Dementia and other neurodegenerative diseases
Degenerative diseases of the brain and nervous system such as dementia, Parkinson’s disease and motor neuron disease, are common and serious health problems of middle and old age.
Dementia results from both vascular and neurodegenerative pathologies. The role of vascular risk factors and whether preventing vascular disease affects the risk of developing dementia is unclear. We are investigating factors that may influence the risk of dementia in prospective studies, including the China Kadoorie Biobank. We also use long-term follow-up via linkage to electronic healthcare records in some large randomised trials of treatments for vascular disease. Our research focuses on the role of vascular risk factors in dementia and on the methodology of assessing cognitive status in very large-scale studies.
We are collaborating with Kings College, London on two randomised trials (MADE and ATTILA) of interventions designed to improve the care of elderly patients with Alzheimer’s disease, and a trial of treatment for elderly patients with late-onset schizophrenia (ATLAS2).
Elderly people are increasingly likely to have a chronic condition and to be admitted to hospital as an emergency. There is some evidence that hospital care may be potentially harmful due to a lack of mobility and a risk of hospital acquired infection. Our Hospital at Home trial examines how providing acute care at home compares with hospital admission.
Dementia and other degenerative diseases of the brain often develop slowly over many years before they are diagnosed, and this can make it difficult to study lifestyle factors which may be linked to their development. Our programme of research using the detailed lifestyle information and complete, long-term follow-up available in the Million Women Study cohort is helping to answer questions about lifestyle and risk of neurodegenerative disease. First published results showed that risk of motor neurone disease was greater in smokers and was lower in women who were overweight or obese compared with lean women.
We are also studying how a range of factors, including smoking, alcohol, obesity, and physical exercise may relate to the risk of developing dementia and Parkinson’s disease over many years. We hope that this work will provide reliable evidence to improve our understanding of these diseases, and to guide public health policy on prevention. Our work on dementia is part of a UK-wide research collaboration, the Dementias Platform UK.
The NDPH Neurodegenerative Diseases Group discusses current and future research and collaboration within and beyond the department. Members include representatives from the Clinical Trial Service Unit and Epidemiological Studies Unit, the Cancer Epidemiology Unit, the MRC Population Health Research Unit, the Health Services Research Unit, the Translational Epidemiology Unit, the Unit of Health Care Epidemiology and the Health Economics Research Centre.