Your search for: 'author:("Brayne, Carol")' has returned 26 results. (0.016s) Save search

Authors: Brayne, Carol | Richard, Edo

Article Type: Editorial

DOI: 10.3233/JAD-190448

Citation: Journal of Alzheimer's Disease, vol. 70, no. s1, pp. S11-S14, 2019

Authors: Stephan, Blossom C.M. | Brayne, Carol

Article Type: Review Article

Abstract: Accurate detection of individuals with cognitive impairment and dementia in addition to identification of those at high risk of future disease is important to guide clinical care, and has research implications regarding clinical trial recruitment and development of dementia preventative strategies. In this narrative review, we describe new proposed criteria for early diagnosis of Alzheimer's disease (AD). We also explore risk factors for dementia and evaluate methods for screening for increased risk of incident disease. We highlight variability in different diagnostic approaches. Additional work needs to be done to validate new methods across different settings (such as population-based, primary care, …and memory clinics), age, and ethnic groups. Having an accurate method to assess for dementia and predict risk in routine clinical care will aid decision making and could ultimately lead to disease prevention. Show more

Keywords: Alzheimer's disease, cognition, dementia, early diagnosis, screening

DOI: 10.3233/JAD-141413

Citation: Journal of Alzheimer's Disease, vol. 42, no. s4, pp. S329-S338, 2014

Authors: Hunter, Sally | Smailagic, Nadja | Brayne, Carol

Article Type: Review Article

Abstract: Alzheimer’s disease (AD) is a clinicopathologically defined syndrome leading to cognitive impairment. Following the recent failures of amyloid-based randomized controlled trials to change the course of AD, there are growing calls for a re-evaluation of basic AD research. Epidemiology offers one approach to integrating the available evidence. Here we examine relationships between evidence from population-based, clinicopathological studies of brain aging and a range of hypotheses from all areas of AD research. We identify various problems, including a lack of systematic approach to measurement of clinical and neuropathological factors associated with dementia in experimental and clinical settings, poor understanding of the …strengths and weaknesses of different observational and experimental designs, a lack of clarity in relation to disease definitions from the clinical, neuropathological, and molecular perspectives, inadequate characterization of brain aging in the human population, difficulties in translation between laboratory-based and population-based evidence bases, and a lack of communication between different sections of the dementia research community. Population studies highlight complexity and predict that therapeutic approaches based on single disease features will not be successful. Better characterization of brain aging in the human population is urgently required to select biomarkers and therapeutic targets that are meaningful to human disease. The generation of detailed and reliable evidence must be addressed before progress toward therapeutic interventions can be made. Show more

Keywords: Age, Alzheimer’s disease, amyloid-β protein, amyloid-β protein precursor, experimental design, population study, risk factors

DOI: 10.3233/JAD-179927

Citation: Journal of Alzheimer's Disease, vol. 64, no. s1, pp. S119-S143, 2018

Authors: Smailagic, Nadja | Lafortune, Louise | Kelly, Sarah | Hyde, Chris | Brayne, Carol

Article Type: Research Article

Abstract: Background: A previous Cochrane systematic review concluded there is insufficient evidence to support the routine use of 18 F-FDG PET in clinical practice in people with mild cognitive impairment (MCI). Objectives: To update the evidence and reassess the accuracy of 18 F-FDG-PET for detecting people with MCI at baseline who would clinically convert to Alzheimer’s disease (AD) dementia at follow-up. Methods: A systematic review including comprehensive search of electronic databases from January 2013 to July 2017, to update original searches (1999 to 2013). All key review steps, including quality assessment using QUADAS 2, were performed independently and blindly by two …review authors. Meta-analysis could not be conducted due to heterogeneity across studies. Results: When all included studies were examined across all semi-quantitative and quantitative metrics, exploratory analysis for conversion of MCI to AD dementia (n = 24) showed highly variable accuracy; half the studies failed to meet four or more of the seven sets of QUADAS 2 criteria. Variable accuracy for all metrics was also found across eleven newly included studies published in the last 5 years (range: sensitivity 56–100%, specificity 24–100%). The most consistently high sensitivity and specificity values (approximately ≥80%) were reported for the sc-SPM (single case statistical parametric mapping) metric in 6 out of 8 studies. Conclusion: Systematic and comprehensive assessment of studies of 18 FDG-PET for prediction of conversion from MCI to AD dementia reveals many studies have methodological limitations according to Cochrane diagnostic test accuracy gold standards, and shows accuracy remains highly variable, including in the most recent studies. There is some evidence, however, of higher and more consistent accuracy in studies using computer aided metrics, such as sc-SPM, in specialized clinical settings. Robust, methodologically sound prospective longitudinal cohort studies with long (≥5 years) follow-up, larger consecutive samples, and defined baseline threshold(s) are needed to test these promising results. Further evidence of the clinical validity and utility of 18 F-FDG PET in people with MCI is needed. Show more

Keywords: Accuracy, Alzheimer’s disease dementia, conversion, 18F-FDG PET, mild cognitive impairment, test predictive value

DOI: 10.3233/JAD-171125

Citation: Journal of Alzheimer's Disease, vol. 64, no. 4, pp. 1175-1194, 2018

Authors: Hayat, Shabina A. | Luben, Robert | Khaw, Kay-Tee | Brayne, Carol

Article Type: Research Article

Abstract: Background: Exploring the domains of cognitive function which are most strongly associated with future dementia may help with understanding risk factors for, and the natural history of dementia. Objective: To examine the association of performance on a range of cognitive tests (both global and domain specific) with subsequent diagnosis of dementia through health services in a population of relatively healthy men and women and risk of future dementia. Methods: We examined the association between performance on different cognitive tests as well as a global score and future dementia risk ascertained through health record linkage in a cohort of 8,581 individuals …(aged 48–92 years) between 2004–2019 with almost 15 years follow-up (average of 10 years) before and after adjustment for socio-demographic, lifestyle, and health characteristics. Results: Those with poor performance for global cognition (bottom 10%) were almost four times as likely to receive a dementia diagnosis from health services over the next 15 years than those who performed well HR = 3.51 (95% CI 2.61, 4.71 p  < 0.001) after adjustment for socioeconomic, lifestyle, and biological factors and also prevalent disease. Poor cognition performance in multiple tests was associated with 10-fold increased risk compared to those not performing poorly in any test HR = 10.82 (95% CI 6.85, 17.10 p  < 0.001). Conclusion: Deficits across multiple cognitive domains substantially increase risk of future dementia over and above neuropsychological test scores ten years prior to a clinical diagnosis. These findings may help further understanding of the natural history of dementia and how such measures could contribute to strengthening future models of dementia. Show more

Keywords: Cognition, dementia, epidemiology, risk

DOI: 10.3233/JAD-210030

Citation: Journal of Alzheimer's Disease, vol. 81, no. 1, pp. 123-135, 2021

Authors: D'Alton, Simon | Hunter, Sally | Whitehouse, Peter | Brayne, Carol | George, Daniel

Article Type: Research Article

Abstract: For the last several decades, Alzheimer's disease (AD) has been widely regarded as a late life event, but is now being redefined as a chronic condition that develops over decades. Concurrently, a preponderance of evidence emerging from basic and clinical research in diverse fields such as cardiovascular, endocrine, and mental health has suggested that the environmental component of clinical AD is not only multifactorial in populations and in individuals, but is also modifiable across the life-course, from conception until death. Re-conceptualizing the environmental component of AD to account for these observations necessitates an approach to brain health that eschews singular, …short- and medium-term methodology and instead reflects long-term complexity. Such thinking is consistent with the ecological models of public health, which emphasize the development of community infrastructure that can foster population and individual health over the life-course by minimizing risk through multifaceted, systemic approaches. Show more

Keywords: Alzheimer's disease, amyloid, dementia, epidemiology, public heath, risk factors, social policy

DOI: 10.3233/JAD-140213

Citation: Journal of Alzheimer's Disease, vol. 42, no. 4, pp. 1151-1163, 2014

Authors: Yang, Zhirong | Edwards, Duncan | Burgess, Stephen | Brayne, Carol | Mant, Jonathan

Article Type: Research Article

Abstract: Background: Prior atherosclerotic cardiovascular disease (ASCVD), including coronary heart disease (CHD) and peripheral artery disease (PAD), are common among patients with stroke, a known risk factor for dementia. However, whether these conditions further increase the risk of post-stroke dementia remains uncertain. Objective: To examine whether prior ASCVD is associated with increased risk of dementia among stroke patients. Methods: A retrospective cohort study was conducted using the Clinical Practice Research Datalink with linkage to hospital data. Patients with first-ever stroke between 2006 and 2017 were followed up to 10 years. We used multi-variable Cox regression models to examine the associations of …prior ASCVD with dementia and the impact of prior ASCVD onset and duration. Results: Among 63,959 patients, 7,265 cases (11.4%) developed post-stroke dementia during a median of 3.6-year follow-up. The hazard ratio (HR) of dementia adjusted for demographics and lifestyle was 1.18 (95% CI: 1.12–1.25) for ASCVD, 1.16 (1.10–1.23) for CHD, and 1.25 (1.13–1.37) for PAD. The HRs additionally adjusted for multimorbidity and medications were 1.07 (1.00–1.13), 1.04 (0.98–1.11), and 1.11 (1.00–1.22), respectively. Based on the fully adjusted estimates, there was no linear relationship between the age of ASCVD onset and post-stroke dementia (all p-trend >0.05). The adjusted risk of dementia was not increased with the duration of pre-stroke ASCVD (all p-trend >0.05). Conclusion: Stroke patients with prior ASCVD are more likely to develop subsequent dementia. After full adjustment for confounding, however, the risk of post-stroke dementia is attenuated, with only a slight increase with prior ASCVD. Show more

Keywords: Atherosclerotic cardiovascular disease, cohort study, coronary artery disease, dementia, peripheral arterial disease, stroke

DOI: 10.3233/JAD-200536

Citation: Journal of Alzheimer's Disease, vol. 77, no. 3, pp. 1157-1167, 2020

Authors: Evans, Isobel E.M. | Martyr, Anthony | Collins, Rachel | Brayne, Carol | Clare, Linda

Article Type: Research Article

Abstract: Background: There is some evidence to suggest that social isolation may be associated with poor cognitive function in later life. However, findings are inconsistent and there is wide variation in the measures used to assess social isolation. Objective: We conducted a systematic review and meta-analysis to investigate the association between social isolation and cognitive function in later life. Methods: A search for longitudinal studies assessing the relationship between aspects of social isolation (including social activity and social networks) and cognitive function (including global measures of cognition, memory, and executive function) was conducted in PsycInfo, CINAHL, PubMed, and AgeLine. A random …effects meta-analysis was conducted to assess the overall association between measures of social isolation and cognitive function. Sub-analyses investigated the association between different aspects of social isolation and each of the measures of cognitive function. Results: Sixty-five articles were identified by the systematic review and 51 articles were included in the meta-analysis. Low levels of social isolation characterized by high engagement in social activity and large social networks were associated with better late-life cognitive function (r  = 0.054, 95% CI: 0.043, 0.065). Sub-analyses suggested that the association between social isolation and measures of global cognitive function, memory, and executive function were similar and there was no difference according to gender or number of years follow-up. Conclusions: Aspects of social isolation are associated with cognitive function in later life. There is wide variation in approaches to measuring social activity and social networks across studies which may contribute to inconsistencies in reported findings. Show more

Keywords: Aging, cognition, cognitive reserve, social isolation

DOI: 10.3233/JAD-180501

Citation: Journal of Alzheimer's Disease, vol. 70, no. s1, pp. S119-S144, 2019

Authors: Seblova, Dominika | Brayne, Carol | Machů, Vendula | Kuklová, Marie | Kopecek, Miloslav | Cermakova, Pavla

Article Type: Research Article

Abstract: Background: Studies from North America and Western Europe suggest stable or declining trends in impaired cognition across birth cohorts. Objective: We aimed to examine changes in the age-specific prevalence of cognitive impairment in the Czech Republic. Methods: The study used two samples from the population-based Czech Survey on Health, Ageing and Retirement in Europe. Age-specific prevalence of cognitive impairment (defined based on scores in verbal fluency, immediate recall, delayed recall, and temporal orientation) was compared between participants in wave 2 (2006/2007; n  = 1,107) and wave 6 (2015; n  = 3,104). Logistic regression was used to estimate the association between the wave …and cognitive impairment, step-wise adjusting for sociodemographic and clinical characteristics. Multiple sensitivity analyses, focusing on alternative operationalizations of relative cognitive impairment, impact of missing cognitive data, and survival bias, were carried out. Results: The most conservative estimate suggested that the age-specific prevalence of cognitive impairment declined by one fifth, from 11% in 2006/2007 to 9% in 2015. Decline was observed in all sensitivity analyses. The change was associated with differences in physical inactivity, management of high blood cholesterol, and increases in length education. Conclusion: Older adults in the Czech Republic, a country situated in the Central and Eastern European region, have achieved positive developments in cognitive aging. Longer education, better management of cardiovascular factors, and reduced physical inactivity seem to be of key importance. Show more

Keywords: Alzheimer’s disease, cognitive impairment, Czech Republic, epidemiology, prevalence, trends

DOI: 10.3233/JAD-190688

Citation: Journal of Alzheimer's Disease, vol. 72, no. 3, pp. 693-701, 2019

Authors: Muzambi, Rutendo | Bhaskaran, Krishnan | Brayne, Carol | Davidson, Jennifer A. | Smeeth, Liam | Warren-Gash, Charlotte

Article Type: Research Article

Abstract: Background: Bacterial infections may be associated with dementia, but the temporality of any relationship remains unclear. Objectives: To summarize existing literature on the association between common bacterial infections and the risk of dementia and cognitive decline in longitudinal studies. Methods: We performed a comprehensive search of 10 databases of published and grey literature from inception to 18 March 2019 using search terms for common bacterial infections, dementia, cognitive decline, and longitudinal study designs. Two reviewers independently performed the study selection, data extraction, risk of bias and overall quality assessment. Data were summarized through a narrative synthesis as high heterogeneity precluded …a meta-analysis. Results: We identified 3,488 studies. 9 met the eligibility criteria; 6 were conducted in the United States and 3 in Taiwan. 7 studies reported on dementia and 2 investigated cognitive decline. Multiple infections were assessed in two studies. All studies found sepsis (n  = 6), pneumonia (n  = 3), urinary tract infection (n  = 1), and cellulitis (n  = 1) increased dementia risk (HR 1.10; 95% CI 1.02–1.19) to (OR 2.60; 95% CI 1.84–3.66). The range of effect estimates was similar when limited to three studies with no domains at high risk of bias. However, the overall quality of evidence was rated very low. Studies on cognitive decline found no association with infection but had low power. Conclusion: Our review suggests common bacterial infections may be associated with an increased risk of subsequent dementia, after adjustment for multiple confounders, but further high-quality, large-scale longitudinal studies, across different healthcare settings, are recommended to further explore this association. Show more

Keywords: Cognition, dementia, infections, prevention, systematic review, Systematic review registration number: CRD42018119294, registered in December 2018

DOI: 10.3233/JAD-200303

Citation: Journal of Alzheimer's Disease, vol. 76, no. 4, pp. 1609-1626, 2020