Imperial College London

DrSaraAhmadi Abhari

Faculty of MedicineSchool of Public Health

Lecturer in the Epidemiology of Ageing
 
 
 
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s.ahmadi-abhari Website

 
 
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Location

 

Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Publication Type
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56 results found

Green C, Beaney T, Salman D, Robb C, de Jager Loots CA, Giannakopoulou P, Udeh-Momoh C, Ahmadi-Abhari S, Majeed A, Middleton LT, McGregor AHet al., 2023, The impacts of social restrictions during the COVID-19 pandemic on the physical activity levels of over 50-year olds: The CHARIOT COVID-19 Rapid Response (CCRR) cohort study., PLoS One, Vol: 18, ISSN: 1932-6203

OBJECTIVES: To quantify the associations between shielding status and loneliness at the start of the COVID-19 pandemic, and physical activity (PA) levels throughout the pandemic. METHODS: Demographic, health and lifestyle characteristics of 7748 cognitively healthy adults aged >50, and living in London, were surveyed from April 2020 to March 2021. The International Physical Activity Questionnaire (IPAQ) short-form assessed PA before COVID-19 restrictions, and up to 6 times over 11 months. Linear mixed models investigated associations between shielding status and loneliness at the onset of the pandemic, with PA over time. RESULTS: Participants who felt 'often lonely' at the outset of the pandemic completed an average of 522 and 547 fewer Metabolic Equivalent of Task (MET) minutes/week during the pandemic (95% CI: -809, -236, p<0.001) (95% CI: -818, -275, p<0.001) than those who felt 'never lonely' in univariable and multivariable models adjusted for demographic factors respectively. Those who felt 'sometimes lonely' completed 112 fewer MET minutes/week (95% CI: -219, -5, p = 0.041) than those who felt 'never lonely' following adjustment for demographic factors. Participants who were shielding at the outset of the pandemic completed an average of 352 fewer MET minutes/week during the pandemic than those who were not (95% CI: -432, -273; p<0.001) in univariable models and 228 fewer MET minutes/week (95% CI: -307, -150, p<0.001) following adjustment for demographic factors. No significant associations were found after further adjustment for health and lifestyle factors. CONCLUSIONS: Those shielding or lonely at pandemic onset were likely to have completed low levels of PA during the pandemic. These associations are influenced by co-morbidities and health status.

Journal article

Chen Y, Araghi M, Bandosz P, Shipley MJ, Ahmadi-Abhari S, Lobanov-Rostovsky S, Venkatraman T, Kivimaki M, O'Flaherty M, Brunner EJet al., 2023, Impact of hypertension prevalence trend on mortality and burdens of dementia and disability in England and Wales to 2060: a simulation modelling study., Lancet Healthy Longev, Vol: 4, Pages: e470-e477

BACKGROUND: Previous estimates of the impact of public health interventions targeting hypertension usually focus on one health outcome. This study aims to consider the effects of change in future hypertension prevalence on mortality, dementia, and disability simultaneously. METHODS: We modelled three plausible scenarios based on observed trends of hypertension prevalence from 2003 to 2017 in England: observed trends continue (baseline scenario); 2017 prevalence remains unchanged; and 2017 prevalence decreases by 50% by 2060. We used a probabilistic Markov model to integrate calendar trends in incidence of cardiovascular disease, dementia, disability, and mortality to forecast their future occurrence in the population of England and Wales. Assuming the hypertension prevalence trend modifies health transition probabilities, we compared mortality outcomes and the burden of dementia and disability to 2060 for the scenarios. FINDINGS: If the decline in hypertension prevalence stops, there would be a slight increase in the number of additional deaths to 2060 (22·9 [95% uncertainty interval 19·0-26·6] more deaths per 100 000 population), although the burdens of disability and dementia in absolute terms would change little. Alternatively, if the downward hypertension prevalence trend accelerates (with prevalence falling by 50% between 2017 and 2060), there would be a modest additional reduction in deaths (57·0 [50·4-63·5] fewer deaths per 100 000 population), a small increase in dementia burden (9·0 [5·1-13·2] more cases per 100 000 population), no significant effect on disability burden, and an 8% gain in healthy life expectancy at age 65 years from 2020 to 2060 (5·3 years vs 4·9 years) compared with the baseline scenario. INTERPRETATION: The major future impact of alternative hypertension prevention strategies appears to be on future life expectancy. The salutary effect of lo

Journal article

Zheng B, Su B, Ahmadi-Abhari S, Kapogiannis D, Tzoulaki I, Riboli E, Middleton Let al., 2023, Dementia risk in patients with type 2 diabetes: Comparing metformin with no pharmacological treatment, ALZHEIMERS & DEMENTIA, ISSN: 1552-5260

Journal article

Zheng B, Udeh-Momoh C, Watermeyer T, Loots C, Ford J, Robb C, Giannakopoulou E-M, Ahmadi-Abhari S, baker S, Novak G, Price Get al., 2022, Practice effect of repeated cognitive tests among older adults: associations with brain amyloid pathology and other influencing factors., Frontiers in Neuroscience, Vol: 14, ISSN: 1662-453X

Background: Practice effects (PE), after repeated cognitive measurements, may mask cognitive decline and represent a challengein clinical and research settings. However, an attenuated practice effect may indicate the presence of brain pathologies. This studyaimed to evaluate practice effects on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scale, andtheir associations with brain amyloid status and other factors in a cohort of cognitively unimpaired older adults enrolled in theCHARIOT-PRO SubStudy.Methods: 502 cognitively unimpaired participants aged 60-85 years were assessed with RBANS in both screening and baseline clinicvisits using alternate versions (median time gap of 3.5 months). We tested PE based on differences between test and retest scoresin total scale and domain-specific indices. Multiple linear regressions were used to examine factors influencing PE, after adjustingfor age, sex, education level, APOE‐ε4 carriage and initial RBANS score. The latter and PE were also evaluated as predictors foramyloid positivity status based on defined thresholds, using logistic regression.Results: Participants’ total scale, immediate memory and delayed memory indices were significantly higher in the second test thanin the initial test (Cohen’s dz = 0.48, 0.70 and 0.35, P < 0.001). On the immediate memory index, the PE was significantly lower inthe amyloid positive group than the amyloid negative group (P = 0.022). Older participants (≥ 70 years), women, non‐APOE‐ε4carriers, and those with worse initial RBANS test performance had larger PE. No associations were found between brain MRIparameters and PE. In addition, attenuated practice effects in immediate or delayed memory index were independent predictorsfor amyloid positivity (P < 0.05).Conclusion: Significant practice effects on RBANS total scale and memory indices were identified in cognitively unimpaired olderadults. The association with amyloid sta

Journal article

Valencia-Hernandez CA, Lindbohm J, Shipley MJ, Wilkinson IB, McEniery CM, Ahmadi-Abhari S, Singh-Manoux A, Kivimaki M, Brunner EJet al., 2022, Aortic Pulse Wave Velocity as Adjunct Risk Marker for Assessing Cardiovascular Disease Risk: Prospective Study, HYPERTENSION, Vol: 79, Pages: 836-843, ISSN: 0194-911X

Journal article

Abbott K, Posma JM, Garcia Perez I, Udeh-Momoh C, Ahmadi-Abhari S, Middleton L, Frost Get 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.

Journal article

Zheng B, Su B, Udeh-Momoh C, Price G, Tzoulaki I, Vamos EP, Majeed A, Riboli E, Ahmadi-Abhari S, Middleton LTet al., 2022, Associations of cardiovascular and non-cardiovascular comorbidities with dementia risk in patients with diabetes: results from a large UK cohort study, JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE, Vol: 9, Pages: 86-91, ISSN: 2274-5807

BackgroundType 2 diabetes (T2D) is an established risk factor for dementia. However, it remains unclear whether the presence of comorbidities could further increase dementia risk in diabetes patients.ObjectivesTo examine the associations between cardiovascular and non-cardiovascular comorbidities and dementia risk in T2D patients.DesignPopulation-based cohort study.SettingThe UK Clinical Practice Research Datalink (CPRD).Participants489,205 T2D patients aged over 50 years in the UK CPRD.MeasurementsMajor cardiovascular and non-cardiovascular comorbidities were extracted as time-varying exposure variables. The outcome event was dementia incidence based on dementia diagnosis or dementia-specific drug prescription.ResultsDuring a median of six years follow-up, 33,773 (6.9%) incident dementia cases were observed. Time-varying Cox regressions showed T2D patients with stroke, peripheral vascular disease, atrial fibrillation, heart failure or hypertension were at higher risk of dementia compared to those without such comorbidities (HR [95% CI] = 1.64 [1.59–1.68], 1.37 [1.34–1.41], 1.26 [1.22–1.30], 1.15 [1.11–1.20] or 1.10 [1.03–1.18], respectively). Presence of chronic obstructive pulmonary disease or chronic kidney disease was also associated with increased dementia risk (HR [95% CI] = 1.05 [1.01–1.10] or 1.11 [1.07–1.14]).ConclusionsA range of cardiovascular and non-cardiovascular comorbidities were associated with further increases of dementia risk in T2D patients. Prevention and effective management of these comorbidities may play a significant role in maintaining cognitive health in T2D patients.

Journal article

Collins B, Bandosz P, Guzman-Castillo M, Pearson-Stuttard J, Stoye G, McCauley J, Ahmadi-Abhari S, Araghi M, Shipley MJ, Capewell S, French E, Brunner EJ, O'Flaherty Met al., 2022, What will the cardiovascular disease slowdown cost? Modelling the impact of CVD trends on dementia, disability, and economic costs in England and Wales from 2020-2029., PLoS One, Vol: 17

BACKGROUND: There is uncertainty around the health impact and economic costs of the recent slowing of the historical decline in cardiovascular disease (CVD) incidence and the future impact on dementia and disability. METHODS: Previously validated IMPACT Better Ageing Markov model for England and Wales, integrating English Longitudinal Study of Ageing (ELSA) data for 17,906 ELSA participants followed from 1998 to 2012, linked to NHS Hospital Episode Statistics. Counterfactual design comparing two scenarios: Scenario 1. CVD Plateau-age-specific CVD incidence remains at 2011 levels, thus continuing recent trends. Scenario 2. CVD Fall-age-specific CVD incidence goes on declining, following longer-term trends. The main outcome measures were age-related healthcare costs, social care costs, opportunity costs of informal care, and quality adjusted life years (valued at £60,000 per QALY). FINDINGS: The total 10 year cumulative incremental net monetary cost associated with a persistent plateauing of CVD would be approximately £54 billion (95% uncertainty interval £14.3-£96.2 billion), made up of some £13 billion (£8.8-£16.7 billion) healthcare costs, £1.5 billion (-£0.9-£4.0 billion) social care costs, £8 billion (£3.4-£12.8 billion) informal care and £32 billion (£0.3-£67.6 billion) value of lost QALYs. INTERPRETATION: After previous, dramatic falls, CVD incidence has recently plateaued. That slowdown could substantially increase health and social care costs over the next ten years. Healthcare costs are likely to increase more than social care costs in absolute terms, but social care costs will increase more in relative terms. Given the links between COVID-19 and cardiovascular health, effective cardiovascular prevention policies need to be revitalised urgently.

Journal article

Udeh-Momoh C, Watermeyer T, Sindi S, Giannakopoulou P, Robb C, Ahmadi Abhari S, Zheng B, Waheed A, McKeand E, Salman D, Beaney T, Loots C, Price G, Atchison C, Car J, Majeed A, McGregor A, Kivipelto M, Ward H, Middleton Let 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

Journal article

Ahmadi Abhari S, Bandosz P, Kivimaki M, Middleton Let al., 2021, Impact of COVID19 on years of life lost with and without disability across 18 European-countries, World Congress of Epidemiology (WCE)

Conference paper

Valencia-Hernandez CA, McEniery C, Wilkinson I, Lindbohm JV, Ahmadi-Abhari S, Shipley MJ, Brunner EJet al., 2021, AORTIC STIFFNESS AS A RISK FACTOR FOR DECLINE IN PHYSICAL FUNCTIONING IN THE WHITEHALL II STUDY, Publisher: BMJ PUBLISHING GROUP, Pages: A56-A57, ISSN: 0143-005X

Conference paper

Salman D, Beaney T, Robb C, Loots CADJ, Giannakopoulou P, Udeh-Momoh C, Ahmadi Abhari S, Majeed F, Middleton LT, McGregor AHet 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

Journal article

Zheng B, Su B, Price G, Tzoulaki I, Ahmadi-Abhari S, Middleton Let al., 2021, Glycemic control, diabetic complications, and risk of dementia in patients with diabetes: results from a large UK cohort study, Diabetes Care, Vol: 44, Pages: 1556-1563, ISSN: 0149-5992

OBJECTIVE Type 2 diabetes is an established risk factor for dementia. However, the roles of glycemic control and diabetic complications in the development of dementia have been less well substantiated. This large-scale cohort study aims to examine associations of longitudinal HbA1c levels and diabetic complications with the risk of dementia incidence among patients with type 2 diabetes.RESEARCH DESIGN AND METHODS Data of eligible patients with diabetes, aged ≥50 years in the U.K. Clinical Practice Research Datalink from 1987 to 2018, were analyzed. Time-varying Cox regressions were used to estimate adjusted hazard ratios (HRs) and 95% CIs for dementia risk.RESULTS Among 457,902 patients with diabetes, 28,627 (6.3%) incident dementia cases were observed during a median of 6 years’ follow-up. Patients with recorded hypoglycemic events or microvascular complications were at higher risk of dementia incidence compared with those without such complications (HR 1.30 [95% CI 1.22–1.39] and 1.10 [1.06–1.14], respectively). The HbA1c level, modeled as a time-varying exposure, was associated with increased dementia risk (HR 1.08 [95% CI 1.07–1.09] per 1% HbA1c increment) among 372,287 patients with diabetes with postdiagnosis HbA1c records. Similarly, a higher coefficient of variation of HbA1c during the initial 3 years of follow-up was associated with higher subsequent dementia risk (HR 1.03 [95% CI 1.01–1.04] per 1-SD increment).CONCLUSIONS Higher or unstable HbA1c levels and the presence of diabetic complications in patients with type 2 diabetes are associated with increased dementia risk. Effective management of glycemia might have a significant role in maintaining cognitive health among older adults with diabetes.

Journal article

Lindbohm J, Sipila PN, Mars N, Knuppel A, Pentti J, Nyberg ST, Frank P, Ahmadi-Abhari S, Brunner EJ, Shipley MJ, Singh-Manoux A, Tabak AG, Batty GD, Kivimaki Met al., 2021, Association between change in cardiovascular risk scores and future cardiovascular disease: analyses of data from the Whitehall II longitudinal, prospective cohort study, LANCET DIGITAL HEALTH, Vol: 3, Pages: E434-E444

Journal article

Robb C, Loots C, Ahmadi-Abhari S, Giannakopoulou P, Udeh-Momoh C, McKeand J, Price G, Car J, Majeed A, Ward H, Middleton Let 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.

Journal article

Valencia-Hernandez CA, McEniery C, Wilkinson IB, Ahmadi-Abhari S, Lindbohm J, Shipley MJ, Brunner EJet al., 2020, ARTERIAL STIFFNESS PROGRESSION AND RISK OF MAJOR ADVERSE CARDIOVASCULAR EVENTS ACCORDING TO HYPERTENSION STATUS IN A COHORT OF BRITISH CIVIL SERVANTS, Publisher: BMJ PUBLISHING GROUP, Pages: A63-A63, ISSN: 0143-005X

Conference paper

Bandosz P, Ahmadi-Abhari S, Guzman-Castillo M, Pearson-Stuttard J, Collins B, Whittaker H, Shipley MJ, Capewell S, Brunner EJ, O'Flaherty Met al., 2020, Potential impact of diabetes prevention on mortality and future burden of dementia and disability: a modelling study, DIABETOLOGIA, Vol: 63, Pages: 104-115, ISSN: 0012-186X

Journal article

Collins B, Bandosz P, Guzman-Castillo M, Pearson-Stuttard J, Stoye G, McCauley J, Ahmadi-Abhari S, Shipley MJ, Araghi M, Capewell S, French E, Brunner EJ, O'Flaherty Met al., 2019, Association between the arrested decline in cardiovascular disease and health and social-care costs: a modelling study, National Conference on Public Health Science Dedicated to New Research in UK Public Health, Publisher: ELSEVIER SCIENCE INC, Pages: 33-33, ISSN: 0140-6736

Conference paper

McRae-McKee K, Chinedu T, Udeh-Momoh CT, Price G, Sumali Bajaj S, de Jager CA, Scott D, Hadjichrysanthou C, McNaughton E, Bracoud L, Ahmadi-Abhari S, De Wolf F, Anderson R, Middleton Let 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.

Journal article

Bandosz P, Ahmadi-Abhari S, Guzman-Castillo M, Pearson-Stuttard J, Collins B, Whittaker H, Shipley MJ, Capewell S, Brunner EJ, O'Flaherty Met al., 2019, THE POTENTIAL IMPACT OF DIABETES PREVENTION ON THE FUTURE UK BURDEN OF DEMENTIA AND DISABILITY, Publisher: BMJ PUBLISHING GROUP, Pages: A22-A22, ISSN: 0143-005X

Conference paper

Collins B, Bandosz P, Guzman-Castillo M, Pearson-Stuttard J, Stoye G, McCauley J, Ahmadi-Abhari S, Shipley MJ, Capewell S, French E, Brunner EJ, O'Flaherty Met al., 2019, WILL SOCIAL CARE NEED MORE RESOURCES? A MODELLING STUDY OF HEALTH AND SOCIAL COSTS IN ENGLAND AND WALES FOR ALTERNATIVE FUTURE CARDIOVASCULAR DISEASE SCENARIOS, Publisher: BMJ PUBLISHING GROUP, Pages: A9-A9, ISSN: 0143-005X

Conference paper

Valencia-Hernandez CA, McEniery C, Wilkinson IB, Ahmadi-Abhari S, Shipley MJ, Brunner EJet al., 2019, Risk of MACE events and arterial stiffness in the Whitehall II study, Publisher: NATURE PUBLISHING GROUP, Pages: 24-25, ISSN: 0950-9240

Conference paper

Lindbohm J, Sipila PN, Mars NJ, Pentti J, Ahmadi-Abhari S, Brunner EJ, Shipley MJ, Singh-Manoux A, Tabak AG, Kivimaki Met al., 2019, 5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study, Lancet Public Health, Vol: 4, Pages: E189-E199, ISSN: 2468-2667

Background Clinical guidelines suggest preventive interventions such as statin therapy for individuals with a highestimated 10-year risk of major cardiovascular events. For those with a low or intermediate estimated risk, risk-factorscreenings are recommended at 5-year intervals; this interval is based on expert opinion rather than on direct researchevidence. Using longitudinal data on the progression of cardiovascular disease risk over time, we compared differentscreening intervals in terms of timely detection of high-risk individuals, cardiovascular events prevented, and healthcare costs.Methods We used data from participants in the British Whitehall II study (aged 40–64 years at baseline) who hadrepeated biomedical screenings at 5-year intervals and linked these data to electronic health records between baseline(Aug 7, 1991, to May 10, 1993) and June 30, 2015. We estimated participants’ 10-year risk of a major cardiovascularevent (myocardial infarction, cardiac death, and fatal or non-fatal stroke) using the revised AtheroscleroticCardiovascular Disease (ASCVD) calculator. We used multistate Markov modelling to estimate optimum screeningintervals on the basis of progression rates from low-risk and intermediate-risk categories to the high-risk category(ie, ≥7·5% 10-year risk of a major cardiovascular event). Our assessment criteria included person-years spent in ahigh-risk category before detection, the number of major cardiovascular events prevented and quality-adjusted lifeyears (QALYs) gained, and screening costs.Findings Of 6964 participants (mean age 50·0 years [SD 6·0] at baseline) with 152700 person-years of follow-up (meanfollow-up 22·0 years [SD 5·0]), 1686 participants progressed to the high-risk category and 617 had a majorcardiovascular event. With the 5-year screening intervals, participants spent 7866 (95% CI 7130–8658) person-yearsunrecognised in the high-risk group. For individuals in the low

Journal article

Valencia-Hernandez C, Ahmadi-Abhari S, Shipley MJ, McEniery C, Wilkinson I, Brunner EJet al., 2018, Hypertension control and 5-year arterial stiffness progression, Publisher: NATURE PUBLISHING GROUP, Pages: 709-709, ISSN: 0950-9240

Conference paper

Brunner EJ, Ahmadi-Abhari S, 2018, Modelling the growing need for social care in older people, LANCET PUBLIC HEALTH, Vol: 3, Pages: E414-E415, ISSN: 2468-2667

Journal article

Brunner EJ, Shipley MJ, Ahmadi-Abhari S, Hernandez CV, Abell JG, Singh-Manoux A, Kawachi I, Kivimaki Met al., 2018, Midlife contributors to socioeconomic differences in frailty during later life: a prospective cohort study, LANCET PUBLIC HEALTH, Vol: 3, Pages: E313-E322, ISSN: 2468-2667

Journal article

Ahmadi-Abhari S, Guzman-Castillo M, Bandosz P, Whittaker H, Shipley MJ, Kivimaki M, Singh-Manoux A, Capewell S, O'Flaherty M, Brunner EJet al., 2017, Impact of tobacco smoking prevalence on cardiovascular and non-cardiovascular deaths in England and Wales, 2017-40: a modelling study, Public Health Science Conference, Publisher: ELSEVIER SCIENCE INC, Pages: S16-S16, ISSN: 0140-6736

Conference paper

Guzman-Castillo M, Ahmadi-Abhari S, Bandosz P, Capewell S, Steptoe A, Singh-Manoux A, Kivamaki M, Shipley MJ, Brunner EJ, O'Flaherty Met al., 2017, FORECASTING TRENDS IN DISABILITY IN ENGLAND AND WALES TO 2030: A MODELLING STUDY, Publisher: BMJ PUBLISHING GROUP, Pages: A88-A88, ISSN: 0143-005X

Conference paper

Ahmadi-Abhari S, Sabia S, Shipley MJ, Kivimaki M, Singh-Manoux A, Tabak A, McEniery C, Wilkinson IB, Brunner EJet al., 2017, Physical Activity, Sedentary Behavior, and Long-Term Changes in Aortic Stiffness: The Whitehall II Study, JOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol: 6, ISSN: 2047-9980

Journal article

Ahmadi-Abhari S, Guzman-Castillo M, Bandosz P, Shipley MJ, Muniz-Terrera G, Singh-Manoux A, Kivimaki M, Steptoe A, Capewell S, O'Flaherty M, Brunner EJet al., 2017, Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study, BMJ-BRITISH MEDICAL JOURNAL, Vol: 358, ISSN: 1756-1833

Journal article

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