Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
Browse
7 results
Search Results
Item Lifestyle and incident dementia: A COSMIC individual participant data meta-analysis(Wiley Periodicals LLC on behalf of Alzheimer's Association, 2024-06-16) Van Asbroeck S; Köhler S; van Boxtel MPJ; Lipnicki DM; Crawford JD; Castro-Costa E; Lima-Costa MF; Blay SL; Shifu X; Wang T; Yue L; Lipton RB; Katz MJ; Derby CA; Guerchet M; Preux P-M; Mbelesso P; Norton J; Ritchie K; Skoog I; Najar J; Sterner TR; Scarmeas N; Yannakoulia M; Dardiotis T; Rolandi E; Davin A; Rossi M; Gureje O; Ojagbemi A; Bello T; Kim KW; Han JW; Oh DJ; Trompet S; Gussekloo J; Riedel-Heller SG; Röhr S; Pabst A; Shahar S; Rivan NFM; Singh DKA; Jacobsen E; Ganguli M; Hughes T; Haan M; Aiello AE; Ding D; Zhao Q; Xiao Z; Narazaki K; Chen T; Chen S; Ng TP; Gwee X; Gao Q; Brodaty H; Trollor J; Kochan N; Lobo A; Santabárbara J; Gracia-Garcia P; Sachdev PS; Deckers K; for Cohort Studies of Memory in an International Consortium (COSMIC)INTRODUCTION: The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics. METHODS: We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis. RESULTS: A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed. DISCUSSION: Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups. HIGHLIGHTS: - A two-step individual participant data meta-analysis was conducted. - This was done at a global scale using data from 21 ethno-regionally diverse cohorts. - The association between a modifiable dementia risk score and dementia was examined. - The association was modified by geographical region and age at baseline. - Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.Item A multidomain intervention against cognitive decline in an at-risk-population in Germany: Results from the cluster-randomized AgeWell.de trial.(John Wiley and Sons, Inc., 2024-01-01) Zülke AE; Pabst A; Luppa M; Roehr S; Seidling H; Oey A; Cardona MI; Blotenberg I; Bauer A; Weise S; Zöllinger I; Sanftenberg L; Brettschneider C; Döhring J; Lunden L; Czock D; Haefeli WE; Wiese B; Hoffmann W; Frese T; Gensichen J; König H-H; Kaduszkiewicz H; Thyrian JR; Riedel-Heller SGINTRODUCTION: We investigated the effectiveness of a multidomain intervention to preserve cognitive function in older adults at risk for dementia in Germany in a cluster-randomized trial. METHODS: Individuals with a Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score ≥ 9 aged 60 to 77 years were recruited. After randomization of their general practitioner (GP), patients received a multidomain intervention (including optimization of nutrition and medication, and physical, social, and cognitive activity) or general health advice and GP treatment as usual over 24 months. Primary outcome was global cognitive performance (composite z score, based on domain-specific neuropsychological tests). RESULTS: Of 1030 participants at baseline, n = 819 completed the 24-month follow-up assessment. No differences regarding global cognitive performance (average marginal effect = 0.010, 95% confidence interval: -0.113, 0.133) were found between groups at follow-up. Perceived restrictions in intervention conduct by the COVID-19 pandemic did not impact intervention effectiveness. DISCUSSION: The intervention did not improve global cognitive performance. HIGHLIGHTS: Overall, no intervention effects on global cognitive performance were detected. The multidomain intervention improved health-related quality of life in the total sample. In women, the multidomain intervention reduced depressive symptoms. The intervention was completed during the COVID-19 pandemic.Item Beneficial and Impeding Factors for the Implementation of Health-Promoting Lifestyle Interventions-A Gender-Specific Focus Group Study.(MDPI (Basel, Switzerland), 2023-02-16) Wittmann FG; Zülke A; Schultz A; Claus M; Röhr S; Luppa M; Riedel-Heller SG; Tchounwou PB(1) Background: The prevalence of dementia increases and so does the number of interventions that address modifiable risk factors for dementia. Recent evidence suggests that there are gender differences in the prevalence of those lifestyle factors as well as in the effectiveness of interventions. This study aims to identify differences in factors that benefit or hinder the effectiveness of interventions since a target group's perspective gets more relevant. (2) Methods: Two focus groups, a female (n = 11) and a male (n = 8) group, were interviewed, audio recorded and transcribed. Qualitative analyses were performed and main- and subcategories were identified. (3) Results: Main differences were observed including aspects of lifestyle changes (e.g., respective diet and importance of an active lifestyle) and gender-typical behavior and perception by relevant healthcare actors. (4) Conclusions: Identified differences might help to address and raise the efficiency of lifestyle interventions. Further, the importance of social aspects and retirement as an auspicious moment to start interventions were identified as relevant by study participants.Item Prospective Associations between Single Foods, Alzheimer’s Dementia and Memory Decline in the Elderly(MDPI (Basel, Switzerland), 2018-07) Fischer K; Melo van Lent D; Wolfsgruber S; Weinhold L; Kleineidam L; Bickel H; Scherer M; Eisele M; van den Bussche H; Wiese B; König H-H; Weyerer S; Pentzek M; Röhr S; Maier W; Jessen F; Schmid M; Riedel-Heller SG; Wagner MBackground: Evidence whether single “cognitive health” foods could prevent cognitive decline is limited. We investigated whether dietary intake of red wine, white wine, coffee, green tea, olive oil, fresh fish, fruits and vegetables, red meat and sausages, assessed by a single-food-questionnaire, would be associated with either incident Alzheimer’s dementia (AD) or verbal memory decline. Methods: Participants aged 75+ of the German Study on Aging, Cognition and Dementia in Primary Care Patients (AgeCoDe) cohort were regularly followed over 10 years (n = 2622; n = 418 incident AD cases). Multivariable-adjusted joint modeling of repeated-measures and survival analysis was used, taking gender and Apolipoprotein E4 (APOE ε4) genotype into account as possible effect modifiers. Results: Only higher red wine intake was associated with a lower incidence of AD (HR = 0.92; P = 0.045). Interestingly, this was true only for men (HR = 0.82; P < 0.001), while in women higher red wine intake was associated with a higher incidence of AD (HR = 1.15; P = 0.044), and higher white wine intake with a more pronounced memory decline over time (HR = −0.13; P = 0.052). Conclusion: We found no evidence for these single foods to be protective against cognitive decline, with the exception of red wine, which reduced the risk for AD only in men. Women could be more susceptible to detrimental effects of alcohol.Item How can urban environments support dementia risk reduction? A qualitative study(John Wiley and Sons Ltd, 2021-12-28) Röhr S; Rodriguez FS; Siemensmeyer R; Müller F; Romero-Ortuno R; Riedel-Heller SGObjective Interventions to reduce the risk of cognitive decline and dementia largely focus on individual-level strategies. To maximize risk reduction, it is also necessary to consider the environment. With the majority of older people living in cities, we explored how urban environments could support risk reduction. Materials and Methods In our qualitative study, we conducted semi-structured interviews with community members aged ≥65 years and stakeholders, all living in Leipzig, Germany. Interview guides were informed by the framework on modifiable risk factors for dementia of the Lancet Commission on Dementia Prevention, Intervention, and Care. Interviews were audio-recorded, verbatim-transcribed, and thematically analysed. Results Community members (n = 10) were M = 73.7 (SD = 6.0) years old and 50% were women. Stakeholders (n = 10) were aged 39–72 years, and 70% were women. Stakeholders' fields included architecture, cultural/arts education, environmental sciences, geriatrics, health policy, information and technology, philosophy, psychology, public health, and urban sociology. Across interviews with both older individuals and stakeholders, three main themes were identified: (i) social participation and inclusion (emphasizing social contacts, social housing, intergenerationality, neighbourhood assistance, information and orientation, digital and technological literacy, lifelong learning, co-creation/co-design), (ii) proximity and accessibility (emphasizing proximity and reachability, mobility, affordability, access to health care, access to cultural events, public toilets), (iii) local recreation and wellbeing (emphasizing safety in traffic, security, cleanliness and environmental protection, urban greenery, climate change and heat waves, outdoor physical activity). Discussion The design of urban environments holds large potential to create favourable conditions for community-dwelling individuals to practice lifestyles that promote brain health. Public policy should involve community members in co-creating such environments.Item Recruitment and Baseline Characteristics of Participants in the AgeWell.de Study—A Pragmatic Cluster-Randomized Controlled Lifestyle Trial against Cognitive Decline(MDPI (Basel, Switzerland), 2021-01) Röhr S; Zülke A; Luppa M; Brettschneider C; Weißenborn M; Kühne F; Zöllinger I; Samos F-AZ; Bauer A; Döhring J; Krebs-Hein K; Oey A; Czock D; Frese T; Gensichen J; Haefeli WE; Hoffmann W; Kaduszkiewicz H; König H-H; Thyrian JR; Wiese B; Riedel-Heller SGTargeting dementia prevention, first trials addressing multiple modifiable risk factors showed promising results in at-risk populations. In Germany, AgeWell.de is the first large-scale initiative investigating the effectiveness of a multi-component lifestyle intervention against cognitive decline. We aimed to investigate the recruitment process and baseline characteristics of the AgeWell.de participants to gain an understanding of the at-risk population and who engages in the intervention. General practitioners across five study sites recruited participants (aged 60–77 years, Cardiovascular Risk Factors, Aging, and Incidence of Dementia/CAIDE dementia risk score ≥ 9). Structured face-to-face interviews were conducted with eligible participants, including neuropsychological assessments. We analyzed group differences between (1) eligible vs. non-eligible participants, (2) participants vs. non-participants, and (3) between intervention groups. Of 1176 eligible participants, 146 (12.5%) dropped out before baseline; the study population was thus 1030 individuals. Non-participants did not differ from participants in key sociodemographic factors and dementia risk. Study participants were M = 69.0 (SD = 4.9) years old, and 52.1% were women. The average Montreal Cognitive Assessment/MoCA score was 24.5 (SD = 3.1), indicating a rather mildly cognitively impaired study population; however, 39.4% scored ≥ 26, thus being cognitively unimpaired. The bandwidth of cognitive states bears the interesting potential for differential trial outcome analyses. However, trial conduction is impacted by the COVID-19 pandemic, requiring adjustments to the study protocol with yet unclear methodological consequences.Item Is dementia incidence declining in high-income countries? A systematic review and meta-analysis(Dove Medical Press, 2018) Roehr S; Pabst A; Luck T; Riedel-Heller SGPurpose: To perform a systematic review and quantitative synthesis of studies on recent trends in dementia incidence in high-income countries (HIC), considering study quality. Methods: PubMed and Web of Science were searched for eligible studies, that is, population-based/community-based prospective cohort studies investigating dementia incidence with similar methods over time, published after 1990. Study selection, data extraction, and quality assessment were performed independently by two investigators. Random-effect meta-analysis and meta-regression were used to estimate incidence change (IC) and to explore associations with study attributes. PRISMA standards were followed. Results: The systematic review included seven studies (42,485 individuals), and the meta-analysis included five studies of sufficient quality. Relating dementia incidence of later cohorts to earlier cohorts (reference) yielded a nonsignificant decrease across HIC (IC =0.82; 95% CI 0.51–1.33), with high heterogeneity (I²=94.9%, P<0.001) and without publication bias (Egger’s t=–1.77; P=0.18). Excluding the Japanese Hisayama study, the only study suggesting an increase, indicated borderline evidence for a decrease across Western HIC (IC =0.69; 95% CI 0.47–1.00; I²=88.1%, P<0.001; Egger’s t=–0.34, P=0.77), again with high heterogeneity. Meta-regression did not reveal an association of incidence rate with calendar year or study attributes; however, analyses were low powered. Conclusion: There is evidence of favorable trends in dementia incidence in Western HIC (stabilizing/decreasing). Reverse trends may occur in HIC of other regions, as exemplified by Japan. However, study number was small and heterogeneity was high. Further cohort studies using consistent methods are needed to draw definite conclusions. Our work may inform such future studies.