The determinants of cognitive decline and dementiaBMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4946 (Published 07 August 2019) Cite this as: BMJ 2019;366:l4946
- Carol Brayne, director1,
- Fiona E Matthews, professor of epidemiology2
- 1Institute of Public Health, Forvie Site, University of Cambridge, Cambridge CB2 2SR, UK
- 2Institute of Health and Society, University of Newcastle, Newcastle, UK
- Correspondence to: C Brayne
Two linked research papers illustrate the tremendous power of the Whitehall study and the value of investment in long term cohort studies.12 The most recent Whitehall II study recruited London based civil servants between 1985 and 1988, with decades of follow-up. Although such a cohort can never be representative of the general population’s full diversity, important insights have been gathered into influences on health and wellbeing through midlife and later life, including occupational status, types of work, and settings.
The emphasis of Whitehall II has now shifted towards age related conditions, in particular cognition and brain health. These new analyses consider dementia (as a dichotomous outcome) and cognitive decline (as a continuum). In both cases, health service records are used: one for ascertainment of exposure and one for outcome.
The first paper, by Krause and colleagues (doi:10.1136/bmj.l4466), is a clinically oriented study of participants …