Publications

All publications by Anja Leist

Our research in the Cognitive Ageing project

17 December 2024

The CRISP project has come to an end on 31 July 2024, but there are still milestones to celebrate!

  • Our emulated trial on hearing aid use to mitigate dementia risk associated with hearing loss is now in press at American Journal of Epidemiology. doi: 10.1093/aje/kwae452 (lead: Jure Mur)
  • Jung Hyun Kim‘s doctoral chapter on the unintended effects of a large minimum wage increase on health: Evidence from South Korea is now in press at Social Science & Medicine.
  • Our analysis of the associations of socioeconomic position with structural brain damage and connectivity and cognitive functioning: The Maastricht Study is now published at Social Science & Medicine. doi: 10.1016/j.socscimed.2024.117111 (lead: Anouk Geraets)
  • The analysis of determinants of cognitive trajectories over 15 years in a low-educated sample is now published in Archives of Gerontology and Geriatrics. doi: 10.1016/j.archger.2024.105555 (thanks to lead author Dr Fabiana Ribeiro!)

We are still working on a number of other projects, among others:

  • The interaction between metabolic markers and menopausal factors and risk of dementia (lead: Anouk Geraets)
  • Improving algorithmic ‘probable dementia’ classification for racial/ethnic groups with transfer learning (lead: Jung Hyun Kim)

Please get in touch for more information.

Time to share new CRISP publications!

Congratulations to the lead authors who did a great job on these papers.

7 June 2024

With – now graduated – Dr Matthias Klee as lead, we have published the validation of the Langa-Weir algorithm in the Survey of Health, Ageing and Retirement in Europe against a number of machine-learning algorithms:

Klee, M., Langa, K. M., & Leist, A. K. (2024). Performance of probable dementia classification in a European multi-country survey. Scientific Reports, 14(1), 6657.https://doi.org/10.1038/s41598-024-56734-7

Again with Dr Matthias Klee as lead, we tested the mediating role of gut microbiome characteristica on the link between education and Mild Cognitive Impairment:

Klee, M., Aho, V. T. E., May, P., Heintz-Buschart, A., Landoulsi, Z., Jónsdóttir, S. R., … & Zelimkhanov, G. (2024). Education as Risk Factor of Mild Cognitive Impairment: The Link to the Gut Microbiome. The Journal of Prevention of Alzheimer’s Disease, 1-10. https://doi.org/10.14283/jpad.2024.19
Some other recent research works

Congratulations to Dr Velma Aho who led the investigation to test if gut microbiome characteristica are different in mild cognitive impairment in Parkinson’s Disease:

Aho, V. T., Klee, M., Landoulsi, Z., Heintz-Buschart, A., Pavelka, L., Leist, A. K., … & Wilmes, P. (2024). Gut microbiome is not associated with mild cognitive impairment in Parkinson’s disease. npj Parkinson’s Disease, 10(1), 78. https://doi.org/10.1038/s41531-024-00687-1

Finally, congratulations to Dr Laura Arbelaez Ossa who led an investigation on the discourse about AI in different governmental and intergovernmental guidelines on AI in healthcare:

Arbelaez Ossa, L., Milford, S. R., Rost, M., Leist, A. K., Shaw, D. M., & Elger, B. S. (2024). AI Through Ethical Lenses: A Discourse Analysis of Guidelines for AI in Healthcare. Science and Engineering Ethics, 30(3), 24. https://doi.org/10.1007/s11948-024-00486-0

Dementia prevention – where is the science and what are the implications?

Article for the general public.

Anja K. Leist

The Ministry of Health, Welfare and Sport of the Netherlands, in collaboration with the World Dementia Council, has published a collection of essays on defeating dementia in September 2023.

Anja contributed an essay on the state of knowledge in dementia prevention. You can find this essay and the whole collection here.

Does (re-)entering the labour market at advanced ages protect against cognitive decline? A matching difference-in-differences approach

Jung Hyun Kim, Graciela Muniz-Terrera, Anja K. Leist
Jung Hyun is a doctoral researcher on the CRISP project.
Journal of Epidemiology & Community Health

20 June 2023 http://dx.doi.org/10.1136/jech-2022-220197

While prolonged labour market participation becomes increasingly important in ageing societies, evidence on the impacts of entering or exiting work beyond age 65 on cognitive functioning is scarce. This study used data from two large population-representative data sets from South Korea and the USA to investigate and compare the effects of the labour market (re-)entry and exit by matching employment and other confounder trajectories prior to the exposure. We chose the Korean Longitudinal Study of Aging (N=1872, 2006–2020) for its exceptionally active labour participation in later life and the Health and Retirement Study (N=4070, 2006–2020) for its growing inequality among US older adults in labour participation. We use the matching difference-in-differences (DID) method, which allows us to make causal claims by reducing biases through matching. We found general positive effects of entering the labour market in South Korea, while in the USA we didn’t find such benefits. Exiting the late-life labour market leads to cognitive decline in both South Korea and the USA. Findings suggest that Korean participants cognitively benefited from late-life labour market participation, while US participants did not. Differences in participant characteristics and reasons for labour market participation may have led to the differential findings.

Gender inequalities as contributors to dementia in Latin America and the Caribbean: what factors are missing from research?

Fabiana S. Ribeiro, Lucía Crivelli, & Anja K. Leist
The Lancet Healthy Longevity

June 2023, https://doi.org/10.1016/S2666-7568(23)00052-1

Fabiana Ribeiro is a postdoctoral researcher in the CRISP project.

 

The current knowledge of modifiable risk factors for dementia comes mainly from high-income countries. In Latin America and Caribbean countries, where the burden of gender and socioeconomic inequalities is greater than in high-income countries, the prevalence of dementia is also higher and disease onset is earlier, especially among women, even after adjustments for life expectancy. In this Personal View, we discuss socioeconomic modifiable risk factors for dementia established by previous studies and postulate further harmful and often hidden factors faced by women that might influence the gender-specific timing of onset and general prevalence of dementia. We emphasise some of the effects of gender roles, their direct and indirect effects on dementia, and how they disproportionately impact women. Finally, we highlight the importance of bringing hidden risk factors to open discussion to promote research with high-quality data and to encourage public policies to promote and preserve women’s health.

Picture (c) Marianna Smiley, Unsplash

Gendered life courses and cognitive functioning in later life: the role of context-specific gender norms and lifetime employment

Ariane Bertogg, Anja K. Leist
European Journal of Ageing

30 March 2023 https://doi.org/10.1007/s10433-023-00751-4

With increasing life expectancy, dementia poses an epidemiological challenge. As a cure has not been developed, the investigation into preventive factors becomes pivotal. Previous research emphasizes the cognitively stimulating and socio-emotional benefits of lifetime employment, but research on heterogeneous patterns across social groups and societal contexts remains sparse. Sociological approaches have a promising potential to provide insights into health inequalities and can contribute to the study of this major societal challenge. We investigate the influence of previous employment biographies on cognitive functioning for men and women aged 50 to 75 in 19 European countries, using longitudinal and retrospective information from the Survey of Health, Ageing and Retirement in Europe. We link individual information on employment biographies and cognitive functioning to contextual measures of gender norms, using aggregated agreement rates to both men’s and women’s role in employment and family. We find that previous employment affects cognitive functioning men and women differently. Part-time employment is beneficial for women’s cognitive functioning, but not for men’s. Traditional gender norms are associated with lower levels of cognitive functioning for both genders and moderate the linkage between previous employment and cognitive functioning. In contexts with more traditional gender norms, men’s part-time employment is associated with lower and women’s part-time employment with higher cognitive functioning. We conclude that employment and non-employment participation can, depending on characteristics of individuals and contexts, benefit or hinder the life-course accumulation of cognitive reserve, and those with norm-deviating behaviour are disadvantaged.

Sex/gender and socioeconomic differences in modifiable risk factors for dementia

Anouk F. J. Geraets & Anja K. Leist
Scientific Reports

5 January 2023

Anouk Geraets is a postdoctoral researcher in the CRISP project.

Code for the statistical analyses on GitHub

Both sex/gender and socioeconomic differences have been reported in the prevalence of modifiable risk factors for dementia. However, it remains unclear whether the associations between modifiable risk factors for dementia and incident dementia differ by sex/gender or socioeconomic status. This study aimed to investigate sex/gender and socioeconomic differences in the associations of modifiable risk factors with incident dementia using a life-course perspective.

We used data from the English Longitudinal Study of Ageing (2008/2009 to 2018/2019). A total of 8,941 individuals were included [mean (standard deviation) age, 66.1 ± 9.8 years; 4,935 (55.2%) were women]. No overall sex/gender difference in dementia risk was found. Dementia risk was higher among those who experienced childhood deprivation [hazard ratio (HR) = 1.51 (1.17; 1.96)], lower occupational attainment [HR low versus high = 1.60 (1.23; 2.09) and HR medium versus high = 1.53 (1.15; 2.06)], and low wealth [HR low versus high = 1.63 (1.26; 2.12)]. Though different associations were found among the subgroups, there might be a sex/gender difference in dementia risk only for low cognitive activity, suggesting a higher risk for women [HR = 2.61 (1.89; 3.60)] compared to men [HR = 1.73 (1.20; 2.49)].

No consistent socioeconomic differences in modifiable dementia risk were found. A population-based approach that tackles inequalities in dementia risk profiles directly may be more effective than individual approaches in dementia prevention.

Mapping of machine learning approaches for description, prediction, and causal inference in the social and health sciences

Anja K. Leist, Matthias Klee, Jung Hyun Kim, David H. Rehkopf, Stéphane P. A. Bordas, Graciela Muniz-Terrera & Sara Wade
Science Advances

19 October 2022 https://doi.org/10.1126/sciadv.abk1942

Machine learning (ML) methodology used in the social and health sciences needs to fit the intended research purposes of description, prediction, or causal inference. This paper provides a comprehensive, systematic meta-mapping of research questions in the social and health sciences to appropriate ML approaches by incorporating the necessary requirements to statistical analysis in these disciplines. We map the established classification into description, prediction, counterfactual prediction, and causal structural learning to common research goals, such as estimating prevalence of adverse social or health outcomes, predicting the risk of an event, and identifying risk factors or causes of adverse outcomes, and explain common ML performance metrics. Such mapping may help to fully exploit the benefits of ML while considering domain-specific aspects relevant to the social and health sciences and hopefully contribute to the acceleration of the uptake of ML applications to advance both basic and applied social and health sciences research.

Figure (c) Matthias Klee, https://doi.org/10.1126/sciadv.abk1942

Prevalence of dementia in Latin America and Caribbean countries: Systematic review and meta-analyses exploring age, sex, rurality, and education as possible determinants

Fabiana Ribeiro, Ana Carolina Teixeira Santos, Paulo Caramelli, & Anja K. Leist
Aging Research Reviews

3 August 2022, https://doi.org/10.1016/j.arr.2022.101703

Fabiana Ribeiro is a postdoctoral researcher in the CRISP project.

What is the rate of dementia in Latin America and the Caribbean? What are the differences by sex/gender, education, and which risk factors are associated with cognitive impairment? Fabiana Ribeiro, postdoc researcher in the CRISP project, has led three publications to understand social and behavioral determinants of cognitive ageing in the lower-resource settings of Brazil and Latin America at large. This meta-analysis is the most comprehensive assessment of the prevalence of dementia in Latin America and the Caribbean.

Earlier research suggested that the prevalence of dementia in Latin America and the Caribbean (LAC) may be higher than in high-income countries. We explored sex, education and urban vs rural residence as determinants that may lead to this disparity in LAC countries. We searched Pubmed, Web of Knowledge, Scopus, Lilacs, and SciELO for studies on dementia in LAC countries published in English, Spanish, and Portuguese. Random-effects models were applied.

Thirty-one studies from 17 LAC countries were included. Pooled prevalence of all-cause dementia was 10.66%. Further analyses with studies providing raw prevalence by sex, area, and educational level showed a higher prevalence for women (8.97%) than for men (7.26%). Also, dementia prevalence was higher for rural than urban residents (7.71% vs 8.68%, respectively). Participants without formal education presented more than double the prevalence of dementia (21.37%) compared to those with at least one year of formal education (9.88%). Studies with more recent data collection showed higher dementia prevalence.

Our findings suggest a high global dementia prevalence in LAC countries and an unequal burden of dementia for women, lower-educated, and rural residents. Secular increases in dementia prevalence call for greater public health efforts for preventative actions.

This study has been published as pre-print: https://www.medrxiv.org/content/10.1101/2021.10.15.21265054v1

Childhood Socioeconomic Disadvantage and Pathways to Memory Performance in Mid to Late Adulthood: What Matters Most?

Katherine J. Ford, Lindsay C. Kobayashi, & Anja K. Leist
Journals of Gerontology: Social Sciences

18 May 2022, https://doi.org/10.1093/geronb/gbac075

Code on GitHub

Katherine Ford is a postdoc at Carleton University who did her PhD affiliated with the CRISP project at the Doctoral Training Unit MINLAB. This is one of the three papers constituting her PhD project.

Adults who grew up in disadvantaged childhood conditions consistently show lower cognitive function in later life. Katherine investigated which aspects of childhood socioeconomic disadvantage were most relevant for memory performance in mid-to-late adulthood, namely, lower-skilled occupation of the primary breadwinner, having few books in the home, overcrowding in the home, and lack of water and heating facilities in the home.

Using the g-formula, she could test for direct and indirect effects through education and occupation. We used data from the English Longitudinal Study of Ageing (n=4,553). The findings show that few books were the most consequential component of childhood socioeconomic disadvantage for later life memory. The total effect of a breadwinner in lower-skilled occupations was smaller but not significantly different from few books, while it was significantly smaller with overcrowding. The latter two total effects were mostly mediated by education and occupation.

We conclude that a literate environment in the childhood home may have lasting direct effects on memory function in mid-to-later life, while parental occupation and overcrowding appear to influence memory primarily through educational and occupational pathways.

The prevalence of mild cognitive impairment in Latin America and the Caribbean: a systematic review and meta-analysis

Fabiana Ribeiro, Ana Carolina Teixeira Santos, and Anja K. Leist
Aging & Mental Health

29 November 2021 https://doi.org/10.1080/13607863.2021.2003297

Fabiana Ribeiro is a postdoctoral researcher in the CRISP project.

What is the rate of mild cognitive impairment (MCI) and dementia in Latin America and the Caribbean? What are the differences by sex/gender, education, and which risk factors are associated with cognitive impairment? Fabiana Ribeiro, postdoc researcher in the CRISP project, has led three publications to understand social and behavioral determinants of cognitive ageing in the lower-resource settings of Brazil and Latin America at large.

In a systematic review on the prevalence of mild cognitive impairment, we find comparatively higher prevalence of MCI in Latin America compared to estimates from higher-income countries, with older and lower-educated individuals showing higher prevalence.

Why do we want to know more about the prevalence of mild cognitive impairment? People with MCI are at high risk of progressing to dementia and thus represent a group that could potentially benefit strongly from brain health interventions.

In another publication, we assessed the prevalence of dementia in Latin America and the Caribbean, exploring sex, education and urban vs rural residence as determinants. This publication is currently available as pre-print here: https://www.medrxiv.org/content/10.1101/2021.10.15.21265054v1

Changes in prevalence of cognitive impairment and associated risk factors in São Paulo, Brazil, 2000-2015

Fabiana Silva Ribeiro, Yeda Aparecida de Oliveira Duarte, Jair Lício Ferreira Santos, & Anja K. Leist
BMC Geriatrics

27 October 2021 https://doi.org/10.1186/s12877-021-02542-x

Fabiana Ribeiro is a postdoctoral researcher in the CRISP project.

With data from São Paulo, we have investigated the prevalence of cognitive impairment over a period of 15 years (2000-2015). In contrast to other studies from higher-resource settings and despite increases in educational attainment, we don’t find secular increases in the prevalence of cognitive impairment, Further, we find increases in disease burden in hypertension, diabetes, and overweight/obesity, which have been found to increase risk of cognitive impairment and dementia. Women showed higher disease burden, possibly related to gender-role attitudes and fewer opportunities to build up cognitive reserve. Individuals self-identifying as black also showed more disadvantaged health profiles, possibly related to structural discrimination leading to lower quantity and quality of education and less advantaged socioeconomic conditions.

Inequality of educational opportunity at time of schooling predicts cognitive functioning in later adulthood

Anja K. Leist, Eyal Bar-Haim, Louis Chauvel
SSM – Population Health

September 2021, https://doi.org/10.1016/j.ssmph.2021.100837

Code on Github

Highlights

Macro-level determinants of older-age cognitive functioning need to be better understood.

The role of inequality of educational opportunity at time of schooling (IEO) for later-life cognition is not yet clear.

In a sample from 16 European countries and Israel, higher IEO predicted lower later-life cognitive functioning.

Particularly women with lower education of the cohorts under investigation seem to have been vulnerable to higher IEO.

 

Picture (c) https://geheimtipp-leipzig.de/klassenfoto-aus-den-1950ern/

Changes in neighborhood-level socioeconomic disadvantage and older Americans’ cognitive functioning

Settels, Jason, and Leist, Anja
Health & Place

Volume 68, March 2021, 102510, https://doi.org/10.1016/j.healthplace.2021.102510

Jason Settels is a postdoctoral researcher at the Institute for Research on Socio-Economic Inequality at the University of Luxembourg.

Main code on GitHub

Neighborhood socioeconomic conditions have an impact on cognitive abilities at older ages, mediated through more proximate factors such as social capital, community involvement, size of close networks, social support, poverty, consumption of alcohol and smoking. Neighborhood disadvantage causes distress and depression. As an example: living in a disadvantaged neighborhood goes along with a restricted social network with weaker ties. Health and cognitive functioning, however, are improved by having a strong social network with strong ties. These factors and their interaction, however, may additionally be modified by individual levels of education. It has been shown that higher education is associated with better cognitive health, as an indicator of early-life cognitive development.

Adopting a dynamic perspective in a U.S. American community sample (NSHAP) to address possible reverse causality, this study hypothesized that worsening neighborhood socioeconomic circumstances are associated with stronger declines in older residents’ cognitive functioning over time. We tested if this relationship may be mediated through different neighborhood and individual-level social and health factors, and if education would play a role in modifying these relationships.

We find that worsening neighborhood socioeconomic conditions go along with decreases in cognitive functioning of older adults. Changes in number of depressive symptoms, size of close networks and physical activity mediate the effect of worsening neighborhood socioeconomic conditions, in a moderate way. We conclude that personal characteristics seem to contribute more to explaining the effects of worsening neighborhood conditions than the investigated contextual characteristics. Having a university degree or not did not moderate the relationship between worsening socioeconomic neighborhood conditions and cognitive decline.

Improving neighborhood socioeconomic conditions may have a positive effect for the cognitive health of older adults. Possible areas of policy interventions may be involving older people in community groups and activities, to improve their social networks, engage in physical activity and ideally decrease depressive symptoms.

 

Returns to Educational and Occupational Attainment in Cognitive Performance for Middle-Aged South Korean Men and Women

Ford, Katherine, and Leist, Anja
Gerontology and Geriatric Medicine

21 March 2021. DOI: 10.1177/23337214211004366

Katherine Ford, MPH, is a doctoral student in Social Sciences, in the Doctoral Training Unit on Migration, Inequalities, and Labour Markets (MINLAB) at the University of Luxembourg.

Code on GitHub

Background: Gender differences in late middle-age cognitive performance may be explained by differences in educational or occupational attainment rates, or gender-patterned returns of similar education and occupation to cognitive reserve. We tested these competing hypotheses in the historically highly gender unequal context of South Korea. Methods: Data came from the 2006 wave of the Korean Longitudinal Study of Aging. We included adults aged 45–65 years. Using quantile regression decompositions, we decomposed cognitive performance differences across quantiles into differences due to rates of educational and occupational attainment and differences due to divergent returns to those characteristics. Results: Gender-based cognitive performance differences across deciles were driven by differences in rates of educational and occupational attainment, while the returns to these characteristics were similar for both genders. Conclusions: Findings suggest that educational and occupational characteristics contribute to cognitive performance similarly in men and women, but discordant rates of these characteristics contribute to performance gaps.

 

Partnership and Cognitive Aging in Europe: Mediating Factors and Social Stratification

Bertogg, Ariane, and Leist, Anja
The Journals of Gerontology: Social Sciences

2 February 2021. DOI: 10.1093/geronb/gbab020

Ariane Bertogg is a postdoctoral researcher at the University of Konstanz, Germany.

Living in a partnership has been shown to benefit later life health in general and decrease the risk of cognitive impairment. Few studies have, however, examined whether different types of partnership transitions also differ with respect to their impact on cognitive trajectories, and whether financial resources, healthy behaviors, cognitive stimulation, and social integration can explain these differences. With data from the Survey of Health, Ageing and Retirement in Europe, and employing fixed effects regression models, we sought to exploit individual-level variation in partnership and simultaneous cognitive changes.

Partnership status was stable in most respondents (around 90%). Compared to remaining partnered and after controlling for sociodemographic factors, transition to divorce was associated with a steeper decline in immediate and delayed recall. Exploring possible mechanisms, both financial resources and social integration, explained these differences. Additional analyses suggested that effects were mostly driven by individuals with lower education.

Partnership transitions remain infrequent events in later life, but our findings indicate that they can induce less favorable cognitive trajectories compared to partnered individuals, particularly for those with lower cognitive reserve.

 

Examining gender differentials in the association of low control work with cognitive performance in older workers

Ford, Katherine, Batty, G. David, and Leist, Anja
European Journal of Public Health, ckaa173, https://doi.org/10.1093/eurpub/ckaa173

Katherine Ford, MPH, is a doctoral student in Social Sciences, in the Doctoral Training Unit on Migration, Inequalities, and Labour Markets (MINLAB) at the University of Luxembourg.

Code on GitHub

We looked into perceived control at work, an important psychosocial work characteristic, and the extent to which changes in control at work influence performance on cognitive tests in older workers. High perceived control was associated with higher performance in verbal fluency.

We didn’t find solid sex/gender differences in how control relates to cognition. However, there are several differences between the genders in the context of control at work: Women and men of the cohorts under investigation had had different work trajectories, different career opportunities, and may have retired early for different reasons. Perceived (and actual) control at work is also different for men and women even in the same occupation. All these are potential sources of bias, which could have masked the findings.

 

Our poster on prevalence of cognitive impairment in Sao Paolo, Brazil, 2000-2015, at the AAIC, July 2020

Ribeiro, Fabiana, Duarte, Yeda, Santos, Jair, and Leist, Anja
Poster presentation (2020, July 30)

 

Leist Research Group Manual

Leist, Anja
Manual (2019, December 12)

The manual should give team members all necessary information to carry out our day-to-day work and intends to put down in words our work and research principles. It refers to policies at our institution and global movements such as #OpenScience where applicable. The manual has been set up concurrently with the research group Anja has established after receiving an ERC Starting Grant for the CRISP project (no. 803239). The manual is partly a reflection of the highest research standards expected by the European Research Council, partly laying out the particular conditions at the University of Luxembourg, and a reflection of Anja’s vision of a healthy research environment. The manual is inspired by Mariam Aly’s lab manual.

Please get in touch for a copy.

Gender inequalities across the life course: A societal perspective on gender differences in dementia

Leist, Anja; Ford, Katherine
Presentation at Alzheimer Europe conference (2019, October 25)

Women are at increased risk of developing dementia, which can only partly be explained with differences in longevity, sex biology, or differences in detection/diagnosis. A promising approach at the population level is the systematic investigation of life course conditions for men and women across countries and cohorts in order to detect if schooling or work opportunities differ by gender. In the cognitive reserve framework, education and work reflect opportunities for cognitively stimulating activities, which increase cognitive reserve across the life course, and which could delay cognitive decline and the diagnosis of dementia. We develop a framework for systematizing gender inequalities across different life stages and life domains, with a focus on systematic disadvantages for women that could be relevant barriers to cognitive reserve development. The new framework leads to testable hypotheses in both the Western and global context regarding life-course socialization and schooling and work opportunities that have been different for men and women. We need to better understand how different life-course opportunities for men and women can create gender differences in dementia at old ages in order to identify individuals at risk today and improve conditions for future generations.

WYLD Special Symposium: Technological Innovations in Dementia Diagnosis and Care

Leist, Anja
Symposium (2019, October 24)
Speakers: Ríona McArdle, Newcastle University; Haza Newman, GerasSolutions Stockholm; Claire Lancaster, University of Oxford; Silka Dawn Freiesleben, Charité Berlin; Katarzyna Hess-Wiktor, Minnity Stockholm

Researchers and entrepreneurs present technological innovations in dementia diagnosis and care, particularly through the use of wearables, apps, and novel data analysis techniques. These innovations address complex challenges of differential dementia diagnosis and ensuring high-quality and safe home and formal care.

Dementia Research Forum – Demenzforschungstage – Journées de recherche sur la démence 2019

Leist, Anja
Report on the “Dementia Research Forum” 2019. Involvement of persons living with dementia and their caregivers in research on cognitive ageing and dementia

available in French, German and English

On 19 and 20 September 2019, the first “Dementia Research Forum” took place at the Belval campus of the University of Luxembourg. People living with dementia, close relatives of persons living with dementia and professionals in the healthcare sector were invited to the university to discuss the research questions of the ERC-CRISP project and to advise the researchers on the research and dissemination of the research results. The idea of giving people affected by dementia a voice in research projects is already being successfully implemented in other countries such as the UK. The report presents some information on the research project for the general public and summarises the contributions of the participants.

The long-lasting impact of inequality of educational opportunities on later-life cognitive functioning

Leist, Anja; Bar-Haim, Eyal; Chauvel, Louis
Presentation (2019, September 14) at the ECSR Conference, Lausanne.

Social and behavioral factors in cognitive aging: Applying the causal inference framework in observational studies

Leist, Anja
Presentation (2019, May 25)

There is an urgent need to better understand how to maintain cognitive functioning at older ages with lifestyle interventions, given that there is currently no medical cure available to prevent, halt or reverse the progression of cognitive decline and dementia. However, in current models, it is still not well established which social and behavioral modifiable factors (e.g. education, BMI, physical activity, sleep, depression) matter most at which ages, and which behavioral profiles are most protective against cognitive decline. In the last years, advances in the fields of causal inference have equipped epidemiology and social sciences with methods and models to approach causal questions in observational studies. The presentation will give an overview of the causal inference framework to investigate the value of behavior changes in cognitive aging. Motivated by conflicting recent publications if physical activity should or should not be recommended to reduce individual risk of cognitive decline, we emulate a target trial where sedentary people are followed over the course of the Survey of Health, Ageing and Retirement in Europe (SHARE) and compare their cognitive development depending on initiating or not physical activity at a later measurement. Extended inclusion/exclusion criteria, and concepts of incident versus prevalent users and multiple eligibility are introduced. The causal inference framework applied to observational studies is able to guide study design to reconcile conflicting evidence from intervention and observational studies. Investigations under the new framework have fewer ethical considerations compared to intervention research and, considering the need to follow up individuals over several decades, are considerably more cost-effective. Limitations are discussed.

Symposium: Early detection and prevention of cognitive decline and dementia: Findings from major European collaborative and research initiatives

Leist, Anja
Symposium (2019, May 25)
Speakers: Craig Ritchie, University of Edinburgh; Alina Solomon, University of Eastern Finland; Graciela Muniz-Terrera, University of Edinburgh; Tom Russ, University of Edinburgh

With still no medical cure for dementia available, major research initiatives have been set up to investigate and target the development of dementia at earlier stages. Several ongoing projects focus on early detection of dementia with the hope to be able to administer personalized interventions for individuals at high risk. Ongoing clinical trials test different interventions on their potential to prevent or delay the onset of dementia. Complementing those efforts, large and long-spanning observational studies can be used to detect long-term precursors of cognitive aging. Indeed, there is increasing evidence for a large window of opportunity for intervention of several decades that could be used for preventative efforts in dementia. The symposium will bring together major European collaborative and research initiatives in the field of early detection and prevention of dementia. The first part of the symposium will present findings from clinical trials, the second part new findings coming from a range of observational studies. The first paper will report on the design and study cohorts of the European Prevention of Alzheimer’s Dementia Consortium (EPAD) and the TriBEKa project. The second paper will focus on new multifactorial models to quantify prevention potential based on the FINGER trial. The third paper will report an integrated analysis of four longitudinal studies of ageing (OCT0, H70, LASA, and MAP) to evaluate the role of cognitively stimulating activities in the transitions from cognitively normal to slightly impaired, severely impaired, and death with multi-state models. The fourth paper will present the contribution of environmental factors over the life course, in particular air pollution, on cognitive change in the Lothian Birth Cohort of 1936. The last paper makes use of recent developments in approaching causal inference in observational studies and applies these to predict cognitive aging and dementia with data from the Survey of Health, Ageing and Retirement in Europe.

New ERC Project on Cognitive Aging

Leist, Anja
Blog post (2018, July 27)

An overview of the objectives of the ERC-CRISP project for a general public.

On my personal website, you can also find information on earlier outreach activities such as a dementia conference and fundraiser, and dementia awareness workshops.