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NEUROEPIDEMIOLOGY OF COGNITIVE DISORDERS

NEUROEPIDEMIOLOGY OF DEGENERATIVE COGNITIVE DISEASES - EDUCATIONAL / RESEARCH ACTIVITIES

 

The Neuro-Epidemiology Unit focuses on the study of neurodegenerative diseases and cognitive disorders. In addition to the clinical services it offers through the cognitive disorders outpatient clinic, it also provides a multi-level research and educational work.

Educational activities include the following:

  • Training of neurology residents regarding the investigation, monitoring and treatment of disorders of cognitive dysfunction. This training takes place primarily through the involvement in clinical care of patients of the Cognitive Disorders Clinic.
  • Educational presentations of a) interesting medical cases followed the Cognitive Disorders Clinic and b) topics related to dementias.
  • Education and training of younger Neurologists and Neurology residents through attendance of many Greek conferences and workshops.
  • Education and training of other health professionals and scientists (psychologists, nurses, etc.) in the diagnostic approach of cognitive decline with emphasis on neuropsychology, in the context of a relevant postgraduate Masters program.
  • Organization on a regular basis of seminars for caregivers regarding medical, legal and financial issues of dementia.

The research interests of the Unit include the investigation of the epidemiology of dementia and cognitive disorders in Greece and the factors associated with dementia prevalence and incidence. For the purpose of the Unit’s research:

  • A detailed database is maintained at the Cognitive Disorders Clinic in order to study the frequency, development and other dimensions of cognitive disorders in the Greek population
  • The Epidemiological study HELIAD [Hellenic Epidemiological Longitudinal Investigation of Aging and Diet] is conducted. HELIAD is a population-based study of mixed urban and rural Greek participants aged ≥65 years. This study is under the auspices of the 1st Department of Neurology of the National and Kapodistrian University of Athens, the Department of Neurology of the University of Thessaly, the Laboratory of Cognitive Neuroscience of the Aristotle University of Thessaloniki and the Department of Nutrition and Dietetics of Harokopio University of Athens. The HELIAD study has randomly enrolled approximately 2000 participants; after an initial assessment, the study includes follow-up visits (performed every three years). For the purpose of the study and after informed consent of the participants, socio-demographic data, detailed medical and family history, social and eating habits, ability to perform daily activities, physical activity, complaints about memory, sleep and mental state are collected. Moreover, a complete physical, neurological and neuropsychological assessment is performed and blood sample is collected for future biomarker and genetic analysis.

 

Currently, based on the data of the Neuroepidemiology Unit, a series of doctoral theses are performed at the National and Kapodistrian University of Athens including the following:

  • "The relationship between subjective cognitive decline and nutrition in the Greek elderly population". The purpose of the study is to determine the incidence of subjective cognitive decline in people aged ≥65 years and to investigate the effect of diet on the possibility of occurrence and on the development of subjective cognitive decline.
  • "Subjective multidimensional impairment and dementia". The aim is to investigate subjective cognitive, functional and motor complaints as a predictor of future cognitive impairment and dementia. Each of the above will be considered as a separate indicator but also in combination as a subjective multidimensional impairment syndrome.

 

Moreover, based on the data of the Neuroepidemiology Unit, a number of doctoral theses are being conducted in other universities, including the following:

  • "Dietary habits and lifestyles of older people (≥65 years)". The purpose of this study is to investigate older adults' lifestyle habits, such as diet, sleep and physical activity, with an emphasis on their association with aging and other characteristics of the elderly.
  • "Impact of the Mediterranean diet and other eating behaviors on neuropsychological function". This project investigates the effect of the Mediterranean diet as a dietary pattern and the consumption of individual foods or the adoption of dietary and other lifestyle behaviors on the cognitive status of older people.
  • "Eating habits, frailty and cognitive decline in the elderly." The aim of this study is to determine the frequency of the syndrome of frailty in people over 65 years of age and to investigate the relationship between dietary habits (food groups, dietary patterns, Mediterranean diet), cognitive functioning and frailty in cross-sectional and prospective analysis.
  • "The relationship between subjective memory complains and frailty in healthy elderly". The purpose of this project is to study whether subjective memory complaints are associated with the occurrence of frailty and whether subjective memory complaints can predict future frailty.
  • "Diagnostic Validity of Neuropsychological Assessment in Illiterate Elderly People". The aim of this study is to investigate the diagnostic validity of neuropsychological assessment in illiterate population aged over 65 years compared to literate individuals of the same age. In particular, the appropriateness and adequacy of the neuropsychological assessment evaluation’s criteria of cognitive impairment are examined.

 

Finally, a number of additional research protocols and postdoctoral research projects are carried out at the Neuro-epidemiological Department including the following:

  • "Nutrition and metabolic factors associated with the development and evolution of Parkinson's symptoms”. The purpose of this study is to investigate the relationship between diet, energy balance, metabolism and Parkinson's symptoms in people of 65 years and older. The findings of the study will help prevent, reduce the progress and improve treatment of Parkinson's disease, as well as contribute to a broader understanding of neurodegenerative disorders.
  • "Mediterranean lifestyle in relation to mental and brain function". Formulation of a combined predictive indicator for cognitive impairment of elderly. The purpose of this work is to investigate the combined effects of various lifestyle factors (diet, physical activity, sleep behavior, functionality) on cognitive functioning and the impact of dementia on the Greek population, as well as on brain function measurements, through imaging methods.

 

Selected publications

  1. Kosmidis MH, Vlachos GS, Anastasiou CA, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Scarmeas N. Dementia Prevalence in Greece: The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD).Alzheimer Dis AssocDisord. 2018.
  2. Ntanasi E, Yannakoulia M, Kosmidis MH, Anastasiou CA, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N. Adherence to Mediterranean Diet and Frailty.J Am Med Dir Assoc.2018 Apr;19(4):315-322.
  3. Anastasiou CA, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Sakka P, Arampatzi X, Bougea A, Labropoulos I, Scarmeas N. Mediterranean diet and cognitive health: Initial results from the Hellenic Longitudinal Investigation of Ageing and Diet. PLoS One. 2017 Aug 1;12(8).
  4. Tsapanou A, Gu Y, O'Shea DM, Yannakoulia M, Kosmidis M, Dardiotis E, Hadjigeorgiou G, Sakka P, Stern Y, ScarmeasN.Sleep quality and duration in relation to memory in the elderly: Initial results from the Hellenic Longitudinal Investigation of Aging and Diet.Neurobiol Learn Mem. 2017 May;141:217-225.
  5. Maraki MI, Yannakoulia M, Stamelou M, Stefanis L, Xiromerisiou G, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Sakka P, Anastasiou CA, Simopoulou E, ScarmeasN.Mediterranean diet adherence is related to reduced probability of prodromal Parkinson's disease.MovDisord. 2019 Jan;34(1):48-57; PMID:30306634.
  6. Dardiotis E, Kosmidis MH, Yannakoulia M, Hadjigeorgiou GM, Scarmeas N. The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD): rationale, study design, and cohort description.Neuroepidemiology. 2014;43(1):9-14.
  7. Scarmeas N. Multimodal dementia prevention – does trial design mask efficacy? Nature Reviews Neurology; 2017; Jun;13(6):322-323.
  8. Vlachos G., Cosentino S., Kosmidis M., Anastasiou C., Yannakoulia M., Dardiotis E., Hadjigeorgiou G., Sakka P.,  Ntanasi E., Scarmeas N. Prevalence and determinants of subjective cognitive decline in a representative Greek elderly population. International Journal of Geriatric Psychiatry, 2019 Jun;34(6):846-854.PMID:30714214
  9. ScarmeasN,Anastasiou CA, Yannakoulia M. Nutrition and prevention of cognitive impairment.Lancet Neurol. 2018 Nov;17(11):1006-1015. Review.PMID:30244829
  10. Bougea A, Maraki MI, Yannakoulia M, Stamelou M, Xiromerisiou G, Kosmidis MH, Ntanasi E, Dardiotis E, Hadjigeorgiou GM, Sakka P, Anastasiou CA, Stefanis L, ScarmeasN.Higher probability of prodromal Parkinson's disease is related to lower cognitive performance. Neurology2019 Apr 3. pii: 10.1212/WNL.0000000000007453. doi: 10.1212/WNL.0000000000007453. [Epub ahead of print]PMID: 30944240

CONTACT

Nikolaos Scarmeas,

Neurologist, Associate Professor; National and Kapodistrian University of Athens

e-mail: ns257[at]columbia[dot]edu

 

1ST DEPARTMENT OF NEUROLOGY: