Dementia is now the leading cause of death in the UK with an estimated 850,000 individuals living with the condition. As the UK population ages, this number is projected to increase to 1 million by 2025, and 2 million by 2050. As there is no cure for dementia, identifying modifiable factors that reduce disease severity and slow down progression following a diagnosis of dementia is a crucial research challenge, could reduce suffering and the high healthcare and social costs associated with dementia. Two potential population level risk factors are rising temperatures and air pollution, which are major public health concerns globally, with consequences for people with dementia. Benefiting from collaborations within King’s College London, London School of Hygiene and Tropical Medicine, University of Cambridge and Oxford University who can provide access to data on temperature, air pollution and routinely collected mental health records, this project aims to systematically explore associations between rising temperatures, air pollution and health service use, cognitive decline, and mortality in people with an established diagnosis of dementia. Throughout the project, the PhD candidate will use a range of state-of-the-art statistical techniques and epidemiological designs to gain a deep understanding of how climate and environmental stressors could affect disease progression in dementia (under main supervision of IB) and the potential mechanisms and moderators (under main supervision of CM).
Yr1: A systematic review of the associations between rising temperatures, air pollution and a range of dementia outcomes
Yr2: Augment the linkages of existing temperature and air pollution databases with four Clinical Research Interactive Search network electronic mental health databases.
Yr3: Conduct epidemiological cross-sites analyses and evaluate existing population-health interventions (e.g. Ultra Low Emission Zones, heat-related notifications)
Yr4: Synthesise findings and draft a list of recommendations for mitigating temperature and air quality measures and identifying vulnerable dementia subgroups.
The impact of climate and environmental stressors on disease progression in people with dementia
Representative Publications
Ronaldson, A., Stewart, R., Mueller, C., Das-Munshi, J., Newbury, J., Mudway, I., Broadbent, M., Fisher, H., Beevers, S., Dajnak, D., Hotopf, M., Hatch, S., & Bakolis, I. (2023). Associations between air pollution and mental health service use in dementia: A retrospective cohort study. Evidence-based mental health (accepted/in press)
Ronaldson, A., Arias de la Torre, J., Ashworth, M., Hansell, A., Hotopf, M., Mudway, I. S., Stewart, R., Dregan, A., & Bakolis, I. (2022). Associations between air pollution and multimorbidity in the UK Biobank: A cross-sectional study. Frontiers in Public Health, 10, [1035415].
https://doi.org/10.3389/fpubh.2022.1035415
Newbury, J. B., Stewart, R., Fisher, H. L., Beevers, S., Dajnak, D., Broadbent, M., Pritchard, M., Shiode, N., Heslin, M., Hammoud, R., Hotopf, M., Hatch, S. L., Mudway, I. S., & Bakolis, I. (2021). Association between air pollution exposure and mental health service use among individuals with first presentations of psychotic and mood disorders: Retrospective cohort study. British Journal of Psychiatry, 219(6), 678-685. https://doi.org/10.1192/bjp.2021.119
Greig F, Perera G, Tsamakis K, Stewart R, Velayudhan L, Mueller C. Loneliness in older adult mental health services during the COVID-19 pandemic and before: Associations with disability, functioning and pharmacotherapy. Int J Geriatr Psychiatry. 2021 Oct 6;37(1):10.1002/gps.5630. doi: 10.1002/gps.5630.
Mueller C, John C, Perera G, Aarsland D, Ballard C, Stewart R. Antipsychotic use in dementia: the relationship between neuropsychiatric symptom profiles and adverse outcomes. Eur J Epidemiol. 2021 Jan;36(1):89-101. doi: 10.1007/s10654-020-00643-2.
Mueller C, Ballard C, Corbett A, Aarsland D. The prognosis of dementia with Lewy bodies. Lancet Neurol. 2017 May;16(5):390-398. doi: 10.1016/S1474-4422(17)30074-1.