From the Heart to the Brain
Insulin and lipids in relation to cardiovascular risk and Alzheimer's disease
I investigated the relationship between plasma insulin, lipids and lipoproteins and age, sex, body fat distribution, smoking habits, alcohol consumption and the use of oral contraceptives. The study was the first epidemiological study providing data on cardiovascular risk factors in British women and discovered a relationship between alcohol consumption and plasma insulin which might explain part of the cardio-protective effect of alcohol. The findings lead to huge international interests and stimulated many experimental, observational and epidemiological studies, which have major impact on clinical practice (see publications 9,10,11,14 & 15).
I also looked at the role of plasma insulin, fatty acids, lipids, lipoproteins and its free peroxidation products in Alzheimer`s disease. The study was the first to report an association between Alzheimer's disease, hyperinsulinaemia and insulin resistance. The results lead to large studies linking Alzheimer’s disease with insulin resistance (see publication 12).
Vascular risk factors in Alzheimer’s disease: A Case-Control study
This case control study looked at the relation between Alzheimer’s disease and obesity, plasma insulin, lipids and lipoproteins. The study revealed an association between Alzheimer’s disease and hyperinsulinaemia, hypertriglyceridemia, low HDL cholesterol, high saturated and low polyunsaturated fatty acids.
The results of this study were the first to show a link between Alzheimer’s disease and abdominal obesity and the metabolic syndrome. An interesting finding has been an association between Alzheimer’s disease, underweight and obesity. The study was chosen as one of the ten most talked about paper from 2000 studies, in the 9th International Conference on Alzheimer’s Disease and Related Disorders, Philadelphia, USA, July 2004. (see publications and conference presentations 6,7 & 8)
A community-based physical exercise program to reduce functional decline in people with Alzheimer’s disease
This study was the first randomised controlled trial showing that a community based exercise program can improve cognitive and physical functioning and independence in activity of daily living in patients with Alzheimer’s disease (see publication 2).
Idiopathic normal pressure hydrocephalus
a-“Incidence, diagnostic criteria and outcome following ventriculo-peritoneal shunting of idiopathic normal pressure hydrocephalus in a memory clinic population. This prospective observational cross-sectional and cohort study” has just been published in the British Medical Journal (BMJ) Open. It recruited 408 consecutive patients with memory problems from the Memory Disorders Clinic, Launceston, between 2010 and 2014. The study is the first to report the higher incidence of INPH and that up to 15% of patients with memory problems might have the condition. We have also reported a simple diagnostic tool to predict the diagnosis of INPH which might help medical practitioners in non-specialised setting. In addition, we have shown that shunt surgery improve cognition, balance and gait for up to one year. (see publication 1)
b- I have also reported a prospective controlled clinical trial showing patients who had ventriculo-peritoneal shunt, compared with those without a shunt, had significant improvement in cognitive, balance, gait and urinary functioning. I have presented the findings of these studies at several national and international meetings
(see publication 4)