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Article ; Online: Interrupted time series evaluation of the impact of a dementia wellbeing service on avoidable hospital admissions for people with dementia in Bristol, England.

Jones, Tim / Redaniel, Maria Theresa / Ben-Shlomo, Yoav

Journal of health services research & policy

2023 Volume 28, Issue 4, Page(s) 262–270

Abstract: Objectives: To determine whether a dementia wellbeing service (DWS) signposting people with dementia to community services decreases the rate of avoidable hospital admissions, in-hospital mortality, complexity of admissions (number of comorbidities) or ... ...

Abstract	Objectives: To determine whether a dementia wellbeing service (DWS) signposting people with dementia to community services decreases the rate of avoidable hospital admissions, in-hospital mortality, complexity of admissions (number of comorbidities) or length of stay. Methods: Interrupted time series analysis to estimate the effects of the DWS on hospital outcomes. We included all unplanned admissions for ambulatory care sensitive conditions ('avoidable hospital admissions') with a dementia diagnosis recorded in the Hospital Episode Statistics. The intervention region was compared with a demographically similar control region in the 2 years before and 3 years after the implementation of the new service (October 2013 to September 2018). Results: There was no strong evidence that admission rates reduced and only weak evidence that the trend in average length of stay reduced slowly over time. In-hospital mortality decreased immediately after the introduction of the dementia wellbeing service compared to comparator areas (x0.64, 95% CI 0.42, 0.97, Conclusions: We found no major impact of the DWS on avoidable hospital admissions, although there was weak evidence for slightly shorter length of stay and reduced complexity of hospital admissions. These findings may or may not reflect a true benefit of the service and require further investigation. The DWS was established to improve quality of dementia care; reducing hospital admissions was never its sole purpose. More targeted interventions may be required to reduce hospital admissions for people with dementia.
MeSH term(s)	Humans ; Interrupted Time Series Analysis ; Hospitalization ; England/epidemiology ; Hospitals ; Dementia/epidemiology ; Dementia/therapy
Language	English
Publishing date	2023-03-23
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1330668-6
ISSN	1758-1060 ; 1355-8196
ISSN (online)	1758-1060
ISSN	1355-8196
DOI	10.1177/13558196231164317
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Zs.A 4529: Show issues

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Article ; Online: Two sample Mendelian Randomisation using an outcome from a multilevel model of disease progression.

Lawton, Michael / Ben-Shlomo, Yoav / Gkatzionis, Apostolos / Hu, Michele T / Grosset, Donald / Tilling, Kate

European journal of epidemiology

2024

Abstract: Identifying factors that are causes of disease progression, especially in neurodegenerative diseases, is of considerable interest. Disease progression can be described as a trajectory of outcome over time-for example, a linear trajectory having both an ... ...

Abstract	Identifying factors that are causes of disease progression, especially in neurodegenerative diseases, is of considerable interest. Disease progression can be described as a trajectory of outcome over time-for example, a linear trajectory having both an intercept (severity at time zero) and a slope (rate of change). A technique for identifying causal relationships between one exposure and one outcome in observational data whilst avoiding bias due to confounding is two sample Mendelian Randomisation (2SMR). We consider a multivariate approach to 2SMR using a multilevel model for disease progression to estimate the causal effect an exposure has on the intercept and slope. We carry out a simulation study comparing a naïve univariate 2SMR approach to a multivariate 2SMR approach with one exposure that effects both the intercept and slope of an outcome that changes linearly with time since diagnosis. The simulation study results, across six different scenarios, for both approaches were similar with no evidence against a non-zero bias and appropriate coverage of the 95% confidence intervals (for intercept 93.4-96.2% and the slope 94.5-96.0%). The multivariate approach gives a better joint coverage of both the intercept and slope effects. We also apply our method to two Parkinson's cohorts to examine the effect body mass index has on disease progression. There was no strong evidence that BMI affects disease progression, however the confidence intervals for both intercept and slope were wide.
Language	English
Publishing date	2024-01-28
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	632614-6
ISSN	1573-7284 ; 0393-2990
ISSN (online)	1573-7284
ISSN	0393-2990
DOI	10.1007/s10654-023-01093-2
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Zs.A 2090: Show issues

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Article ; Online: Prodromal multiple sclerosis: considerations and future utility.

Harding, Katharine E / Kreft, Karim L / Ben-Shlomo, Yoav / Robertson, Neil P

Journal of neurology

2024 Volume 271, Issue 4, Page(s) 2129–2140

Abstract: A multiple sclerosis (MS) prodrome has recently been described and is characterised by increased rates of healthcare utilisation and an excess frequency of fatigue, bladder problems, sensory symptoms and pain, in the years leading up to clinical onset of ...

Abstract	A multiple sclerosis (MS) prodrome has recently been described and is characterised by increased rates of healthcare utilisation and an excess frequency of fatigue, bladder problems, sensory symptoms and pain, in the years leading up to clinical onset of disease. This important observation may have several potential applications including in the identification of risk factors for disease, the potential to delay or prevent disease onset and early opportunities to alter disease course. It may also offer possibilities for the use of risk stratification algorithms and effective population screening. If standardised, clearly defined and disease specific, an MS prodrome is also likely to have a profound influence on research and clinical trials directed at the earliest stages of disease. In order to achieve these goals, it is essential to consider experience already gleaned from other disorders. More specifically, in some chronic neurological disorders the understanding of disease pro-drome is now well advanced and has been successfully applied. However, understanding of the MS prodrome remains at an early stage with key questions including the length of the prodrome, symptom specificity and potential benefits of early intervention as yet unanswered. In this review we will explore the evidence available to date and suggest future research strategies to address unanswered questions. In addition, whilst current understanding of the MS prodrome is not yet sufficient to justify changes in public health policy or MS management, we will consider the practical utility and future application of the MS prodrome in a wider health care setting.
MeSH term(s)	Humans ; Multiple Sclerosis/epidemiology ; Risk Factors ; Disease Progression ; Fatigue/etiology ; Prodromal Symptoms
Language	English
Publishing date	2024-02-11
Publishing country	Germany
Document type	Review ; Journal Article
ZDB-ID	187050-6
ISSN	1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
ISSN (online)	1432-1459
ISSN	0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
DOI	10.1007/s00415-023-12173-4
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Article: Views and Perceptions of People Aged 55+ on the Vaccination Programme for Older Adults in the UK: A Qualitative Study.

Silvonen, Taru / Kesten, Jo / Cabral, Christie / Coast, Jo / Ben-Shlomo, Yoav / Christensen, Hannah

Vaccines

2023 Volume 11, Issue 4

Abstract: Vaccination reduces the risks related to infectious disease, especially among more vulnerable groups, such as older adults. The vaccines available to older adults in the UK through the government-funded programme currently include influenza, pneumococcal, ...

Abstract	Vaccination reduces the risks related to infectious disease, especially among more vulnerable groups, such as older adults. The vaccines available to older adults in the UK through the government-funded programme currently include influenza, pneumococcal, shingles and COVID-19 vaccines. The purpose of the programme is disease prevention and improving wellbeing among the ageing population. Yet, the target population's views of the programme remain unknown. This paper aims to increase the understanding of older adults' perceptions of the vaccination programme available in the UK. A total of 13 online focus groups (56 informants) were carried out for this qualitative study. The findings indicate that getting vaccinated involves personal decision-making processes, which are influenced by previous experiences and interpersonal interactions. Factors related to the wider community and culture are less prominent in explaining vaccination decisions. However, opportunistic vaccination offers, a lack of information and a lack of opportunities to discuss vaccines, especially with healthcare professionals, are prominent factors. The study provides in-depth data about the rationale behind older adults' vaccination decisions in the UK. We recommend that the provision of information and opportunities to discuss vaccines and infectious disease be improved to enable older adults' to make better informed decisions regarding the vaccines available to them.
Language	English
Publishing date	2023-04-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines11040870
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Article: The elephant in the room: critical reflections on mortality rates among individuals with Parkinson's disease.

Dommershuijsen, Lisanne J / Darweesh, Sirwan K L / Ben-Shlomo, Yoav / Kluger, Benzi M / Bloem, Bastiaan R

NPJ Parkinson's disease

2023 Volume 9, Issue 1, Page(s) 145

Language	English
Publishing date	2023-10-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2819218-7
ISSN	2373-8057
ISSN	2373-8057
DOI	10.1038/s41531-023-00588-9
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Article ; Online: Psychological Health in Young Adults With Kidney Failure: A 5-Year Follow-up of the SPEAK Study.

Al-Talib, Mohammed / Caskey, Fergus J / Inward, Carol / Ben-Shlomo, Yoav / Hamilton, Alexander J

Kidney medicine

2023 Volume 5, Issue 6, Page(s) 100637

Language	English
Publishing date	2023-04-06
Publishing country	United States
Document type	Journal Article
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2023.100637
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Article ; Online: Predictors and prognosis of population-based subjective cognitive decline: longitudinal evidence from the Caerphilly Prospective Study (CaPS).

Ball, Harriet A / Coulthard, Elizabeth / Fish, Mark / Bayer, Antony / Gallacher, John / Ben-Shlomo, Yoav

BMJ open

2023 Volume 13, Issue 10, Page(s) e073205

Abstract: Objectives: To understand associations between the subjective experience of cognitive decline and objective cognition. This subjective experience is often conceptualised as an early step towards neurodegeneration, but this has not been scrutinised at ... ...

Abstract	Objectives: To understand associations between the subjective experience of cognitive decline and objective cognition. This subjective experience is often conceptualised as an early step towards neurodegeneration, but this has not been scrutinised at the population level. An alternative explanation is poor meta-cognition, the extreme of which is seen in functional cognitive disorder (FCD). Design: Prospective cohort (Caerphilly Prospective Study). Setting: Population-based, South Wales, UK. Participants: This men-only study began in 1979; 1225 men participated at an average age of 73 in 2002-2004, including assessments of simple subjective cognitive decline (sSCD, defined as a subjective report of worsening memory or concentration). Dementia outcomes were followed up to 2012-2014. Data on non-completers was additionally obtained from death certificates and local health records. Primary and secondary outcome measures: The primary outcome measure was incident dementia over 10 years. Secondary outcome measures included prospective change in objective cognition and cross-sectional cognitive internal inconsistency (the existence of a cognitive ability at some times, and its absence at other times, with no intervening explanatory factors except for focus of attention). Results: sSCD was common (30%) and only weakly associated with prior objective cognitive decline (sensitivity 36% (95% CI 30 to 42) and specificity 72% (95% CI 68 to 75)). Independent predictors of sSCD were older age, poor sleep quality and higher trait anxiety. Those with sSCD did not have excess cognitive internal inconsistency, but results suggested a mild attentional deficit. sSCD did not predict objective cognitive change (linear regression coefficient -0.01 (95% CI -0.13 to 0.15)) nor dementia (odds ratio 1.35 (0.61 to 2.99)) 10 years later. Conclusions: sSCD is weakly associated with prior objective cognitive decline and does not predict future cognition. Prior sleep difficulties and anxiety were the most robust predictors of sSCD. sSCD in the absence of objective decline appears to be a highly prevalent example of poor meta-cognition (ie, poor self-awareness of cognitive performance), which could be a driver for later FCD.
MeSH term(s)	Male ; Humans ; Aged ; Prospective Studies ; Cross-Sectional Studies ; Cognitive Dysfunction/epidemiology ; Cognitive Dysfunction/psychology ; Cognition ; Prognosis ; Dementia/epidemiology ; Dementia/psychology
Language	English
Publishing date	2023-10-16
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-073205
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Article: Commentary: "Association between diabetes mellitus, prediabetes and risk, disease progression of Parkinson's disease: a systematic review and meta-analysis".

Lawton, Michael / Ben-Shlomo, Yoav / Athauda, Dilan / Malek, Naveed / Grosset, Donald G

Frontiers in aging neuroscience

2023 Volume 15, Page(s) 1223636

Language	English
Publishing date	2023-06-15
Publishing country	Switzerland
Document type	Journal Article ; Comment
ZDB-ID	2558898-9
ISSN	1663-4365
ISSN	1663-4365
DOI	10.3389/fnagi.2023.1223636
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Article ; Online: Psychosocial Health Among Young Adults With Kidney Failure: A Longitudinal Follow-up of the SPEAK (Surveying Patients Experiencing Young Adult Kidney Failure) Study.

Al-Talib, Mohammed / Caskey, Fergus J / Inward, Carol / Ben-Shlomo, Yoav / Hamilton, Alexander J

Kidney medicine

2023 Volume 6, Issue 2, Page(s) 100763

Abstract: Rationale & objective: There have been no longitudinal studies examining the evolution of psychosocial health of young adults with kidney failure as they age. We aimed to address this in the Surveying Patients Experiencing Young Adult Kidney Failure-2 ( ... ...

Abstract	Rationale & objective: There have been no longitudinal studies examining the evolution of psychosocial health of young adults with kidney failure as they age. We aimed to address this in the Surveying Patients Experiencing Young Adult Kidney Failure-2 (SPEAK-2) study. Study design: 5-year follow-up longitudinal survey of the original SPEAK cohort. Setting & participants: 16- to 30-year-olds in the UK receiving kidney replacement therapy (KRT) between 2015 and 2017 who participated in the SPEAK study. Exposure: Kidney failure and KRT modality. Outcomes: Psychosocial health and lifestyle behaviors. Analytical approach: Within-cohort changes in psychosocial health were analyzed using the paired Results: We obtained 158 survey responses; 129 had previously responded to SPEAK. Of these, 90% had a kidney transplant. Compared to the general population, respondents were less likely to be married or have children and were more likely to be living with their parents. Respondents had nearly 15 times greater odds of being unable to work due to health (odds ratio [OR] = 14.41; 95% confidence interval [CI], 8.0-26.01; Limitations: Low response rate resulting in imprecise and potentially biased estimates and impact of COVID-19 pandemic while survey was active on psychosocial health. Conclusions: Young adults with kidney failure have persistent poorer psychosocial health compared to their healthy peers as they age. Our findings also suggest a potential causal relationship between KRT modality and psychosocial health.
Language	English
Publishing date	2023-12-01
Publishing country	United States
Document type	Journal Article
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2023.100763
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Article ; Online: Suicide under the Nazi-regime: A Case-control Study among Amsterdam Jews.

Tammes, Peter / Jones, Tim / Ben-Shlomo, Yoav / Simpkin, Andrew J

Archives of suicide research : official journal of the International Academy for Suicide Research

2022 Volume 27, Issue 4, Page(s) 1231–1244

Abstract: Objective: Jewish suicides increased heavily under Nazi-rule. This research investigated risk factors for dying from suicide according to sociodemographic characteristics, local context, and time periods.: Methods: Nazi-registration of Amsterdam ... ...

Abstract	Objective: Jewish suicides increased heavily under Nazi-rule. This research investigated risk factors for dying from suicide according to sociodemographic characteristics, local context, and time periods. Methods: Nazi-registration of Amsterdam residents of Jewish origin in 1941 linked to death and suicide lists. The added suicides after the Nazi-invasion (1940, n = 115) and the suicides when deportation trains ran (1942/1943, n = 182) were each matched to 25 controls using sex and age. Suicide was compared across migrant, occupational, marital, and religious status and neighborhood religiosity. Conditional logistic regression was applied, stratified by time period. Results: In 1940, immigrant (cf. native born, odds ratio (OR) 1.89, 95%CI 1.21-2.96, Conclusions: In 1940, immigrants' higher suicide risk likely indicates greater fear of Nazis while religious affiliation's lower risk might indicate a protective effect of religious belief. In 1942/1943, risk differences markedly attenuated likely indicating increased fear of Nazis among all Jews.HighlightsReligiously affiliated Jews showed reduced risk of dying from suicide after the Nazi-invasionJewish immigrants showed higher risk of dying from suicide after the Nazi-invasionBy 1942/1943, these risks attenuated indicating fear of the Nazis spread and nullified religion's protection.
Language	English
Publishing date	2022-09-15
Publishing country	England
Document type	Journal Article
ZDB-ID	1283671-0
ISSN	1543-6136 ; 1381-1118
ISSN (online)	1543-6136
ISSN	1381-1118
DOI	10.1080/13811118.2022.2114866
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