa H, Ritchie CW, Willis DR, Coppinger J, Ball DE, Murray JF, Largent EA. Framework for disclosing AD biomarker results following cognitive assessment within a pragmatic, multi‐country implementation evaluation. Alzheimers Dement 2022. [DOI: 10.1002/alz.063746] [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)
| | | | | | - Ishtar Govia
- The University of the West Indies, Mona Campus Kingston Jamaica
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25
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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]
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26
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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
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27
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Lorenzini L, Orso B, García DV, Pontillo G, Ingala S, Haller S, Blennow K, Frisoni GB, Chetelat G, Payoux P, Martinez‐Lage P, Ewers M, Waldman A, Ritchie CW, Gispert JD, Visser PJ, Mutsaerts HJMM, Tijms BM, Wink AM, Barkhof F. Concerted alterations of functional connectivity and WM integrity in relationship to early amyloid deposition. Alzheimers Dement 2022. [DOI: 10.1002/alz.064588] [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)
- Luigi Lorenzini
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Beatrice Orso
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location VuMC, Vijre Universiteit Amsterdam Amsterdam Netherlands
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa Genova Italy
| | - David Vállez García
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, location VUmc Amsterdam Netherlands
| | - Giuseppe Pontillo
- Department of Advanced Biomedical Sciences, University “Federico II” Naples Italy
- Department of Electrical Engineering and Information Technology, University of Naples “Federico II” Naples Italy
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Sven Haller
- University of Geneva, Faculty of Medicine Geneva Switzerland
- Uppsala University Uppsala Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
| | - Giovanni B Frisoni
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli Brescia Italy
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals Geneva Switzerland
| | - Gael Chetelat
- Normandie University, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen‐Normandie, Cyceron Caen France
| | - Pierre Payoux
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
- INSERM, Imagerie cérébrale et handicaps neurologiques Toulouse France
| | | | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Adam Waldman
- Imperial College London London United Kingdom
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
| | - Craig W. Ritchie
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
| | - Juan Domingo Gispert
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina Madrid Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
| | - Pieter Jelle Visser
- Alzheimer Centrum Limburg, Maastricht University Maastricht Netherlands
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience Campus, VU University Medical Center Amsterdam Netherlands
| | - Henri JMM Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University Ghent Belgium
| | - Betty M. Tijms
- Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Alle Meije Wink
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center Amsterdam Netherlands
| | - Frederik Barkhof
- Institutes of Neurology and Healthcare Engineering, University College London London United Kingdom
- Department of Computer Science and Centre for Medical Image Computing, University College London London United Kingdom
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28
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Saunders TS, Jenkins ND, Blennow K, Ritchie CW, Muniz Terrera G, Muniz G. Interactions between apolipoprotein E, sex, and amyloid‐beta on cerebrospinal fluid p‐tau levels in the European Prevention of Alzheimer’s Dementia Longitudinal Cohort Study (EPAD LCS). Alzheimers Dement 2022. [DOI: 10.1002/alz.069263] [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)
- Tyler S Saunders
- Centre for Discovery Brain Sciences at the University of Edinburgh Edinburgh United Kingdom
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
| | - Natalie D Jenkins
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
| | - Craig W. Ritchie
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
| | - Graciela Muniz Terrera
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
- Ohio University Athens OH USA
| | - Graciela Muniz
- Centre for Discovery Brain Sciences at the University of Edinburgh Edinburgh United Kingdom
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29
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Saunders S, Gregory S, Clement MHS, Birck C, van der Geyten S, Ritchie CW. The European Prevention of Alzheimer's Dementia Programme: An Innovative Medicines Initiative-funded partnership to facilitate secondary prevention of Alzheimer's disease dementia. Front Neurol 2022; 13:1051543. [PMID: 36484017 PMCID: PMC9723139 DOI: 10.3389/fneur.2022.1051543] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/28/2022] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Tens of millions of people worldwide will develop Alzheimer's disease (AD), and only by intervening early in the preclinical disease can we make a fundamental difference to the rates of late-stage disease where clinical symptoms and societal burden manifest. However, collectively utilizing data, samples, and knowledge amassed by large-scale projects such as the Innovative Medicines Initiative (IMI)-funded European Prevention of Alzheimer's Dementia (EPAD) program will enable the research community to learn, adapt, and implement change. METHOD In the current article, we define and discuss the substantial assets of the EPAD project for the scientific community, patient population, and industry, describe the EPAD structure with a focus on how the public and private sector interacted and collaborated within the project, reflect how IMI specifically supported the achievements of the above, and conclude with a view for future. RESULTS The EPAD project was a €64-million investment to facilitate secondary prevention of AD dementia research. The project recruited over 2,000 research participants into the EPAD longitudinal cohort study (LCS) and included over 400 researchers from 39 partners. The EPAD LCS data and biobank are freely available and easily accessible via the Alzheimer's Disease Data Initiative's (ADDI) AD Workbench platform and the University of Edinburgh's Sample Access Committee. The trial delivery network established within the EPAD program is being incorporated into the truly global offering from the Global Alzheimer's Platform (GAP) for trial delivery, and the almost 100 early-career researchers who were part of the EPAD Academy will take forward their experience and learning from EPAD to the next stage of their careers. DISCUSSION Through GAP, IMI-Neuronet, and follow-on funding from the Alzheimer's Association for the data and sample access systems, the EPAD assets will be maintained and, as and when sponsors seek a new platform trial to be established, the learnings from EPAD will ensure that this can be developed to be even more successful than this first pan-European attempt.
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Affiliation(s)
- Stina Saunders
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | | | | | - Serge van der Geyten
- Janssen Research and Development, Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Craig W. Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Brain Health Scotland, Edinburgh, United Kingdom
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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.
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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
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Gregory S, Saunders S, Ritchie CW. Science disconnected: the translational gap between basic science, clinical trials, and patient care in Alzheimer's disease. Lancet Healthy Longev 2022; 3:e797-e803. [PMID: 36356629 DOI: 10.1016/s2666-7568(22)00219-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/22/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
Both research and clinical practice have traditionally centred on the dementia syndrome of Alzheimer's disease rather than its preclinical and prodromal stages. However, there is a strong scientific and ethical impetus to shift focus to earlier disease stages to improve brain health outcomes and help to keep affected individuals symptom-free (dementia-free) for as long as possible. We provide an overview of recent advancements in early detection, drug development, and trial methodology that should be utilised in the development of new therapies for use in brain health clinics. We propose a triad approach to Alzheimer's disease clinical trials, encompassing (1) experimental medicine studies to gather greater knowledge of disease mechanisms, (2) a more comprehensive platform of phase 2 learning trials to inform phase 3 confirmatory trials, and (3) precision medicine involving smaller subgroups of patients with shared characteristics. This triad would ensure that treatment targets are identified accurately, trial methodology focuses on at-risk populations, and sensitive outcome measures capture potential treatment effects. Clinical services around the world must embrace the brain health clinic model so that neurodegenerative diseases can be detected in their earliest phase to quicken drug development pipelines and potentially improve prognosis.
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Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatient Department 2, Western General Hospital, University of Edinburgh, Edinburgh, UK.
| | - Stina Saunders
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatient Department 2, Western General Hospital, University of Edinburgh, Edinburgh, UK
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatient Department 2, Western General Hospital, University of Edinburgh, Edinburgh, UK; Brain Health Scotland, Edinburgh, UK
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Low A, Prats-Sedano MA, McKiernan E, Carter SF, Stefaniak JD, Nannoni S, Su L, Dounavi ME, Muniz-Terrera G, Ritchie K, Lawlor B, Naci L, Malhotra P, Mackay C, Koychev I, Ritchie CW, Markus HS, O’Brien JT. Modifiable and non-modifiable risk factors of dementia on midlife cerebral small vessel disease in cognitively healthy middle-aged adults: the PREVENT-Dementia study. Alzheimers Res Ther 2022; 14:154. [PMID: 36224605 PMCID: PMC9554984 DOI: 10.1186/s13195-022-01095-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
Background Considerable overlap exists between the risk factors of dementia and cerebral small vessel disease (SVD). However, studies remain limited to older cohorts wherein pathologies of both dementia (e.g. amyloid) and SVD (e.g. white matter hyperintensities) already co-exist. In younger asymptomatic adults, we investigated differential associations and interactions of modifiable and non-modifiable inherited risk factors of (future) late-life dementia to (present-day) mid-life SVD. Methods Cognitively healthy middle-aged adults (aged 40–59; mean 51.2 years) underwent 3T MRI (n = 630) as part of the PREVENT-Dementia study. To assess SVD, we quantified white matter hyperintensities, enlarged perivascular spaces, microbleeds, lacunes, and computed composite scores of SVD burden and subtypes of hypertensive arteriopathy and cerebral amyloid angiopathy (CAA). Non-modifiable (inherited) risk factors were APOE4 status and parental family history of dementia. Modifiable risk factors were derived from the 2020 Lancet Commission on dementia prevention (early/midlife: education, hypertension, obesity, alcohol, hearing impairment, head injuries). Confirmatory factor analysis (CFA) was used to evaluate the latent variables of SVD and risk factors. Structural equation modelling (SEM) of the full structural assessed associations of SVD with risk factors and APOE4*risk interaction. Results In SEM, the latent variable of global SVD related to the latent variable of modifiable midlife risk SVD (β = 0.80, p = .009) but not non-modifiable inherited risk factors of APOE4 or family history of dementia. Interaction analysis demonstrated that the effect of modifiable risk on SVD was amplified in APOE4 non-carriers (β = − 0.31, p = .009), rather than carriers. These associations and interaction effects were observed in relation to the SVD subtype of hypertensive arteriopathy, rather than CAA. Sensitivity analyses using separate general linear models validated SEM results. Conclusions Established modifiable risk factors of future (late-life) dementia related to present-day (mid-life) SVD, suggesting that early lifestyle modifications could potentially reduce rates of vascular cognitive impairment attributed to SVD, a major ‘silent’ contributor to global dementia cases. This association was amplified in APOE4 non-carriers, suggesting that lifestyle modifications could be effective even in those with genetic predisposition to dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01095-4.
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Affiliation(s)
- Audrey Low
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Maria A. Prats-Sedano
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Elizabeth McKiernan
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Stephen F. Carter
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - James D. Stefaniak
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Stefania Nannoni
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Li Su
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.11835.3e0000 0004 1936 9262Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Maria-Eleni Dounavi
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Graciela Muniz-Terrera
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Karen Ritchie
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK ,grid.457377.5INSERM, Montpellier, France
| | - Brian Lawlor
- grid.8217.c0000 0004 1936 9705Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Lorina Naci
- grid.8217.c0000 0004 1936 9705Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Paresh Malhotra
- grid.417895.60000 0001 0693 2181Division of Brain Science, Imperial College Healthcare NHS Trust, London, UK
| | - Clare Mackay
- grid.4991.50000 0004 1936 8948Department of Psychiatry, Oxford University, Oxford, UK
| | - Ivan Koychev
- grid.4991.50000 0004 1936 8948Department of Psychiatry, Oxford University, Oxford, UK
| | - Craig W. Ritchie
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Hugh S. Markus
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John T. O’Brien
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Festari C, Massa F, Cotta Ramusino M, Gandolfo F, Nicolosi V, Orini S, Aarsland D, Agosta F, Babiloni C, Boada M, Borroni B, Cappa S, Dubois B, Frederiksen KS, Froelich L, Garibotto V, Georges J, Haliassos A, Hansson O, Jessen F, Kamondi A, Kessels RPC, Morbelli S, O'Brien JT, Otto M, Perret-Liaudet A, Pizzini FB, Ritchie CW, Scheltens P, Vandenbulcke M, Vanninen R, Verhey F, Vernooij MW, Yousry T, Van Der Flier WM, Nobili F, Frisoni GB. European consensus for the diagnosis of MCI and mild dementia: Preparatory phase. Alzheimers Dement 2022; 19:1729-1741. [PMID: 36209379 DOI: 10.1002/alz.12798] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 03/02/2022] [Revised: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Etiological diagnosis of neurocognitive disorders of middle-old age relies on biomarkers, although evidence for their rational use is incomplete. A European task force is defining a diagnostic workflow where expert experience fills evidence gaps for biomarker validity and prioritization. We report methodology and preliminary results. METHODS Using a Delphi consensus method supported by a systematic literature review, 22 delegates from 11 relevant scientific societies defined workflow assumptions. RESULTS We extracted diagnostic accuracy figures from literature on the use of biomarkers in the diagnosis of main forms of neurocognitive disorders. Supported by this evidence, panelists defined clinical setting (specialist outpatient service), application stage (MCI-mild dementia), and detailed pre-assessment screening (clinical-neuropsychological evaluations, brain imaging, and blood tests). DISCUSSION The Delphi consensus on these assumptions set the stage for the development of the first pan-European workflow for biomarkers' use in the etiological diagnosis of middle-old age neurocognitive disorders at MCI-mild dementia stages. HIGHLIGHTS Rational use of biomarkers in neurocognitive disorders lacks consensus in Europe. A consensus of experts will define a workflow for the rational use of biomarkers. The diagnostic workflow will be patient-centered and based on clinical presentation. The workflow will be updated as new evidence accrues.
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Affiliation(s)
- Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Matteo Cotta Ramusino
- Unit of Behavioral Neurology, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Federica Gandolfo
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy
| | - Valentina Nicolosi
- UOC Neurologia, Ospedale Magalini (ULSS 9 - Veneto), Villafranca di Verona (VR), Italy
| | - Stefania Orini
- Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, Brescia, Italy
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
- European DLB Consortium
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- European Academy of Neurology
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
- Hospital San Raffaele of Cassino, Cassino (FR), Italy
- Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology
| | - Mercè Boada
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
- European FTLD network
| | - Stefano Cappa
- Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
- Scuola Universitaria Superiore IUSS Pavia, Pavia, Italy
- Federation of the European Societies of Neuropsychology
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), ICM, Salpetriere Hospital, AP-HP, University Paris 6, Paris, France
| | - Kristian S Frederiksen
- European Academy of Neurology
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
- European Alzheimer Disease Consortium
| | - Valentina Garibotto
- NIMTLab, Faculty of Medicine, University of Geneva, Switzerland
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
- Center for Biomedical Imaging, CIBM, Geneva, Switzerland
- European Association of Nuclear Medicine
| | | | - Alexander Haliassos
- ESEAP-Proficiency Testing Scheme for Clinical Laboratories, Athens, Greece
- International Federation of Clinical Chemistry
| | - Oskar Hansson
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmo, Sweden
| | - Frank Jessen
- European Alzheimer Disease Consortium
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Anita Kamondi
- Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology
- Department of Neurology, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Roy P C Kessels
- Federation of the European Societies of Neuropsychology
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Dept of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - John T O'Brien
- European DLB Consortium
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Markus Otto
- European FTLD network
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Armand Perret-Liaudet
- International Federation of Clinical Chemistry
- Laboratory of Neurobiology, Department of Biochemistry and Molecular Biology, Hospices civils de Lyon; Research and Resources Memory Centre, Lyon, France
- BioRan Team, Centre de Recherche en Neurosciences de Lyon, CNRS UMR5292, INSERM U1028, Lyon, France
| | - Francesca B Pizzini
- Verona University Hospital, Verona University, Dept. of Diagnostic and Public Health, Verona, Italy
- European Union of Medical Specialists
| | - Craig W Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Brain Health Scotland, Edinburgh, UK
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mathieu Vandenbulcke
- Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven, Belgium
- European Association of Geriatric Psychiatry
| | - Ritva Vanninen
- European Union of Medical Specialists
- University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Frans Verhey
- European Association of Geriatric Psychiatry
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- European Society of Neuroradiology
| | - Tarek Yousry
- European Society of Neuroradiology
- Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK
| | - Wiesje M Van Der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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Dounavi ME, Low A, Muniz-Terrera G, Ritchie K, Ritchie CW, Su L, Markus HS, O’Brien JT. Fluid-attenuated inversion recovery magnetic resonance imaging textural features as sensitive markers of white matter damage in midlife adults. Brain Commun 2022; 4:fcac116. [PMID: 35611309 PMCID: PMC9123845 DOI: 10.1093/braincomms/fcac116] [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: 06/28/2021] [Revised: 01/28/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
White matter hyperintensities are common radiological findings in ageing and a typical manifestation of cerebral small vessel disease. White matter hyperintensity burden is evaluated by quantifying their volume; however, subtle changes in the white matter may not be captured by white matter hyperintensity volumetry. In this cross-sectional study, we investigated whether magnetic resonance imaging texture of both white matter hyperintensities and normal appearing white matter was associated with reaction time, white matter hyperintensity volume and dementia risk in a midlife cognitively normal population. Data from 183 cognitively healthy midlife adults from the PREVENT-Dementia study (mean age 51.9 ± 5.4; 70% females) were analysed. White matter hyperintensities were segmented from 3 Tesla fluid-attenuated inversion recovery scans using a semi-automated approach. The fluid-attenuated inversion recovery images were bias field corrected and textural features (intensity mean and standard deviation, contrast, energy, entropy, homogeneity) were calculated in white matter hyperintensities and normal appearing white matter based on generated textural maps. Textural features were analysed for associations with white matter hyperintensity volume, reaction time and the Cardiovascular Risk Factors, Aging and Dementia risk score using linear regression models adjusting for age and sex. The extent of normal appearing white matter surrounding white matter hyperintensities demonstrating similar textural associations to white matter hyperintensities was further investigated by defining layers surrounding white matter hyperintensities at increments of 0.86 mm thickness. Lower mean intensity within white matter hyperintensities was a significant predictor of longer reaction time (t = −3.77, P < 0.01). White matter hyperintensity volume was predicted by textural features within white matter hyperintensities and normal appearing white matter, albeit in opposite directions. A white matter area extending 2.5 – 3.5 mm further from the white matter hyperintensities demonstrated similar associations. White matter hyperintensity volume was not related to reaction time, although interaction analysis revealed that participants with high white matter hyperintensity burden and less homogeneous white matter hyperintensity texture demonstrated slower reaction time. Higher Cardiovascular Risk Factors, Aging, and Dementia score was associated with a heterogeneous normal appearing white matter intensity pattern. Overall, greater homogeneity within white matter hyperintensities and a more heterogeneous normal appearing white matter intensity profile were connected to a higher white matter hyperintensity burden, while heterogeneous intensity was related to prolonged reaction time (white matter hyperintensities of larger volume) and dementia risk (normal appearing white matter). Our results suggest that the quantified textural measures extracted from widely used clinical scans, might capture underlying microstructural damage and might be more sensitive to early pathological changes compared to white matter hyperintensity volumetry.
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Affiliation(s)
- Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, United Kingdom
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, United Kingdom
| | | | - Karen Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom
- INM, Univ Montpellier, INSERM, Montpellier, France
| | - Craig W. Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, United Kingdom
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
| | - Hugh S. Markus
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - John T. O’Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, United Kingdom
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35
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Low A, Prats-Sedano MA, Stefaniak JD, McKiernan EF, Carter SF, Douvani ME, Mak E, Su L, Stupart O, Muniz G, Ritchie K, Ritchie CW, Markus HS, O'Brien JT. CAIDE dementia risk score relates to severity and progression of cerebral small vessel disease in healthy midlife adults: the PREVENT-Dementia study. J Neurol Neurosurg Psychiatry 2022; 93:481-490. [PMID: 35135868 PMCID: PMC9016254 DOI: 10.1136/jnnp-2021-327462] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Received: 06/24/2021] [Accepted: 12/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Markers of cerebrovascular disease are common in dementia, and may be present before dementia onset. However, their clinical relevance in midlife adults at risk of future dementia remains unclear. We investigated whether the Cardiovascular Risk Factors, Ageing and Dementia (CAIDE) risk score was associated with markers of cerebral small vessel disease (SVD), and if it predicted future progression of SVD. We also determined its relationship to systemic inflammation, which has been additionally implicated in dementia and SVD. METHODS Cognitively healthy midlife participants were assessed at baseline (n=185) and 2-year follow-up (n=158). To assess SVD, we quantified white matter hyperintensities (WMH), enlarged perivascular spaces (EPVS), microbleeds and lacunes. We derived composite scores of SVD burden, and subtypes of hypertensive arteriopathy and cerebral amyloid angiopathy. Inflammation was quantified using serum C-reactive protein (CRP) and fibrinogen. RESULTS At baseline, higher CAIDE scores were associated with all markers of SVD and inflammation. Longitudinally, CAIDE scores predicted greater total (p<0.001), periventricular (p<0.001) and deep (p=0.012) WMH progression, and increased CRP (p=0.017). Assessment of individual CAIDE components suggested that markers were driven by different risk factors (WMH/EPVS: age/hypertension, lacunes/deep microbleeds: hypertension/obesity). Interaction analyses demonstrated that higher CAIDE scores amplified the effect of age on SVD, and the effect of WMH on poorer memory. CONCLUSION Higher CAIDE scores, indicating greater risk of dementia, predicts future progression of both WMH and systemic inflammation. Findings highlight the CAIDE score's potential as both a prognostic and predictive marker in the context of cerebrovascular disease, identifying at-risk individuals who might benefit most from managing modifiable risk.
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Affiliation(s)
- Audrey Low
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Maria A Prats-Sedano
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - James D Stefaniak
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK.,Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Stephen F Carter
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Maria-Eleni Douvani
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.,Department of Neuroscience, The University of Sheffield, Sheffield, UK
| | - Olivia Stupart
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Graciela Muniz
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Karen Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK.,INSERM, Montpellier, France
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Hugh S Markus
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - John Tiernan O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Hillary RF, Gadd DA, McCartney DL, Shi L, Campbell A, Walker RM, Ritchie CW, Deary IJ, Evans KL, Nevado‐Holgado AJ, Hayward C, Porteous DJ, McIntosh AM, Lovestone S, Robinson MR, Marioni RE. Genome- and epigenome-wide studies of plasma protein biomarkers for Alzheimer's disease implicate TBCA and TREM2 in disease risk. Alzheimers Dement (Amst) 2022; 14:e12280. [PMID: 35475137 PMCID: PMC9019629 DOI: 10.1002/dad2.12280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022]
Abstract
Introduction The levels of many blood proteins are associated with Alzheimer's disease (AD) or its pathological hallmarks. Elucidating the molecular factors that control circulating levels of these proteins may help to identify proteins associated with disease risk mechanisms. Methods Genome-wide and epigenome-wide studies (nindividuals ≤1064) were performed on plasma levels of 282 AD-associated proteins, identified by a structured literature review. Bayesian penalized regression estimated contributions of genetic and epigenetic variation toward inter-individual differences in plasma protein levels. Mendelian randomization (MR) and co-localization tested associations between proteins and disease-related phenotypes. Results Sixty-four independent genetic and 26 epigenetic loci were associated with 45 proteins. Novel findings included an association between plasma triggering receptor expressed on myeloid cells 2 (TREM2) levels and a polymorphism and cytosine-phosphate-guanine (CpG) site within the MS4A4A locus. Higher plasma tubulin-specific chaperone A (TBCA) and TREM2 levels were significantly associated with lower AD risk. Discussion Our data inform the regulation of biomarker levels and their relationships with AD.
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Affiliation(s)
- Robert F. Hillary
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
| | - Danni A. Gadd
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
| | - Daniel L. McCartney
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
| | - Liu Shi
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Archie Campbell
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
| | - Rosie M. Walker
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
- Centre for Clinical Brain Sciences, Chancellor's Building, 49 Little France CrescentUniversity of EdinburghEdinburghUK
| | - Craig W. Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Ian J. Deary
- Lothian Birth Cohorts, Department of PsychologyUniversity of EdinburghEdinburghUK
| | - Kathryn L. Evans
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
| | | | - Caroline Hayward
- MRC Human Genetics UnitInstitute of Genetics and CancerUniversity of EdinburghEdinburghUK
| | - David J. Porteous
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
| | - Andrew M. McIntosh
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
- Division of Psychiatry, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Simon Lovestone
- Department of PsychiatryUniversity of OxfordOxfordUK
- NeurodegenerationJohnson and Johnson Medical LtdWokinghamUK
| | - Matthew R. Robinson
- Medical Genomics GroupInstitute of Science and Technology AustriaKlosterneuburgAustria
| | - Riccardo E. Marioni
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Cancer, University of EdinburghEdinburghUK
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37
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Gregory S, Linz N, König A, Langel K, Pullen H, Luz S, Harrison J, Ritchie CW. Remote data collection speech analysis and prediction of the identification of Alzheimer's disease biomarkers in people at risk for Alzheimer's disease dementia: the Speech on the Phone Assessment (SPeAk) prospective observational study protocol. BMJ Open 2022; 12:e052250. [PMID: 35292490 PMCID: PMC8928245 DOI: 10.1136/bmjopen-2021-052250] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Identifying cost-effective, non-invasive biomarkers of Alzheimer's disease (AD) is a clinical and research priority. Speech data are easy to collect, and studies suggest it can identify those with AD. We do not know if speech features can predict AD biomarkers in a preclinical population. METHODS AND ANALYSIS The Speech on the Phone Assessment (SPeAk) study is a prospective observational study. SPeAk recruits participants aged 50 years and over who have previously completed studies with AD biomarker collection. Participants complete a baseline telephone assessment, including spontaneous speech and cognitive tests. A 3-month visit will repeat the cognitive tests with a conversational artificial intelligence bot. Participants complete acceptability questionnaires after each visit. Participants are randomised to receive their cognitive test results either after each visit or only after they have completed the study. We will combine SPeAK data with AD biomarker data collected in a previous study and analyse for correlations between extracted speech features and AD biomarkers. The outcome of this analysis will inform the development of an algorithm for prediction of AD risk based on speech features. ETHICS AND DISSEMINATION This study has been approved by the Edinburgh Medical School Research Ethics Committee (REC reference 20-EMREC-007). All participants will provide informed consent before completing any study-related procedures, participants must have capacity to consent to participate in this study. Participants may find the tests, or receiving their scores, causes anxiety or stress. Previous exposure to similar tests may make this more familiar and reduce this anxiety. The study information will include signposting in case of distress. Study results will be disseminated to study participants, presented at conferences and published in a peer reviewed journal. No study participants will be identifiable in the study results.
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Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
| | - Nicklas Linz
- ki elements, ki elements, Saarbrucken, Saarland, Germany
| | - Alexandra König
- Stars Team, National Institute for Research in Computer Science and Automation, Nice, France
| | - Kai Langel
- Janssen Healthcare Innovation, Beerse, Belgium
| | - Hannah Pullen
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
| | - Saturnino Luz
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - John Harrison
- Metis Cognition Ltd, Kilmington Common, UK
- Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
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Saunders S, Ritchie CW, Russ TC, Muniz-Terrera G, Milne R. Correction to: Assessing and disclosing test results for 'mild cognitive impairment': the perspective of old age psychiatrists in Scotland. BMC Geriatr 2022; 22:165. [PMID: 35227205 PMCID: PMC8887141 DOI: 10.1186/s12877-022-02770-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Stina Saunders
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - Craig W Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Brain Health Scotland, Glasgow, UK
| | - Tom C Russ
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Alzheimer Scotland Dementia Research Centre, Edinburgh, UK
| | | | - Richard Milne
- Society and Ethics Research, Wellcome Connecting Science, Cambridge, UK.,Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Saunders S, Ritchie CW, Russ TC, Muniz-Terrera G, Milne R. Assessing and disclosing test results for ‘mild cognitive impairment’: the perspective of old age psychiatrists in Scotland. BMC Geriatr 2022; 22:50. [PMID: 35022025 PMCID: PMC8754072 DOI: 10.1186/s12877-021-02693-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/15/2021] [Indexed: 03/11/2023] Open
Abstract
Abstract
Background
Mild cognitive impairment (MCI) is a condition that exists between normal healthy ageing and dementia with an uncertain aetiology and prognosis. This uncertainty creates a complex dynamic between the clinicians’ conception of MCI, what is communicated to the individual about their condition, and how the individual responds to the information conveyed to them. The aim of this study was to explore clinicians’ views around the assessment and communication of MCI in memory clinics.
Method
As part of a larger longitudinal study looking at patients’ adjustment to MCI disclosure, we interviewed Old Age Psychiatrists at the five participating sites across Scotland. The study obtained ethics approvals and the interviews (carried out between Nov 2020–Jan 2021) followed a semi-structured schedule focusing on [1] how likely clinicians are to use the term MCI with patients; [2] what tests clinicians rely on and how much utility they see in them; and [3] how clinicians communicate risk of progression to dementia. The interviews were voice recorded and were analysed using reflective thematic analysis.
Results
Initial results show that most clinicians interviewed (Total N = 19) considered MCI to have significant limitations as a diagnostic term. Nevertheless, most clinicians reported using the term MCI (n = 15/19). Clinical history was commonly described as the primary aid in the diagnostic process and also to rule out functional impairment (which was sometimes corroborated by Occupational Therapy assessment). All clinicians reported using the Addenbrooke’s Cognitive Examination-III as a primary assessment tool. Neuroimaging was frequently found to have minimal usefulness due to the neuroradiological reports being non-specific.
Conclusion
Our study revealed a mixture of approaches to assessing and disclosing test results for MCI. Some clinicians consider the condition as a separate entity among neurodegenerative disorders whereas others find the term unhelpful due to its uncertain prognosis. Clinicians report a lack of specific and sensitive assessment methods for identifying the aetiology of MCI in clinical practice. Our study demonstrates a broad range of views and therefore variability in MCI risk disclosure in memory assessment services which may impact the management of individuals with MCI.
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40
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Ritchie CW, Waymont JMJ, Pennington C, Draper K, Borthwick A, Fullerton N, Chantler M, Porteous ME, Danso SO, Green A, McWhirter L, Muniz Terrera G, Simpson S, Thompson G, Trépel D, Quinn TJ, Kilgour A. The Scottish Brain Health Service Model: Rationale and Scientific Basis for a National Care Pathway of Brain Health Services in Scotland. J Prev Alzheimers Dis 2022; 9:348-358. [PMID: 35543009 DOI: 10.14283/jpad.2021.63] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In order to address the oft-cited societal, economic, and health and social care impacts of neurodegenerative diseases, such as Alzheimer's disease, we must move decisively from reactive to proactive clinical practice and to embed evidence-based brain health education throughout society. Most disease processes can be at least partially prevented, slowed, or reversed. We have long neglected to intervene in neurodegenerative disease processes, largely due to a misconception that their predominant symptom - cognitive decline - is a normal, age-related process, but also due to a lack of multi-disciplinary collaboration. We now understand that there are modifiable risk factors for neurodegenerative diseases, that successful management of common comorbidities (such as diabetes and hypertension) can reduce the incidence of neurodegenerative disease, and that disease processes begin (and, crucially, can be detected, reduced, and delayed, prevented, or treated) decades earlier in life than had previously been appreciated. Brain Health Scotland, established by Scottish Government and working in partnership with Alzheimer Scotland, propose far-reaching public health and clinical practice approaches to reduce neurodegenerative disease incidence. Focusing here on Brain Health Scotland's clinical offerings, we present the Scottish Model for Brain Health Services. To our knowledge, the Scottish Model for Brain Health, built on foundations of personalised risk profiling, targeted risk reduction and prevention, early disease detection, equity of access, and harnessing comprehensive data to assist in clinical decision-making, marks the first example of a nationwide approach to overhauling clinical, societal, and political approaches to the prevention, assessment, and treatment of neurodegenerative disease.
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Affiliation(s)
- C W Ritchie
- Prof. Craig Ritchie, University of Edinburgh, United Kingdom,
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Gregory S, Ritchie CW, Ritchie K, Shannon O, Stevenson EJ, Muniz-Terrera G. Mediterranean diet score is associated with greater allocentric processing in the EPAD LCS cohort: A comparative analysis by biogeographical region. Front Aging 2022; 3:1012598. [PMID: 36568511 PMCID: PMC9780498 DOI: 10.3389/fragi.2022.1012598] [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] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Background: Adherence to the Mediterranean diet (MedDiet), a primarily plant-based eating pattern, has been associated with lower dementia incidence. Much of the research has focused on Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI), with less research looking at the preclinical symptomatically silent stages that pre-empt MCI and AD dementia. Although there is evidence from studies conducted globally, no studies have compared the effects of the MedDiet within and outside of the Mediterranean region in one cohort. Methods: Our study explored cross-sectional and longitudinal associations between MedDiet and cognition in the pan-European EPAD LCS, comparing those living within and outside of the Mediterranean region (as classified by European Union biogeographical definitions). After deriving MEDAS scores to quantify adherence to the MedDiet, we used linear regression and linear mixed effects models to test for associations between the MEDAS score and cognitive function measured by the Four Mountains Test (FMT) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). We additionally calculated MEDAS continuous and PYRAMID scores to provide alternative measures of MedDiet adherence. Results: We included 1826 participants, mean age 65.69 (±7.42) years, majority female (56.2%) with family history (65.8%) and minority APOEε4 carriers (38.9%). Higher MEDAS scores were associated with better performance on the FMT both cross-sectionally (n = 1,144, ß: -0.11, SE: 0.04, p = 0.007) and longitudinally (slope: 0.10, 95% CI: 0.04-0.17, p: 0.002). The effect was marginally greater in the Mediterranean region in the cross-sectional analysis, with a stronger effect emerging longitudinally. In exploratory analyses, the association between MEDAS and FMT scores was only seen in female participants. A sensitivity analysis excluding Toulouse and Perugia, as cities near, but not within, the biogeographical region, found significant associations between higher MEDAS and MEDAS continuous scores, and a number of RBANS total and index scores. Conclusion: MedDiet adherence is associated with better FMT scores, with effects seen most strongly in the Mediterranean region from longitudinal data. Our sensitivity analysis suggested a more global cognitive benefit of MedDiet adherence. This study highlights the need to further explore for whom and for what brain health outcomes the MedDiet confers benefit. This evidence would identify a window of opportunity in the life-course to maximise the benefit and better inform public health campaigns and patient-level interventions.
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Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Karen Ritchie
- Institut National de la Santé et de la Recherche Médicale (INSERM), E361 Epidemiology of Nervous System Pathologies, La Colombière Hospital, Montpelier, France
| | - Oliver Shannon
- Human Nutrition Research Centre, Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma J Stevenson
- Human Nutrition Research Centre, Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Department of Social Medicine, Ohio University, Athens, OH, United States
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Edison P, Femminella GD, Ritchie CW, Holmes C, Walker Z, Ridha BH, Raza S, Livingston NR, Nowell J, Busza G, Frangou E, Love S, Williams G, Lawrence RM, McFarlane B, Archer H, Coulthard E, Underwood B, Koranteng P, Karim S, Bannister C, Perneczky R, Prasanna A, Junaid K, McGuinness B, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Holscher C, Mansouri A, Chester‐Jones M, Holmes J, Williams SCR, Brooks DJ, Harrison JE, Tadros G, Passmore AP, Ballard C. Evaluation of liraglutide in the treatment of Alzheimer's disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.057848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Paul Edison
- Imperial College London London United Kingdom
| | | | - Craig W. Ritchie
- Centre for Dementia Prevention University of Edinburgh Edinburgh United Kingdom
| | - Clive Holmes
- University of Southampton Southampton United Kingdom
| | - Zuzana Walker
- Division of Psychiatry University College London London United Kingdom
| | - Basil H Ridha
- Dementia Research Centre, Institute of Neurology, University College London London United Kingdom
| | - Sanara Raza
- Imperial College London London United Kingdom
| | | | | | - Gail Busza
- Imperial College London London United Kingdom
| | | | | | | | - Robert M Lawrence
- South West London and St George's Mental Health NHS Trust London United Kingdom
| | - Brady McFarlane
- Southern Health NHS Foundation Trust Southampton United Kingdom
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust Cambridge United Kingdom
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust Northampton United Kingdom
| | - Salman Karim
- Lancashire Care NHS Foundation Trust Preston United Kingdom
| | | | - Robert Perneczky
- Imperial College London London United Kingdom
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
- University Hospital LMU Munich Germany
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust Wolverhampton United Kingdom
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust Nottingham United Kingdom
| | - Bernadette McGuinness
- Ageing Research Group Centre for Public Health Queen's University Belfast Belfast United Kingdom
| | | | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust Derby United Kingdom
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust Bradford United Kingdom
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust Warrington United Kingdom
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust Redruth United Kingdom
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust South Petherton United Kingdom
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust Shrewsbury United Kingdom
| | | | | | | | | | - Steven CR Williams
- Institute of Psychiatry Psychology and Neuroscience King's College London London United Kingdom
| | - David J Brooks
- Imperial College London London United Kingdom
- Newcastle University Newcastle United Kingdom
- Aarhus University Aarhus Denmark
| | - John E Harrison
- King's College ‐ Institute of Psychiatry Psychology & Neuroscience London United Kingdom
| | - George Tadros
- Heart of England NHS Foundation Trust Birmingham United Kingdom
| | | | - Clive Ballard
- University of Exeter Medical School Exeter United Kingdom
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Saunders S, Ritchie CW, Russ TC, Muñiz‐Terrera G, Milne R. Assessing and disclosing test results for MCI: The perspective of UK old age psychiatrists. Alzheimers Dement 2021. [DOI: 10.1002/alz.053816] [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)
| | - Craig W. Ritchie
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
| | - Tom C Russ
- University of Edinburgh Edinburgh United Kingdom
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh Edinburgh United Kingdom
| | - Graciela Muñiz‐Terrera
- Centre for Clinical Brain Sciences at the University of Edinburgh Edinburgh United Kingdom
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Udeh‐Momoh CT, Zheng B, Price GJ, de Jager CA, Robb C, Watermeyer TJ, Toopchiani ST, Ford J, Su B, Giannakopoulou P, Saad ZS, Fogle M, Ritchie CW, Perneczky R, Baker S, Novak GP, Ahmadi‐Abhari S, Middleton LT. Gender differences in the moderating capacity of reserve and resilience factors on the association of Alzheimer’s disease brain pathology and cognitive function. Alzheimers Dement 2021. [DOI: 10.1002/alz.055453] [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: 11/08/2022]
Affiliation(s)
| | - Bang Zheng
- Imperial College London London United Kingdom
| | | | | | | | - Tam J Watermeyer
- Northumbria University Newcastle United Kingdom
- University of Edinburgh Edinburgh United Kingdom
| | | | - Jamie Ford
- Imperial College London London United Kingdom
| | - Bowen Su
- Imperial College London London United Kingdom
| | - Parthenia Giannakopoulou
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine London United Kingdom
| | - Ziad S. Saad
- Janssen Research and Development LLC San Diego CA USA
| | | | - 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
| | - Robert Perneczky
- Imperial College London London United Kingdom
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Susan Baker
- Janssen Research and Development New Brunswick NJ USA
| | - Gerald P Novak
- Johnson & Johnson New Brunswick NJ USA
- Janssen Pharmaceutical Research and Development Titusville NJ USA
| | - Sara Ahmadi‐Abhari
- Ageing Epidemiology Research Unit, Imperial College London London United Kingdom
| | - Lefkos T Middleton
- Imperial College London London United Kingdom
- Ageing Epidemiology Research Unit, Imperial College London London United Kingdom
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45
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Low A, Prats‐Sedano M, Stefaniak JD, Dounavi M, McKiernan E, Carter SF, Mak E, Su L, Muñiz‐Terrera G, Ritchie K, Ritchie CW, Markus HS, O'Brien JT. The effects of age and hypertension on cerebral small‐vessel disease differ between men and women at midlife: The PREVENT Dementia study. Alzheimers Dement 2021. [DOI: 10.1002/alz.053626] [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)
- Audrey Low
- University of Cambridge Cambridge United Kingdom
| | | | - James D Stefaniak
- University of Cambridge Cambridge United Kingdom
- University of Manchester Manchester United Kingdom
| | | | | | | | - Elijah Mak
- University of Cambridge Cambridge United Kingdom
| | - Li Su
- University of Cambridge Cambridge United Kingdom
| | - Graciela Muñiz‐Terrera
- Centre for Clinical Brain Sciences at the University of Edinburgh Edinburgh United Kingdom
| | - Karen Ritchie
- University of Edinburgh Edinburgh United Kingdom
- INSERM Montpellier France
| | - Craig W Ritchie
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
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Hunter MB, Saunders S, Russ TC, Ritchie CW, Muñiz‐Terrera G. Reliability and participant acceptance of remotely administered RBANS in an MCI and Alzheimer’s disease cohort. Alzheimers Dement 2021. [DOI: 10.1002/alz.053801] [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: 11/06/2022]
Affiliation(s)
| | | | - Tom C Russ
- University of Edinburgh Edinburgh United Kingdom
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh Edinburgh United Kingdom
- Centre for Dementia Prevention, University of Edinburgh Edinburgh United Kingdom
- NHS Lothian Edinburgh United Kingdom
| | - Craig W. Ritchie
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
| | - Graciela Muñiz‐Terrera
- Centre for Clinical Brain Sciences at the University of Edinburgh Edinburgh United Kingdom
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Saunders S, Muñiz‐Terrera G, Russ TC, Ritchie CW. Adjustment to test, risk and diagnostic disclosures in people with mild cognitive impairment: An observational cohort study. Alzheimers Dement 2021. [DOI: 10.1002/alz.054077] [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: 11/11/2022]
Affiliation(s)
| | | | - Tom C Russ
- University of Edinburgh Edinburgh United Kingdom
| | - Craig W. Ritchie
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
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Gispert JD, Alves IL, Gray KR, Buckley C, Collij LE, Heeman F, Salvadó G, García DV, Connelly P, Boutoleau‐Bretonnière C, Pasquier F, Dumurgier J, Gabelle A, Dubois B, Payoux P, Grau‐Rivera O, Martinez‐Lage P, Boada M, Marquié M, Vandenberghe R, Hanseeuw BJ, Kivipelto M, Schöll M, Scheltens P, Frisoni GB, Ritchie CW, Vellas B, Stephens AW, Ford L, Molinuevo J, Visser PJ, Farrar G, Barkhof F. Current status and quantitative results of the AMYPAD prognostic and natural history study. Alzheimers Dement 2021. [DOI: 10.1002/alz.055540] [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: 11/11/2022]
Affiliation(s)
- Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- Pompeu Fabra University Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBER‐BBN) Madrid Spain
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
| | - Isadora Lopes Alves
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | | | - Lyduine E. Collij
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | | | | | | | | | - Julien Dumurgier
- Cognitive Neurology Center Hôpital Lariboisière‐Fernand Widal APHP Paris France
- Université de Paris Inserm U1153 Epidemiology of Ageing and Neurodegenerative Diseases Paris France
| | | | - Bruno Dubois
- Sorbonne Université AP‐HP Hôpital de la Pitié‐Salpêtrière Boulevard de l'hôpital Paris France
| | - Pierre Payoux
- Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Oriol Grau‐Rivera
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
| | - Pablo Martinez‐Lage
- Center for Research and Advanced Therapies CITA‐Alzheimer Foundation San Sebastian Spain
| | - Mercè Boada
- Research Center and Memory Clinic Fundació ACE Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain
| | - Marta Marquié
- Research Center and Memory Clinic Fundació ACE Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain
| | - Rik Vandenberghe
- UZ Leuven Leuven Belgium
- Laboratory for Cognitive Neurology Leuven Brain Institute KU Leuven Leuven Belgium
| | | | - Miia Kivipelto
- Kuopio University Hospital Kuopio Finland
- Division of Clinical Geriatrics Centre for Alzheimer Research Department of Neurobiology Care Sciences, and Society (NVS) Karolisnka Institutet Stockholm Sweden
- Imperial College London London United Kingdom
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
- Department of Clinical Physiology Sahlgrenska Academy Hospital Gothenburg Sweden
- University College London London United Kingdom
| | | | | | - Craig W. Ritchie
- Centre for Dementia Prevention at the University of Edinburgh Edinburgh United Kingdom
| | - Bruno Vellas
- Institute of Aging Toulouse University Hospital‐UMR 1295 Toulouse France
- INSERM‐University of Toulouse UMR 1027 Toulouse France
| | | | - Lisa Ford
- Janssen Research and DEvelopment Titusville NJ USA
| | - Jose Molinuevo
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- H. Lundbeck A/S Copenhagen Denmark
| | - Pieter Jelle Visser
- Alzheimer Center Limburg School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
- Department of Neurobiology Care Sciences and Society Division of Neurogeriatrics Karolinska Institutet Stockholm Sweden
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Gill Farrar
- GE Healthcare Pharmaceutical Diagnostics Amersham United Kingdom
| | - Frederik Barkhof
- Institutes of Neurology and Healthcare Engineering University College London London United Kingdom
- Amsterdam UMC VU University Medic]al Center Amsterdam Netherlands
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49
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Dubbelman MA, Jutten RJ, Harrison JE, Ritchie CW, Aleman A, de Jong FJ, Scheltens P, Sikkes SA. Capturing functional change in early Alzheimer’s disease: Comparing instruments and scoring techniques to detect subtle decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.053749] [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: 11/11/2022]
Affiliation(s)
- Mark A. Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - John E Harrison
- King's College ‐ Institute of Psychiatry, Psychology & Neuroscience London United Kingdom
- Metis Cognition Ltd. Kilmington United Kingdom
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam Netherlands
| | - Craig W. Ritchie
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
| | - André Aleman
- University of Groningen, University Medical Center Groningen Groningen Netherlands
| | - Frank Jan de Jong
- Department of Neurology & Alzheimer Center Erasmus MC, Erasmus Medical Center Rotterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center, Amsterdam, Netherlands Amsterdam Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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50
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Dwyer J, Bork J, Zisko L, Goldfeder G, Trotter J, Ritchie CW, Neild J, Syson J, Draper K. Global Alzheimer’s Platform Foundation® (GAP) development of a transatlantic Alzheimer’s disease clinical trial network. Alzheimers Dement 2021. [DOI: 10.1002/alz.052297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- John Dwyer
- Global Alzheimer's Platform Foundation Washington DC USA
| | - Jason Bork
- Global Alzheimer's Platform Foundation Washington DC USA
| | - Leigh Zisko
- Global Alzheimer's Platform Foundation Washington DC USA
| | - Gabe Goldfeder
- Global Alzheimer's Platform Foundation Washington DC USA
| | | | - Craig W. Ritchie
- Centre for Clinical Brain Sciences The University of Edinburgh Edinburgh United Kingdom
| | - Julie Neild
- Global Alzheimer's Platform Foundation Washington DC USA
| | - Judi Syson
- Global Alzheimer's Platform Foundation Washington DC USA
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