Graham M. Farina F, Ritchie C, Lawlor B, Naci L.
Cambridge Quarterly of Healthcare Ethics. 31: 4, 498–505 (2022)
DOI: https://doi.org/10.1017/S0963180122000408
Summary
A general obligation to make aggregate research results available to participants has been widely supported in the bioethics literature. However, dementia research presents several challenges to this perspective, particularly because of the fear associated with developing dementia. The authors argue that considerations of respect for persons, beneficence, and justice fail to justify an obligation to make aggregate research results available to participants in dementia research. Nevertheless, there are positive reasons in favor of making aggregate research results available; when the decision is made to do so, it is critical that a clear strategy for communicating results is developed, including what support will be provided to participants receiving aggregate research results.
Amy Heneghan, Feng Deng, Katie Wells, Karen Ritchie, Graciela Muniz-Terrera , Craig W Ritchie, Brian Lawlor, Lorina Naci.
Journal of Alzheimer’s Disease (2022).
DOI: 10.3233/JAD-220267
Summary
Mid-life lifestyle factors, including occupation, as well as engagement in physical, social and intellectual activities were evaluated. The impact of risk and protective lifestyle factors was measured in three aspects of cognition, verbal and visual memory, visual short-term memory and visuospatial function. Lifestyle activities significantly impacted cognition in mid-life. More frequent engagement in physically, socially and intellectually stimulating activities was associated with better verbal and visual memory, both at baseline and at follow-up. Critically, a significant association was also found between family history of dementia with lifestyle and visuospatial function, at follow-up. Impaired visuospatial function is one of the earliest cognitive deficits in AD. These findings suggest that modifiable lifestyle activities may offset AD risk-related cognitive decrements in mid-life, and support the targeting of stimulating lifestyle activities for the prevention of Alzheimer’s Disease.
Maria-Eleni Dounavi, Audrey Low, Graciela Muniz Terrera, Karen Ritchie, Craig W. Ritchie, Li Su, Hugh S. Markus, John T O’Brien.
Brain Communications (2022)
DOI: https://academic.oup.com/braincomms/article/4/3/fcac116/6580683
Summary
Structural brain magnetic resonance imaging scans are typically used to measure properties of brain areas such as their volume or thickness. However, the intensity values of the acquired scans, can further be analysed and ‘texture’ can be quantified. Textural analysis examines variations in the image intensity and quantifies properties such as homogeneity or contrast of the image at a regional level. In this study we have measured textural properties of brain scans from PREVENT-Dementia participants and investigated if these were connected to performance in a reaction time task, to a marker of cerebrovascular pathology (white matter hyperintensity -WMH volume) and to a cardiovascular dementia risk score (CAIDE). Our findings suggest that textural measures might capture subtle underlying damage in normal appearing brain areas and could be more sensitive measures of early changes compared to WMH volume.
Maria-Eleni Dounavi, Coco Newton, Elijah Mak, Audrey Low, Graciela Muniz Terrera, Guy B. Williams, Brian Lawlor, Lorina Naci, Paresh Malhotra, Clare E. Mackay, Ivan Koychev, Karen Ritchie, Craig W. Ritchie, Li Su, John T O’Brien.
Journal of Neurology (2022)
DOI: http://dx.doi.org/10.1136/jnnp-2021-32746
Summary
Structural brain alterations such as volume loss in brain structures like the hippocampus, or thinning of the brain cortex typically occur before cognitive symptomatology in people who will later develop dementia. In this study we investigated whether middle-aged participants in the PREVENT-Dementia study at risk of future dementia based on their genetic or cardiovascular risk demonstrated prominent structural brain alterations. Genetic risk was not associated with changes in brain volume even in the hippocampal subfields or with cortical thinning. A higher cardiovascular risk though (CAIDE dementia risk score) incorporating information on age, sex, education, blood pressure, cholesterol, body mass index and activity was associated with cortical thinning. This study highlights that in midlife, cardiovascular risk and not genetic risk for dementia is related to patterns of brain changes which are reminiscent of the patterns observed in dementia.
Audrey Low, Maria A Prats-Sedano, James D Stefaniak, Elizabeth Frances McKiernan, Stephen F Carter, Maria-Eleni Dounavi, Elijah Mak, Li Su, Olivia Stupart, Graciela Muniz Terrera, Karen Ritchie, Craig W Ritchie, Hugh S Markus, John Tiernan O’Brien
Journal of Neurology, Neurosurgery & Psychiatry (2022)
DOI: http://dx.doi.org/10.1136/jnnp-2021-327462
Summary
Cerebral small vessel disease (SVD) refers to abnormalities of the small vessels of the brain. Importantly, SVD is linked to increased risk of cognitive impairment and dementia, and can appear decades before dementia onset. To understand the contribution of SVD to dementia at midlife, we examined whether a well-established dementia risk score (Cardiovascular Risk Factors, Ageing and Dementia; CAIDE) was related to SVD in healthy middle-aged volunteers in the PREVENT study. Results showed that the CAIDE dementia risk score, which is predictive of dementia 20 years later, was linked to greater midlife severity of all four SVD markers assessed, and 2-year progression of white matter lesions and systemic inflammation. While age was a strong risk factor of SVD, a higher CAIDE score amplified the effect of age on SVD. Findings highlight the value of the CAIDE score as both a prognostic and predictive marker in the context of cerebrovascular disease and related vascular cognitive impairment, and in identifying at-risk individuals who might benefit most from managing dementia risk through lifestyle modifications.
