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Ethnic Differences in Dementia Risk: A Systematic Review and Meta-Analysis

Shiekh, Suhail Ismail ; Cadogan, Sharon Louise ; Lin, Liang-Yu ; [et al.]

IOS Press ; 2021

In: Journal of Alzheimer's Disease Vol. 80, No. 1 ( 2021-03-09), p. 337-355

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In: Journal of Alzheimer's Disease, IOS Press, Vol. 80, No. 1 ( 2021-03-09), p. 337-355

Abstract: Background: Globally around 50 million people have dementia. Risk factors for dementia such as hypertension and diabetes are more common in Black, Asian, and other ethnic minorities. There are also marked ethnic inequalities in care seeking, likelihood of diagnosis, and uptake of treatments for dementia. Nevertheless, ethnic differences in dementia incidence and prevalence remain under-explored. Objective: To examine published peer-reviewed observational studies comparing age-specific or age-adjusted incidence or prevalence rates of dementia between at least two ethnic groups. Methods: We searched seven databases on 1 September 2019 using search terms for ethnicity, dementia, and incidence or prevalence. We included population-based studies comparing incidence or prevalence of dementia after accounting for age of at least two ethnic groups in adults aged 18 or more. Meta-analysis was conducted for eligible ethnic comparisons. Results: We included 12 cohort studies and seven cross-sectional studies. Thirteen were from the US, and two studies each from the UK, Singapore, and Xinjiang Uyghur Autonomous Region in China. The pooled risk ratio for dementia incidence obtained from four studies comparing Black and White ethnic groups was 1.33 (95% CI 1.07–1.65; I-squared = 58.0%). The pooled risk ratio for dementia incidence comparing the Asian and White ethnic groups was 0.86 (95% CI 0.728–1.01; I-squared = 43.9%). There was no difference in the incidence of dementia for Latino ethnic group compared to the White ethnic group. Conclusion: Evidence to date suggest there are ethnic differences in risk of dementia. Better understanding of the drivers of these differences may inform efforts to prevent or treat dementia.

Type of Medium: Online Resource

ISSN: 1387-2877 , 1875-8908

URL: Article

DOI: 10.3233/JAD-201209

Language: Unknown

Publisher: IOS Press

Publication Date: 2021

detail.hit.zdb_id: 2070772-1

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Vitamin D Deficiency or Supplementation and the Risk of Human Herpesvirus Infections or Reactivation: A Systematic Review and Meta-analysis

Lin, Liang-Yu ; Bhate, Ketaki ; Forbes, Harriet ; [et al.]

Oxford University Press (OUP) ; 2021

In: Open Forum Infectious Diseases Vol. 8, No. 1 ( 2021-01-01)

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In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 8, No. 1 ( 2021-01-01)

Abstract: Vitamin D may protect against respiratory virus infections, but any association with herpesviruses is unclear. Methods We undertook a systematic review of vitamin D deficiency or supplementation and the risk of 8 human herpesviruses. Six databases and 4 gray literature databases were searched for relevant cohort studies, case–control studies, and clinical trials. Results Ten studies were included, all conducted among immunosuppressed patients. There was no evidence that vitamin D deficiency is associated with cytomegalovirus (CMV) disease (pooled risk ratio, 1.06; 95% CI, 0.66–1.7), herpes zoster after transplantation (1 study), or HHV-8 among HIV patients (1 study). Vitamin D supplementation may decrease herpes zoster among hemodialysis patients (1 study) or CMV disease after renal transplantation (1 study), but supplementation was not associated with reduced EBV viral load among multiple sclerosis patients (1 study). Conclusions Any association between vitamin D and herpesviruses remains inconclusive. Further studies in the general population are needed.

Type of Medium: Online Resource

ISSN: 2328-8957

URL: Article

DOI: 10.1093/ofid/ofaa570

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2021

detail.hit.zdb_id: 2757767-3

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Distribution of vitamin D status in the UK: a cross-sectional analysis of UK Biobank

Lin, Liang-Yu ; Smeeth, Liam ; Langan, Sinead ; [et al.]

BMJ ; 2021

In: BMJ Open Vol. 11, No. 1 ( 2021-01), p. e038503-

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In: BMJ Open, BMJ, Vol. 11, No. 1 ( 2021-01), p. e038503-

Abstract: No recent large studies have described the distribution of vitamin D status in the UK. Understanding the epidemiology of vitamin D deficiency is important to inform targeted public health recommendations. This study aimed to investigate the distribution of factors associated with serum vitamin D status in a large national cohort. Design A cross-sectional study. Setting The UK Biobank, a prospective cohort study following the health and well-being of middle-aged and older adults recruited between 2006 and 2010. Participants A total of 449 943 participants aged 40–69 years with measured serum vitamin D status were eligible for the analysis. Participants completed a questionnaire about sex, age, ethnic background, vitamin D supplementation, smoking, drinking and socioeconomic status. Primary and secondary outcome measures We investigated the distribution of serum vitamin D status and the association between demographic factors and vitamin D deficiency or insufficiency. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level 〈 25 nmol/L. Multivariable logistic regression was used to assess the association between demographic factors and vitamin D status. Results Asian (n=4297/8000, 53.7%) and black (n=2459/7046, 34.9%) participants had a higher proportion of vitamin D deficiency than white participants (n=50 920/422 907, 12%). During spring and winter, the proportion of vitamin D deficiency was higher across the UK and higher in the north than in the south. Male sex, abnormal body mass index, non-white ethnic backgrounds, smoking and being more socioeconomically deprived were associated with higher odds of vitamin D deficiency. Increasing age, taking vitamin D supplements and drinking alcohol were associated with lower odds of deficiency. Conclusions Vitamin D status varied among different ethnic groups and by season and geographical area within the UK. Taking supplements was associated with a lower risk of vitamin D deficiency. These findings support the vitamin D supplementation recommendations of Public Health England.

Type of Medium: Online Resource

ISSN: 2044-6055 , 2044-6055

URL: Article

DOI: 10.1136/bmjopen-2020-038503

Language: English

Publisher: BMJ

Publication Date: 2021

detail.hit.zdb_id: 2599832-8

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The association between vitamin D status and COVID-19 in England: A cohort study using UK Biobank

Lin, Liang-Yu ; Mulick, Amy ; Mathur, Rohini ; [et al.]

Public Library of Science (PLoS) ; 2022

In: PLOS ONE Vol. 17, No. 6 ( 2022-6-6), p. e0269064-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 6 ( 2022-6-6), p. e0269064-

Abstract: Recent studies indicate that vitamin D supplementation may decrease respiratory tract infections, but the association between vitamin D and COVID-19 is still unclear. Objective To explore the association between vitamin D status and infections, hospitalisation, and mortality due to COVID-19. Methods We used UK Biobank, a nationwide cohort of 500,000 individuals aged between 40 and 69 years at recruitment between 2006 and 2010. We included people with at least one serum vitamin D test, living in England with linked primary care and inpatient records. The primary exposure was serum vitamin D status measured at recruitment, defined as deficiency at 〈 25 nmol/L, insufficiency at 25–49 nmol/L and sufficiency at ≥ 50 nmol/L. Secondary exposures were self-reported or prescribed vitamin D supplements. The primary outcome was laboratory-confirmed or clinically diagnosed SARS-CoV-2 infections. The secondary outcomes included hospitalisation and mortality due to COVID-19. We used multivariable Cox regression models stratified by summertime months and non-summertime months, adjusting for demographic factors and underlying comorbidities. Results We included 307,512 participants (54.9% female, 55.9% over 70 years old) in our analysis. During summertime months, weak evidence existed that the vitamin D deficiency group had a lower hazard of being diagnosed with COVID-19 (hazard ratio [HR] = 0.86, 95% confidence interval [CI] = 0.77–0.95). During non-summertime, the vitamin D deficiency group had a higher hazard of COVID-19 compared with the vitamin D sufficient group (HR = 1.14, 95% CI = 1.01–1.30). No evidence was found that vitamin D deficiency or insufficiency was associated with either hospitalisation or mortality due to COVID-19 in any time strata. Conclusion We found no evidence of an association between historical vitamin D status and hospitalisation or mortality due to COVID-19, along with inconsistent results for any association between vitamin D and diagnosis of COVID-19. However, studies using more recent vitamin D measurements and systematic COVID-19 testing are needed.

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0269064

DOI: 10.1371/journal.pone.0269064.g001

DOI: 10.1371/journal.pone.0269064.g002

DOI: 10.1371/journal.pone.0269064.t001

DOI: 10.1371/journal.pone.0269064.t002

DOI: 10.1371/journal.pone.0269064.t003

DOI: 10.1371/journal.pone.0269064.t004

DOI: 10.1371/journal.pone.0269064.t005

DOI: 10.1371/journal.pone.0269064.s001

DOI: 10.1371/journal.pone.0269064.s002

DOI: 10.1371/journal.pone.0269064.s003

DOI: 10.1371/journal.pone.0269064.s004

DOI: 10.1371/journal.pone.0269064.s005

DOI: 10.1371/journal.pone.0269064.s006

DOI: 10.1371/journal.pone.0269064.s007

DOI: 10.1371/journal.pone.0269064.s008

DOI: 10.1371/journal.pone.0269064.s009

DOI: 10.1371/journal.pone.0269064.s010

DOI: 10.1371/journal.pone.0269064.s011

DOI: 10.1371/journal.pone.0269064.s012

DOI: 10.1371/journal.pone.0269064.s013

DOI: 10.1371/journal.pone.0269064.s014

DOI: 10.1371/journal.pone.0269064.s015

DOI: 10.1371/journal.pone.0269064.r001

DOI: 10.1371/journal.pone.0269064.r002

DOI: 10.1371/journal.pone.0269064.r003

DOI: 10.1371/journal.pone.0269064.r004

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2022

detail.hit.zdb_id: 2267670-3

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Association between vitamin D and incident herpes zoster: a UK Biobank study

Lin, Liang-Yu ; Mathur, Rohini ; Mulick, Amy ; [et al.]

Royal College of General Practitioners ; 2022

In: British Journal of General Practice Vol. 72, No. 724 ( 2022-11), p. e842-e848

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In: British Journal of General Practice, Royal College of General Practitioners, Vol. 72, No. 724 ( 2022-11), p. e842-e848

Abstract: Vitamin D has immunomodulatory effects, but any association with herpes zoster (HZ) is unclear. Aim To explore the association between vitamin D status and risk of incident HZ in adults in the UK. Design and setting A cohort study involving participants of UK Biobank (a database containing the health information from half a million individuals) across England, Wales, and Scotland, who had at least one vitamin D testing result with linked primary care electronic health records. Method The primary exposure was vitamin D status, categorised as deficient ( 〈 25 nmol/L), insufficient (25–49 nmol/L), or sufficient (≥50 nmol/L). The secondary exposures were self-reported vitamin D supplementation at baseline assessment and vitamin D prescription records. The outcome was diagnosed incident HZ, identified from linked primary care or hospital inpatient records. Weibull regression was used, adjusting for potential confounders, including demographic factors, comorbidities, and immunosuppression. Results In total, 177 572 eligible participants were included in the analysis, with a mean follow-up time of 10.1 years (standard deviation 1.9 years). No evidence showed that low vitamin D was associated with a higher incidence of HZ, compared with people with sufficient vitamin D (deficient: adjusted hazard ratio [HR] 0.99, 95% confidence interval [CI] = 0.90 to 1.10; insufficient: HR 1.03, 95% CI = 0.96 to 1.10). No evidence was found that supplementing vitamin D or receiving vitamin D prescription was associated with HZ incidence (supplementation: HR 0.88, 95% CI = 0.67 to 1.16; prescription: HR 1.11, 95% CI = 0.91 to 1.34). Conclusion No association of vitamin D status, supplementation, or prescription with incident HZ was observed. No evidence supported vitamin D supplementation as a strategy to prevent HZ.

Type of Medium: Online Resource

ISSN: 0960-1643 , 1478-5242

URL: Article

DOI: 10.3399/BJGP.2021.0623

RVK:

XA 34050

Language: English

Publisher: Royal College of General Practitioners

Publication Date: 2022

detail.hit.zdb_id: 2097982-4

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Vitamin D deficiency or supplementation and the risk of human herpesvirus infections or reactivation: a systematic review protocol

Lin, Liang-Yu ; Bhate, Ketaki ; Forbes, Harriet ; [et al.]

BMJ ; 2019

In: BMJ Open Vol. 9, No. 10 ( 2019-10), p. e031867-

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In: BMJ Open, BMJ, Vol. 9, No. 10 ( 2019-10), p. e031867-

Abstract: Human herpesviruses induce lifelong latent infections and may reactivate as the immune system deteriorates. Recent studies have suggested that vitamin D, an essential element of bone health, may have some effect of protecting against infections, but investigations of its potential to prevent herpesvirus infection or reactivation are limited. We will review the current literature examining vitamin D and the risk of herpesvirus infections or reactivation. Methods and analysis Our systematic review will address two research questions: (1) Do deficient/insufficient serum vitamin D levels increase the risk of herpesvirus infections and (2) Does vitamin D supplementation protect against herpesvirus infections? We will include only intervention studies with control groups, cohort studies and case-control studies. We will use subject headings and keywords to search for synonyms of ‘vitamin D’ and ‘herpesviruses’ (including herpes simplex virus type 1 and 2, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus and human herpesviruses type 6, 7 and 8) in Medline, Embase, Global Health, Web of Science, Scopus and Cochrane Central Register of Controlled Trials, and the grey literature databases Open Grey, EThOS and BASE from inception to 31 August 2019. References to the included articles and relevant systematic reviews will also be examined. Two reviewers will independently screen the study titles and abstracts, and examine the full texts to decide the final eligibility. They will independently extract data from the studies and assess bias using the Cochrane Collaboration approach. A third researcher will solve any discrepancies. The results will be narratively synthesised; if an adequate number of studies is included and the homogeneity between studies is acceptable, a meta-analysis will be performed. We will assess the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework, and display the results in a summary of findings table. Ethics and dissemination Ethical review is not required for a systematic review. We will publish the results in a peer-review journal. Any amendments to the protocol will be recorded in the supplementary section. PROSPERO registration number CRD42019130153.

Type of Medium: Online Resource

ISSN: 2044-6055 , 2044-6055

URL: Article

DOI: 10.1136/bmjopen-2019-031867

Language: English

Publisher: BMJ

Publication Date: 2019

detail.hit.zdb_id: 2599832-8

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Post-COVID-19 condition and persisting symptoms in English schoolchildren: repeated surveys to March 2022

Warren-Gash, Charlotte ; Lacey, Andrea ; Cook, Sarah ; [et al.]

Springer Science and Business Media LLC ; 2023

In: BMC Infectious Diseases Vol. 23, No. 1 ( 2023-04-05)

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In: BMC Infectious Diseases, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-04-05)

Abstract: Both post-COVID-19 condition (long COVID) and the presence of persisting symptoms that do not meet formal definitions of post-COVID-19-condition may adversely affect quality of life and function. However, their prevalence among children and young people in England is unclear. Methods We used data from repeated surveys in a large cohort of English schoolchildren from the COVID-19 Schools Infection Survey (SIS) for the school year 2021/22 to describe the weighted prevalence of post-COVID-19-condition and compare persisting symptoms between individuals with a positive SARS-CoV-2 test and those with neither a positive test history nor suspected infection. Results Among 7797 children from 173 schools, 1.8% of primary school pupils (aged 4 to 11 years), 4.5% of secondary school pupils in years 7–11 (aged 11 to 16 years) and 6.9% of those in years 12–13 (aged 16 to 18 years) met a definition of post-COVID-19 condition in March 2022. Specific persisting symptoms such as anxiety or difficulty concentrating were frequently reported regardless of prior infection status and increased with age: 48.0% of primary school pupils, 52.9% of secondary school pupils in years 7–11 and 79.5% in years 12–13 reporting at least one symptom lasting more than 12 weeks. Persisting loss of smell and taste, cardiovascular and some systemic symptoms were more frequently reported by those with a previous positive test. Conclusions We showed that ongoing symptoms were frequently reported by English schoolchildren regardless of SARS-CoV-2 test results and some specific symptoms such as loss of smell and taste were more prevalent in those with a positive test history. Our study emphasises the wide-ranging impacts of the COVID-19 pandemic on the health and wellbeing of children and young people.

Type of Medium: Online Resource

ISSN: 1471-2334

URL: Article

DOI: 10.1186/s12879-023-08203-1

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2023

detail.hit.zdb_id: 2041550-3

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