25 results found
Abbott K, Posma JM, Garcia Perez I, et al., 2022, Evidence-Based Tools for Dietary Assessments in Nutrition Epidemiology Studies for Dementia Prevention, The journal of prevention of Alzheimer's disease, ISSN: 2274-5807
Increasing evidence proposes diet as a notable modifiable factor and viable target for the reduction of Alzheimer’s Disease risk and age-related cognitive decline. However, assessment of dietary exposures is challenged by dietary capture methods that are prone to misreporting and measurement errors. The utility of -omics technologies for the evaluation of dietary exposures has the potential to improve reliability and offer new insights to pre-disease indicators and preventive targets in cognitive aging and dementia. In this review, we present a focused overview of metabolomics as a validation tool and framework for investigating the immediate or cumulative effects of diet on cognitive health.
Ford J, Kafetsouli D, wilson H, et al., 2022, At a Glance: An Update on Neuroimaging and Retinal Imaging in Alzheimer’s Disease and Related Research, The journal of prevention of Alzheimer's disease, ISSN: 2274-5807
Udeh-Momoh C, Watermeyer T, Sindi S, et al., 2021, Health, lifestyle and psycho-social determinants of poor sleep quality during the Early Phase of the COVID-19 pandemic: a focus on UK older adults deemed clinically extremely vulnerable, Frontiers in Public Health, Vol: 9, Pages: 1-11, ISSN: 2296-2565
Background: Several studies have assessed the impact of COVID-19-relatedlockdownson sleep quality across global populations. However, no study to date has specifically assessed at-riskpopulations, particularly those at highest risk of complications from coronavirus infection deemed “clinically-extremely-vulnerable-(COVID-19CEV)” [as defined by Public Health England, 2020].Methods: In this cross-sectional study, we surveyed 5,558 adults aged ≥50 years (of whom 523 met criteria for COVID-19CEV) during the first pandemic wave that resulted in a nationwide-lockdown (April-June 2020) with assessments of sleep quality (an adapted sleep scale that captured multiple sleep indices before and during the lockdown), health/medical, lifestyle, psychosocial and socio demographic factors. We examined associations between these variablesand sleep quality;and explored interactions of COVID-19CEV status with significant predictors of poor sleep,to identify potential moderating factors. Results: 37% of participants reported poor sleep quality which was associated with younger age, female sex and multimorbidity. Significant associations with poor sleep included health/medical factors: COVID-19 CEV status, higher BMI, arthritis, pulmonary disease, and mental health disorders; and the following lifestyle and psychosocial factors: living alone, higher alcohol consumption, an unhealthy diet and higher depressive and anxiety symptoms. Moderators of the negative relationship between COVID-19 CEV status and good sleep quality were marital status, loneliness, anxiety and diet. Within this subgroup, less anxious and less lonely males, as well as females with healthier diets, reported better sleep. Conclusions: Sleep quality in older adults was compromised during the sudden unprecedented nation-wide lockdown due to distinct modifiable factors. An important contribution of our study is the assessment of a &ldquo
Udeh-Momoh C, Watermeyer T, 2021, Female specific risk factors for the development of Alzheimer's disease neuropathology and cognitive impairment: Call for a precision medicine approach, AGEING RESEARCH REVIEWS, Vol: 71, ISSN: 1568-1637
Salman D, Beaney T, Robb C, et al., 2021, The impact of social restrictions during the COVID-19 pandemic on the physical activity levels of adults aged 50-92 years: a baseline survey of the CHARIOT COVID-19 Rapid Response prospective cohort study, BMJ Open, Vol: 11, Pages: 1-12, ISSN: 2044-6055
Objectives: Physical inactivity is more common in older adults, is associated with social isolation and loneliness, and contributes to increased morbidity and mortality. We examined the effect of social restrictions to reduce COVID-19 transmission in the UK (lockdown), on physical activity (PA) levels of older adults, and the social predictors of any change.Design: Baseline analysis of a survey-based prospective cohort study Setting: Adults enrolled in the Cognitive Health in Ageing Register for Investigational and Observational Trials (CHARIOT) cohort from General Practitioner (GP) practices in North West London were invited to participate from April to July 2020.Participants: 6,219 cognitively healthy adults aged 50 to 92 years completed the survey.Main outcome measures: Self-reported PA before and after the introduction of lockdown, as measured by Metabolic Equivalent of Task (MET) minutes. Associations of PA with demographic, lifestyle and social factors, mood and frailty.Results: Mean PA was significantly lower following the introduction of lockdown, from 3,519 MET minutes/week to 3,185 MET minutes/week (p<0.001). After adjustment for confounders and pre-lockdown PA, lower levels of PA after the introduction of lockdown were found in those who were over 85 years old (640 [95% CI: 246 to 1034] MET minutes/week less); were divorced or single (240 [95% CI: 120 to 360] MET minutes/week less); living alone (277 [95% CI: 152 to 402] MET minutes/week less); reported feeling lonely often (306 [95% CI: 60 to 552] MET minutes/week less); and showed symptoms of depression (1007 [95% CI: 1401 to 612] MET minutes/week less) compared to those aged 50-64 years, married, co-habiting, and not reporting loneliness or depression, respectively. Conclusions and Implications: Markers of social isolation, loneliness and depression were associated with lower PA following the introduction of lockdown in the UK. Targeted interventions to increase PA in these groups should be consid
Watermeyer T, Robb C, Gregory S, et al., 2021, Therapeutic implications of hypothalamic-pituitary-adrenal-axis modulation in Alzheimer’s disease: a narrative review of pharmacological and lifestyle interventions, Frontiers in Neuroendocrinology, Vol: 60, ISSN: 0091-3022
With disease-modifying treatments for Alzheimer’s disease (AD) still elusive, the search for alternative intervention strategies has intensified. Growing evidence suggests that dysfunction in hypothalamic-pituitaryadrenal-axis (HPAA) activity may contribute to the development of AD pathology. The HPAA, may therefore offer a novel target for therapeutic action. This review summarises and critically evaluates animal and human studies investigating the effects of pharmacological and non-pharmacological intervention on HPAA modulation alongside cognitive performance. The interventions discussed include glucocorticoid receptor antagonists and 11β-hydroxysteroid dehydrogenase inhibitors as well as lifestyle treatments such as physical activity, diet, sleep and contemplative practices. Pharmacological HPAA modulators improve pathology and cognitive deficit in animal AD models, but human pharmacological trials are yet to provide definitive support for such benefits. Lifestyle interventions may offer promising strategies for HPAA modification and cognitive health, but several methodological caveats across these studies were identified. Directions for future research in AD studies are proposed.
Robb C, Loots C, Ahmadi-Abhari S, et al., 2020, Associations of social isolation with anxiety and depression during the early COVID-19 Pandemic: a survey of older adults in London, UK, Frontiers in Psychiatry, Vol: 11, Pages: 1-12, ISSN: 1664-0640
The COVID-19 pandemic is imposing a profound negative impact on the health and wellbeing of societies and individuals, worldwide. One concern is the effect of social isolation as a result of social distancing on the mental health of vulnerable populations, including older people.Within six weeks of lockdown, we initiated the CHARIOT COVID-19 Rapid Response Study, a bespoke survey of cognitively healthy older people living in London,to investigate the impact of COVID-19 and associated social isolation on mental and physical wellbeing. The sample was drawn from CHARIOT, a register of people over 50 who have consented to be contacted for ageing related research. A total of 327,127 men and women (mean age=70.7 [SD=7.4]) participated in the baseline survey, May-July 2020. Participants were asked about changes to the 14 components of the Hospital Anxiety Depression scale (HADS) after lockdown was introduced in the UK,on 23rd March. A total of 12.8% of participants reported feeling worse on the depression components of HADS (7.8% men and 17.3% women) and 3612.3% reported feeling worse on the anxiety components (7.8% men and 16.5% women). Fewer participants reported feeling improved (1.5% for depression and 4.9% for anxiety). Women, younger participants, those single/widowed/divorced, reporting poor sleep, feelings of loneliness and who reported living alone were more likely to indicate feeling worse on both the depression and/or anxiety components of the HADS. There was a significant negative association between subjective loneliness and worsened components of both depression (OR 17.24, 95% CI 13.20, 22.50) and anxiety (OR 10.85, 95% CI 8.39, 14.03). Results may inform targeted interventions and help guide policy recommendations in reducing the effects of social isolation related to the pandemic, and beyond, on the mental health of older people.
Zheng B, Tal R, Yang Z, et al., 2020, Cortisol hypersecretion and the risk of Alzheimer’s disease: A systematic review and meta-analysis, Ageing Research Reviews, Vol: 64, Pages: 1-11, ISSN: 1568-1637
BackgroundMorning cortisol levels have been reported to be elevated among patients with Alzheimer’s disease (AD); yet no meta-analysis has been conducted to confirm the existence and magnitude of this association. It also remains unclear whether hypercortisolism is a risk factor for AD.MethodsPubMed, EMBASE, and PsycINFO were systematically searched for eligible studies. Cross-sectional data were pooled using random-effects meta-analyses; the differences in morning cortisol levels between patients and cognitively normal controls were quantified. Longitudinal studies were qualitatively synthesised due to methodological heterogeneity.Results17,245 participants from 57 cross-sectional studies and 19 prospective cohort studies were included. Compared with cognitively normal controls, AD patients had moderately increased morning cortisol in blood (g = 0.422, P < 0.001; I2 = 48.5 %), saliva (g = 0.540, P < 0.001; I2 = 13.6 %), and cerebrospinal fluids (g = 0.565, P = 0.003; I2 = 75.3 %). A moderate elevation of morning cortisol was also detected in cerebrospinal fluids from patients with mild cognitive impairment (MCI) versus controls (g = 0.309, P = 0.001; I2 = 0.0 %). Cohort studies suggested that higher morning cortisol may accelerate cognitive decline in MCI or mild AD patients, but the results in cognitively healthy adults were inconsistent.ConclusionsMorning cortisol was confirmed to be moderately elevated in AD patients and may have diagnostic and prognostic values for AD.
Udeh-Momoh C, Loots C, Price G, et al., 2020, Transition from physical to virtual visit format for a longitudinal brain ageing study, in response to the Covid-19 pandemic. Operationalising adaptive methods and challenges, Alzheimer's and Dementia: Translational Research and Clinical Interventions, Vol: 6, Pages: 1-7, ISSN: 2352-8737
The COVID-19 pandemic necessitated adaptations to standard operations and management of clinical studies, following lockdown measures put in place by several governments to reduce SARS-COV-2 spread. In this paper, we describe our telehealth strategy developed for transitioning our dementia prevention clinical observational prospective study from face-to-face visits to virtual visits, to ensure the ongoing collection of longitudinal data. We share the lessons learned in terms of challenges experienced and solutions implemented to achieve successful administration of study assessments. Our methods will be useful for informing longitudinal observational or interventional studies that require a feasible model for remote data collection, in cognitively unimpaired adults.
McRae-McKee K, Chinedu T, Udeh-Momoh CT, et al., 2019, Perspective: Clinical relevance of the dichotomous classification of Alzheimer’s disease biomarkers: Should there be a “grey zone”?, Alzheimers & Dementia, Vol: 15, Pages: 1348-1356, ISSN: 1552-5260
The 2018 National Institute on Aging and the Alzheimer's Association (NIA-AA) research framework recently redefined Alzheimer's disease (AD) as a biological construct, based on in vivo biomarkers reflecting key neuropathologic features. Combinations of normal/abnormal levels of three biomarker categories, based on single thresholds, form the AD signature profile that defines the biological disease state as a continuum, independent of clinical symptomatology. While single thresholds may be useful in defining the biological signature profile, we provide evidence that their use in studies with cognitive outcomes merits further consideration. Using data from the Alzheimer's Disease Neuroimaging Initiative with a focus on cortical amyloid binding, we discuss the limitations of applying the biological definition of disease status as a tool to define the increased likelihood of the onset of the Alzheimer's clinical syndrome and the effects that this may have on trial study design. We also suggest potential research objectives going forward and what the related data requirements would be.
Udeh-Momoh C, Su B, Evans S, et al., 2019, Cortisol, Amyloid- , and Reserve Predicts Alzheimer's disease progression for cognitively normal older adults, Journal of Alzheimer's Disease, Vol: 70, Pages: 551-560, ISSN: 1387-2877
Elevated cortisol as a measure of hypothalamic-pituitary-adrenal-axis hyperactivity has emerged as a predictor of clinical progression of Alzheimer’s disease (AD), in conjunction with amyloid-β (Aβ) abnormalities. Yet factors exist which have the propensity to delay AD symptomatic expression in the face of an AD-type biomarker-based pathological profile. This study sought to determine whether abnormal cerebrospinal fluid (CSF) Aβ and elevated cortisol levels are associated with clinical transition to mild cognitive impairment (MCI) and AD in cognitively normal (CN) individuals, and if this association is modified by reserve proxies. Data from 91 CN individuals participating in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) with available morning CSF cortisol and Aβ42 were evaluated. Reserve was modelled as a latent composite score of standardized intracranial volume and lifetime experience proxies. Cox regressions were used to test associations between baseline CSF cortisol/Aβ42, reserve score and AD progression; adjusting for age, sex, apolipoprotein E genotype, and depressive symptoms. Individuals with elevated cortisol + abnormal Aβ42 levels at baseline showed highest risk of clinical progression. After a median of 84 months follow-up, significant cortisol/Aβ/ reserve interaction for clinical progression was noted (adjusted HR = 0.15, p < 0.001), suggesting a moderating effect of reserve on the association between cortisol/Aβ+ and clinical progression. Our findings indicate that cortisol hypersecretion accelerates clinical progression in CN individuals presenting with pathological Aβ42. High reserve reduces the associated AD progression risk in these high-risk individuals.
Ward H, McLellan H, Udeh-Momoh C, et al., 2019, Use of online dietary recalls among older UK adults: A feasibility study of an online dietary assessment tool, Nutrients, Vol: 11, ISSN: 2072-6643
This study examined the feasibility of including myfood24, an online 24-hour dietary recall tool, in a cohort studies of older adults. Participants (n = 319) were recruited during follow-up visits for the CHARIOT-Pro Sub-study, a prospective study of cognitively healthy adults aged 60–85 years at baseline. Email invitations were sent over three consecutive months, with weekly reminders. Multivariable regression models were applied to examine the number of recalls completed in relation to technology readiness (TR) scores and demographic characteristics. Ninety-four percent of people agreed to participate. Among participants, 67% completed at least one recall, and 48% completed two or more. Participants who completed multiple recalls reported higher self-confidence with technology and received a higher TR score than those who did not complete any recalls. A one-point higher TR score was associated with higher odds of completing three recalls compared to zero recalls (OR 1.70, 95% CI 0.96–3.01); this association was further attenuated after adjustment for demographic and other TR-related covariates (OR 1.35, 95% CI 0.63–2.88). This study demonstrates reasonable participation rates for a single myfood24 recall among older adults participating in a cohort study but suggests that further support may be required to obtain multiple recalls in this population.
Udeh-Momoh C, Price G, Ropacki M, et al., 2019, Prospective Evaluation of Cognitive Health and Related Factors in Elderly at Risk for Developing Alzheimer’s Dementia: A Longitudinal Cohort study, The Journal of Prevention of Alzheimer's Disease, ISSN: 2274-5807
Stern Y, Arenaza-Urquijo EM, Bartrés-Faz D, et al., 2018, Whitepaper: Defining and investigating cognitive reserve, brain reserve, and brain maintenance, Alzheimer's & Dementia, ISSN: 1552-5260
Robb CE, Udeh-Momoh CUM, Wagenpfeil SW, et al., 2017, Biomarkers and functional decline in prodromal Alzheimer’s disease, Journal of Alzheimers Disease, Vol: 58, Pages: 69-78, ISSN: 1875-8908
Background: Little is known of possible associations between Alzheimer’s disease (AD) biomarkers and instrumental activities of daily living (IADL) change over time.Objective: The present study seeks to identify relationships between baseline imaging and fluid biomarker profiles, and decline in IADL utilizing data collated from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort.Methods: Generalized estimating equations analysis, adjusted for cognitive deterioration, was applied to a cohort of 509 individuals from all stages of ADNI, including 156 healthy controls, 189 early mild cognitive impairment (MCI) patients and 164 MCI patients.Results: A significant correlation was found between baseline biomarkers, specifically CSF Aβ and FDG PET, and IADL change over a 3-year period in individuals with MCI. Importantly, comparable correlations between presence of pathological biomarker levels and temporal decline in both functional and cognitive performance were also noted.Discussion: We show that distinct baseline biomarkers may predict latent changes in IADL. Our results necessitate a revision of the commonly held view upholding cognitive changes as the predominant endpoint measure associated with presence of abnormal baseline biomarkers.
Hannen R, Udeh-Momoh C, Upton J, et al., 2017, Dysfunctional Skin-Derived Glucocorticoid Synthesis Is a Pathogenic Mechanism of Psoriasis, Journal of Investigative Dermatology, Vol: 137, Pages: 1630-1637, ISSN: 0022-202X
Glucocorticoids (GC) are the primary steroids that regulate inflammation and have been exploited therapeutically in inflammatory skin diseases. Despite the broad-spectrum therapeutic use of GC, the biochemical rationale for locally treating inflammatory skin conditions is poorly understood, as systemic GC production remains largely functional in these patients. GC synthesis has been well characterized in healthy skin, but the pathological consequence has not been examined. Here we show de novo GC synthesis, and GC receptor expression is dysfunctional in both nonlesional and lesional psoriatic skin. Use of GC receptor epidermal knockout mice with adrenalectomy allowed for the distinction between local (keratinocyte) and systemic GC activity. Compensation exhibited by adult GC receptor epidermal knockout mice demonstrated that keratinocyte-derived GC synthesis protected skin from topical phorbol 12-myristate 13-acetate-induced inflammatory assault. Thus, localized de novo GC synthesis in skin is essential for controlling inflammation, and loss of the GC pathway in psoriatic skin represents an additional pathological process in this complex inflammatory skin disease.
Udeh-Momoh CT, Piers T, Waite E, et al., 2017, Adrenal-dependent regulation of glutamatergic-related plasticity: impact of endogenous glucocorticoids on natural synaptic, British Neuroscience Association, Publisher: SAGE Publications, ISSN: 2158-2440
Udeh-Momoh CT, Price G, Su B, et al., 2016, THE CHARIOT COGNITIVE RESERVE COMPOSITE: A CONSTRUCT AND PREDICTIVE VALIDITY STUDY, The 13th International Conference on Alxheimer's and Parkinson's Disease
Udeh-Momoh CT, Spiga F, Waite E, et al., 2016, Corticosteroid-driven response of synaptic plasticity-associated targets are differentially regulated in the rodent brain: transcriptional actions of receptor modulators, Society for Endocrinology BES 2016, Publisher: Oxford University Press (OUP), ISSN: 1470-3947
Meakin LB, Udeh C, Galea GL, et al., 2015, Exercise does not enhance aged bone's impaired response to artificial loading in C57Bl/6 mice, BONE, Vol: 81, Pages: 47-52, ISSN: 8756-3282
Udeh CT, Brooks S, Janghra N, et al., 2014, Glucocorticoid signalling actions are disrupted in Huntington’s disease, Society for Neuroscience
Smith CJ, Emsley HC, Udeh CT, et al., 2012, Interleukin-1 receptor antagonist reverses stroke-associated peripheral immune suppression, CYTOKINE, Vol: 58, Pages: 384-389, ISSN: 1043-4666
Udeh CT, Waite EJ, Thomson FJ, et al., 2012, Targeting cognitive impairment in anxiety disorders: transcriptional actions of glucocorticoid receptor modulators, Publisher: ELSEVIER SCIENCE BV, Pages: S98-S99, ISSN: 0924-977X
Emsley HC, Smith CJ, Udeh CT, et al., 2011, Stroke-associated immune suppression is reversed by interleukin-1 receptor antagonist and is related to hypothalamic-pituitary-adrenal axis activity, Annual Congress of the British-Society-for-Immunology, Publisher: WILEY-BLACKWELL, Pages: 183-183, ISSN: 0019-2805
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