Seb Walsh

The Nottingham Consensus provides a policy roadmap to reduce dementia risk, the UK's leading cause of death. Recommendations include:

📢 Launch a targeted public health campaign to address key modifiable risk factors

💬 Adapt communication strategies to ensure relevance across diverse communities

How do we prevent as much future dementia as possible?

A one-page summary of my PhD research into population-level approaches to dementia risk reduction available here: www.cph.cam.ac.uk/sites/defaul...

Full thesis here: www.repository.cam.ac.uk/items/e83e56...

🚨In this new systematic review in BMJ JECH, most of the 18 studies reported dynamic associations between lifecourse socioeconomic change and dementia risk. Highest risk for those born poor who stay poor.

Eleanor Williams, @ilk21.bsky.social , Carol Brayne @cph.bsky.social

What works to reduce socioeconomic inequalities in hospitalisations and readmissions? Systematic review of the equity impacts of population-level, health service and integrative interventions Inequalities exist in hospitalisation rates, which are undesirable and costly for health systems; with higher rates in populations with lower levels of income, education or residing in socioeconomical...

"Interventions that reduced socioeconomic inequalities were those implemented and enforced across entire populations/systems or... were supportive and tailored to the differing needs of individuals across socioeconomic groups in their design and delivery."

bmjpublichealth.bmj.com/content/3/2/...

Population-level Dementia Risk Reduction YouTube video by Dementia Researcher

Now on YouTube: Our Dementia Research Salon Livestream recording exploring #Dementia Risk Reduction - guest host Luis Tojo speaks with @sebwalsh.bsky.social, @simonesalemme.bsky.social & @timothydalyalz.bsky.social on prevention, policy & population health

youtu.be/E12QCc5uWek

Social Media Use Trajectories and Cognitive Performance in Adolescents This study uses prospectively collected data from the ABCD study to assess the relationship between longitudinal patterns of social media use (hours per day) and cognitive performance after 2 years in...

Increases in social media use throughout early adolescence significantly associated with [small] lower performance in specific aspects of cognitive function

Social Media Use Trajectories and Cognitive Performance in Adolescents jamanetwork.com/journals/jam...

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

/End

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

3/

...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

2/

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....

1/

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!

4/

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

3/

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-...).

2/

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?

1/

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...

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.