Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission

The Lancet, Journal Year: 2024, Volume and Issue: 404(10452), P. 572 - 628

Published: July 31, 2024

Language: Английский

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Social participation and risk of developing dementia

Nature Aging, Journal Year: 2023, Volume and Issue: 3(5), P. 532 - 545

Published: May 18, 2023

The increasing number of people with dementia globally illustrates the urgent need to reduce dementia's scale and impact. Lifetime social participation may affect risk by cognitive reserve, through brain maintenance reducing stress improving cerebrovascular health. It therefore have important implications for individual behavior public health policy aimed at burden. Observational study evidence indicates that greater in midlife late life is associated 30–50% lower subsequent risk, although some this not be causal. Social interventions led improved cognition but, partly due short follow-up small numbers participants, no reduction dementia. We summarize linking dementia, discuss potential mechanisms which likely mitigate impact neuropathology brain, consider future clinical prevention interventions. This Review provides evidence-based update on association between interaction authors propose a framework promote as preventative strategy against

Language: Английский

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Life course epidemiology and public health

The Lancet Public Health, Journal Year: 2024, Volume and Issue: 9(4), P. e261 - e269

Published: March 27, 2024

Life course epidemiology aims to study the effect of exposures on health outcomes across life from a social, behavioural, and biological perspective. In this Review, we describe how changes way causes chronic diseases are understood, with example hypertension, breast cancer, dementia, it guides prevention strategies. uses complex methods for analysis longitudinal, ideally population-based, observational data takes advantage new approaches causal inference. It informs primordial prevention, exposure risk factors, an eco-social perspective in which disease conceived as results interactions between endowment, behaviours, social networks, family influences, socioeconomic conditions course. More broadly, population-based high-risk strategies prenatal period old age, contributing evidence-based data-informed public actions. assess contribution reflect current future challenges field its integration into policy making.

Language: Английский

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The EAT-Lancet Diet Index, Plasma Proteins, and Risk of Heart Failure in a Population-Based Cohort

JACC Heart Failure, Journal Year: 2024, Volume and Issue: 12(7), P. 1197 - 1208

Published: April 3, 2024

The landmark EAT-Lancet Commission proposed that a planetary health diet is comprised mainly of plant-based foods. However, studies examining whether this associated with heart failure (HF) are currently lacking. In addition, the potential proteomics mechanism on association between and HF warrants further elucidation. This study aims to both examine index risk identify plasma proteins underlying such an association. prospective cohort included 23,260 participants. cases during follow-up were identified through Swedish national register. An (score range: 0-42) was created assess adherence reference diet. subcohort (n = 4,742), fasting quantified. During median 25.0 years, 1,768 incident documented. After adjusting for sociodemographic, lifestyle, diabetes, hypertension, use lipid-lowering drugs, body mass index, HR per 3-point increase 0.93 (95% CI: 0.88-0.97). robust in several sensitivity analyses. Among 136 proteins, total 8 (AM, GDF15, IL6, TIM, CTSD, CCL20, FS, FUR) inversely positively HF; overall proteomic score mediated 9.4% 2.2%-32.1%) Higher lower HF. eight provide information pathways mediating

Language: Английский

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State-Level Indicators of Childhood Educational Quality and Incident Dementia in Older Black and White Adults

JAMA Neurology, Journal Year: 2023, Volume and Issue: 80(4), P. 352 - 352

Published: Feb. 13, 2023

Importance Higher educational attainment is associated with reduced dementia risk, but the role of quality understudied, presenting a major evidence gap, especially as it may contribute to racial inequities. Objective To evaluate association between state-level during childhood and risk. Design, Setting, Participants This cohort study analyzed longitudinal data collected from January 1, 1997, through December 31, 2019 (23-year follow-up period). The sample comprised members Kaiser Permanente Northern California (KPNC), large integrated health care delivery system, who completed an optional survey 1964-1972. Eligible individuals were US born; non-Hispanic Black or White; aged 65 years older 1996; still alive; did not have diagnosis lapse in KPNC membership greater than 90 days 1 1996. Exposures Historical administrative indicators school (school term length, student-teacher ratio, attendance rates) linked participants using birth state year (with 6-year lag) divided into tertiles pooled sample. Main Outcomes Measures Dementia diagnoses electronic records 1997 March August 2022. associations incident estimated Cox proportional hazards regression models. Results Among 21 450 participated survey, born before availability (n = 87) missing 585) excluded. final analytic was 20 778 (56.5% women, 43.5% men; mean [SD] age, 74.7 [6.5] years; 18.8% Black; 81.2% 41.0% less high education). individuals, 76.2% 86.1% (vs 20.8%-23.3% White individuals) attended schools states lowest tertiles. Highest lowest) lower risk (student-teacher ratio: hazard ratio [HR], 0.88 [95% CI, 0.83-0.94]; rates: HR, 0.80 0.73-0.88]; length: 0.79 0.73-0.86]). Effect estimates differ by race attenuated adjustment for attainment. Conclusions Relevance In this study, state-average more common among higher Differential investment high-quality education due structural racism disparities.

Language: Английский

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Plasma proteins related to inflammatory diet predict future cognitive impairment

Molecular Psychiatry, Journal Year: 2023, Volume and Issue: 28(4), P. 1599 - 1609

Published: Feb. 3, 2023

Dysregulation of the immune system and dietary patterns that increase inflammation can risk for cognitive decline, but mechanisms by which inflammatory nutritional habits may affect development impairment in aging are not well understood. To determine whether plasma proteins linked to diet predict future impairment, we applied high-throughput proteomic assays samples from a subset (n = 1528) Women's Health Initiative Memory Study (WHIMS) participants (mean [SD] baseline age, 71.3 [SD 3.8] years). Results provide insights into how associated with an immune-related proteome identify group (CXCL10, CCL3, HGF, OPG, CDCP1, NFATC3, ITGA11) related over 14-year follow-up period. Several these were also dementia across two external cohorts (ARIC, ESTHER), correlated biomarkers Alzheimer's disease (AD) pathology (Aβ42/40) and/or neurodegeneration (NfL), MRI-defined index neurodegenerative brain atrophy separate cohort (BLSA). In addition evaluating their biological relevance, assessing potential role AD, characterizing immune-tissue/cell-specific expression, leveraged published RNA-seq results examine vitro regulation genes encoding candidate might be altered response challenge. Our findings indicate higher relate levels immunologically relevant highlight molecular mediators subsequent age-related impairment.

Language: Английский

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Grief and Economic Stressors by Sex, Gender, and Education

Neurology, Journal Year: 2025, Volume and Issue: 104(8)

Published: March 31, 2025

The prevalence and impact of stressful life events (SLEs) on age-related Alzheimer disease (AD)-related pathways may depend social determinants including gender education. We investigated whether specific SLEs are associated with AD pathology neurodegeneration how these associations differ by This cross-sectional study included cognitively unimpaired participants, most a family history sporadic AD, from the ALzheimer's FAmilies (ALFA) cohort, based in Barcelona, Spain. Participants had available assessments occurrence type lifetime lumbar puncture and/or structural MRI. performed multiple regression analyses to examine SLE (1) pathologies (CSF phosphorylated tau 181 [p-tau181] β-amyloid [Aβ] 42/40) (2) markers neurogranin GM volumes voxel-wise) interaction stratification (women/men) In total, 1,290 participants (mean age = 59.4 years, range: 48-77 99% White 61% women) were (393 1,234 spectroscopic MRI assessments). Less educated women reported more grief-related economic-related SLEs. Furthermore, abuse reproductive Grief-related CSF outcomes while economic MRI-based outcomes, both an age-independent manner. Specifically, partner's death was lower Aβ42/40 (B -5.19; 95% CI -9.61 -0.76; p 0.022) higher p-tau181 0.18; 0.05-0.32; 0.007) 0.19; 0.007). driven less men women. Unemployment loss limbic frontal areas, women, respectively. Older adults at risk cognitive decline education be susceptible experience Men who have experienced widowhood unemployment financial difficulties benefit interventions.

Language: Английский

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Cataract, Cataract Surgery, and Risk of Incident Dementia: A Prospective Cohort Study of 300,823 Participants

Biological Psychiatry, Journal Year: 2022, Volume and Issue: 93(9), P. 810 - 819

Published: June 14, 2022

Language: Английский

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Sex/gender and socioeconomic differences in modifiable risk factors for dementia

Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)

Published: Jan. 3, 2023

Abstract Both sex/gender and socioeconomic differences have been reported in the prevalence of modifiable risk factors for dementia. However, it remains unclear whether associations between dementia incident differ by or status. This study aimed to investigate with using a life-course perspective. We used data from English Longitudinal Study Ageing (2008/2009 2018/2019). A total 8,941 individuals were included [mean (standard deviation) age, 66.1 ± 9.8 years; 4,935 (55.2%) women]. No overall difference was found. Dementia higher among those who experienced childhood deprivation [hazard ratio (HR) = 1.51 (1.17; 1.96)], lower occupational attainment [HR low versus high 1.60 (1.23; 2.09) HR medium 1.53 (1.15; 2.06)], wealth 1.63 (1.26; 2.12)]. Though different found subgroups, there might be only cognitive activity, suggesting women 2.61 (1.89; 3.60)] compared men 1.73 (1.20; 2.49)]. consistent population-based approach that tackles inequalities profiles directly may more effective than individual approaches prevention.

Language: Английский

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Socioeconomic Status Transition Throughout Life and Risk of Dementia

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(5), P. e2412303 - e2412303

Published: May 21, 2024

Socioeconomic status (SES) is associated with dementia. However, the role of SES transitions in dementia less explored; such evidence would be useful to understand whether social mobility healthy longevity at older ages.

Language: Английский

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