ATHLOS: Ageing Trajectories of Health: Longitudinal Opportunities and Synergies

This EU-funded project aims to achieve a better understanding of ageing by identifying patterns of healthy ageing trajectories, the determinants of those patterns, the critical points in time when changes in trajectories are produced, and to propose timely clinical and public health interventions to optimise healthy.

BOPPP: Beta-blockers or placebo for primary prophylaxis of oesophageal varices

BOPPP is a UK multicentre trial of beta blockers to prevent sudden bleeding from the oesophagus in patients with Liver disease (cirrhosis), funded by NHS NIHR. Patients with cirrhosis often develop enlarged veins in their oesophagus which can burst with distressing and possibly fatal consequences. BOPPP will recruit patients with moderately enlarged veins and test whether prescription of a beta blocker, Carvedilol, can reduce the incidence of bleeding. The trial will follow patients over five years. KHE will undertake the economic analysis which includes a lifetime simulation model.

DePEC: Global Health Research Group on Dementia Prevention and Enhanced Care

Findings from high-income countries show that targeting risk factors for heart/stroke disease can reduce dementia risk. We do not know whether this also applies for LMICs or whether their healthcare systems are equipped to deliver such preventative care. Post-diagnostic dementia care, defined as holistic, integrated continuing care in the context of declining function and increasing family carer needs, if present, varies considerably. Worryingly the 2016 World Alzheimer Report found the current specialist-led model of dementia care unaffordable and unsustainable, especially for LMICs. It urged more efficient 'taskshifted/task-shared' dementia care i.e. increased, and more appropriate use, of GP and community services as in other chronic illness care. The project’s goal is to reduce the personal and societal burden of dementia by developing approaches to reduce future numbers getting dementia and develop more efficient post-diagnostic care. The project will bring together: dementia experts in public health/primary care (Newcastle), global epidemiological 10/66 dementia research group from King's College London (KCL), with a strong existing LMICs network and new LMICs partners, one from each economic category (upper LMIC-Malaysia, LMIC-India and least developed Tanzania) to create a global, multi-disciplinary translational research group.

Find out more about the DePEC Project

Developing And Testing An Eco-epidemiological Model Of The Maintenance Of Psychotic Disorders: An Interdisciplinary, Mixed Methods Study

This British Academy-funded post-doctoral fellowship, led by Dr Tessa Roberts, examines the role of neighbourhoods in influencing the course of psychotic disorders. The course of psychotic disorders is highly variable. There is some evidence of better course in the global south, which has been speculatively attributed to greater social cohesion. However, most studies have been limited to the role of individual-level factors in explaining variance in course, neglecting the role of social context. Dr Roberts is using a mixed-methods eco-epidemiological approach to investigate how the communities and neighbourhoods in which people live affect the course of psychosis in Trinidad (a diverse society in the global south, since most previous research focuses on Western Europe/North America). She will use geospatial qualitative methods to investigate how embodied experiences of neighbourhoods affect people with psychosis. She will then work with communities in Trinidad to co-create improved measures of neighbourhood environments. Finally, she will test whether the neighbourhood characteristics that people with psychosis identify as important are associated with improved social and clinical outcomes as measured in the INTREPID II programme.

EPOCH: The impact of the Environment and Pollution On Cognitive Health: Building the knowledge base through international collaboration

Vibrant, high-density, destination-rich neighbourhood environments provide opportunities for older residents to engage in physical, social and mental activities that benefit cognitive health. However, such environments are also associated with harmful levels of traffic-related pollution and noise. Understanding the complexity of these two dimensions on cognitive function in older people has been investigated in few studies, most have either focused on a limited number of built environmental features which promote physical activity (such as green spaces, local services) or on ambient air pollution in single geographical locations with restricted environmental variability. To understand the effects of different neighbourhood attributes on cognitive health, it is essential to examine covarying positive and negative environmental influences across diverse geographical locations. To address these knowledge gaps, this project aims to investigate the influence of complex environmental factors on cognitive health. This will be undertaken by enhancing environmental and air pollution measurements (UK: Cognitive Function and Ageing Study (CFAS) II, CFAS Wales, English Longitudinal Study of Ageing (ELSA); Australia: Personality And Total Health through life project (PATH), Sydney Memory and Ageing Study (MAS), Older Australian Twin Study (OATS)) and augmenting with studies with existing measures (UK: Biobank). As ambient air pollution, population density and access to green areas are substantially higher in the UK than in Australia undertaking similar analysis from data in the two continents enables more detailed investigation of the variability of environmental conditions beyond the range of values in a single country. Specific objectives are to: (1)Develop methods to enable the synthesis of environmental measures that promote physical, social and mental activities with those that cause environmental hazards across ageing cohorts in UK and Australia. (2)Determine how these environmental factors affect cognitive decline, such as changes in memory, attention and executive function, and incidence of cognitive impairment and dementia. (3)Understand the modifying effects of sex, indicators of socio-economic disadvantage, genetic risk of dementia and geographical location on the above associations. (4)Capacity development. Expanding the future generation of researchers in environmental research and ageing is a key objective of this collaboration.

ESRC Centre for Society and Mental Health

Centre for Society and Mental Health will investigate how rapid changes in modern society impact on our mental health. Based at King’s College London, the new Centre will develop policies and practices for creating mentally healthy environments. The Centre will address questions in three key areas where there is the greatest need: Young people - what impact have recent social and economic changes, from the rise of social media to the growth of precarious employment, had on the mental health of young people? Marginalised communities - what impact have recent social and economic changes, such as prolonged austerity, had on the mental health of disadvantaged communities, including black and minority ethnic? Work and welfare - what impact have widespread welfare reforms had on mental health, and what welfare policies might better promote mental health?

FACTOID: A Feasibility study of Acceptance and Commitment Therapy for Older people with treatment-resistant generalised anxiety Disorder

The FACTOID Study is examining how acceptable and feasible it is to develop a new form of talking therapy for older people with generalised anxiety disorder or chronic worrying that has not responded to treatment well. This new form of talking therapy is based on Acceptance and Commitment Therapy; a form of talking therapy that helps people to learn new ways of handling distressing thought and feelings.

Find out more about the FACTOID Project

INTREPID II: INternational Research Programme on Psychoses In Diverse Settings

Around 20 million worldwide experience a psychotic disorder. However, what we know about these disorders is based on research done mainly in Europe, North America, and Australia. We know little about these disorders in other places, especially developing countries. The overall aim of this project is to address the research questions: what is the variability – in incidence, presentation, outcome and impact – of disorders in diverse developing countries?

Find out more about the INTREPID II Project

MUTUAL: Investigating MUltimorbidity ThroUgh cApacity buiLding

More than half of older people around the world have more than one chronic condition. This accumulation of manifest diseases is otherwise known as multimorbidity. As populations age and the burden from noncommunicable diseases increases, there is a growing focus on the goal of postponing the onset of morbidity due to chronic conditions. Little is known about patterns, clusters, and overall economic burden of multimorbidity in Low Middle-Income Countries. This project aims to develop a capacity building programme which is research embedded across 3 sites (Brazil, Ethiopia and Malaysia). Training will be delivered in 3 areas of need (advanced statistical methods/epi, health economics and evidence synthesis). Postdoctoral early career researchers across the three countries will then work together to generate evidence on some of the key gaps on multimorbidity in LMIC, with the support of UK and in-country tutors. This project will not only generate evidence on clusters, patterns and burden of multimorbidity across the sites, but will also create a network and platform for future training and research activities around the topic of multimorbidity.

PINNACLE: The Epidemiology Of ParkINson In LatiN AmeriCa: Learning From UndEr-represented Populations

Principal Investigator: Dr Matthew Prina, King’s College London. Co-Investigators: Dr Jorge Llibre, Washington University in St Louis; Professor Caroline Tanner, University of California. Funder: Michael J Fox Foundation for Parkinson's Disease. This research project seeks to determine parkinsonism and PD prevalence, incidence, correlates and impact in six Latin American countries (Cuba, Dominican Republic, Mexico, Puerto Rico, Peru, Venezuela) and to also explore the main cognitive and neuro-psychiatric features of PD. We also aim to start a discourse with different stakeholders on future research priorities for PD in Latin America. We hypothesize the following: 1-The prevalence and incidence of PD in those LatAm countries will be as high if not higher than in High Income countries (HIC). 2-The main predictors of PD-MCI/PDD will include age, educational level, socio-economic status, and ApoE4 status (Any ApoE4 allele vs no ApoE4). 3-Frequency of PD-MCI/PDD is higher in PD patients living in LatAm relative to those living in HIC, due to: A) lower educational level and socio-economic status, B) increased levels of frailty and C) higher frequency of comorbidity. The proposed research is innovative in its integrative approach, combining complementary methods from epidemiology and social science to better explore the unique social risk factors that drive PD in Latino. This hasn’t been done before in the proposed populations and includes breakthrough innovations such as: a) inclusion of well-characterized research cohorts and community-based samples in a setting with limited data on PD epidemiology; b) Inclusion of multiethnic and cross-country Latino sub-groups cohorts; c) Multilevel clinical-cognitive and environment interactions and cross-populations comparisons.

REACH: Resilience, Ethnicity, and AdolesCent Mental Health

Most mental health problems first emerge during adolescence.  Their frequency, type, and persistence over time vary by ethnic group.  Understanding what factors increase and decrease risk for such problems during these critical phases, in a range of ethnic groups, is important for developing strategies for prevention and intervention.  REACH aims to investigate the impact of social, psychological, and biological risk and protective factors on the occurrence and persistence of mental health problems over time in large, ethnically diverse cohorts of adolescents.

Find out more about the REACH Project

Risk and Protective Factors for Unfounded Paranoid Ideation in Adolescents: A Virtual Reality Study

With 50% of all adult mental health problems beginning before the age of 14, adolescence is a critical developmental period during which targeted intervention to prevent the emergence of psychosis and other mental health problems may have a substantial impact. The critical first step to developing such interventions is to understand what factors increase and decrease risk, and the mechanisms through which they exert their effects. This project aims to examine the prevalence and incidence of unfounded paranoid ideation amongst adolescents using virtual reality to investigate predictors of and mechanisms associated with the onset and maintenance of paranoid thinking in a cohort of 400 young people in South London. To find out more, please contact Charlotte Gayer-Anderson at charlotte.gayer-anderson@kcl.ac.uk