scholarly journals Protocol for the Island Study Linking Ageing and Neurodegenerative Disease (ISLAND): a Prospective, Online, Public Health Cohort Study Targeting Dementia Risk Reduction (Preprint)

10.2196/34688 ◽  
2021 ◽  
Author(s):  
Larissa Bartlett ◽  
Kathleen Doherty ◽  
Maree Farrow ◽  
Sarang Kim ◽  
Edward Hill ◽  
...  
2021 ◽  
Author(s):  
Larissa Bartlett ◽  
Kathleen Doherty ◽  
Maree Farrow ◽  
Sarang Kim ◽  
Edward Hill ◽  
...  

BACKGROUND Up to 40% of incident dementia is considered attributable to behavioural and lifestyle factors. Given the current lack of medical treatments and the projected increase in dementia prevalence, a focus on prevention through risk reduction is needed. OBJECTIVE The Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) is a long-term prospective, online cohort study with nested interventions. This 10-year public health project aims to increase dementia risk knowledge and promote changes in dementia risk behaviours at individual and population level. METHODS ISLAND participants (target n=10,000) reside in Tasmania, Australia and are aged 50 years or over. Survey data on knowledge, attitudes and behaviours related to modifiable dementia risk factors will be modelled longitudinally with intervention engagement indices, cognitive functioning and blood-based biomarkers. RESULTS In the initial 12 months, 6,410 participants provided baseline data and have been provided with a personalised dementia risk profile, and guidelines for reducing risk, across nine behavioural and lifestyle domains. Within this first year over one quarter of the cohort (27%) undertook the Preventing Dementia massive open online course and 12% enrolled in university study via the Campus intervention. CONCLUSIONS Recruitment targets are feasible and efforts are ongoing to achieve a representative sample. Findings will inform future public health dementia risk reduction initiatives, by showing whether, when and how dementia risk can be lowered through interventions delivered in an uncontrolled, real-world context.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041211
Author(s):  
Irene Heger ◽  
Sebastian Köhler ◽  
Martin van Boxtel ◽  
Marjolein de Vugt ◽  
KlaasJan Hajema ◽  
...  

ObjectivesEvaluate the effect of a health promotion campaign aimed at increasing awareness about dementia risk reduction in middle-aged community-dwelling individuals in the Netherlands.DesignA 10-month public health campaign using mass media and community participation, supported by eHealth. Population-level difference in awareness before and after the campaign, including variation between demographic groups, was assessed in two independent cross-sectional samples from the same target population.SettingThe public health campaign was launched in the Province of Limburg, the Netherlands, targeting all inhabitants aged 40–75 years old. Three specific districts within the Province were chosen for an additional community participation approach, in which local stakeholders were invited to support the campaign.ResultsNo pre- (n=590) post- (n=602) difference was observed in people agreeing to the statement that dementia risk reduction is possible (X2(1)=1.27, p=0.260). For the individual lifestyle factors, physical activity (7.6% increase (X2(1)=7.48, p=0.006)) and healthy diet (10.5% increase (X2(1)=12.37, p≤0.001)) were identified more often as being protective against dementia after the campaign. Of all risk/protective factors assessed, cognitive activity was identified most often at both preassessment (79.4%) and postassessment (80.4%), but there was no increase in awareness (X2(1)=0.17, p=0.677). Self-reported exposure to the campaign was associated with greater awareness and motivation for behavioural change (X2(1)=6.52, p=0.011). Compared with mass media only, the addition of community participation resulted in better recognition of campaign material and the eHealth platform.ConclusionsThis study was not able to reach a population-level increase of awareness of dementia risk reduction. Two out of the three lifestyle factors that formed the foundation of the campaign were identified more often after the campaign. Those reported having been exposed to the campaign were more aware and more inclined towards behavioural change.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028654 ◽  
Author(s):  
Emma R Russell ◽  
Katy Stewart ◽  
Daniel F Mackay ◽  
John MacLean ◽  
Jill P Pell ◽  
...  

IntroductionIn the past decade, evidence has emerged suggesting a potential link between contact sport participation and increased risk of late neurodegenerative disease, in particular chronic traumatic encephalopathy. While there remains a lack of clear evidence to test the hypothesis that contact sport participation is linked to an increased incidence of dementia, there is growing public concern regarding the risk. There is, therefore, a pressing need for research to gain greater understanding of the potential risks involved in contact sports participation, and to contextualise these within holistic health benefits of sport.Methods and analysisFootball’s InfluencE on Lifelong health and Dementia risk is designed as a retrospective cohort study, with the aim to analyse data from former professional footballers (FPF) in order to assess the incidence of neurodegenerative disease in this population. Comprehensive electronic medical and death records will be analysed and compared with those of a demographically matched population control cohort. As well as neurodegenerative disease incidence, all-cause, and disease-specific mortality, will be analysed in order to assess lifelong health. Cox proportional hazards models will be run to compare the data collected from FPFs to matched population controls.Ethics and disseminationApprovals for study have been obtained from the University of Glasgow College of Medical, Veterinary and Life Sciences Research Ethics Committee (Project Number 200160147) and from National Health Service Scotland’s Public Benefits and Privacy Panel (Application 1718-0120).


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 834-P
Author(s):  
HYUK-SANG KWON ◽  
SOON JIB YOO ◽  
MIN-KYUNG LEE ◽  
GA EUN NAM

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michael Wainberg ◽  
Stefan Kloiber ◽  
Breno Diniz ◽  
Roger S. McIntyre ◽  
Daniel Felsky ◽  
...  

AbstractPrevention of major depressive disorder (MDD) is a public health priority. Identifying biomarkers of underlying biological processes that contribute to MDD onset may help address this public health need. This prospective cohort study encompassed 383,131 white British participants from the UK Biobank with no prior history of MDD, with replication in 50,759 participants of other ancestries. Leveraging linked inpatient and primary care records, we computed adjusted odds ratios for 5-year MDD incidence among individuals with values below or above the 95% confidence interval (<2.5th or >97.5th percentile) on each of 57 laboratory measures. Sensitivity analyses were performed across multiple percentile thresholds and in comparison to established reference ranges. We found that indicators of liver dysfunction were associated with increased 5-year MDD incidence (even after correction for alcohol use and body mass index): elevated alanine aminotransferase (AOR = 1.35, 95% confidence interval [1.16, 1.58]), aspartate aminotransferase (AOR = 1.39 [1.19, 1.62]), and gamma glutamyltransferase (AOR = 1.52 [1.31, 1.76]) as well as low albumin (AOR = 1.28 [1.09, 1.50]). Similar observations were made with respect to endocrine dysregulation, specifically low insulin-like growth factor 1 (AOR = 1.34 [1.16, 1.55]), low testosterone among males (AOR = 1.60 [1.27, 2.00]), and elevated glycated hemoglobin (HbA1C; AOR = 1.23 [1.05, 1.43]). Markers of renal impairment (i.e. elevated cystatin C, phosphate, and urea) and indicators of anemia and macrocytosis (i.e. red blood cell enlargement) were also associated with MDD incidence. While some immune markers, like elevated white blood cell and neutrophil count, were associated with MDD (AOR = 1.23 [1.07, 1.42]), others, like elevated C-reactive protein, were not (AOR = 1.04 [0.89, 1.22]). The 30 significant associations validated as a group in the multi-ancestry replication cohort (Wilcoxon p = 0.0005), with a median AOR of 1.235. Importantly, all 30 significant associations with extreme laboratory test results were directionally consistent with an increased MDD risk. In sum, markers of liver and kidney dysfunction, growth hormone and testosterone deficiency, innate immunity, anemia, macrocytosis, and insulin resistance were associated with MDD incidence in a large community-based cohort. Our results support a contributory role of diverse biological processes to MDD onset.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048042
Author(s):  
Andrew Hayward ◽  
Ellen Fragaszy ◽  
Jana Kovar ◽  
Vincent Nguyen ◽  
Sarah Beale ◽  
...  

IntroductionThe coronavirus (COVID-19) pandemic has caused significant global mortality and impacted lives around the world. Virus Watch aims to provide evidence on which public health approaches are most likely to be effective in reducing transmission and impact of the virus, and will investigate community incidence, symptom profiles and transmission of COVID-19 in relation to population movement and behaviours.Methods and analysisVirus Watch is a household community cohort study of acute respiratory infections in England and Wales and will run from June 2020 to August 2021. The study aims to recruit 50 000 people, including 12 500 from minority ethnic backgrounds, for an online survey cohort and monthly antibody testing using home fingerprick test kits. Nested within this larger study will be a subcohort of 10 000 individuals, including 3000 people from minority ethnic backgrounds. This cohort of 10 000 people will have full blood serology taken between October 2020 and January 2021 and repeat serology between May 2021 and August 2021. Participants will also post self-administered nasal swabs for PCR assays of SARS-CoV-2 and will follow one of three different PCR testing schedules based on symptoms.Ethics and disseminationThis study has been approved by the Hampstead National Health Service (NHS) Health Research Authority Ethics Committee (ethics approval number 20/HRA/2320). We are monitoring participant queries and using these to refine methodology where necessary, and are providing summaries and policy briefings of our preliminary findings to inform public health action by working through our partnerships with our study advisory group, Public Health England, NHS and government scientific advisory panels.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040817
Author(s):  
Patrick O'Byrne ◽  
Amanda Vandyk ◽  
Lauren Orser ◽  
Marlene Haines

ObjectiveTo report the results of a nurse-led pre-exposure prophylaxis (PrEP) delivery service.DesignThis was a prospective cohort study conducted from 5 August 2018 to 4 March 2020. It involved manual chart review to collect data. Variables were described using frequencies and percentages and analysed using χ2 testing. Those significant in bivariate analysis were retained and entered into a binary multiple logistic regression. Hierarchical modelling was used, and only significant factors were retained.SettingThis study occurred in an urban public health unit and community-based sexually transmitted infection (STI) clinic in Ottawa, Canada.ParticipantsOf all persons who were diagnosed with a bacterial STI in Ottawa and everyone who presented to our STI clinic during the study period, there were 347 patients who met our high-risk criteria for PrEP; these criteria included patients who newly presented with any of the following: HIV contacts, diagnosed with a bacterial STI or single use of HIV PEP. Further, eligibility could be determined based on clinical judgement. Patients who met the foregoing criteria were appropriate for PrEP-RN, while lower-risk patients were referred to elsewhere. Of the 347 patients who met our high-risk criteria, 47% accepted and 53% declined. Of those who accepted, 80% selected PrEP-registered nurse (RN).Primary and secondary outcome measuresUptake, acceptance, engagement and attrition factors of participants who obtained PrEP through PrEP-RN.Findings69% of participants who were eligible attended their intake PrEP-RN visit. 66% were retained in care. Half of participants continued PrEP and half were lost to follow-up. We found no significant differences in the uptake, acceptance, engagement and attrition factors of participants who accessed PrEP-RN regarding reason for referral, age, ethnicity, sexual orientation, annual income, education attainted, insurance status, if they have a primary care provider, presence or absence of depression or anxiety and evidence of newly acquired STI during the study period.ConclusionsNurse-led PrEP is an appropriate strategy for PrEP delivery.


Sign in / Sign up

Export Citation Format

Share Document