A fascinating article in the August edition of Prevention Science has me looking at Alzheimer’s Disease in a whole different way. Rather than me seeing it as an outcome, a disease which today afflicts tens of millions of people around the world, I now see it as a brain injury which to some extent can be prevented. Hence I thought this article might be of interest to other injury prevention researchers: sometimes looking at a problem from a different angle can highlight research directions and solutions that otherwise may have remained hidden.
Anstey, Cherbuin and Herath considered Alzheimer’s Disease from a different perspective: rather than focussing on diagnoses, they focused on risk factors with the goal of developing prevention strategies that can be incorporated into populations across the globe. This is the approach they took:
1. They conducted a systematic search of the literature to identify both risk and protective factors in Alzheimer’s Disease, considering the effect sizes in the extant literature in particular. Four protective factors (fish intake, social engagement, cognitive activity, physical activity) and 11 risk factors (age, sex, education, body mass index, diabetes, depression, serum cholesterol, traumatic brain injury, smoking, alcohol intake, pesticide exposure) were gleaned from a possible 35 factors identified in the search.
2. They developed an algorithm to combine the odds ratios into a risk score for developing Alzheimer’s Disease, allowing for interactions amongst the risk and protective factors over the life course.
3. They developed a self-report questionnaire to assess the risk and protective factors.
This approach means that the findings are more generalisable than the findings from the traditional single-cohort cross-sectional study. Generalisability in particular is a research dimension that is often problematic, and it is a research dimension that can hamper the identification of effective avenues of intervention. Given the ageing population in societies such as Australia, identifying such interventions and thereby preventing Alzheimer’s Disease has never been more critical.