Environmental risk factors in cogntive decline

Accurate risk assessment for cognitive impairment and dementia is increasingly important given the current lack of effective disease-modifying treatments for AD and other dementias. Validated risk assessment tools that can be administered at very low cost provide methods for low-income countries and regions to assess dementia risk and apply prevention strategies. Given current projections of increasing dementia prevalence, there is an urgent need for validated risk assessment tools that have been evaluated on well-characterized samples, over long time periods. To address this important issue, I investigated the association of an AD genetic risk score and a risk score comprised of lifestyle, medical, and demographic factors (the ANU-ADRI) with the risk of progression from normal cognition to Mild Cognitive Impairment (MCI) or Dementia. I observed that a higher score (indicating greater risk) on the ANU-ADRI was predictive of progression from normal cognition to MCI/Dementia, while the genetic risk score was not. Secondly, I investigated the association of the ANU-ADRI and GRS with two latent factors representing general cognitive a32514bility and dementia severity. I observed that a higher ANU-ADRI was associated with both general cognitive ability and dementia severity, however, it was associated with a larger deleterious effect on dementia severity. In contrast, the GRS was only associated with a deleterious effect on dementia severity. These results complement previous evidence that the ANU-ADRI is predictive of AD and dementia. This also provides further support for using the ANU-ADRI for individual patient assessment and for informing intervention and treatment strategies aimed at delaying or preventing dementia.

Selected Publications:

1. Andrews SJ, Eramudugolla R, Velez JI, Cherbuin N, Easteal S, Anstey KJ. (2017). Validating the role of the Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI) and a genetic risk score in progression to cognitive impairment in a population-based cohort of older adults followed for 12 years. Alzheimer’s Research & Therapy. 9:1-16. PubMed PMID: 28259165
2. Andrew SJ, McFall G, Dixon R, Cherbuin N, Eramudugolla R, Anstey K. (2018). Alzheimer’s environmental and genetic risk scores are differentially associated with general cognitive ability and dementia severity. Alzheimer Disease & Associated Disorders. 33(2):95-103. PubMed PMID: 30681434.