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See detailBeing a World Young Leader in Dementia: Between academic brilliance and acts of kindness. Blog post
Leist, Anja UL

E-print/Working paper (2020)

The blog post describes my journey from being selected as an 'Emerging Leader in Dementia' in 2014/15 by the UK Science and Innovation Network to helping to form, with other emerging leaders, a truly ... [more ▼]

The blog post describes my journey from being selected as an 'Emerging Leader in Dementia' in 2014/15 by the UK Science and Innovation Network to helping to form, with other emerging leaders, a truly global network of World Young Leaders in Dementia, now spanning 400+ members in 29+ countries, and aiming to facilitate careers of young professionals in the field of dementia. [less ▲]

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See detailHow to actively protect against dementia. Epidemiological evidence from Luxembourg
Leist, Anja UL

Presentation (2020, February)

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See detailHealth inequalities in the first six months of the COVID-19 pandemic
Leist, Anja UL

in Mein, Georg; Pause, Johannes (Eds.) Self and Society in the Corona Crisis. Perspectives from the Humanities and Social Sciences (2020)

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See detailPartnership transitions and cognitive functioning among the European 50+
Bertogg, Ariane; Leist, Anja UL

Scientific Conference (2020)

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See detailPrevalence of Mild Cognitive Impairment in Latin America and the Caribbean: A Systematic Review
Ribeiro, Fabiana UL; Teixeira-Santos, Carolina; Leist, Anja UL

in Innovation in Aging (2020), 4(S1), 897898

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See detailExamining gender differentials in the association of low control work with cognitive performance in older workers
Ford, Katherine Joy UL; Batty, G. David; Leist, Anja UL

in European Journal of Public Health (2020)

Background: Limited workplace control, an important dimension of job strain, can reduce occupational opportunities for problem solving and learning. Women may have fewer professional resources to mitigate ... [more ▼]

Background: Limited workplace control, an important dimension of job strain, can reduce occupational opportunities for problem solving and learning. Women may have fewer professional resources to mitigate effects of low control, while conversely, gender-role norms may moderate the influence of occupational psychosocial risk factors. We therefore examined if the links between control and cognitive function were similarly gendered. Methods: This observational, longitudinal study included respondents of the Survey of Health, Ageing and Retirement in Europe who were aged 50-64 years at entry, employed, and provided at least two measurements of control and cognition (n=6,697). Relationships between control and cognition, quantified with standardised scores from verbal fluency, immediate and delayed word recall tests, were explored using linear fixed-effect and random-effect models with gender interactions. Results: Consistent trends of improved verbal fluency performance with high control were evident across analyses, equal to producing around three-quarters of a word more under high control conditions, with an effect size roughly equal to 0.1 standard deviation units (fully adjusted models, range 0.077-0.104 SD), although associations with recall tests were inconsistent. We did not find evidence of clear gender differences in control–cognition relationships for any of the cognitive domains. Conclusions: The cognitive health of older European workers may benefit from improved workplace control irrespective of gender. Possible sources of bias that could explain the lack of gender differences are discussed, particularly gender differences in labour force participation, response behaviour in job control ratings, and implications of gender-role norms on the importance of occupational risk factors. [less ▲]

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See detailUsing cohort data to emulate lifestyle interventions: Long-term beneficial effects of initiating physical activity on cognitive decline and dementia
Leist, Anja UL; Muniz-Terrera, Graciela; Solomon, Alina

in Alzheimer's and Dementia: the Journal of the Alzheimer's Association (2020), 16

Background: Intervention studies have shown beneficial short-term effects of physical activity on cognitive decline and reduced risk of dementia. However, randomized controlled trial data of lifestyle ... [more ▼]

Background: Intervention studies have shown beneficial short-term effects of physical activity on cognitive decline and reduced risk of dementia. However, randomized controlled trial data of lifestyle interventions over long time spans are not available due to lack of resources, feasibility or ethical reasons. Drawing from the principles of emulating a ‘target trial’, which apply design principles of randomized trials to the analysis of observational data, cohort data of a large European survey were analyzed to understand the long-term effects of physical activity changes. Method: Biennial assessments of the economic, social, and health situation of respondents aged 50 and older came from the Survey of Health, Ageing and Retirement in Europe (2004-2017). Cognitive functioning (immediate recall, delayed recall, and verbal fluency) and self-reported diagnosis of dementia were assessed at each follow-up. The target trial included sedentary respondents at t1 who, at follow-up (t2), stayed sedentary (“control group”) or newly reported vigorous physical activity more often than once a week (initiators, “treatment group”). Inclusion and exclusion criteria were implemented as close as possible to those of the FINGER trial. Inverse-probability weighting accounted for the probability of initiating physical activity with a large set of predictor variables. Selecting respondents aged 50-85 years old who met the target trial inclusion and exclusion criteria, assessments of cognitive functioning and self-reported diagnosis of dementia were available for 8,781 respondents at t3 (on average 3.02 years later), 3,858 respondents at t4 (5.84 years), and 2,304 respondents at t5 (7.72 years). A total of 304 respondents reported a diagnosis of dementia. Result: Initiators of vigorous physical activity had higher cognitive functioning at two follow-ups compared to non-initiators (t3: “average treatment effect on the treated”, ATET=0.059, CI: 0.028, 0.090), which remained significant after implementing inclusion and exclusion criteria. Initiators had lower risk of dementia compared to non-initiators at all three follow-ups (t3: ATET=-0.009, CI: -0.015, -0.005, relative risk decrease -46.7%), remaining significant after implementing inclusion and exclusion criteria. Conclusion: Emulating a target trial showed long-term benefits of initiating physical activity for cognitive functioning and dementia risk. Multidomain interventions related to nutrition, social, cognitive activities etc. can be similarly emulated. [less ▲]

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See detailMental health impact of the confinement measures during the COVID-19 pandemic
Pauly, Claire UL; Schroeder, Valerie; Pauly, Laure UL et al

in Innovation in Aging (2020), 4(S1), 952

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See detailPrevalence of memory impairment 2000-2015 in Sao Paolo, Brazil
Ribeiro, Fabiana UL; de Oliveira Duarte, Yeda; Santos, Jair Licio Ferreira et al

in Alzheimer's and Dementia: the Journal of the Alzheimer's Association (2020), 16

Background: Decreases in prevalence of memory impairment and dementia over the last two decades have been observed in different countries for cohorts entering older age. We sought to explore the changes ... [more ▼]

Background: Decreases in prevalence of memory impairment and dementia over the last two decades have been observed in different countries for cohorts entering older age. We sought to explore the changes in prevalence of cognitive impairment across four waves of the Health, Welfare and Aging survey (SABE) with data collected in Sao Paolo, Brazil, in 2000, 2006, 2010, and 2015. Method: Mini Mental State Exam (MMSE) scores and covariate values were available for 5,191 respondents (62.4% female) aged 60 to 99 across four waves. Cognitive impairment was defined as having <=12 points on a 19-point abbreviated version of the MMSE. Age group, educational attainment (no formal schooling, primary, secondary, post-secondary), self-reported heart disease, stroke, diabetes, hypertension, and BMI (<18.5, 18.5-24.9, 25-29.9, 30+) were adjusted for. Result: In more recent waves, prevalence of cognitive impairment was higher for respondents aged 60-64 years (9.0% in 2015 vs. 4.6% in 2000), 65-69 years (9.7% in 2015 vs. 5.8% in 2006) and 70-74 years (13.9% in 2015 vs. 5.8% in 2006). Between 2015 and 2000, respondents were increasingly more likely to report some formal education (90.8% vs. 75.3%), secondary (17.6% vs. 7.3%) or postsecondary education (11.4% vs. 4.3%). Respondents were increasingly more likely to report hypertension (66.5% vs. 54.2%), diabetes (28.7% vs. 17.8%), and be overweight/obese (74.1% vs. 58.9%). In age-adjusted logistic regressions, respondents in 2015 were more likely to show cognitive impairment compared to 2000 (OR 1.84, CI 1.20-2.82). Conclusion: SABE respondents showed higher prevalence of cognitive impairment in 2015 compared to respondents of the same age in earlier waves, but differences disappeared after adjusting for chronic disease burden and educational attainment. [less ▲]

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See detailThe patients’ perspective on access to and use of Personal Health Records
Paccoud, Ivana UL; Baumann, Michèle UL; Le Bihan, Etienne UL et al

Scientific Conference (2020)

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with ... [more ▼]

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with the access to and use of Personal Health Records. The findings come from the INTERREG APPS project that investigated preferences for and intention to use Personal Health Records in four cross-border regions, in Lorraine/France, Luxembourg, Rhineland-Palatinate and Saarland/Germany, and Wallonia/Belgium. [less ▲]

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See detailWYLD Special Symposium: Technological Innovations in Dementia Diagnosis and Care
Leist, Anja UL

Scientific Conference (2019, October)

Researchers and entrepreneurs present technological innovations in dementia diagnosis and care, particularly through the use of wearables, apps, and novel data analysis techniques. These innovations ... [more ▼]

Researchers and entrepreneurs present technological innovations in dementia diagnosis and care, particularly through the use of wearables, apps, and novel data analysis techniques. These innovations address complex challenges of differential dementia diagnosis and ensuring high-quality and safe home and formal care. [less ▲]

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See detailEN/FR/DE Bericht über die "Demenzforschungstage" 2019. Einbezug von Betroffenen in die Forschung zu kognitivem Altern und Demenz
Leist, Anja UL

Report (2019)

On 19 and 20 September 2019, the first "Dementia Research Forum" took place on the Belval campus of the University of Luxembourg. People living with dementia were invited to the university to discuss the ... [more ▼]

On 19 and 20 September 2019, the first "Dementia Research Forum" took place on the Belval campus of the University of Luxembourg. People living with dementia were invited to the university to discuss the research questions of the ERC-CRISP project and to advise the researchers on the dissemination of the research results. The idea of giving people affected by dementia a voice in research projects is already being successfully implemented in other countries such as the UK. The report presents some information on the research project for the general public. After that, the contributions of the participants are summarised. [less ▲]

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See detailGender inequalities across the life course: A societal perspective on gender differences in dementia
Leist, Anja UL; Ford, Katherine Joy UL

Scientific Conference (2019, October)

Introduction. Women are at increased risk of developing dementia, which can only partly be explained with differences in longevity, sex biology, or differences in detection/diagnosis. A promising approach ... [more ▼]

Introduction. Women are at increased risk of developing dementia, which can only partly be explained with differences in longevity, sex biology, or differences in detection/diagnosis. A promising approach at the population level is the systematic investigation of life course conditions for men and women across countries and cohorts in order to detect if schooling or work opportunities differ by gender. In the cognitive reserve framework, education and work reflect opportunities for cognitively stimulating activities, which increase cognitive reserve across the life course, and which could delay cognitive decline and the diagnosis of dementia. Method. We develop a framework for systematizing gender inequalities across different life stages and life domains, with a focus on systematic disadvantages for women that could be relevant barriers to cognitive reserve development. For the empirical analysis, we gather individual information and performance on cognitive tests from several harmonized cross-national aging surveys, i.e. the U.S. Health and Retirement Study and sister studies (SHARE, ELSA, SAGE), separated by cohort. Historical figures on gender inequalities for countries and cohorts, and their relevant timings in the life course of the older respondents, e.g. during schooling, were gathered from different sources, and merged with the individual-level data. Results. The new framework leads to testable hypotheses in both the Western and global context regarding life-course socialization and schooling and work opportunities that have been different for men and women. We will present preliminary evidence of how female (dis)advantages on different cognitive tests – memory, executive functioning – are mirroring societal gender inequalities. Discussion. We need to better understand how different life-course opportunities for men and women can create gender differences in dementia at old ages in order to identify individuals at risk today and improve conditions for future generations. [less ▲]

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See detailIncome Inequality and the Strength of the Origins-Health Gradient in 20 European Countries
Chauvel, Louis UL; Bar-Haim, Eyal UL; Leist, Anja UL

Scientific Conference (2019, September 12)

Health is determined by socio-economic position not only of the individual, but also by that of their parents. The intergenerational transmission of health via parental socioeconomic status is suggested ... [more ▼]

Health is determined by socio-economic position not only of the individual, but also by that of their parents. The intergenerational transmission of health via parental socioeconomic status is suggested to vary according to contextual factors such as income inequality. Earlier studies with a comparative perspective had a limited number of countries available. This study uses 20 countries at up to five waves from the European Social Survey (2008-2016) and SWIID in order to examine the extent to which income inequality is related to the origins-health gradient. The higher the income inequality of a given country and year, the stronger the origins-health gradient. Contrary to earlier findings, this association can be fully explained by intergenerational transmission of status, i.e. education. Implications of this finding are that health is largely determined by educational attainment and associated health behaviors, giving societal context a less prominent role than earlier studies suggested. [less ▲]

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See detailBrain health and dementia risk reduction
Leist, Anja UL

Presentation (2019, June 05)

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See detailEpidemiology of and inequalities in ageing
Leist, Anja UL

Presentation (2019, June 05)

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See detailSocial and behavioral factors in cognitive aging: Applying the causal inference framework in observational studies
Leist, Anja UL

Scientific Conference (2019, May 25)

Rationale: There is an urgent need to better understand how to maintain cognitive functioning at older ages with lifestyle interventions, given that there is currently no medical cure available to prevent ... [more ▼]

Rationale: There is an urgent need to better understand how to maintain cognitive functioning at older ages with lifestyle interventions, given that there is currently no medical cure available to prevent, halt or reverse the progression of cognitive decline and dementia. However, in current models, it is still not well established which social and behavioral modifiable factors (e.g. education, BMI, physical activity, sleep, depression) matter most at which ages, and which behavioral profiles are most protective against cognitive decline. In the last years, advances in the fields of causal inference have equipped epidemiology and social sciences with methods and models to approach causal questions in observational studies. Method: The presentation will give an overview of the causal inference framework to investigate the value of behavior changes in cognitive aging. Motivated by conflicting recent publications if physical activity should or should not be recommended to reduce individual risk of cognitive decline, we emulate a target trial where sedentary people are followed over the course of the Survey of Health, Ageing and Retirement in Europe (SHARE) and compare their cognitive development depending on initiating or not physical activity at a later measurement. Extended inclusion/exclusion criteria, and concepts of incident versus prevalent users and multiple eligibility are introduced. Discussion: The causal inference framework applied to observational studies is able to guide study design to reconcile conflicting evidence from intervention and observational studies. Investigations under the new framework have fewer ethical considerations compared to intervention research and, considering the need to follow up individuals over several decades, are considerably more cost-effective. Limitations are discussed. [less ▲]

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See detailSymposium: Early detection and prevention of cognitive decline and dementia: Findings from major European collaborative and research initiatives
Leist, Anja UL

Scientific Conference (2019, May)

With still no medical cure for dementia available, major research initiatives have been set up to investigate and target the development of dementia at earlier stages. Several ongoing projects focus on ... [more ▼]

With still no medical cure for dementia available, major research initiatives have been set up to investigate and target the development of dementia at earlier stages. Several ongoing projects focus on early detection of dementia with the hope to be able to administer personalized interventions for individuals at high risk. Ongoing clinical trials test different interventions on their potential to prevent or delay the onset of dementia. Complementing those efforts, large and long-spanning observational studies can be used to detect long-term precursors of cognitive aging. Indeed, there is increasing evidence for a large window of opportunity for intervention of several decades that could be used for preventative efforts in dementia. The symposium will bring together major European collaborative and research initiatives in the field of early detection and prevention of dementia. The first part of the symposium will present findings from clinical trials, the second part new findings coming from a range of observational studies. The first paper will report on the design and study cohorts of the European Prevention of Alzheimer’s Dementia Consortium (EPAD) and the TriBEKa project. The second paper will focus on new multifactorial models to quantify prevention potential based on the FINGER trial. The third paper will report an integrated analysis of four longitudinal studies of ageing (OCT0, H70, LASA, and MAP) to evaluate the role of cognitively stimulating activities in the transitions from cognitively normal to slightly impaired, severely impaired, and death with multi-state models. The fourth paper will present the contribution of environmental factors over the life course, in particular air pollution, on cognitive change in the Lothian Birth Cohort of 1936. The last paper makes use of recent developments in approaching causal inference in observational studies and applies these to predict cognitive aging and dementia with data from the Survey of Health, Ageing and Retirement in Europe. [less ▲]

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