BURA Collection:

Cognitive reserve and everyday functioning in cognitively unimpaired older adults: evidence from the CAN-PROTECT study

Sat, 12 Sep 2026 00:00:00 GMT

Title: Cognitive reserve and everyday functioning in cognitively unimpaired older adults: evidence from the CAN-PROTECT study Authors: Ghahremani, Maryam; Guan, Dylan X; Ballard, Clive; Creese, Byron; Corbett, Anne; Pickering, Ellie; Smith, Eric E; Ismail, Zahinoor Abstract: Background: Cognitive reserve (CR) is thought to buffer against the clinical manifestation of dementia, preserving cognitive function despite accumulating pathology. However, less is known about how CR relates to the capacity to independently perform activities of daily living (ADL), particularly among cognitively unimpaired (CU) older adults. Here, we investigated this association. Methods: Baseline data from 1571 CU participants (mean age: 64.7 ± 7.6; 81.3% female) from the CAN-PROTECT study were analyzed. A composite CR score was derived from education, occupational complexity, and engagement in cognitively stimulating activities. Functional ability was measured using the Standard Assessment of Global Everyday Activities (SAGEA) scale, capturing cognitive, applied cognitive, instrumental, and basic ADL, and mobility. Negative binomial models examined associations between CR and global and domain-specific ADL, adjusting for age, sex, cognition, behavior, and physical/sensory limitations. Additional models tested the independent contribution of CR components to functional outcomes. Mediation analyses assessed the effect of CR on quality of life (QoL) through ADL abilities. Results: Higher CR was associated with lower global ADL impairment (count ratio = 0.58, 95% CI, 0.36-0.94, p = .027), driven by 49% less impairment in applied cognitive ADL (95% CI, 0.26-0.97, p = .038). Among CR domains, education showed the most consistent association with lower impairment across all ADL domains and was indirectly linked to better QoL through improved function. Conclusions: CR, particularly education, may play an important role in supporting functional abilities and QoL among CU older adults. Enhancing CR may be a promising avenue to promote functional independence and healthy aging, even in the absence of cognitive impairment. Description: Data availability: Due to the confidential nature of participant demographic health data, CAN-PROTECT study data are not publicly available in a data repository. However, individual access to the data may be provided upon reasonable request to the corresponding author.

Predictors of unhealthy aging

Mon, 12 Oct 2026 00:00:00 GMT

Title: Predictors of unhealthy aging Authors: Creese, Byron Abstract: This Special Section of International Psychogeriatrics contains five papers relating to unhealthy aging. Four are epidemiological and seek to identify factors that predict poor health, frailty, mortality and loneliness. The fifth describes the initial stages of the development of an intervention to target loneliness. Collectively, then, and in a broad sense, they represent two parts of the pathway towards tackling poor health outcomes in later life. ...

“How can we help our children if no one’s helping us?”: Parent and clinician priorities for mental health support in children with rare genetic conditions who have intellectual and developmental disabilities – a framework analysis

Wed, 23 Sep 2026 00:00:00 GMT

Title: “How can we help our children if no one’s helping us?”: Parent and clinician priorities for mental health support in children with rare genetic conditions who have intellectual and developmental disabilities – a framework analysis Authors: Wolstencroft, Jeanne; Housby, Harriet; Bhudia, Shriya; Lee, Irene; Vainieri, Isabella; Bednarczuk, Nadja; Oliver, Bonamy R; Wynn, Sarah L; Bennett, Sophie D; Chawner, Samuel; Hall, Jeremy; Hope-Bell, Josh; Owen, Michael; van den Bree, Marianne; Skuse, David; Raymond, F Lucy; Srinivasan, Ramya; IMAGINE-ID Consortium Abstract: Background: Next-generation sequencing technologies are now routinely used in the NHS to identify rare genetic conditions (RGCs) in children with intellectual and developmental disabilities (IDDs). As such, the proportion of children diagnosed in early childhood (<6 years) is rising rapidly. The risk of mental health conditions in this group is high, however anecdotal accounts suggest little mental health support is provided. The present study aimed to (1) define the challenges and facilitators in accessing mental health support for families caring for children with RGC and IDD, and (2) explore family and healthcare professional priorities for mental health support. Focus groups were conducted with parents of children with RGC and IDD and neurodisability medical professionals. De-identified transcripts of interviews were analysed using Framework Analysis. Eleven parents of children with RGC and IDD (anxiety problems n = 7; behavioural difficulties n = 4), and four professionals participated in the focus groups. Results: The framework analysis identified general healthcare challenges related to having an RGC, including an absence of information in ‘the big black hole’ of the post-diagnostic void, ‘falling between the cracks’ and being stuck in a loop of referrals. It also identified barriers that were specific to accessing mental health support, including difficulties in understanding how to navigate services, diagnostic overshadowing (where the RGC diagnosis acted as an exclusion criterion for accessing services) and the emotional burden of seeking mental health support. Facilitators in accessing mental health support included parental resilience, happenstance, finding key advocates and getting other diagnoses that were more widely recognised. Parent and practitioner priorities for support were aligned. They included support for families post-genetic diagnosis, training and education for healthcare professionals, early mental health support and care-co-ordination. Conclusion: Children with IDD and RGC diagnosed in early childhood and their caregivers face unique challenges in accessing mental health support for their child. Innovative approaches are needed to support parents caring for an IDD child diagnosed with RGC in early infancy and to provide better training for professionals on RGC management. Description: The publisher is sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.; IMAGINE-ID Consortium: Samuel Chawner, Jeremy Hall, Josh Hope-Bell, Michael Owen, Marianne van den Bree, David Skuse, F. Lucy Raymond & Ramya Srinivasan; Data availability: The transcripts generated during the current study are not publicly available to preserve confidentiality, but are available from the corresponding author on reasonable request.

Mild Behavioural Impairment and Everyday Functioning in Cognitively Unimpaired Older Adults: Evidence From the CAN-PROTECT Study

Sun, 14 Jun 2026 00:00:00 GMT

Title: Mild Behavioural Impairment and Everyday Functioning in Cognitively Unimpaired Older Adults: Evidence From the CAN-PROTECT Study Authors: Ghahremani, Maryam; Guan, Dylan X; Ballard, Clive; Creese, Byron; Corbett, Anne; Pickering, Ellie; Smith, Eric E; Ismail, Zahinoor Abstract: Background: Recognizing early clinical signs of dementia is key to optimizing emerging therapies, including monoclonal antibodies. Mild behavioural impairment (MBI) characterizes later-life emergent and persistent nropsychiatric symptoms linked to greater dementia risk, representing a behavioural manifestation of the underlying neurodegenerative disease for some. The association of MBI with functional ability may therefore reveal subtle functional decline as an additional early risk marker in cognitively unimpaired (CU) older adults. Methods: Baseline data from 1714 CU participants from the CAN-PROTECT study were analyzed. MBI was assessed using the MBI Checklist (MBI-C) (continuous and dichotomized, MBI+ ≥8). Functional ability was assessed using the SAGEA scale capturing instrumental and basic activities. Negative binomial models examined associations between MBI and function, adjusting for demographics, cognition, and physical/sensory limitations. Results: Higher MBI-C scores (count ratio [CR] = 1.07; 95%CI: 1.06-1.07) and MBI+ status (CR = 2.64; 95%CI: 2.36-2.95) were associated with greater global and domain-specific functional impairments. Conclusion: Findings highlight the importance of assessing both behavioural and functional changes in CU adults to identify at-risk individuals for timely interventions. Description: Data availability statement: Due to the confidential nature of participant demographic health data, CAN-PROTECT study data are not publicly available on a data repository. However, individual access to the data may be provided upon reasonable request to the corresponding author.