In particular they describe the development of a dementia risk ontology and the further development of an automated mapping system based on stemming and comparison at phrase level. The project successfully maps this ontology of dementia risk to data within the Maastricht Aging Study.

The authors discuss the increasing recognition of factors that exacerbate or reduce the risk of developing dementia and the potential to modify these risks among people in mid-life. They point to evidence that the public remains not yet fully aware of the links between health related behaviour and dementia. This project set in France, Netherlands, Ireland and Scotland has already identified and ranked risk factors and developed an online profiler that results in the production of a personalised Lifestyle for Brain Health (LIBRA) global score and profile. This is then supported with information for the person on identified risk factors, recommendations and goal setting for behaviour change. The programme will conclude with a RCT feasibility study to explore participant, GP and practice nurses’ understanding of modifiable risk factors and use of the personalised Libra score and profile.

It describes the rationale for undertaking a feasibility randomised controlled trial (RCT) and for adopting normalisation process theory as the underpinning theoretical framework for the process evaluation. This protocol paper presents the study aims and describes the study design in detail including recruitment, baseline data collection, randomisation, the intervention and control arm of the feasibility RCT as well as the process evaluation and its role in understanding the experiences and perspectives of the In-MINDD participants. The authors then discuss the primary outcomes and present the analysis plan for the study.

The Lifestyle for Brain Health (LIBRA) model was developed as part of the Innovative Midlife Intervention for Dementia Prevention (In-MINDD) project, led by Dublin City University. The project aimed to support people in midlife to reduce their risk of developing dementia or at least delaying its onset by making lifestyle changes. The model is based on 11 dementia risk and protective factors: alcohol consumption, coronary heart disease, physical inactivity, diabetes, high cholesterol, smoking, obesity, hypertension, Mediterranean diet, depression, and cognitive activity. The model was evaluated in a large population-based study, the Maastricht Ageing Study, a 12-year longitudinal study focusing on cognitive ageing. A LIBRA risk score for dementia was developed. When comprised only of modifiable risk factors, Lifestyle for Brain Health predicted future risk of dementia and cognitive impairment. A one-point increase in LIBRA scores related to a 19% higher risk for dementia and a 9% higher risk of cognitive impairment. From these results, it could be concluded that modifiable risk factors have an influence on a person’s risk of developing dementia. Focusing on modifiable risk factors is important and LIBRA may contribute to new prevention strategies for dementia, such as raising awareness that people in middle age may have a window of opportunity for reducing their dementia risk by prioritising lifestyle changes.

The study found that 51% of the patients were robust or not-frail, with 49% at an intermediate or complete stage of frailty.  It suggests that escalating frailty is positively associated with increasing number of medical comorbidities and advancing age rather than being a marker of cognitive decline and severity of illness. The study suggests that optimising the management of co-morbid illness in people with dementia may play a role in minimizing the health impact of frailty in this group. 

(2012) evaluated the cost-effectiveness of implementing a policy of prion filtration of red blood cells in ROI, based on a literature review on efficacy and safety of prion filters, a cost effectiveness analysis and analysis of two models of prion filtration. It concluded that the introduction of prion filtration for all transfusion recipients was not cost-effective by traditional standards of cost-effectiveness, whilst acknowledging that factors other than cost-effectiveness may influence the decision on whether or not to implement a policy of prion filtration of red blood cells in ROI.  

Covering the period 1998 to 2007, it involved 29 patients attending a lithium treatment clinic who had been commenced on lithium treatment for affective disorders such as depression, bipolar disorder and schizoaffective disorder. The study reported that no new cases of dementia developed over a mean follow-up period of 38 months. Given the limitations, the authors tentatively suggest that lithium may have a protective effect against cognitive decline in people with affective disorder and in those with concurrent affective disorder and cognitive impairment.

Very rare and unusual causes account for about 5% of cases of dementia.  Variant CJD, a human prion disease, is one of the rarer causes of dementia, caused when meat from cattle infected with bovine spongiform encephalopathy (BSE) is eaten. It typically affects younger adults. ROI has the second highest rate of vCJD in the world, with four cases reported to date. To complement existing measures adopted to contain the risk of vCJD transmission from transfusion of blood or blood products originating from subclinical carriers of the disease, prion-removing filters have been developed to reduce the risk of vCJD transmission. 

Data was analysed (using multiple regression analysis) to determine the effects of early life education, midlife employment and later life age of retirement on the age of onset of Alzheimer’s disease. This study found no effect of education or employment on the age of onset of Alzheimer’s disease, but found a significant effect of a later retirement age in delaying the onset of Alzheimer’s disease.