The Israel Registry for Alzheimer’s Prevention (IRAP) Study: Design and Baseline Characteristics

2020 ◽  
Vol 78 (2) ◽  
pp. 777-788
Author(s):  
Ramit Ravona-Springer ◽  
Inbal Sharvit-Ginon ◽  
Ithamar Ganmore ◽  
Lior Greenbaum ◽  
Barbara B. Bendlin ◽  
...  

Background: Family history of Alzheimer’s disease (AD) is associated with increased dementia-risk. Objective: The Israel Registry for Alzheimer’s Prevention (IRAP) is a prospective longitudinal study of asymptomatic middle-aged offspring of AD patients (family history positive; FH+) and controls (whose parents have aged without dementia; FH–) aimed to unravel the contribution of midlife factors to future cognitive decline and dementia. Here we present the study design, methods, and baseline characteristics. Methods: Participants are members of the Maccabi Health Services, 40–65 years of age, with exquisitely detailed laboratory, medical diagnoses and medication data available in the Maccabi electronic medical records since 1998. Data collected through IRAP include genetic, sociodemographic, cognitive, brain imaging, lifestyle, and health-related characteristics at baseline and every three years thereafter. Results: Currently IRAP has 483 participants [mean age 54.95 (SD = 6.68) and 64.8% (n = 313) women], 379 (78.5%) FH+, and 104 (21.5%) FH–. Compared to FH–, FH+ participants were younger (p = 0.011), more often males (p = 0.003) and with a higher prevalence of the APOE E4 allele carriers (32.9% FH+, 22% FH–; p = 0.040). Adjusting for age, sex, and education, FH+ performed worse than FH–in global cognition (p = 0.027) and episodic memory (p = 0.022). Conclusion: Lower cognitive scores and higher rates of the APOE E4 allele carriers among the FH+ group suggest that FH ascertainment is good. The combination of long-term historical health-related data available through Maccabi with the multifactorial information collected through IRAP will potentially enable development of dementia-prevention strategies already in midlife, a critical period in terms of risk factor exposure and initiation of AD-neuropathology.

Autism ◽  
2022 ◽  
pp. 136236132110689
Author(s):  
Nisha Narvekar ◽  
Virginia Carter Leno ◽  
Greg Pasco ◽  
Mark H Johnson ◽  
Emily JH Jones ◽  
...  

Autism is diagnosed based on social and communication difficulties, restricted and repetitive behaviours and sensory anomalies. Existing evidence indicates that anxiety and atypical sensory features are associated with restricted and repetitive behaviours, but cannot clarify the order of emergence of these traits. This study uses data from a prospective longitudinal study of infants with and without a family history of autism ( N = 247; Elevated Likelihood N = 170 and Typical Likelihood N = 77). Longitudinal cross-lag models tested bidirectional pathways between parent-rated infant fear/shyness and perceptual sensitivity at 8, 14 and 24 months, and associations between these domains and parent-rated restricted and repetitive behaviours and social communication scores at 36 months. In addition to within-domain continuity, higher levels of fear/shyness at 14 months were associated with higher levels of perceptual sensitivity at 24 months. Higher levels of both fear/shyness and perceptual sensitivity at 24 months were associated with greater restricted and repetitive behaviours and social communication scores at 36 months. Results demonstrate the directionality of developmental pathways between fear/shyness and perceptual sensitivity in infancy and toddlerhood, but question theories that argue that these domains specifically underlie restricted and repetitive behaviours rather than autism. Identifying how early emerging anxiety and sensory behaviours relate to later autism is important for understanding pathways and developing targeted support for autistic children. Lay abstract Restricted interests and repetitive behaviours are central to the diagnosis of autism and can have profound effects on daily activities and quality of life. These challenges are also linked to other co-occurring conditions such as anxiety and sensory sensitivities. Here, we looked at whether early emerging signs of anxiety and sensory problems appear before symptoms of autism by studying infants with a family history of autism, as these infants are more likely to develop autism themselves. Studying infant siblings provides an opportunity for researchers to focus on early developmental markers of autism as these infants can be followed from birth. This study found that early infant signs of anxiety (e.g. fear/shyness) predicted later perceptual sensitivity, and those infants who scored higher on fear/shyness and sensitivity were more likely to experience more persistent repetitive behaviours, but also social and communication difficulties in toddlerhood. Early signs of anxiety and perceptual sensitivity may thus relate to both later social difficulties and repetitive behaviours. These findings support the importance of further research exploring the causal links between these domains in relation to autism, resulting in increased understanding of children who go onto develop autism in the future and guiding early interventions and supports.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A203-A203
Author(s):  
Maurice Ohayon ◽  
Y J Chen ◽  
Marie-Lise Cote

Abstract Introduction Chronic nausea and vomiting (CNV), common symptoms in patients with GI disorders like gastroparesis, can be a debilitating health problem with considerable impact on patients’ health-related quality of life during daytime. Yet, little is known about how CNV may impact on sleepiness and fatigue during the daytime. Our aim was to examine the impact of CNV on daytime sleepiness and fatigue based on the data from a longitudinal study. Methods Prospective longitudinal study with two waves: 12,218 subjects interviewed by phone during wave 1 (W1); 10,931 during wave 2 (W2) three years later. The sample was representative of the US general population. Analyses included subjects participating to both waves (N=10,931). CNV was defined as episodes of nausea and vomiting occurring at least twice a month for at least 1 month (outside pregnancy). Logistic regression models were employed to determine whether CNV is a predictive variable for excessive sleepiness or fatigue. Results Out of all W1 participants, 9.8% (95% CI: 9.2%-10.4%) reported nausea only while 3% (95% CI: 2.7%-3.3%) reported CNV. In W2, 7.7% (95% CI: 7.2%-8.2%) reported nausea only and 2.5% (95% CI: 2.2%-2.8%) reported having CNV. Of the subjects who participated in both W1 and W2, 25.7% of them reported CNV in W1. CNV subjects reported more frequently excessive daytime sleepiness (53.5% vs. 25.9%) and being moderately or severely fatigued (38.6% vs, 5.4%) compared with the participants without nausea or vomiting. After controlling for age, sex, BMI, health status, alcohol intake, sleep disorders and psychiatric disorders that might impact on daytime sleepiness or fatigue, it was found that subjects with CNV at both W1 and W2 had a significantly higher relative risk of reporting daytime sleepiness (RR: 2.7 (95% CI:1.9–3.9) p<0.0001) and fatigue (RR: 4.9 (95% CI:3.2–7.5) p<0.0001) at W2, compared with the participants without nausea or vomiting. Conclusion Many factors are likely to influence daytime sleepiness. CNV appears to be an important contributor even after controlling for several factors that can explain the sleepiness. This underlines the extent to which alertness could be disturbed and impacted by chronicity of nausea/vomiting symptoms. Support (if any) This analysis study was funded by Takeda Pharmaceutical Company


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