PREVENT Dementia Study Research Articles

Associations between midlife chronic conditions and medication use with anxiety and depression: A cross-sectional analysis of the PREVENT Dementia study.

Background:Multimorbidity including physical and mental illness is increasing in prevalence. We aimed to investigate the associations between physical conditions and medication use with anxiety and depression in midlife.Methods:We conducted an observational cross-sectional study of volunteers in the PREVENT Dementia study. Using logistic and linear regression, we investigated the association between increasing numbers of self-reported chronic physical conditions and medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest.Results:Of the 210 participants, 148 (71%) were women and 188 (90%) Caucasian. The mean age was 52 (standard deviation (SD) = 5.5) years. The mean number of physical conditions was 2.2 (SD = 1.9) and medications 1.7 (SD = 2.2). Each additional physical condition was associated with increased odds of self-reported depression (odds ratio (OR) 1.41, 95% confidence interval (CI) 1.11–1.80; p = 0.004, adjusted for age and gender) and anxiety disorder (OR 1.70, 95% CI 1.30–2.37; p < 0.001). Increasing medication use was associated with self-reported depression (adjusted OR per additional medication 1.35, 95% CI 1.08–1.71; p = 0.008) but not anxiety disorder. For each additional condition, CES-D scores increased by 0.72 (95% CI 0.11–1.33; p = 0.020) and for each extra medication, by 0.88 (95% CI 0.32–1.44; p = 0.002). There was no significant association between increasing conditions and medications with STAI scores. In models accounting for antidepressant use, all associations were attenuated.Conclusions:Having more physical conditions is associated with anxiety and depression in midlife, and taking more medications is associated with depression but not anxiety.

Association between midlife dementia risk factors and longitudinal brain atrophy: the PREVENT-Dementia study

BackgroundIncreased rates of brain atrophy on serial MRI are frequently used as a surrogate marker of disease progression in Alzheimer’s disease and other dementias. However, the extent to which they...

ASSOCIATIONS BETWEEN CHRONIC PHYSICAL CONDITIONS, MEDICATIONS AND MENTAL HEALTH IN AN AGING COHORT

Older people increasingly live with multiple chronic conditions and medications. We explored their interactions with mental health in the PREVENT Dementia study participants. Using logistic and linear regression, we investigated the association between increasing self-reported chronic physical conditions and current medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest. Among 210 participants, each additional condition was associated with increased odds of depression (adjusted OR, 95% CI: 1.41, 1.11-1.80; P=0.005) and anxiety (1.71, 1.35-2.21; P<0.001). Each additional medication was associated with depression (1.36, 1.07-1.73; P=0.010) but not anxiety. For each additional condition, CES-D scores increased by 0.62 (0.04-1.20, P=0.035) and for each medication, by 0.66 (0.12-1.21, P=0.017). There was no significant association between conditions or medications and STAI scores. These findings provide crucial information on the future brain health of these individuals.

Research participants as collaborators: Background, experience and policies from the PREVENT Dementia and EPAD programmes.

Despite the growing importance of public and patient involvement in biomedical research, comparatively little attention has been paid to the important role of research participants themselves. Our aim in this paper is to explore the impact research participant involvement has within the PREVENT and the European Prevention of Alzheimer's Dementia (EPAD) projects. In this paper, we report the experiences of involving research participants as collaborators in prospective cohort studies exploring early changes in the brain as pathways towards and risks for dementia. We use minutes and feedback from members of the panel and steering committee to understand the experience and impact on the study. We describe the aims and structure of the participant panel established within the PREVENT Dementia study and highlight its contributions to the organisation, conduct and future of the study. Key areas of contribution identified include recruitment, inclusion of additional sub-studies, understanding the participant experience and contributing to the future of the study. We then describe how the PREVENT Dementia panel forms the basis for participant involvement within EPAD project.

Allocentric and Egocentric Spatial Processing in Middle-Aged Adults at High Risk of Late-Onset Alzheimer's Disease: The PREVENT Dementia Study.

Impairments in spatial processing due to hippocampal degeneration have been observed in the years immediately preceding the diagnosis of Alzheimer's disease (AD) dementia. The demonstration of changes in spatial processing in preceding decades would provide a cognitive marker for pre-clinical AD and an outcome measure for early intervention trials. The present study examined allocentric and egocentric spatial processing in relation to future dementia risk in a middle-aged cohort. The CAIDE Dementia Risk Score (DRS) was calculated for 188 persons aged 40 to 59, of whom 94 had a parent with dementia. Participants underwent the Four Mountains Test (4MT) of allocentric spatial processing, the Virtual Reality Supermarket Trolley Task (VRSTT) of egocentric spatial processing, and 3T MRI scans. A significant negative association was found between the DRS and 4MT (Spearman correlation - 0.26, p = 0.0006), but not with the VRSTT. The 4MT was also found to be a better predictor of risk than tests of episodic memory, verbal fluency, or executive functioning. The results suggest that allocentric rather than egocentric processing may be a potential indicator of risk for late-onset AD, consistent with the hypothesis that the earliest cognitive changes in AD are driven by tau-related degeneration in the medial temporal lobe rather than amyloid-only deposition in the medial parietal lobe.

Cerebral small vessel disease in middle age and genetic predisposition to late-onset Alzheimer's disease

IntroductionCerebral small vessel disease (CSVD) is associated with late-onset Alzheimer's disease (LOAD) and might contribute to the relationship between apolipoprotein E ε4 (APOE ε4) and LOAD, in older people. However, it is unclear whether CSVD begins in middle age in individuals genetically predisposed to LOAD. MethodsWe assessed the relationship between radiological markers of CSVD, white matter hyperintensities and microbleeds, and genetic predisposition to LOAD in a cross-sectional analysis of cognitively normal subjects aged 40–59 years recruited from the PREVENT Dementia study. ResultsMicrobleed prevalence was 14.5%, and mean ± standard deviation white matter hyperintensity percentage of total brain volume was 0.41 ± 0.28%. There was no significant association between APOE ε4 carrier status or history of parental dementia and white matter hyperintensity volume (P = .713, .912 respectively) or microbleeds (P = .082, .562 respectively) on multiple regression. DiscussionGenetic predisposition to LOAD, through APOE genotype or AD family history, is not associated with CSVD in middle age.