The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD): study description and preliminary data

Transcription

1 The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD): study description and preliminary data Margioti E 1,5, Sakka P 1, Dardiotis E 2, Kosmidis MH 5, Yannakoulia M 4, Hadjigeorgiou GM 2, Scarmeas Nikos 3 1 Athens Association of Alzheimer s disease and Related Disorders 2 Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa 3 Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Greece 4 Department of Nutrition Science-Dietetics, Harokopio University, Athens 5 Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece 25th Annual Conference of Alzheimer Europe, 2-4 September 2015 Ljubljana, Slovenia

2 Background Alzheimer s disease (AD) is a progressive, irreversible, neurodegenerative disease that has been described as a rapidly growing epidemic in modern societies. The prevalence of AD for those over the age of 65 years is approximately 6% in European populations. Due to increasing longevity and lack of effective prevention, however, a dramatic rise in the prevalence of AD is anticipated. Thus, there is an urgent need for effective pharmaceutical treatments as well as preventive strategies. In Greece, population-representative, recent data concerning AD prevalence and incidence of diseases of cognitive aging are lacking. Ferri CP et al. Global prevalence of dementia: a Delphi consensus study. Lancet 2005; 366:

3 What is HELIAD? The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) is a population-based, multidisciplinary, collaborative study designed to estimate, in the Greek population over the age of 65 years, the prevalence and incidence of AD, other dementias, mild cognitive impairment (MCI), and other neuropsychiatric conditions of aging and to investigate associations between nutrition and cognitive dysfunction/age-related neuropsychiatric diseases. The study also ascertains several demographic, medical, social, environmental, clinical, nutritional, and neuropsychological determinants and lifestyle activities. We here present the design of the HELIAD and highlight the main baseline characteristics of the first 1900 participants who completed the initial evaluation. Dardiotis et al., Neuroepidemiology, 2014;43(1):9-14

4 Method The HELIAD has several strengths. It has been designed based on the experience of previous community based epidemiological studies, particularly the Washington Heights-Inwood Columbia Aging Project at Columbia University and previous studies at the University of Thessaly. All procedures were approved by the Institutional Ethics Review Board of the University of Thessaly. The study has being conducted in Larissa, Thessaly since 2009 and in Maroussi, Athens since 2013 and is still on going. Community-dwelling individuals have been selected to participate in the study through random sampling from municipality registries. The study is prospective in design with planned reevaluation in 3 years. Dardiotis et al. Neuroepidemiology, 2014;43(1):9-14 Scarmeas et al. Ann Neurol 2006; 59:

5 Method Sessions took place at day care centers for the elderly, the participants homes or municipal public health clinics. Neurologists carried out a complete and structured neurological evaluation. Trained psychometricians administered a complete battery of neuropsychological tests assessing all major cognitive domains. Dietary intake was evaluated through a semi qualitative Food Frequency Questionnaire (FFQ) developed and validated for the Greek population. The initial evaluation was completed during a single visit, which lasted about 1,5-2 hours per participant. Georgia Copy Figure test Dardiotis et al. Neuroepidemiology, 2014;43(1):9-14 Scarmeas et al. Ann Neurol 2006; 59:

6 Results In total, 1900 participants have already completed the initial evaluation and 520 have been reassessed after an average of 3 years. According to data analyses from the first subgroup of 1900 participants: Sex: 60,3% women Mean Age: 72,92±5,784 (65 93) years Mean duration of education: 10,96±4,9 (minimum 0 - maximum 30) Illiteral population: 5,4% Mean score for MMSE: 26,87±3,19 Married: 74,1 %

7 Medical conditions % Hypertension 62,5 Dyslipidemia 39,8 Diabetes mellitus 16,9 Coronary heart disease 10,3 Myocardial infarction 3,0 Congestive heart failure 1,6 Arrhythmia 10,3 Chronic obstructive pulmonary disease/other pulmonary disease 6,7 Thyroid disease 12,7 Hyperthyroidism 1,8 Hypothyroidism 11,0 Liver disease 0,4 Renal insufficiency 0,1 Peptic ulcer disease 3,5 Peripheral vascular disease 2,6 Cancer 5,2 Arthritis 9,8 Traumatic brain injury 10,8 Seizures 0,7 Parkinson s disease 1,4 Multiple sclerosis 0,1 Vitamin B12 deficiency 0,4 Normal pressure hydrocephalus 0,1 Results Demographic data between groups Sex (female ) Age (years) Education (years) Mini Mental State Examination (MMSE) City Mean/% p Maroussi Larissa Maroussi Larissa Maroussi Larissa Maroussi Larissa 64,70% 58,80% 71,42±7,04 73,39±5,58 12,42±4,41 6,34±4,08 27,58±3,21 26,58±3,10 *,031 *,003 *,000 *,001

8 Results Housewife Farmer Feeder Worker Craftsman Freelancher Public servant in office Public servant- worker Work in a private office Instructor Manager Other % OCCUPATIONS %

9 Results DIAGNOSIS PARENT S MEDICAL HISTORY Father's medical history Mother's medical history Dementia Other 4% 2% Mild Cognitive Impairement 11% Normal 83%

10 Results SUBJECTIVE MEMORY COMPLAINTS No Yes Person that first noticed symptoms of loss of memory 0% Other 36% Children Husband/wife 64% Him/herself Complaints % No difficulty in remembering names 88,4 No difficulty in remembering things just read or heard 77,9 Problems going shopping because of memory loss 94,8 Problems getting chores done around the house because of memory loss 95,3 Difficulty in remembering the right word in speech 73,6 %

11 Partnerships and Consensus European Medical Information Framework (EMIF)

12 Conclusion The HELIAD study will provide important data regarding the prevalence, incidence and risk factors of dementia and several other neuropsychiatric diseases in order to design and implement comprehensive and effective policies and strategies in the Mediterranean region. 3 rd Diagnostic meeting, June2015 Dementia Day Care Center, Maroussi

13 25th Annual Conference of Alzheimer Europe, 2-4 September 2015 Ljubljana, Slovenia Thanks for your sustained attention! Aegean Rally, July 2015