Publications by authors named "Topiwala A"
Background: The long-term impact of opioid use disorder (OUD) on brain health has been little explored although of potentially high public health importance.
Objectives: To investigate the potential causal impact of OUD on later life brain health outcomes, including dementia, stroke and brain structure.
Methods: Observational and Mendelian randomization (MR) analyses were conducted.
Background: Cannabis use during adolescence and young adulthood has been associated with brain harm, yet despite a rapid increase in cannabis use among older adults in the past decade, the impact on brain health in this population remains understudied.
Objective: To explore observational and genetic associations between cannabis use and brain structure and function.
Methods: We examined 3641 lifetime cannabis users (mean (SD) age 61.
Article Synopsis
- - Metabolic syndrome (MetS) is linked to poorer brain health in adults without dementia, indicated by lower brain volume and higher levels of white matter hyperintensity.
- - A study of 37,395 adults found that individuals with MetS performed worse on various cognitive tests, including working memory and processing speed, which suggests cognitive decline may begin before dementia onset.
- - The research highlights the need for more studies to determine if improving MetS can positively impact brain health and cognitive function over time.
Article Synopsis
- Increases in harmful drinking among older adults have raised concerns about its impact on brain health, prompting a study focused on the relationship between alcohol consumption and changes in brain structure over time.
- The study analyzed data from 530 participants aged 70 to 90, assessing various brain regions and volumes over a 6-year period while considering average alcohol intake and binge-drinking behaviors.
- Results indicated that low-level alcohol consumption was associated with less brain atrophy in certain areas, while heavier drinking and binge-drinking were linked to poorer white matter integrity and greater atrophy in the corpus callosum.
Article Synopsis
- * The research involved over 228,000 UK adults and demonstrated that using simple, routine predictors can generate accurate risk estimates for several diseases, achieving a discrimination rate of 70% or higher (AUROC).
- * The findings suggest that existing health check data can effectively evaluate 10-year risks for various diseases without needing complex technology or invasive tests, potentially enhancing patient care and management.
Objectives: Preservation of brain health is an urgent priority for the world's ageing population. The evidence base for brain health optimisation strategies is rapidly expanding, but clear recommendations have been limited by heterogeneity in measurement of brain health outcomes. We performed a scoping review to systematically evaluate brain health measurement in the scientific literature to date, informing development of a core outcome set.
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- The NHS Health Check is a UK program aimed at preventing cardiovascular disease and assessing risks, but its long-term effectiveness is uncertain.
- A study compared 48,602 participants who underwent the NHS Health Check to 48,602 matched individuals who did not, tracking diagnoses over an average of 9 years.
- Results showed that while the NHS Health Check led to higher diagnosis rates in the first two years, it ultimately resulted in lower risks for various diseases and reduced mortality rates in the longer term.
Article Synopsis
- The menopause transition is linked to increased cardiometabolic risk factors, which may lead to brain abnormalities known as white matter hyperintensities (WMHs).
- A study analyzed data from nearly 10,000 UK Biobank women to compare cardiometabolic health indicators like BMI, blood lipids, and glucose levels between premenopausal and postmenopausal groups.
- Results showed postmenopausal women had worse cardiometabolic health markers, with specific changes in BMI and waist-to-hip ratio over time, indicating distinct health trajectories for women before and after menopause.
Article Synopsis
- Alcohol-related liver disease (ARLD) is a significant public health issue, and identifying high-risk individuals can enhance public health strategies.
- In a study of 312,599 active drinkers from the UK Biobank, both binge drinking and genetic predisposition (measured using a polygenic risk score, PRS) were found to significantly increase the risk of alcohol-related cirrhosis (ARC).
- Diabetes also raised ARC risk across all drinking patterns and genetic categories, highlighting a complex interplay between drinking behavior, genetics, and diabetes that offers potential for targeted interventions in high-risk individuals.
Article Synopsis
- Current dementia risk scores are not very effective across different ages and regions, prompting the need for a new score.
- Researchers developed the UK Biobank Dementia Risk Score (UKBDRS) using two UK cohorts, identifying key predictors like age, education, and health history.
- The UKBDRS showed strong accuracy in identifying at-risk individuals and outperformed existing dementia risk scores from Australia, Finland, and the UK.
Article Synopsis
- - A study looked at how lifestyle-related factors like obesity, sedentary behavior, sleep deprivation, smoking, and alcohol use impact brain structure, focusing on hippocampal and total grey matter volumes across 3838 European participants.
- - Key findings showed that high alcohol consumption and obesity were linked to smaller brain volumes, but other factors didn't show significant effects, and a cumulative unhealthy lifestyle score correlated with lower total grey matter volume.
- - The study highlights that lifestyle factors shouldn't be considered separately, as having multiple unhealthy behaviors can lead to a greater decline in overall brain volume.
Article Synopsis
- - Studies on the relationship between gout and neurodegenerative diseases show mixed results, but there are indications that gout is linked to smaller brain volumes and increased brain iron levels.
- - Gout patients have a higher risk of developing dementia, Parkinson's disease, and essential tremor, especially in the first three years after being diagnosed with gout.
- - The findings suggest that gout may negatively impact brain structure and increase susceptibility to neurodegenerative conditions, potentially leading to cognitive and motor issues early in the disease's progression.
Article Synopsis
- Telomeres protect chromosome ends, and their shortening is linked to aging and increased risk for neurological disorders like dementia.
- Study shows that longer leucocyte telomere length (LTL) in 31,661 UK Biobank participants is connected to larger brain volumes and healthier brain structures measured by MRI.
- Longer LTL appears to lower the risk for developing all-cause dementia, indicating a potential protective effect against neurodegenerative diseases.
Alcohol's impact on telomere length, a proposed marker of biological aging, is unclear. We performed the largest observational study to date (in n = 245,354 UK Biobank participants) and compared findings with Mendelian randomization (MR) estimates. Two-sample MR used data from 472,174 participants in a recent genome-wide association study (GWAS) of telomere length.
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- The study investigates the link between alcohol consumption and brain iron levels, particularly focusing on whether moderate drinking contributes to iron accumulation in the brain, which may lead to cognitive deficits.
- Utilizing data from 20,729 UK Biobank participants, researchers compared self-reported alcohol intake with genetic predictions and assessed brain iron content through advanced imaging techniques, focusing on specific brain regions and liver tissues.
- Findings indicate that higher alcohol consumption is associated with increased brain iron markers, suggesting that alcohol-related cognitive impairments could potentially be mediated by this iron accumulation.
Moderate alcohol consumption is widespread but its impact on brain structure and function is contentious. The relationship between alcohol intake and structural and functional neuroimaging indices, the threshold intake for associations, and whether population subgroups are at higher risk of alcohol-related brain harm remain unclear. 25,378 UK Biobank participants (mean age 54.
View Article and Find Full Text PDFBackground: Trajectories of depressive symptoms over the lifespan vary between people, but it is unclear whether these differences exhibit distinct characteristics in brain structure and function.
Methods: In order to compare indices of white matter microstructure and cognitive characteristics of groups with different trajectories of depressive symptoms, we examined 774 participants of the Whitehall II Imaging Sub-study, who had completed the depressive subscale of the General Health Questionnaire up to nine times over 25 years. Twenty-seven years after the first examination, participants underwent magnetic resonance imaging to characterize white matter hyperintensities (WMH) and microstructure and completed neuropsychological tests to assess cognition.
Article Synopsis
- Subjective cognitive complaints are common among older adults, but it's unclear if they indicate real cognitive issues or are tied to mental health symptoms such as depression.
- In a study of 800 older adults, researchers found that while subjective memory complaints were prevalent (41%), there were no significant differences in brain structure between those with and without these complaints.
- The analysis suggests that these complaints are more closely linked to depressive symptoms rather than actual cognitive decline or neurodegenerative damage, indicating the need for clinicians to consider mental health when assessing memory issues.
A diagnosis of alcohol use disorder is associated with a higher risk of dementia, but a dose-response relationship between alcohol intake consumption and cognitive impairment remains unclear. Alcohol is associated with a range of effects on the central nervous system at different doses and acts on a number of receptors. Acute disorders include Wernicke's encephalopathy (WE), traumatic brain injury, blackouts, seizures, stroke and hepatic encephalopathy.
View Article and Find Full Text PDFAlcohol consumption is associated with reduced creatine levels in the hippocampus of older adults.
Psychiatry Res Neuroimaging
January 2020
Besides its well established susceptibility to ageing, the hippocampus has also been shown to be affected by alcohol consumption. Proton spectroscopy (H-MRS) of the hippocampus, particularly at high-field 7T MRI, may further our understanding of these associations. Here, we aimed to examine how hippocampal metabolites varied with age and alcohol consumption.
View Article and Find Full Text PDFImportance: Poor cardiovascular health is an established risk factor for dementia, but little is known about its association with brain physiology in older adults.
Objective: To examine the association of cardiovascular risk factors, measured repeatedly during a 20-year period, with cerebral perfusion at older ages.
Design, Setting, And Participants: In this longitudinal cohort study, individuals were selected from the Whitehall II Imaging Substudy.
Background: There is significant heterogeneity in the clinical expression of structural brain abnormalities, including Alzheimer's disease biomarkers. Some individuals preserve their memory despite the presence of risk factors or pathological brain changes, indicating resilience. We aimed to test whether resilient individuals could be distinguished from those who develop cognitive impairment, using sociodemographic variables and neuroimaging.
View Article and Find Full Text PDFObjective: We aim to estimate the risk of perpetrating aggression in Alzheimer disease (AD) and mild cognitive impairment (MCI) by conducting a systematic review and meta-analysis of primary studies.
Methods: A systematic search was conducted in six bibliographic databases according to a preregistered protocol. Studies that reported aggressive behaviors in individuals with AD and MCI compared with healthy individuals or those with other dementia etiologies were identified.
Antipsychotic medications are widely prescribed in elderly populations for a range of psychiatric symptoms. Evidence for their efficacy in this population is limited, and such individuals are at increased risk of numerous side-effects, including stroke and death, particularly in those with dementia. There appears to be a mismatch between the current evidence base and what is occurring in clinical practice, especially in the use of antipsychotics to treat delirium and behavioural and psychological disturbance in dementia.
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