Most people want to know what puts them at risk of dementia and how to reduce this risk. So far, most of our understanding of dementia and how we might prevent or delay it, comes from studies of white European people.
Knowledge of illnesses in populations of different ethnicities has been helpful in understanding more about cardiovascular disease and diabetes but this work has not been done for dementia. Studies in South Asia show that South Asian people have dementia at higher rates compared to those in Europe. Studying the South Asian (Indian, Pakistani, Bangladeshi and Sri Lankan) population provides an opportunity to understand more about why and how dementia develops. South Asians are the largest minority ethnic group in the UK but there is little information as to how common dementia is or the risks for it in South Asian people compared to Europeans. Studies in South Asia show that dementia is more common there than in Europe. South Asians more often have problems which are risk factors for dementia, such as diabetes and obesity. This research proposal aims to find out:
1. How common dementia is in UK-based South Asians.
2. The effect of risk factors like diabetes on dementia risk in South Asians.
3. Whether it is possible to predict someones risk of getting dementia by looking at all the risk factors they have.
This research will improve our understanding of how common dementia is in the UKs biggest minority group. It will help us know what risks are particularly important for this group. It will let us work out an individuals risk of dementia, taking their ethnicity into account.
It is important to understand what causes dementia so we can find ways to prevent and treat it. So far, most of our understanding of dementia and how we might prevent or delay it, comes from studies of European people.
Studying dementia risk in diverse rather than homogenous populations makes research more relevant and impactful and increases understanding more about how dementia develops. This approach has been successful in understanding more about cardiovascular disease and diabetes but has not yet been used in dementia. Previous studies have shown a higher prevalence of dementia in South Asia compared to Europe indicating greater susceptibility. We plan to use routinely collected data from primary care, linked to hospital episode statistics and mortality data to understand more about how dementia develops in order to improve risk prediction and therefore improve dementia prevention in the longer term.
We currently do not know: dementia prevalence in UK based South Asians; dementia environmental risk factor frequency in South Asians; and the impact of these risk factors in South Asians.
We will first establish prevalence of all-cause dementia in different ethnic groups by finding all patients with recorded diagnoses of dementia/prescriptions for anti-dementia medication prior to a pre-specified date and dividing this by the number of people contributing data for that period. We will then establish the frequency of cardiovascular and lifestyle factors and the impact of each of these on dementia risk, stratified by ethnic group. Finally we will use a random selection of patients to develop a risk prediction model and will test its ability to predict dementia in those who did not contribute data for model development.
Incidence and prevalence of all-cause dementia, Alzheimers dementia, vascular dementia and mixed dementia
Naaheed Mukadam - Chief Investigator - University College London ( UCL )
Naaheed Mukadam - Corresponding Applicant - University College London ( UCL )
David Osborn - Collaborator - University College London ( UCL )
Gill Livingston - Collaborator - University College London ( UCL )
Irene Petersen - Collaborator - University College London ( UCL )
Kenan Direk - Collaborator - University College London ( UCL )
Kingshuk Pal - Collaborator - University College London ( UCL )
Muhammad Qummer ul Arfeen - Collaborator - University College London ( UCL )
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation