Associations of socioeconomic status and healthy lifestyle with incident early-onset and late-onset dementia: a prospective cohort study

The Lancet Healthy Longevity, Год журнала: 2023, Номер 4(12), С. e693 - e702

Опубликована: Ноя. 29, 2023

BackgroundModifiable risk factor estimates are sparse for early-onset dementia incidence. This study aimed to estimate and compare the profiles of late-onset dementia, explore complex relationships between socioeconomic status, lifestyles, risk.MethodsIn this prospective cohort study, we used data from UK Biobank analysis dementia. For analyses, were collected on those aged younger than 60 years without prevalent at baseline. 65 or older end follow-up. Participants with missing information factors excluded. Two models test associations incidence status. The first model tested status incidence, adjusting covariates. Participant was defined using education level, income, employment via latent class analysis. second additionally included a healthy lifestyle score, which constructed smoking, alcohol consumption, physical activity, Healthy Diet Index. Incident as case diagnosed before age. Multivariable-adjusted Cox proportional hazard regression ratio (HR) We multivariable-adjusted proportional-hazard HR both dementia.FindingsBetween 2007 2010, 257 345 individuals in 294 133 During mean follow-up 11·9–12·5 years, 502 cases 5768 documented. Risk typically dissimilar instance, age sex adjusted low (vs high) 4·40 (95% CI 3·43–5·65) 1·90 (1·74–2·07) yielding HRs 2·32 (1·78–3·02). After various factors, participants had increased (3·38, 2·61–4·37), overall mediated 3·2% (1·8–5·7) association. Individuals unhealthy lifestyles higher (5·40, 3·66–7·97). No significant interaction observed association seemed be more pronounced type 2 diabetes (HR 11·21, 95% 2·70–46·57).InterpretationEarly-onset might have different profiles; although similar, magnitude greater Only small proportion inequity by indicates that measures other promotion improve social determinants health warranted.FundingThe National Key Research Development Program China, Natural Science Foundation Hubei Province Fund Distinguished Young Scholars, Fundamental Funds Central Universities.

Язык: Английский

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Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper

Neuropsychology Review, Год журнала: 2023, Номер unknown

Опубликована: Ноя. 30, 2023

Abstract Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has potential to add substantial value impact our role across settings. However, there are numerous approaches intervention, requiring different sets skills, with varying levels supporting evidence diagnostic groups. This guidance paper provides overview considerations recommendations help guide selection, delivery, implementation adults older adults. We aimed provide a useful source information clinicians, health service managers, policy-makers, educators, researchers regarding such interventions. Considerations were developed by expert working group neuropsychologists in Australia, based on relevant consensus opinion consultation members national neuropsychology body. While sit within Australian context, many have international relevance. include (i) principles important intervention delivery (e.g. being biopsychosocial case formulation person-centred goals); (ii) description competencies effective delivery; (iii) summary three key cohorts: acquired injury, psychiatric disorders, adults, focusing sound improving activity participation outcomes; (iv) sustainable ‘core business’; finally, (v) call action.

Язык: Английский

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Investigating Equivalence of In-Person and Telehealth-Based Neuropsychological Assessment Performance for Individuals Being Investigated for Younger Onset Dementia

Archives of Clinical Neuropsychology, Год журнала: 2024, Номер 39(5), С. 594 - 607

Опубликована: Янв. 20, 2024

Given the rapid shift to in-home teleneuropsychology models, more research is needed investigate equivalence of non-facilitator models delivery for people with younger onset dementia (YOD). This study aimed determine whether equivalent performances were observed on neuropsychological measures administered in-person and via in a sample being investigated YOD.

Язык: Английский

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Unfolding memories: Crafting digital life storybooks for dementia care via telehealth

Advances in Clinical and Experimental Medicine, Год журнала: 2025, Номер 34(10), С. 0 - 0

Опубликована: Янв. 8, 2025

Background.Dementia, a rapidly growing cognitive disorder, has profound impact on the lives of individuals and their caregivers across globe.Digital life storybooks have emerged as promising nonpharmacological intervention to improve wellbeing people living with dementia (PLWD).Objectives.This study aims investigate feasibility developing applying digital storybook for PLWD using telehealth, while evaluating its communication skills, quality (QoL) satisfaction levels. Material methods.A mixed-method design will be employed, involving pairs primary (dyads) recruited from teaching hospital non-profit organization in Malaysia.The involves creation use facilitated remotely via telehealth channels.Data collected at 6 points time: prior commencement development, submission an application, biweekly basis, conclusion assessment period.Quantitative measures include Holden Communication Scale, Quality Life-Alzheimer's Disease Scale (QoL-AD) Caregiving Relationship (QCPR) questionnaire.Qualitative data gathered through validated open-ended questions.Results.Implications facilitating future research, contributing person-centered care practices, providing tools better understand connect PLWD.The findings contribute understanding mechanisms which can benefit caregivers. Conclusions.The successful implementation this protocol could significant implications both formal informal settings, ultimately those affected by dementia.

Язык: Английский

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Blood biomarker profiles in young-onset neurocognitive disorders: A cohort study

Australian & New Zealand Journal of Psychiatry, Год журнала: 2025, Номер unknown

Опубликована: Янв. 17, 2025

Young-onset neurocognitive symptoms result from a heterogeneous group of neurological and psychiatric disorders which present diagnostic challenge. To identify such factors, we analysed the Biomarkers in Younger-Onset Neurocognitive Disorders cohort, study individuals <65 years old presenting with for diagnosis who have undergone cognitive biomarker analyses. Sixty-five participants (median age at assessment 56 years, 45% female) were recruited during their index presentation to Royal Melbourne Hospital Neuropsychiatry Centre, tertiary specialist service Melbourne, Australia, categorized as either early-onset Alzheimer's disease (n = 18), non-Alzheimer's neurodegeneration 23) or primary 24). Levels neurofilament light chain, glial fibrillary acidic protein phosphorylated-tau 181, apolipoprotein E genotype late-onset polygenic risk scores determined. Information-theoretic model selection identified discriminatory factors. Neurofilament 181 levels elevated compared other categories. A multi-omic that combination blood biomarkers, but not score, discriminated between (area under curve ⩾ 0.975, 95% confidence interval: 0.825-1.000). Phosphorylated-tau alone significantly causes 0.950, 0.877-1.00). Discriminating disease, young-onset is possible by combining profiles biomarkers. These results support utilizing biomarkers work-up highlight need development disease-specific score.

Язык: Английский

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Telephone and online support programs and assistive technologies that support informal carers of people living with young-onset dementia: A systematic review

Dementia, Год журнала: 2025, Номер unknown

Опубликована: Фев. 14, 2025

Objective: Carers of people with young-onset dementia can be challenged by the care they provide. Little is known about types telephone and online support programs assistive technologies that may help to assist them caregiving. This review aimed identify informal carers find useful for caring dementia. Design: A systematic followed Preferred Reporting Items Systematic Reviews Meta-Analyses guidelines. An electronic search following five English databases was conducted: PubMed, PsycINFO, CINAHL, Web Science, Embase. In addition, reference lists eligible studies were manually searched further studies. Databases using synonyms derivates “dementia,” “Alzheimer’s disease,” “young onset”, “early “caregiver”, “online” “technology”. Results: We found 12 manuscripts meet study inclusion criteria. The dominant programs. Other included safety monitoring support, telehealth, a simple TV remote control. While reported positive effects programs, technologies, such as improved self-efficacy, satisfaction, knowledge, well-being, reduced burden, stress, depression, anxiety, scarce, limited number explored. Conclusion: Given increasing it disappointing paucity available explored this population. Technologies population need developed evaluated.

Язык: Английский

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Data‐driven discovery of midlife cardiometabolic profile associated with incident early‐onset and late‐onset dementia

Diabetes Obesity and Metabolism, Год журнала: 2025, Номер unknown

Опубликована: Март 6, 2025

Cardiometabolic risk factors have been associated with the of late-onset dementia. However, evidence regarding early-onset dementia was inconsistent, and impact clustered cardiometabolic unclear. We aimed to investigate associations profiles incident Among 289 494 UK Biobank participants, cluster analysis built on 12 common markers. Analyses were performed those aged <65 years at baseline (n = 249 870) for ≥65 end follow-up 191 213) During a median 14.1 years, 279 cases 3167 documented. five clusters identified (cluster 1 [obesity-dyslipidemia pattern], 2 [high blood pressure 3 liver enzymes 4 [inflammation pattern] 5 [relatively healthy pattern]), significantly higher risks both dementia; however, estimate (hazard ratio 2.58, 95% CI 1.61-4.14) larger than that (1.36, 1.09-1.71). Cluster 1.39, 1.13-1.72). No significant interactions observed between apolipoprotein E ε4 genotype. patterns characterised by relatively high enzyme levels or systemic inflammation increased Identification high-risk subgroups according distinct might help develop more precise strategies prevention regardless (APOE) status.

Язык: Английский

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Effectiveness of the Hayling and Brixton Tests for Detecting Dementia, Progressive Cognitive Decline, and Mild Cognitive Impairment in Middle to Older Aged Adults: A Systematic Review and Meta-analysis

Neuropsychology Review, Год журнала: 2025, Номер unknown

Опубликована: Апрель 17, 2025

Abstract The aging population is increasing the prevalence of dementia, neurodegenerative disorders, and mild cognitive impairment, which are associated with declines in executive functioning. In people these accurate tests can aid early detection functioning decline facilitate access to interventions. Hayling Brixton (HBTs) popular that assess inhibitory control. HBTs may be especially effective for detecting disorders disinhibition, such as behavioral-variant frontotemporal dementia (bvFTD). However, effectiveness impairment has yet collated. A comprehensive search five databases identified 50 studies compared performances adults aged 40 years over a disorder, or (e.g., Parkinson’s disease, Alzheimer’s bvFTD) cognitively-healthy controls. Hedges’ g effect sizes groups on scores (Inhibition Errors, Inhibition Reaction Time (RT), Automatic RT, minus Errors). (combined) showed negative effects all ( − 0.37 1.13), performing worst 0.54 1.56). RT Errors were most 1.55; 1.34). types performed similar after outliers removed only low risk-of-bias analyzed. Overall, middle older adults, those dementia. no score type recommended differentiating types, AD bvFTD.

Язык: Английский

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Global trends in prevalence, disability adjusted life years, and risk factors for early onset dementia from 1990 to 2021

Scientific Reports, Год журнала: 2025, Номер 15(1)

Опубликована: Апрель 18, 2025

This study aims to analyze temporal trends in the prevalence and disability-adjusted life year (DALY) burden of early-onset dementia (EOD) globally from 1990 2021 assess attributable burdens modifiable risk factors. Data Global Burden Disease Study (GBD) were used. EOD was defined as individuals aged 40-64. The analysis included case numbers, age-standardized rates (ASPRs), DALY (ASDRs) with 95% confidence intervals (CIs), stratified by global, regional, national levels, sociodemographic index (SDI), sex. Joinpoint regression evaluated average annual percent change (AAPC). Population fractions (PAFs) estimated proportion DALYs global number cases nearly doubled 2021, reaching 7.758 million (95% CI 5.827-10.081) 3.774 1.696-8.881) 2021. ASPR ASDR increased slightly 355.9 267.2-462.8) 173.3 77.9-407.7) per 100,000 In highest high-middle SDI countries at 387.6 291.1-506.8), while middle 182.9 82.2-431). fastest increase low low-middle 2010 AAPCs 0.42% 0.34-0.50) 0.36% 0.33-0.39), respectively. A significant negative correlation found between ASDR. During COVID-19 pandemic (2019-2021), high-SDI declined, other regions saw an accelerated increase. high fasting plasma glucose (FPG) most factor for EOD-related globally, PAFs body mass FPG increasing all since 1990, PAF smoking decreased. countries, particularly rising during pandemic. growing influence metabolic factors underscores need targeted public health policies resource allocation mitigate burden.

Язык: Английский

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Association Between Metabolic Syndrome and Young-Onset Dementia

Neurology, Год журнала: 2025, Номер 104(10)

Опубликована: Апрель 23, 2025

Young-onset dementia (YOD) poses substantial societal and health care burdens. Although metabolic syndrome (MetS) is recognized as a contributor to late-onset dementia, its effect on YOD remains unclear. This study aimed determine whether MetS individual components increase the risk of YOD, including all-cause Alzheimer disease (AD), vascular (VaD). We conducted nationwide population-based cohort using data from Korean National Insurance Service. Individuals aged 40-60 who underwent national check-ups in 2009 were included followed until December 31, 2020, or age 65, whichever came first. was defined according established guidelines, incorporating measurements waist circumference, blood pressure, fasting glucose, triglycerides, high-density lipoprotein cholesterol. Covariates age, sex, income level, smoking status, alcohol consumption, comorbidities such hypertension, diabetes, dyslipidemia, depression. The primary outcome incident diagnosis before 65; secondary outcomes young-onset AD VaD. Multivariable Cox proportional hazards models used estimate hazard ratios (HRs) with 95% CIs. A total 1,979,509 participants (mean 49.0 years; 51.3% men; 50.7% MetS) included. Over an average follow-up 7.75 years, 8,921 individuals (0.45%) developed YOD. associated 24% higher (adjusted HR 1.24, CI 1.19-1.30), 12.4% increased (HR 1.12, 1.03-1.22), 20.9% VaD 1.21, 1.08-1.35). Significant interactions noted younger (40-49 vs 50-59), female drinking obesity, In this large cohort, significantly These findings suggest that interventions targeting may help mitigate risk. However, observational design precludes definitive causal inferences, reliance claims could introduce misclassification bias. Future research longitudinal designs comprehensive collection needed validate expand these associations.

Язык: Английский

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