Neuroepidemiology最新文献

Introduction: Dementia with symptom onset before the age of 65 is referred to as early-onset dementia (EOD). Many gaps exist regarding EOD etiology, including the role of environmental factors.

Methods: We conducted a population-based case-control study in Modena province, Northern Italy, enrolling and geocoding 326 EOD cases and 1,941 sex- and age-matched controls, to investigate the association of traffic-related benzene, green spaces around the place of residence, and exposure to artificial outdoor light at night (LAN). We used nonlinear modeling to assess the relation between environmental variables and disease risk, overall, and separately for Alzheimer's dementia (AD) and non-AD.

Results: Green spaces generally showed an inverse association with EOD risk that was almost linear for AD and inverted U-shaped for non-AD. We observed a weak positive association between traffic-related benzene exposure and EOD risk that seemed limited to AD, with little change in risk for non-AD. Exposure to LAN showed an inverse linear association with small differences across the two disease subgroups. Analyses stratified by sex and age showed generally stronger (but statistically imprecise) associations in females and older individuals.

Conclusion: Overall, these results are consistent with some environmental influences on EOD risk, particularly with a beneficial effect of green spaces and LAN, as well as a possible adverse role of air pollution, particularly for AD.

Introduction: Studies of Parkinson's disease (PD) caregiver stress have examined many contributing factors, but a clear understanding of the impact of Parkinson's disease psychosis (PDP) on caregiver burden has been difficult to ascertain from existing evidence. The evidence has been collected primarily in small, heterogeneous studies that do not lend themselves to meta-analysis.

Objective: To understand current evidence on the association between PDP and caregiver burden despite the heterogeneity of populations studied and methods used.

Methods: Following PRISMA guidelines, PubMed, Embase, and ClinicalTrials.gov were searched from inception through April 1, 2025, for English-language articles using predefined search terms. Eligible original research included individuals with PD, assessment of psychosis symptoms, defined caregivers, and evaluation of the association between psychosis and caregiver burden. Data was extracted independently, and study quality was assessed using the Newcastle Ottawa Scale. The exposure was PDP, and the outcome was caregiver burden.

Results: Twenty-six articles met inclusion criteria. Most studies enrolled fewer than 100 participants; 9 of these (34.6%) had low risk of bias. Psychosis symptoms were assessed via validated questionnaires in 17 studies, self-report in 7, and unspecified methods in 2. Definitions of caregiver varied, with 4 studies including paid caregivers. Among 10 studies adjusting for confounders, 6 (60%) reported a significant positive association between PDP symptoms and caregiver burden. Of the 4 multivariate studies without a significant association, 3 found positive relationships between other patient psychiatric symptoms and this burden.

Conclusion: While the quality of research is variable and studies include an array of different population definitions and measurement approaches, higher-quality studies indicate PDP is associated with greater caregiver burden. To facilitate the well-being of patients with PDP and their caregivers, it is important to identify and address the specific caregiver challenges due to psychosis symptoms in PD.

Background: The systematic assessment of the burden of common neurological disorders in Europe based on latest epidemiological data remains lacking.

Methods: We extracted data on disability-adjusted life years (DALYs), mortality, prevalence, and incidence of neurological disorders from the Global Burden of Disease 2021 study from 1990 to 2021. Future trends over the next 15 years were projected using autoregressive integrated moving average modeling.

Results: In 2021, the age-standardized DALYs rates (ASDRs) of neurological disorders in Europe (1,502.3/100,000 population) were significantly higher than the global average (1,385.1/100,000 population). Among them, the ASDRs in Western Europe (1,584.23/100,000 population) were notably higher than that in Central Europe (1,354.65/100,000 population) and Eastern Europe (1,375.03/100,000 population). Ischemic stroke (31.98%) and Alzheimer's disease (20.24%) were the major contributors to the disease burden in Europe. Age-stratified analysis revealed that the elderly population (≥65 years old) bore the burden of stroke and Alzheimer's disease and other dementia. The overall disease burden was higher in females. From 1990 to 2021, data indicated a significant decline in the disease burden of ischemic stroke, Alzheimer's disease and other dementias, encephalitis, idiopathic epilepsy, intracerebral hemorrhage, and meningitis. Conversely, Parkinson's disease and other neurological disorders showed an upward trend. ARIMA forecast analysis suggested that from 2021 to 2036, the predicted ASDRs for neurological disorders would be lower compared to previous levels.

Conclusion: Neurological disorders impose a greater burden in Europe than globally, primarily driven by ischemic stroke and Alzheimer's disease, with Western Europe, elderly, and female populations being disproportionately affected.

The Pathology, Alzheimer's and Related Dementias Study (PARDoS) is a community-based clinical-pathologic study of aging and dementia in a large and diverse sample of Brazilians. Its long-term objective is to identify the environmental, genetic and molecular drivers of common conditions across the adult life span with an emphasis on Alzheimer's Disease and Related Disorders clinical and neuropathologic traits. From July 31st 2021 through February 11th, 2025, 4,790 brains were collected at two autopsy centers and a major hospital system in the State of Sao Paulo, Brazil. Samples of other organs are also being collected. Their mean age was 71.7 years (range 18-106), 40.2% were Black/Mixed, 52.7% were male, their mean education was 6.3 years (range 0-25). Among those aged 65+, 32.9% had dementia and 18.8% had mild cognitive impairment. Neuropathologic data collection is ongoing. PARDoS fills several major gaps among clinical-pathologic studies given the large numbers and its unique age and education range, and socioeconomic status, race, sex, and other organ collection. Here we present the study design, demographic characteristics of the first 4,790 autopsied participants, and clinical characteristics of the first 4,283 with informant interviews.

Background: This study aimed to quantify the stroke burden attributable to anxiety at global, regional, and national levels, from 1990 to 2021.

Methods: We systematically searched PubMed, Embase, and MEDLINE from inception to July 24, 2024, for longitudinal studies reporting the association between anxiety and the subsequent stroke risk. Pooled hazard ratios (HRs) were calculated using random-effects meta-analysis. Anxiety prevalence and stroke-related disability-adjusted life years (DALYs) for adults aged 20 and older were obtained from the Global Burden of Disease Study 2021. Within a comparative risk assessment framework, we computed population attributable fractions, age-standardized DALY rates (ASDRs) and assessed cross-country inequalities using the slope index of inequality (SII) and concentration index.

Results: Of 5,343 initially identified records, six studies met inclusion criteria, yielding a pooled HR of 1.25 (95% confidence interval [CI]: 1.07-1.45). The global anxiety-attributable stroke burden remained substantial, with ASDR per 100,000 population declining from 195.94 (95% CI: 145.67-252.55) in 2000 to 133.50 (95% CI: 100.07-171.72) in 2021. Regionally, the middle sociodemographic index (SDI) region and Eastern Mediterranean Region exhibited the highest ASDRs in 2021. Countries with low and low-middle SDI accounted for the highest ASDRs. Inequality metrics confirmed greater burden in lower-SDI countries for males (SII: -111.52, 95% CI: -131.75 to -91.28; concentration index: -0.0921, 95% CI: -0.1333 to -0.0509) and females (SII: -148.95, 95% CI: -177.35 to -120.55; concentration index: -0.1193, 95% CI: -0.1629 to -0.0756) in 2021.

Conclusions: Our findings underscore the association between anxiety and the risk of stroke, demonstrating the anxiety-associated stroke burden. Integrating mental health management into public health policies and clinical practice might have the potential to reduce the stroke burden and improve health outcomes.

Aim: The aim of the study was to describe the design, the neuroimaging protocol as well as the baseline characteristics of the participants from Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), which will be part of an extensive investigation of the determinants of brain aging based on high-resolution neuroimaging 3T and 7T magnetic resonance imaging (MRI) conceptualized by the Ageing and Brain Working Study Group from ELSA-Brasil.

Methods: A representative sample of 2,165 participants (mean age = 60.3 [9.9] years, 55.5% female) for further neuroimaging and study with the protocol described here was selected from ELSA-Brasil. The criteria used for selection into this protocol were cognitive status and age in wave 3 (2017-2019), and participants were split into two subsamples: (1) a randomized sample of participants with <70 years at wave 3 (2017-2019) categorized in three groups based on their global cognitive trajectories from wave 1 to wave 3 - (1) below the average (z-score <-1, n = 620), (2) average (z-score = -1 to +1, n = 835), and (3) above-average performance (z-score >+1, n = 215); and (2) all participants with ≥70 years at wave 3 were classified as SuperAgers cases (n = 171) and their matched controls (n = 324) based on delayed memory (wave 3). Both samples will be scanned using a 3T MRI, and an additional 7T MRI exam will be conducted in the SuperAgers study to further evaluate brain connectivity. An extensive dataset of sociodemographic, lifestyle, cognitive, mental health, frailty, and other laboratory and clinical exams collected since the baseline of the main study will be considered as predictors of structural and functional patterns of brain aging. The main characteristics of participants and the MRI protocol are described here.

Results: Among those under 70 years, the above-average group for cognition showed better cognitive and mental health scores than the other groups (most p values <0.001). Considering the elderly who were 70 years or older, SuperAgers showed higher scores for delayed recall memory, better global cognition, and verbal fluency than controls at wave 3 (all p values <0.001).

Conclusion: The ELSA-Brasil study will be a unique opportunity to unravel the determinants of brain aging in an admixed sample in Latin America.

Objective: The aim of the study to evaluate global trends in Parkinson's disease (PD) burden (measured by disability-adjusted life years, DALYs) among individuals aged ≥60 years from 1990 to 2021, and project future trends to 2046.

Methods: Using Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized DALY rates (ASDR) via Joinpoint regression. Age-Period-Cohort (APC) modeling disentangled age, period, and birth cohort effects. Decomposition analysis quantified contributions of population growth, aging, and epidemiological changes. Bayesian APC (BAPC) projected DALYs to 2046.

Results: Global PD DALYs increased from 2.55 million (95% uncertainty interval: 2.33-2.79) in 1990 to 6.80 million (6.04-7.49) in 2021. ASDR rose annually by 0.31% (average annual percent change = 0.31%, 95% CI: 0.29-0.33), with pronounced male predominance (male ASDR 2021: 861.9 vs. female: 498.9; male-to-female ratio: 1.73). The highest ASDR occurred in high-middle socio-demographic index (SDI) regions (683.7) and the lowest occurred in low SDI (612.9). APC analysis revealed disease risk peaked at ages 85-94 and increased with successive birth cohorts. Decomposition identified population growth as the primary driver of DALY increases (81.55% globally), exceeding contributions from aging (8.74%) and epidemiological shifts (9.71%). BAPC projections indicated rising absolute DALYs (+104% by 2046) but declining ASDR (607.3 by 2046), with widening gender disparities.

Conclusion: PD burden escalates globally due to demographic aging and population growth. Urgent international collaboration is needed for targeted interventions, particularly in high-burden regions and for older males.

Introduction: Thyroid disease has been implicated in the pathology of neurodegenerative diseases. However, its role in amyotrophic lateral sclerosis (ALS) is unclear. This study aimed to investigate the association between thyroid disease, including hypothyroidism and hyperthyroidism, and the risk of ALS.

Methods: We used a matched cohort design to evaluate UK Biobank data on participants enrolled between 2006 and 2010 who were followed up until 2022. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: The study cohort comprised 42,684 patients with thyroid disease (females: 80%). Thyroid disease was moderately associated with an increased risk of ALS development (HR: 1.44, 95% CI: 1.02-2.02), and this association remained similar following adjustment for comparative height at the age of 10 years (HR: 1.44, 95% CI: 1.03-2.03). Hyperthyroidism showed a potential association with an increased risk of ALS development among individuals aged ≤60 years (HR: 21.22, 95% CI: 1.64-274.46) and in females (HR: 3.02, 95% CI: 1.13-8.08).

Conclusion: Our findings demonstrate that thyroid disease is associated with a moderately increased risk of ALS development. Given the multifunctional role of the thyroid gland, further in-depth studies examining the relationship between thyroid conditions and ALS are warranted.

Background: Multiple sclerosis (MS) is a chronic neurological disorder that primarily affects young adults and is characterized by inflammation of the central nervous system. Although genetic, immunological, and environmental factors contribute to MS risk, the role of diet remains underexplored in the Kuwaiti population. This case-control study evaluated the dietary and lifestyle factors associated with MS risk in Kuwait.

Methods: A total of 152 confirmed MS cases, diagnosed according to the revised McDonald criteria, and 279 controls were enrolled from private hospitals and a public office setting. Data on demographics, medical history, sun exposure, physical activity, supplement use, and dietary intake were collected using a structured electronic questionnaire. Nutrient intake was estimated using food frequency data and nutrient databases. Multivariable logistic regression was used to identify dietary and lifestyle factors independently and significantly (p < 0.05) associated with MS risk.

Results: Compared with controls, MS cases were more likely to be Kuwaiti nationals (adjusted OR = 7.85, 95% CI: 2.85-21.60), have lifelong history of obesity (adjusted OR = 3.12, 95% CI: 1.34-7.25), or exceed recommended sodium intake (adjusted OR = 5.05, 95% CI: 2.22-11.51). MS cases also showed inadequate vitamin C intake (adjusted OR = 3.45, 95% CI: 1.64-7.27), irregular vitamin D supplement use (adjusted OR = 0.27, 95% CI: 0.14-0.54), or insufficient vitamin B2 intake (adjusted OR = 2.25, 95% CI: 1.05-4.83). Regular light physical activity (≥3 times per week) was associated with significantly reduced MS risk (adjusted OR = 0.23, 95% CI: 0.10-0.53).

Conclusion: This study identified high sodium intake, inadequate vitamin B2 consumption, and obesity as significant risk factors for MS, while regular light physical activity appeared to lower MS risk. Public health initiatives addressing these factors may help reduce MS risk in Kuwait and other similar settings. Future studies are needed to confirm these findings.