7 results on '"Mullin, Donncha S."'
Search Results
2. Mechanisms of motoric cognitive risk—Hypotheses based on a systematic review and meta‐analysis of longitudinal cohort studies of older adults.
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Mullin, Donncha S., Cockburn, Alastair, Welstead, Miles, Luciano, Michelle, Russ, Tom C., and Muniz‐Terrera, Graciela
- Abstract
We aimed to refine the hypothesis that motoric cognitive risk (MCR), a syndrome combining measured slow gait speed and self‐reported cognitive complaints, is prognostic of incident dementia and other major causes of morbidity in older age. We propose mechanisms on the relationship between motor and cognitive function and describe a roadmap to validate these hypotheses. We systematically searched major electronic databases from inception to August 2021 for original longitudinal cohort studies of adults aged ≥60 years that compared an MCR group to a non‐MCR group with any health outcome. Fifteen cohorts were combined by meta‐analysis. Participants with MCR were at an increased risk of cognitive impairment (adjusted hazard ratio [aHR] 1.76, 95% CI 1.49–2.08; I2 = 24.9%), dementia (aHR 2.12, 1.85–2.42; 33.1%), falls (adjusted Relative Risk 1.38, 1.15–1.66; 62.1%), and mortality (aHR 1.49, 1.16–1.91; 79.2%). The prognostic value of MCR is considerable and mechanisms underlying the syndrome are proposed. [ABSTRACT FROM AUTHOR]
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- 2022
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3. Life course exposure to air pollution and the risk of mild cognitive impairment and dementia in the Lothian Birth Cohort 1936.
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Jutila, Otto‐Emil Ilmari, Welstead, Miles, Mullin, Donncha S, Tomlinson, Samuel, Vieno, Massimo, Cox, Simon R, Baranyi, Gergo, Russ, Tom C, Luciano, Michelle, and Karlsson, Ida K
- Abstract
Background: Air pollution has been associated with the risk of pathological cognitive decline and dementia (Chandra et al., 2022). Past research has focused on cross‐sectional associations or short‐term exposure measurement, and there is a lack of studies investigating the impact of air pollution throughout the life course of the individual which examines sensitive periods. In this study, the relationship of air pollution exposure at different periods across the life course and the risk of dementia and mild cognitive impairment (MCI) was investigated. Method: Historic fine particulate matter (PM2.5) was modeled using the EMEP4UK atmospheric chemistry transport model for several time periods (1935, 1950, 1970, 1980, and 1990) was combined with contemporary data for time period 2001 and 2007 to calculate the lifetime exposure for 576 participants of the Lothian Birth Cohort (LBC) 1936 who had information about lifetime residential history. There were 69 individuals with all‐cause dementia from age 70 years (baseline) onwards were clinically ascertained and 156 individuals with MCI derived at the ages 76, 79, and 82 years according to the NIA‐AA workgroups guidelines. A multivariable Cox proportional hazards model was developed to investigate associations between PM2.5 exposure at each time period with both cognitive outcomes, adjusting for sex, parental occupational social class (OSC) and of Apolipoprotein e4 allele (APOE4) status, childhood smoking (<16 years), years of education, adulthood OSC, smoking status at age 70, and early retirement (<60 years) dependent on time period. Result: Higher exposure (1SD [0.25µg/m3]) of PM2.5 in later life (2007, age 71 years) had a statistically significant (P = 0.0262) association with increased risk of MCI (HR 1.25, 95% CI 1.02‐1.54) and other time periods were positively associated but not statistically significant (P>0.05). There was no statistically significant (P>0.05) association between PM2.5 exposure at any time period and risk of all cause dementia. Conclusion: Later life exposure to PM2.5 had a positive association with MCI which could suggest that this is a sensitive period in the life course model. This could indicate that people in later life are more susceptible to the impact of air pollution on cognitive decline and therefore risk of MCI. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Trajectories of Motoric Cognitive Risk and Incident Dementia in Scotland.
- Author
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Mullin, Donncha S
- Abstract
Background: Motoric cognitive risk syndrome (MCR) ‐ objective slow gait and subjective cognitive complaints ‐ is quick and easy to measure, making it a potentially useful clinical tool for identifying those at high risk of developing dementia. This is the first exploration of MCR syndrome's predictive ability for incident dementia in a Scottish cohort (Lothian Birth Cohort 1936) and the first examination of the various trajectories of MCR. Method: We classified a total of 680 community‐dwelling participants (mean [SD] age 76.3 [0.8] years) free from dementia into non‐MCR or MCR groups. We used cox proportional hazard methods to evaluate the risk of developing all‐cause dementia in the years following MCR diagnosis. Our final model adjusted for age, sex, comorbidity index, apolipoprotein E status, physical activity level, and years of education. We analysed the trajectories for everyone with MCR by tracking their outcomes over 9 years. All analyses were performed in R version 4.0.2. Result: The prevalence of MCR at baseline was 5.6% (n = 38/680). After 9 years of follow‐up, 11.6% (n = 79/680) of the total cohort developed dementia. The presence of MCR increased the risk of dementia (adjusted hazard ratio 2.37 [95%CI 1.06‐5.32; p = 0.0359]). The trajectories of those with MCR at baseline were: i) reverted to healthy (n = 6/38), ii) ongoing MCR (n = 13/38), iii) progressed to dementia (n = 9/38), or iv) died (n = 10/38). Conclusion: MCR showed similar prognostic ability for dementia in a Scottish cohort as for other populations. MCR could identify a target group for early interventions of modifiable risk factors to prevent incident dementia. Individuals with MCR follow similar trajectories to the related predementia syndrome, Mild Cognitive Impairment. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Motoric cognitive risk syndrome: Its prognostic value for dementia and other adverse age‐related health outcomes—A systematic review.
- Author
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Mullin, Donncha S., Cockburn, Alastair, Welstead, Miles, Luciano, Michelle, Russ, Tom C., and Muñiz‐Terrera, Graciela
- Abstract
Background: Motoric Cognitive Risk (MCR), a syndrome combining objective slow gait speed and subjective cognitive complaints, is being used to identify older adults at high risk of developing dementia. Yet, uncertainty exists regarding the prognostic value of MCR for this and other major causes of morbidity in ageing, such as cognitive impairment and falls. This review is the first to synthesise all mental and physical health outcomes associated with MCR since the term was coined in 2013, and with its component parts of objective slow gait and subjective cognitive complaint prior to 2013. The aim of the review is to evaluate the prognostic value of MCR for adverse age‐related health outcomes. Method: Results from multiple databases (MEDLINE, AMED, EMBASE, CINAHL, PsycINFO, and the Cochrane library; inception to May 2021) for original longitudinal cohort studies of adults aged ≥60 years that compared an MCR group to a non‐MCR group, for any health outcome were screened independently and risk of bias was assessed. We meta‐analysed incident health outcome results where appropriate using a restricted maximum‐likelihood estimator. Result: Of 1057 records identified, 15 studies were eligible. Of these, 11 studies that examined 15 cohorts were combined by meta‐analysis reporting on four health outcomes: cognitive impairment (n=6,458), dementia (n=9,955), falls (n=12,640), and mortality (n=19,818). Risk of bias was deemed low‐to‐moderate in all studies except one, where falls was the outcome. Our meta‐analysis found that participants with MCR were at an increased risk of cognitive impairment (adjusted hazard ratio (aHR) 1.76, 95%CI 1.49–2.08; I2=24.9%), dementia (aHR 2.12, 1.85–2.42; 33.1%), falls (adjusted Relative Risk 1.38, 1.15–1.66; 62.1%), and mortality (aHR 1.49, 1.16–1.91; 79.2%), see figure 1. Conclusion: Evidence suggests that participants with MCR at baseline are at an increased risk of cognitive impairment, dementia, falls, and mortality on follow‐up. [ABSTRACT FROM AUTHOR]
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- 2021
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6. Motoric cognitive risk syndrome trajectories and incident dementia over 10 years
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Mullin, Donncha S., Gadd, Danni, Russ, Tom C., Luciano, Michelle, and Muniz-Terrera, Graciela
- Abstract
•Motoric Cognitive Risk (MCR) syndrome is a high-risk state for adverse health outcomes in older adults characterized by measured slow gait speed and self-reported cognitive complaints.•We used both Cox proportional hazards and competing risk regression methods to evaluate the risk of developing all-cause incident dementia over 10 years of follow-up for individuals with and without MCR.•The presence of MCR increased the risk of incident dementia (adjusted hazard ratio 2.34, 95%CI 1.14–4.78, p = 0.020), as did fewer years of education and higher depression symptoms.•MCR showed similar prognostic ability for dementia in a Scottish cohort as for other populations. MCR could identify a target group for early interventions of modifiable risk factors to prevent incident dementia.
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- 2023
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7. Measuring multimorbidity beyond counting diseases: systematic review of community and population studies and guide to index choice
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Stirland, Lucy E, González-Saavedra, Laura, Mullin, Donncha S, Ritchie, Craig W, Muniz-Terrera, Graciela, and Russ, Tom C
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ObjectivesTo identify and summarise existing indices for measuring multimorbidity beyond disease counts, to establish which indices include mental health comorbidities or outcomes, and to develop recommendations based on applicability, performance, and usage.DesignSystematic review.Data sourcesSeven medical research databases (Medline, Web of Science Core Collection, Cochrane Library, Embase, PsycINFO, Scopus, and CINAHL Plus) from inception to October 2018 and bibliographies and citations of relevant papers. Searches were limited to English language publications.Eligibility criteria for study selectionOriginal articles describing a new multimorbidity index including more information than disease counts and not focusing on comorbidity associated with one specific disease. Studies were of adults based in the community or at population level.ResultsAmong 7128 search results, 5560 unique titles were identified. After screening against eligibility criteria the review finally included 35 papers. As index components, 25 indices used conditions (weighted or in combination with other parameters), five used diagnostic categories, four used drug use, and one used physiological measures. Predicted outcomes included mortality (18 indices), healthcare use or costs (13), hospital admission (13), and health related quality of life (7). 29 indices considered some aspect of mental health, with most including it as a comorbidity. 12 indices are recommended for use.Conclusions35 multimorbidity indices are available, with differing components and outcomes. Researchers and clinicians should examine existing indices for suitability before creating new ones.Systematic review registrationPROSPERO CRD42017074211.
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- 2020
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