Professor Dame V Beral
University of Oxford
Million Women Study
Alzheimer's disease & other dementias|Neurodegenerative disease in general
In 1996-2001 we recruited a cohort of 1.3 million women, a quarter of the female UK population then aged 50-64 years. About 99% have been followed for more than 10 years for hospital admissions and deaths. Mean age is now 70 years and conditions associated with ageing, such as dementia and osteoporosis, are becoming increasingly common. We plan to focus on these emerging health problems, following the cohort for a further 5 years by electronic linkage to NHS records. The increasing availability of electronic routinely collected NHS records has revolutionized questions that can be addressed in cohort studies. Only recently was it possible to obtain linked NHS records for cause-specific hospital admissions in England. Linkage to NHS primary care prescription and diagnostic data has just become available. For women with a primary care or hospital record of dementia, we will confirm diagnoses and classify them by phenotype, where possible. We will then examine associations with postulated risk factors, taking care to avoid ‘reverse causation bias’ by focusing on the 15,000 women first diagnosed with dementia 10+ years after reporting risk factors. Bisphosphonates are increasingly used for osteoporosis, but surprisingly little robust information exists about their safety. Recent reports of serious pathological lesions of the bone and other possible long-term side effects are stimulating debate about the balance between beneficial and adverse effects in users. Randomized trials have been too small, with too little follow-up, to evaluate such effects. About 10% of study participants have used bisphosphonates, permitting reliable assessment of their net effect, overall and by duration of use. The uniqueness and timeliness of the research planned derives mainly from the size and maturity of the cohort, the wealth of prospectively collected personal data, and the virtually complete follow-up via electronic NHS records.