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INTRODUCTION: Hearing loss (HL) has been associated with cognitive decline and dementia. We examined the temporal association between prevalent and incident HL and cognitive change. METHODS: A total of 1823 participants (24‐82 years) from the Maastricht Aging Study (MAAS) were assessed at baseline, 6 and 12 years, including pure‐tone audiometry. Linear‐mixed models were used to test the association between HL and cognition, adjusted for demographics and other dementia risk factors. RESULTS: Participants with prevalent and incident HL showed a faster decline in verbal memory, information processing speed, and executive function than participants without HL. Decline was steady from baseline to 6 and 12 years for prevalent HL, but time‐delayed from 6 to 12 years for incident HL. Having a hearing aid did not change associations. DISCUSSION: Findings support the notion that HL is a risk factor for cognitive decline independent of other dementia risk factors. Onset of HL preceded onset of cognitive decline. Highlights: We examined cognitive change in prevalent and incident hearing loss.Prevalent and incident hearing loss were associated with faster cognitive decline.For prevalent hearing loss, decline was steady from baseline to 6 and 12 years.Onset of hearing loss preceded the onset of cognitive decline.Having a hearing aid did not change the observed associations. [ABSTRACT FROM AUTHOR]

A 2013 systematic review and Delphi consensus study identified 12 modifiable risk and protective factors for dementia, which were subsequently merged into the "LIfestyle for BRAin health" (LIBRA) score. We systematically evaluated whether LIBRA requires revision based on new evidence. To identify modifiable risk and protective factors suitable for dementia risk reduction, we combined an umbrella review of systematic reviews and meta‐analyses with a two‐round Delphi consensus study. The review of 608 unique primary studies and opinions of 18 experts prioritized six modifiable factors: hearing impairment, social contact, sleep, life course inequalities, atrial fibrillation, and psychological stress. Based on expert ranking, hearing impairment, social contact, and sleep were considered the most suitable candidates for inclusion in updated dementia risk scores. As such, the current study shows that dementia risk scores need systematic updates based on emerging evidence. Future studies will validate the updated LIBRA score in different cohorts. Highlights: An umbrella review was combined with opinions of 18 dementia experts.Various candidate targets for dementia risk reduction were identified.Experts prioritized hearing impairment, social contact, and sleep.Re‐assessment of dementia risk scores is encouraged.Future work should evaluate the predictive validity of updated risk scores. [ABSTRACT FROM AUTHOR]

Background: Finding eligible participants for dementia prevention trials is challenging, resulting in prolonged recruitment periods, underpowered studies, and excessive costs. The Dutch Brain Research Registry (DBRR) is an online platform to facilitate recruitment of research participants. We evaluated different recruitment strategies with the ambition to optimize recruitment for the multi‐domain lifestyle intervention trial FINGER‐NL. Method: DBRR registrants were prescreened for FINGER‐NL based on available profile information. Potentially eligible registrants received an automatic study invitation. Those interested were contacted for additional telephonic screening and, if eligible, included in the trial. Five recruitment strategies within 2022 were executed with the goal to increase the number of DBRR registrants: 1) a paid Facebook‐campaign, 2) referral via (patient)‐organizations, 3) newspaper articles, 4) live‐events, and 5) national television appearance (W.F&E.S.). Recruitment source was traced (online; UTM tags) and/or reported by the participant. For most recruitment strategies, we involved a nationally well‐known ambassador (E.S.) who advocates a healthy lifestyle to improve brain‐health (Figure 1). For each strategy, we described the number of individuals registered, eligible and included in FINGER‐NL. We calculated efficiency (%eligible/prescreened) as a reflection of the proportion of eligible participants reached, and effectiveness (%included/registered) as a reflection of the proportion of participants included in FINGER‐NL Result: In 2022, the DBRR recruited 11234 new registrants. The highest numbers of registrants and highest number of inclusions were reached with national television appearance and the Facebook‐campaign (Table 1). In particular, the Facebook advertisement with a lifestyle theme and well‐known ambassador outperformed all other advertisements in number of registrations (Figure 1). After initial prescreening, between 18‐35% of registrants were eligible. Most efficient were national television and the Facebook‐campaign. Between 4‐12% of new registrants were included in the trial. Most effective strategies were national television appearance and referrals via patient‐organizations Conclusion: Our results show that mass‐media, i.e. tailor‐made Facebook‐campaigns, national television appearance and events, are efficient ways to reach large numbers of eligible participants, especially when well‐known ambassador(s) were included. Recruitment strategies with detailed information about in‐ and exclusion of the trial are most effective. The DBRR provides an efficient and effective recruitment and prescreening process for the FINGER‐NL trial. [ABSTRACT FROM AUTHOR]

Background: Hearing impairment (HI) is a common and often treatable condition that is associated with increased risk of cognitive impairment and dementia. However, little is known about the cognitive course of individuals with incident HI. The objective of this study was to investigate the temporal association between prevalent and incident HI and change in cognition over 12 years. Method: Data was used from the Maastricht Ageing Study (MAAS), a Dutch cohort of 1823 cognitively healthy individuals aged 24‐82 years. Individuals were repeatedly assessed at baseline, 6 and 12 years. Hearing acuity was assessed using pure‐tone audiometry thresholds in decibel (dB). Prevalent (baseline) HI was categorized into no HI (average acuity <20 dB), mild HI (≥ 20 and <35 dB) and moderate to profound HI (≥35 dB). The presence of incident HI was defined by an average threshold of 20 dB at 6‐ or 12‐years in those without HI at baseline and follow‐up data (n = 1071). Verbal memory, information processing speed, and executive function were assessed. Linear mixed models were used to test the association between HI and change in cognitive function over time, adjusted for age, sex, education, and a composite score of 11 modifiable dementia risk factors. Result: Participants with mild prevalent HI (n = 322; 17.8%) and moderate to profound prevalent HI (n = 198; 10.9%) showed more decline over time in verbal memory, information processing speed, and executive function than participants without prevalent HI, independently of the other demographical and risk factors in the model. Likewise, participants with incident HI (n = 360; 33.6%) showed more decline over time in all cognitive domains than those with normal hearing at follow‐up. Comparing slopes across time showed a steady cognitive decline across all time points for prevalent HI, while for incident HI, a more time‐delayed pattern of increasing decline from 6 to 12 years was observed. Conclusion: Prevalent and incident HI predict cognitive decline in adults aged between 24‐82 years. This association is already present in individuals with mild HI. Findings for incident HI suggest that cognitive decline evolves gradually over time and after the onset of HI, possibly opening a window for risk management. [ABSTRACT FROM AUTHOR]

Background: Evidence on the effectiveness of multidomain lifestyle interventions to prevent cognitive decline in non‐demented older individuals is mixed. The multidomain FINGER study1 found small positive effects on cognition among older people at risk for dementia. As part of the World‐Wide FINGERS initiative to replicate and build on these results, FINGER‐NL aims to investigate the effectiveness of a 2‐year high versus low intensive multidomain lifestyle intervention on cognitive functioning in Dutch older at‐risk individuals. Method: FINGER‐NL is a Dutch multi‐center, randomized, controlled, multidomain lifestyle intervention trial aiming to include 1,206 adults at risk for cognitive decline. Adults aged 60‐80 years with at least 3 modifiable dementia risk factors (based on 'LIfestyle for BRAin Health' (LIBRA))2 and either a family history of dementia or self‐reported cognitive decline are eligible for inclusion. Participants are randomized (1:1 ratio) to either a high (HI‐group) or low‐intensity (LI‐group) intervention group. The multi‐domain intervention comprises a combination of 7 lifestyle components (physical exercise, cognitive training, cardiovascular risk management, nutritional counseling (with a specific focus on the MIND diet), sleep counseling, stress management, social activities) and 1 nutritional product (Souvenaid, 125ml). The HI‐group receives a personalized, supervised and hybrid intervention consisting of group meetings and individual sessions guided by a lifestyle coach. The LI‐group receives online lifestyle‐related health education. Primary outcome is 2‐year change from baseline on the cognitive composite score covering processing speed, executive function and memory. Secondary outcomes including changes in specific cognitive domains, instrumental activities of daily living, LIBRA score, and lifestyle component specific outcomes. For recruitment, we use the Dutch Brain Research Registry.3 Result: Participant recruitment started in January 2022. So far, 2405 people were interested, 1711 individuals have been screened for eligibility, 949 underwent baseline testing and 880 participants (73% of target sample) have been randomized and started with the intervention. The intervention is well‐accepted based on drop‐out rate (0.5%) and use of the online intervention portal. We expect to finalize randomization in Q2 of 2023 and complete the two‐year trial in 2025. Conclusion: Results so far show that FINGER‐NL is well on track, the intervention is well‐accepted and the trial will reach its inclusion target. [ABSTRACT FROM AUTHOR]

The relationship between short-term variations of air pollutants concentrations and occurrence of ST-elevated myocardial infarction (STEMI) remains controversial. Most studies have been performed in highly polluted areas. To analyze the association between air pollutant concentrations and admission for STEMI in a low-to-average polluted urban area. We reviewed the medical data of the prospective SCALIM registry to identify all patients (n = 631) admitted between 06/2011 and 12/2018 for STEMI in our department living in the urban area of Limoges, France, and matched them with daily and hourly averaged concentrations of air pollutants (particulate matter ≤ 2.5 μm, PM 2.5 , and ≤ 10 μm PM 10 , nitrogen dioxide, NO 2 , and ozone, O 3) monitored in the same area. Each patient was his/her own control in this study with four control periods in the past month preceding the STEMI case. The risk of STEMI was 30.5% higher with every 10-units PM 10 peak concentration increase in the two hours preceding STEMI symptoms (P < 0.001). This association remained valid despite adjustment for every cardiovascular risk factor, as well as in patients without severe coronary artery disease, or those with ≤ 2 cardiovascular risk factors and those with history of MI. A 10-unit increase in PM 2.5 median concentration in the six hours preceding symptoms was also significatively associated with STEMI but only for patients with ≤ 2 cardiovascular risk factors. The O 3 and NO 2 concentrations were not associated with STEMI. The PM 10 pollution level was associated with the risk of STEMI, even in an area not considered as highly polluted. [ABSTRACT FROM AUTHOR]