Seb Walsh

Alzheimer's disease outlook: controversies and future directions For the first time, reductions in cerebral β-amyloid pathology load and rate of cognitive and functional decline have been achieved in Alzheimer's disease, through pharmacological intervention in rand...

A privilege to represent the population health perspective, alongside Carol Brayne @cph.bsky.social , in this new @thelancet.com Series on #Alzheimer's disease. Expertly led by Giovanni Frisoni

Alzheimer's disease outlook: controversies and future directions www.thelancet.com/journals/lan...

Evidence gap in blood biomarkers for Alzheimer’s disease Willem van Gool and colleagues argue that moves to use blood biomarkers in clinical practice or population screening are inappropriate without evidence on outcomes important to patients and carers T...

Out of 800+ studies on blood-based biomarkers for Alzheimer's, not a single one measured actual changes in patient outcomes.

doi.org/10.1136/bmj-...

Key questions for the future of amyloid research in dementia: a framework for integrating complex datasets - Molecular Psychiatry Molecular Psychiatry - Key questions for the future of amyloid research in dementia: a framework for integrating complex datasets

A key (too often ignored) aspect of Alzheimer's research is translation of findings between familial disease, specialist clinics, and general population. In this piece we identify key unanswered research questions and describe a framework for knowledge integration.

www.nature.com/articles/s41...

Evidence, The Elderly and Common Sense A recent trial presented at the ESC meeting addresses the question of reducing blood pressure meds in the elderly. It’s an important study—for numerous reasons.

Nice write-up of the RETREAT-FRAIL trial from @nejm.org paper by John Mandrola in the Sensible Medicine substack

www.sensible-med.com/p/evidence-t...

(Paper: www.nejm.org/doi/full/10....)

Prevalence and co-occurrence of dementia risk factors in Denmark: A nationwide study The clustering of dementia risk factors is common and has implications for policies targeting risk reduction.To estimate the prevalence of 16 dementia…

New paper with Janet Janbek using 🇩🇰 registry data to examine prevalence/co-occurrence of dementia risk factors. 82% of people >65 have multiple risk factors, speaking to the need for upstream public health action. More work soon from this collaboration!

www.sciencedirect.com/science/arti...

Countrywide natural experiment links built environment to physical activity - Nature By analysing the smartphone data of 2,112,288 participants, in particular observing and comparing the activity of the same individual in two different environments, we find that increases in the walka...

We assume that the built environment affects how active we are but solid evidence lacking.

Important paper from 🇺🇸 using📱data to show moving from less walkable neighbourhood to more, or vice versa, has meaningful effect on activity, sustained 3 months after moving

www.nature.com/articles/s41...

Interested? Take a read (it's open access) and get in touch.

Big thanks to co-authors, brought together under the
DEMON Network

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The hope is that this provides a platform for people starting out in the dementia research field to make it easier to incorporate an SDOD lens, by knowing what evidence we do have and where the gaps are

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...all evidence linking social determinants to dementia across 6 domains (education, food environment, housing, SES, physical environment, and social inclusion) identifying where there are reviews/meta-analyses, where there is only primary evidence, and where we have nothing

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What evidence do we have on the Social Determinants of Dementia (SDOD)?

Delighted that this scoping review, a year or so in the making, is now published in @alzdemjournals.bsky.social. Expertly led by Anouk Geraets, we identified...

doi.org/10.1002/alz....

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Making social sciences foundational to academic medicine In this Perspective, Sahar Sadjadi and colleagues discuss the imperative for incorporating social sciences into medical research, education and implementation.

Making social sciences foundational to academic medicine - putting the 'social' into 'social determinants of health'.

dx.plos.org/10.1371/jour...

Adherence to four dietary indices and the risk of all‐cause and cause‐specific dementia: Findings from the UK Biobank study - Carrasco‐Marín - Diabetes, Obesity and Metabolism - Wiley Online Library dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/...

Dementia and the disappearing subject: a framing analysis of drugs for dementia in UK news media

doi.org/10.1016/j.ss...

A lifespan perspective on cognitive reserve and risk for dementia INTRODUCTION We addressed whether higher education plays a causal role in reducing dementia risk by comparing two indices of cognitive reserve: education and young adult general cognitive ability (G...

Analyses from Sweden suggesting that cognitive reserve is really rooted in early life, with limited opportunity therefore to affect this in adulthood. Supported by findings from the 1946 birth cohort in the UK

doi.org/10.1002/alz....

Great to work on this with UK colleagues Naaheed Mukadam, Gill Livingston (@uclpsychiatry.bsky.social), and Carol Brayne (@cph.bsky.social). Susanne Roehr, and colleagues from Uni of Auckland

Issue with PAFs for dementia are that we could never actually achieve risk factor eradication

So, in 🇳🇿 , Etu Ma'u has led modelling of 15-25% reductions in risk factors (still ambitious) and shown meaningful PIFs over time, esp for Maori and Pacific peoples

doi.org/10.1002/alz....

Huge thanks to co-authors:
@jackmbirch.bsky.social , Richard Merrick, Lindsay Wallace, @ilk21.bsky.social , Linda Clare, Oli Mytton, Louise Lafortune, Wendy Wills, Carol Brayne @cph.bsky.social

And to funder:
@nihr.bsky.social

#Dementia #PublicHealth

Interested in learning more about population-level approaches to dementia risk reduction?

Check out our Population-Level Approaches to Dementia Risk Reduction (PLADRR) research group webpages: coghealth.net.au/population-b... including our evidence hub!

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By comparing against our previous work on what population-level, low-agency interventions are effective at lowering dementia risk factors (see: doi.org/10.1016/j.ec...) we make 4 recommendations for new policies, and 7 recommendations for policies that could be strengthened

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We find a general balance across reach and agency (see figure).

But with reports of a trend towards individual-level and high-agency interventions (see: health.org.uk/reports-and-...).

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Scoping review of dementia primary prevention policies in England: do they balance reach and agency? Objectives To ascertain the balance of dementia risk reduction policies in England, considering their reach (population-wide vs targeted at specific individuals) and agency (the level of resource requ...

Delighted to see the final paper from my PhD published in
BMJ Public Health.

A scoping review of dementia primary prevention policies in England: do they balance reach and agency?

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bmjpublichealth.bmj.com/content/3/1/...

From PhD to PI in ten 'easy' steps Our warts-and-all account of what it's like to do public health research.

>10 years old but still as relevant - 10 tips for progressing from PhD to PI from @martinwhite33.bsky.social

fuseopenscienceblog.blogspot.com/2012/05/from...

Ngaire in a patterned top stands at a podium next to slides showing a Withered tree and a blooming tree

Next up is Prof Ngaire Kerse with a lot of great updates on what's happening in Aotearoa for dementia care and population level risk reduction. Look @sebwalsh.bsky.social it's your equali-tree! #ANZSGM2025

A couple of months ago in @bmj.com (I’m that far behind!).

This is something we should care about. We need a medical workforce that is diverse and who can relate to patients and others in the MDT.

Interested in how we lower the population's risk of developing? Check out the refreshed webpages of our research group, including an up to date Evidence Hub.

Interested in learning more? Get in touch!

coghealth.net.au/population-b...

The roots of dementia can start in childhood – prevention should be a lifelong goal It’s never too early – or late – to protect your brain. Research shows dementia prevention could begin as early as childhood.

theconversation.com/the-roots-of...

Do people really want to know their risk of getting Alzheimer’s? A US study shows that many research participants don’t want to know their risks of getting Alzheimer’s disease.

theconversation.com/do-people-re...

The Limited Role of Alzheimer Disease Blood-Based Biomarkers in Primary Care This Viewpoint examines the use of blood-based biomarkers to test for Alzheimer disease and outlines why they should not be the first or only tool used in screening for cognitive impairment.

The Limited Role of Alzheimer Disease Blood-Based Biomarkers in Primary Care

jamanetwork.com/journals/jam...

Factors associated with non‐participation in the Healthy Cognitive Ageing Project BACKGROUND Understanding cognitive decline trajectories is crucial for dementia prevention, as many cases go undetected. Identifying participation biases in such studies is essential for data validi.....

V important paper from Sarah and team on external validity of cognitive assessment studies. Non-response in cognitive studies is not random - people not taking part are older, have lower cognition, and reduced functioning. Must weight analyses!

alz-journals.onlinelibrary.wiley.com/doi/full/10....

Blood-based biomarkers of Alzheimer’s disease and incident dementia in the community - Nature Medicine In a community-based cohort of more than 2,000 older adults from Sweden, blood biomarkers for Alzheimer’s disease were able to predict dementia up to 16 years before disease onset.

In population-based study (Kungsholmen), NPVs high but PPVs for blood based biomarkers 30% for single biomarkers, 45% for combination. Median follow-up 10 years. Just can't see how screening could ever be feasible with these kinds of values

www.nature.com/articles/s41...