Publications
174 results found
Juraschek SP, Hu J-R, Cluett JL, et al., 2023, Orthostatic Hypotension, Hypertension Treatment, and Cardiovascular Disease: An Individual Participant Meta-Analysis., JAMA, Vol: 330, Pages: 1459-1471
IMPORTANCE: There are ongoing concerns about the benefits of intensive vs standard blood pressure (BP) treatment among adults with orthostatic hypotension or standing hypotension. OBJECTIVE: To determine the effect of a lower BP treatment goal or active therapy vs a standard BP treatment goal or placebo on cardiovascular disease (CVD) or all-cause mortality in strata of baseline orthostatic hypotension or baseline standing hypotension. DATA SOURCES: Individual participant data meta-analysis based on a systematic review of MEDLINE, EMBASE, and CENTRAL databases through May 13, 2022. STUDY SELECTION: Randomized trials of BP pharmacologic treatment (more intensive BP goal or active agent) with orthostatic hypotension assessments. DATA EXTRACTION AND SYNTHESIS: Individual participant data meta-analysis extracted following PRISMA guidelines. Effects were determined using Cox proportional hazard models using a single-stage approach. MAIN OUTCOMES AND MEASURES: Main outcomes were CVD or all-cause mortality. Orthostatic hypotension was defined as a decrease in systolic BP of at least 20 mm Hg and/or diastolic BP of at least 10 mm Hg after changing position from sitting to standing. Standing hypotension was defined as a standing systolic BP of 110 mm Hg or less or standing diastolic BP of 60 mm Hg or less. RESULTS: The 9 trials included 29 235 participants followed up for a median of 4 years (mean age, 69.0 [SD, 10.9] years; 48% women). There were 9% with orthostatic hypotension and 5% with standing hypotension at baseline. More intensive BP treatment or active therapy lowered risk of CVD or all-cause mortality among those without baseline orthostatic hypotension (hazard ratio [HR], 0.81; 95% CI, 0.76-0.86) similarly to those with baseline orthostatic hypotension (HR, 0.83; 95% CI, 0.70-1.00; P = .68 for interaction of treatment with baseline orthostatic hypotension). More intensive BP treatment or active therapy lowered risk of CVD or all-cause mortality among
Kootar S, Huque MH, Kiely KM, et al., 2023, Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk., BMJ Open, Vol: 13
INTRODUCTION: Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual's risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the public and general practitioners. METHODS AND ANALYSIS: Ten high-quality cohort studies from multiple countries were identified, which met eligibility criteria, including large representative samples, long-term follow-up, data on clinical diagnoses of dementia and NCDs, recognised modifiable risk factors for the four NCDs and mortality data. Pooled harmonised data from the cohorts will be used, with 65% randomly allocated for development of the predictive model and 35% for testing. Predictors include sociodemographic characteristics, general health risk factors and lifestyle/behavioural risk factors. A subdistribution hazard model will assess the risk factors' contribution to the outcome, adjusting for competing mortality risks. Point-based scoring algorithms will be built using predictor weights, internally validated and the discriminative ability and calibration of the model will be assessed for the outcomes. Sensitivity analyses will include recalculating risk scores using logistic regression. ETHICS AND DISSEMINATION: Ethics approval is provided by the University of New South Wales Human Research Ethics Committee (UNSW HREC; protocol numbers HC200515, HC3413). All data are deidentified and securely stored on servers at Neuroscience Research Australia. Study findings will be presented at conferences and published in peer-reviewed journals. The tool w
Lennon MJ, Lam BCP, Lipnicki DM, et al., 2023, Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life An Individual Participant Data Meta-Analysis, JAMA NETWORK OPEN, Vol: 6, ISSN: 2574-3805
Kootar S, Huque MH, Eramudugolla R, et al., 2023, Validation of the CogDrisk Instrument as Predictive of Dementia in Four General Community-Dwelling Populations, JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE, Vol: 10, Pages: 478-487, ISSN: 2274-5807
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- Citations: 1
Huque MH, Kootar S, Eramudugolla R, et al., 2023, CogDrisk, ANU-ADRI, CAIDE, and LIBRA Risk Scores for Estimating Dementia Risk., JAMA Netw Open, Vol: 6
IMPORTANCE: While the Australian National University-Alzheimer Disease Risk Index (ANU-ADRI), Cardiovascular Risk Factors, Aging, and Dementia (CAIDE), and Lifestyle for Brain Health (LIBRA) dementia risk tools have been widely used, a large body of new evidence has emerged since their publication. Recently, Cognitive Health and Dementia Risk Index (CogDrisk) and CogDrisk for Alzheimer disease (CogDrisk-AD) risk tools have been developed for the assessment of dementia and AD risk, respectively, using contemporary evidence; comparison of the relative performance of these risk tools is limited. OBJECTIVE: To evaluate the performance of CogDrisk, ANU-ADRI, CAIDE, LIBRA, and modified LIBRA (LIBRA with age and sex estimates from ANU-ADRI) in estimating dementia and AD risks (with CogDrisk-AD and ANU-ADRI). DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study obtained data from the Rush Memory and Aging Project (MAP), the Cardiovascular Health Study Cognition Study (CHS-CS), and the Health and Retirement Study-Aging, Demographics and Memory Study (HRS-ADAMS). Participants who were free of dementia at baseline were included. The factors were component variables in the risk tools that included self-reported baseline demographics, medical risk factors, and lifestyle habits. The study was conducted between November 2021 and March 2023, and statistical analysis was performed from January to June 2023. MAIN OUTCOMES AND MEASURES: Risk scores were calculated based on available factors in each of these cohorts. Area under the receiver operating characteristic curve (AUC) was calculated to measure the performance of each risk score. Multiple imputation was used to assess whether missing data may have affected estimates for dementia risk. RESULTS: Among the 6107 participants in 3 validation cohorts included for this study, 2184 participants without dementia at baseline were available from MAP (mean [SD] age, 80.0 [7.6] years; 1606 [73.5%] female), 548 participants
Walsh S, Govia I, Peters R, et al., 2023, Authors' response to: A new dementia prevention approach requires new language., Alzheimers Dement, Vol: 19, Pages: 3750-3751
Walsh S, Govia I, Peters R, et al., 2023, What would a population-level approach to dementia risk reduction look like, and how would it work?, ALZHEIMERS & DEMENTIA, Vol: 19, Pages: 3203-3209, ISSN: 1552-5260
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- Citations: 6
Xu Y, Aung HLJ, Bateman RJS, et al., 2023, Higher systolic blood pressure in early-mid adulthood is associated with poorer cognitive performance in those with a dominantly inherited Alzheimer's disease mutation but not in non-carriers. Results from the DIAN study, ALZHEIMERS & DEMENTIA, ISSN: 1552-5260
Wilson N-A, Peters R, Lautenschlager NTT, et al., 2023, Testing times for dementia: a community survey identifying contemporary barriers to risk reduction and screening, ALZHEIMERS RESEARCH & THERAPY, Vol: 15
Xu Y, Bouliotis G, Beckett NS, et al., 2023, Left ventricular hypertrophy and incident cognitive decline in older adults with hypertension, JOURNAL OF HUMAN HYPERTENSION, Vol: 37, Pages: 307-312, ISSN: 0950-9240
Xu Y, Phu J, Aung HL, et al., 2023, Frequency of coexistent eye diseases and cognitive impairment or dementia: a systematic review and meta-analysis, EYE, ISSN: 0950-222X
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- Citations: 1
Peters R, Anderson C, 2023, BLOOD PRESSURE, ANTIHYPERTENSIVES AND DEMENTIA, AN INDIVIDUAL PATIENT DATA META-ANALYSIS, 29th Scientific Meeting of the International Society of Hypertension (ISH), Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E15-E16, ISSN: 0263-6352
Chong TWH, Rego T, Lai R, et al., 2023, Preferences and Perspectives of Australian General Practitioners Towards a New "Four-in-One" Risk Assessment Tool for Preventative Health: The LEAD! GP Project, JOURNAL OF ALZHEIMERS DISEASE, Vol: 94, Pages: 801-814, ISSN: 1387-2877
Huque H, Eramudugolla R, Chidiac B, et al., 2023, Could Country-Level Factors Explain Sex Differences in Dementia Incidence and Prevalence? A Systematic Review and Meta-Analysis, JOURNAL OF ALZHEIMERS DISEASE, Vol: 90, Pages: 1231-1241, ISSN: 1387-2877
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- Citations: 5
Peters R, Xu Y, Fitzgerald O, et al., 2022, Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis, EUROPEAN HEART JOURNAL, Vol: 43, Pages: 4980-4990, ISSN: 0195-668X
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- Citations: 18
Xu Y, Warwick J, Eramudugolla R, et al., 2022, No clear associations between subjective memory concerns and subsequent change in cognitive function: the PATH through life study, EUROPEAN JOURNAL OF AGEING, Vol: 19, Pages: 1181-1188, ISSN: 1613-9372
Xu Y, Warwick J, Eramudugolla R, et al., 2022, No clear associations between subjective memory concerns and subsequent change in cognitive function: the PATH through life study., Eur J Ageing, Vol: 19, Pages: 1181-1188, ISSN: 1613-9372
The literature on subjective memory concerns (SMC) as a predictor for future cognitive decline is varied. Furthermore, recent research has pointed to additional complexity arising from variability in the experience of SMC themselves (i.e. whether they are remitting or sustained over time). We investigated the associations between SMC and objectively measured cognition in an Australian population-based cohort. Four waves (4-year intervals between waves) of data from 1236 participants (aged 62.4 ± 1.5 years, 53% male) were used. We categorized participants as experiencing SMC, when they indicated that their memory problems might interfere with their day-to-day life and/or they had seen a doctor about their memory. SMC was categorized as "no" reported SMC, "remitting", "new-onset" or "sustained" SMC. Cognitive assessment of immediate and delayed recall, working memory, psychomotor speed, attention and processing speed were assessed using a neuropsychological battery. Eighteen percent of participants were characterised as having SMC: 6% (77) "remitting", 6% (77) "new-onset" and 6% (69) "sustained" SMC. There was no consistent evidence for an association between SMC and subsequent decline in cognition. However, SMC was associated with poorer performance on contemporaneous tasks of attention and processing speed compared to "no" SMC. Asking about SMC may indicate a current decline in cognitive function but, in this sample at least, did not indicate an increased risk of future decline.
Jicha GA, Abner EL, Arnold SE, et al., 2022, Committee on High-quality Alzheimer's Disease Studies (CHADS) consensus report, ALZHEIMERS & DEMENTIA, Vol: 18, Pages: 1109-1118, ISSN: 1552-5260
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- Citations: 3
Chong TWH, Kootar S, Wilding H, et al., 2022, Exercise interventions to reduce anxiety in mid-life and late-life anxiety disorders and subthreshold anxiety disorder: a systematic review, THERAPEUTIC ADVANCES IN PSYCHOPHARMACOLOGY, Vol: 12, ISSN: 2045-1253
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- Citations: 4
Peters R, Xu Y, Eramudugolla R, et al., 2022, Diastolic Blood Pressure Variability in Later Life May Be a Key Risk Marker for Cognitive Decline, HYPERTENSION, Vol: 79, Pages: 1037-1044, ISSN: 0194-911X
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- Citations: 8
Lancaster K, Xu Y, Savage G, et al., 2022, Blood pressure change and cognition in childhood and early adulthood: a systematic review, THERAPEUTIC ADVANCES IN CHRONIC DISEASE, Vol: 13, ISSN: 2040-6223
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- Citations: 1
Peters R, Dodge HH, James S, et al., 2022, The epidemiology is promising, but the trial evidence is weak. Why pharmacological dementia risk reduction trials haven't lived up to expectations, and where do we go from here?, ALZHEIMERS & DEMENTIA, Vol: 18, Pages: 507-512, ISSN: 1552-5260
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- Citations: 5
Chowdhary N, Barbui C, Anstey KJ, et al., 2022, Reducing the Risk of Cognitive Decline and Dementia: WHO Recommendations, FRONTIERS IN NEUROLOGY, Vol: 12, ISSN: 1664-2295
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- Citations: 23
Anstey KJ, Zheng L, Peters R, et al., 2022, Dementia Risk Scores and Their Role in the Implementation of Risk Reduction Guidelines, FRONTIERS IN NEUROLOGY, Vol: 12, ISSN: 1664-2295
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- Citations: 7
Walsh S, Govia I, Wallace L, et al., 2022, A whole-population approach is required for dementia risk reduction, LANCET HEALTHY LONGEVITY, Vol: 3, Pages: E6-E8, ISSN: 2666-7568
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- Citations: 21
Keay L, Ren K, Nguyen H, et al., 2022, Risk factors common to leading eye health conditions and major non-communicable diseases: a rapid review and commentary, F1000Research, Vol: 11, ISSN: 2046-1402
Background: To gain an understanding of the intersection of risk factors between the most prevalent eye health conditions that are associated with vision impairment and non-communicable diseases (NCDs). Methods: A series of rapid reviews of reviews reporting on non-modifiable risk factors, age and sex, and modifiable risk factors, including social determinants, were conducted for five common eye health conditions that are the leading causes of vision impairment globally (refractive error including uncorrected refractive error, cataract, age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy) and five prevalent NCDs (cancer, cardiovascular disease, chronic respiratory disease, dementia, and depressive disorders). Articles published within approximately 5 years to the end of 2019 were identified through expert recommendation, PubMED, Ovid Medline, the Lancet Global Burden of Disease series, the International Agency for Research on Cancer and World Cancer Research Fund. Results: Of 9,213 records identified, 320 records were eligible. Eye health conditions and NCDs share many risk factors. Increased age was found to be the most common shared risk factor, associated with increased risks of AMD, cataract, diabetic retinopathy, glaucoma, refractive error, cancer, cardiovascular disease, chronic obstructive pulmonary disease, and dementia. Other shared risk factors included smoking, obesity, alcohol consumption (mixed results), and physical activity was protective, though limited evidence was found for eye conditions. Social determinants are well documented as risk factors for NCDs. Conclusion: There is substantial overlap in common established risk factors for the most frequent vision impairing eye conditions and leading NCDs. Increasing efforts should be made to integrate preventative and risk reduction interventions to improve health, with greatest shared benefits for initiatives which aim to reduce smoking, improve diet, and promote phys
Anstey KJ, Kootar S, Huque MH, et al., 2022, Development of the CogDrisk tool to assess risk factors for dementia, ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING, Vol: 14
Lewis ET, Williamson M, Lewis LP, et al., 2022, The Feasibility of Deriving the Electronic Frailty Index from Australian General Practice Records, CLINICAL INTERVENTIONS IN AGING, Vol: 17, Pages: 1589-1598
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- Citations: 2
Lewis ET, Howard L, Cardona M, et al., 2021, Frailty in Indigenous Populations: A Scoping Review, FRONTIERS IN PUBLIC HEALTH, Vol: 9
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- Citations: 3
de Heus RAA, Tzourio C, Lee EJL, et al., 2021, Association Between Blood Pressure Variability With Dementia and Cognitive Impairment: A Systematic Review and Meta-Analysis, HYPERTENSION, Vol: 78, Pages: 1478-1489, ISSN: 0194-911X
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- Citations: 35
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