Public Health.

Background: Short sleep duration, low physical activity and high sedentary time are associated with higher dementia risk. To date, previous studies have considered these behaviors in isolation, and not as inter-related behaviors part of the 24-h day. Compositional data analysis (CoDA) treats these behaviors as inter-related within a constrained 24hrs.

Public Health.

Background: Frailty is a complex clinical state that is associated with poorer health outcomes and increased dementia risk in older adults. It is routinely measured using the Frailty Index, which is a proportional score based on the number of 'deficits' that an individual has. Whilst such measures are useful for risk assessment, the aggregation of highly heterogeneous deficit profiles in genetic studies may obscure important insights into the underlying biology of frailty.

Public Health.

Background: Dementia is a global public health concern, that poses daily challenges to the individuals, families, and healthcare systems worldwide. Sixty percent of those affected reside in low- and middle-income countries (LMICs), where 71% of new cases are anticipated by 2025. Most dementia studies focus on high-income countries, emphasizing the need for region-specific investigations in areas like Southeast Asia, where diverse cultural, economic, and healthcare settings present unique complexities.

Public Health.

Background: People living in diverse rural areas have shown higher rates of Alzheimer's disease and related dementias (ADRD) compared with their urban counterparts. Further, individuals in rural areas have higher rates of modifiable risk factors for ADRD, such as physical inactivity and alcohol misuse, that account for up to 40% of dementia cases. This study aimed to investigate the efficacy of a novel public health initiative to reduce dementia incidence in both urban and rural settings in Australia's island state: Tasmania.

Public Health.

Background: The global population of adults over the age of 65 is expected to surpass 2 billion by 2050. Alongside this rise in the aging population, the incidence of age-related cognitive decline and dementia will continue to grow. Importantly, women are at an elevated risk of cognitive decline compared to men.

Public Health.

Background: Anxiety and depression are mood disorders that can manifest decades before the onset of dementia, including mild cognitive impairment (MCI) and Alzheimer's disease (AD). A systematic review with meta-analysis was conducted to investigate whether anxiety/depression modifies the risk of MCI/AD.

Method: Embase, Global Health, MEDLINE, APA PsycInfo (from inception to July 2023) were systematically searched for well-structured cohort studies examining the association between anxiety/depression and dementia.

Public Health.

Background: Population dementia prevalence is traditionally estimated using cohort studies, surveys, routinely-collected administrative data, and registries. Hospital Electronic Health Records (EHRs) are comprised of rich structured and unstructured (text) clinical data that are underutilised for this purpose. We aimed to develop a suite of algorithms using routinely-collected EHR data to reliably identify cases of dementia, as a key step towards incorporating such data in prevalence estimation.

Public Health.

Background: Previous research has focused on early-life education to reduce dementia risk, yet there is great potential for enhancing cognitive reserve in later-life through educational interventions, even for people with low early-life educational attainment. In 2019, we launched ISLAND (Island Study Linking Ageing and Neurodegenerative Disease) Campus, offering free university study to participants, with flexible in-person/online learning models removing educational, socioeconomic and geographical barriers. After four years, here we investigate our core hypothesis: that engagement in later life education leads to improvements in modifiable risk factors for dementia, cognition and plasma biomarkers.

Public Health.

Background: Social connections are associated with brain health, but the extent to which social connections are heritable remains unclear. Using longitudinal twin data, we explored the heritable and environmental contributions to social connections. We hypothesised that social connections patterns would be moderately heritable and would be associated with better cognitive and mental health over time.

Public Health.

Background: The Maintain Your Brain (MYB) randomised controlled trial (RCT) aimed to prevent cognitive decline and dementia through a multidomain risk-reduction intervention delivered digitally. The intervention targeted four modifiable risk areas (physical inactivity, poor diet, cognitive inactivity, and depression and/or anxiety). MYB ran for three years and targeted older Australians aged 55-77 years.

Public Health.

Background: The BetterBrains Trial is a prospective behavior-modification blinded endpoint randomized controlled trial to delay cognitive decline in middle-aged adults (aged 40-70) with a family history of dementia. The primary outcome is absence of decline on at-least one out of four cognitive tests at 24-months. We present trial recruitment and current participant completion statistics and baseline demographic, modifiable dementia risk factor (MDRF) and cognitive characteristics of the randomized sample, blinded to intervention arm.

Public Health.

Background: The Maintain Your Brain (MYB) randomised controlled trial (RCT) examined the effect of a multi-domain internet-based dementia prevention program against a control group (information only) over three years among Australians aged 55-77 years. A cost-effective analysis (CEA) quantified the differences in costs (direct healthcare and program costs) and effectiveness outcomes between the intervention and control groups from a health care sector perspective.

Method: An economic evaluation was conducted alongside the MYB trial.

Public Health.

Background: Most people with dementia reside in low- and middle-income countries (LMICs) where resources, research, services, and support are often very limited. Research into dementia risk prediction is scarce in LMIC settings, and those prediction models developed in high-income countries generally do not transport well to LMICs. This suggesting a dire need for LMIC specific dementia risk models.

Public Health.

Background: Dementia is a global health challenge, especially in low- and middle-income countries like Peru, where diagnosis, access, and awareness are limited. Within the IMPACT Dementia project, a component focuses on developing, testing, and implementing an mHealth-enabled system for dementia screening and diagnosis, and assessing its cost-effectiveness.

Methods: Phase I.

Public Health.

Background: Although the importance of body weight in later life for brain health has been established, less is known about body shape and composition. This study aims to examine their associations with dementia and cognitive changes in older adults.

Method: Data were obtained from over 17,000 community-dwelling individuals aged 65-98 years, recruited in Australia and the US.

Public Health.

Background: Socioeconomic factors have an impact on long-term neurovascular health. Education attainment (EA) is a socioeconomic factor which may be related to vascular risk factors and brain health. We investigated the relation of EA and cerebral small vessel disease (CSVD) in community dwelling participants free of stroke and dementia.

Public Health.

Background: Nearly 1 in 3 older adults are living with mild cognitive impairment (MCI) or subjective cognitive decline (SCD), which places them at increased risk of developing Alzheimer's disease or related dementias (ADRD). Behavioral interventions can improve cognitive function and reduce dementia risk factors, but most are in-person and time-intensive. We are conducting a randomized, controlled trial to assess the impact of 12- and 24-week online interventions on cognitive function and dementia risk.

Public Health.

Background: Lifestyle modifications incorporating a healthy diet, physical activity, brain training and health monitoring have proven effective in preventing dementia and related cognitive decline (REF). The Australian-Multidomain Lifestyle Intervention to reduce dementia risk (AU-ARROW) is an ongoing 2-yearintervention, which is the Australian contribution to the World-Wide FINGERS network. Here we report on preliminary findings of baseline dietary energy and nutrient intakes of AU-ARROW participants.

Public Health.

Background: Clinical guidelines in Australia discourage disclosure of apolipoprotein E (APOE) genotypes but advances in Alzheimer's disease (AD) therapeutics will likely change this. Limited work has assessed interest in APOE disclosure in Australian adults, and it remains unclear which characteristics are associated with interest within this sample. In a large group of middle-aged adults, this study aimed to describe interest in APOE disclosure and investigate differences in demographic and clinical characteristics and AD risk perceptions among groups with varying interest in disclosure.

Public Health.

Background: Alzheimer's disease (AD) is a neurodegenerative disorder with significant environmental factors, including diet, that influence its onset and progression. While the ketogenic diet (KD) holds promise in reducing metabolic risks and potentially affecting AD progression, only a few studies have explored the KD's molecular impact for markers of AD therapeutic potential. The BEAM diet study simultaneously profiled the KD's effect on the lipidome, blood and cerebrospinal metabolome, and microbiome of both cognitively impaired and cognitively normal individuals.

Public Health.

Background: Evidence suggests that diet may play a modifiable role in reducing Alzheimer's disease (AD) risk. Higher adherence to the Mediterranean diet (MeDi) is linked to a lower incidence of mild cognitive impairment (MCI) and AD. Increasing evidence indicates the potential utility of a cytoskeletal protein found in astrocytes, plasma Glial Fibrillary Acidic Protein (GFAP), as a marker specific for AD pathogenesis.

Public Health.

Background: Type 2 diabetes (T2D) and Alzheimer's disease (AD) are amongst the top 10 leading causes of death worldwide. T2D is associated with increased AD risk and brain beta amyloid (Aβ) burden, suggesting underlying mechanistic relationship between AD and T2D. Insulin signalling pathways, which can regulate the accumulation of Aβ and phosphorylation of tau in the brain, is a possible underlying mechanism of the T2D-AD relationship.

Public Health.

Background: People living with dementia and their carers, particularly those from culturally and linguistically diverse backgrounds, consistently demonstrate limited knowledge about and negative attitudes towards dementia. This can limit access to preventive and post-diagnostic care. Culturally sensitive dementia education is an inclusive and practical intervention that can be used in multicultural contexts to increase awareness and destigmatise the condition.

Public Health.

Background: Current literature focuses on the association between gut dysbiosis and the aggregation of Aβ, the development of tau protein, as well as neuroinflammation and oxidative stress associated with AD. Since the brain and gut are connected (gut-brain axis), gut microbiota and their metabolites may influence AD progression, or vice versa, if AD pathogenesis impacts the microbiome. Observational studies have shown an altered taxonomic composition of gut microbiota in AD patients compared to cognitively normal (CN) controls.