Close
Explore more Centres, Projects and Groups
Welcome
Welcome Banner
Banner
Graphic with human heads overlapping each other. Credit: Lightspring via Shutterstock

Brain Health Group

Understanding drivers of global brain health using diverse data 

Bottom Content
Logo List Links
Intro Blocks List
About

In the Brain Health research group, we aim to understand causes and consequences of poor brain health across populations using large health datasets to inform brain health promotion strategies.

Donations
About
About Brain Health Group 2 columns
About Brain Health Group 2 columns left paragraph
Paragraph

We are a group of researchers working to understand the epidemiology of brain health conditions with a major focus on ageing populations worldwide. Maintaining brain health into older age is a key global health challenge. Over 20% of adults aged over 60 experience conditions that disrupt normal brain health and function; the most common are depression and dementia, affecting 7% and 5% of older individuals respectively.

Our research uses longitudinal electronic health records and multidimensional research cohorts from across settings (in the UK and internationally). We apply causal inference methods to these datasets to generate insights into the determinants and outcomes of brain health conditions. We work closely with collaborators including clinicians, public health professionals, epidemiologists, statisticians, and health data scientists. Ultimately, our research aims to inform public health approaches to improving brain health worldwide.

Plain English summary

People worldwide are living longer. Maintaining good brain health into older age is a major health challenge.  'Brain health’ refers to how well a person’s brain functions across areas such as cognition, emotion and movement. Good brain health enables people to live well and function in society. We study brain health in different populations around the world. Our research uses anonymous health data from GPs and hospitals. We also work with data from surveys and cohort studies to explore brain health across different groups of people. We seek advice from experts in medicine, public health, statistics and those with lived experience. Our research aims to identify ways to improve people’s brain health.

Resources

Who we are
Team Block
Profiles List
Prof Charlotte Warren-Gash

Charlotte
Warren-Gash

Clin Prof of Epi & Health Data Science
Dr Kwabena Asare

Kwabena
Asare

Research Fellow
Dr Sharon Cadogan

Sharon
Cadogan

Research Fellow
Dr Georgia Gore-Langton

Georgia
Gore-Langton

Research Fellow
Mr Louis Tunnicliffe

Louis
Tunnicliffe

Research Assistant
Research
Research Brain Health Group 2 columns
Research Brain Health Group 2 columns left paragraph
Paragraph

According to the National Institute on Aging, ‘brain health’ refers to how well a person’s brain functions across several areas. Aspects of brain health include:

  • Cognitive health — how well you think, learn, and remember
  • Motor function — how well you make and control movements, including balance
  • Emotional function — how well you interpret and respond to emotions
  • Tactile function — how well you feel and respond to sensations of touch — including pressure, pain, and temperature

Brain health can be affected by age-related changes in the brain, injuries such as stroke or traumatic brain injury, mood disorders such as depression, substance use disorder or addiction, and diseases such as Alzheimer’s disease. 

Our principal areas of research are:

Acute infections and brain health in ageing populations

Through a Wellcome-funded programme of work, we are investigating relationships between a range of infections and different components of brain health in older age. Key questions include:

  • What risks do acute infections pose to brain health in UK and US populations?
  • Do relationships between infections and brain health differ in India or Mexico compared to the UK and US?
  • What mediates relationships between infections and brain health?

Risk factors and complications of herpesviruses

We have conducted studies of the risk factors, burden, and complications of herpesviruses in large cohorts and health records datasets. These include:

  • Quantifying acute complications associated with herpes zoster (shingles) including acute neurological, ocular, skin, and visceral complications
  • Showing a lack of association between herpes zoster and either dementia or Parkinson’s disease
  • Investigating risk factors for herpes zoster and herpes simplex virus type 1

Dementia risk factors and inequalities

Our work on better understanding population drivers of dementia includes:

  • Investigating ethnic inequalities in dementia diagnoses
  • Identifying factors affecting dementia risk among people with diabetes, atrial fibrillation, and stroke
  • Assessing the validity of dementia diagnosis codes in electronic health records

Policy work on brain health promotion

We input into policy consultations relevant to brain health and work with initiatives such as Think Brain Health Global and organisations such as Alzheimer’s Research UK on brain health promotion activities. We also input into wider policy consultations on topics such as using health data for research.

 

Publications

See our selected recent publications below

Publications
Publications List
Incident dementia risk among patients with type 2 diabetes receiving metformin versus alternative oral glucose-lowering therapy: an observational cohort study using UK primary healthcare records.
Doran W, Tunnicliffe L, Muzambi R, Rentsch CT, Bhaskaran K, Smeeth L, Brayne C, Williams DM, Chaturvedi N, Eastwood SV, Dunachie SJ, Mathur R, Warren-Gash C.
2024
BMJ Open Diabetes Res Care. 2024 Jan; 12(1)e003548.
Common infections and neuroimaging markers of dementia in three UK cohort studies.
Green RE, Sudre CH, Warren-Gash C, Butt J, Waterboer T, Hughes AD, Schott JM, Richards M, Chaturvedi N, Williams DM.
2024
2024 Jan Online ahead of print.
Herpes zoster and risk of incident Parkinson’s disease in US Veterans: a matched cohort study.
Tunnicliffe L, Weil RS, Breuer J, Rodriguez-Barradas MS, Smeeth L, Rentsch C*, Warren-Gash C* *joint senior authors
2024
Movement Disorders. 2024 Jan 16. Online ahead of print.
Acute cardiovascular events after COVID-19 in England in 2020: a self-controlled case series study.
Davidson JA, Banerjee A, Strongman H, Herrett E, Smeet L, Breuer J, Warren-Gash C.
2023
Clin Epidemiol. 2023 Sept 1;15:911-92110.2147/CLEP.S421062
Severe COVID-19 outcomes by cardiovascular risk profile in England in 2020: a population-based cohort study.
Warren-Gash C, Davidson JA, Strongman H, Herrett E, Smeeth L, Breuer J, Banerjee A.
2023
Lancet Reg Health Eur. 2023 Apr;27:100604.
Exploring the impact of mental health conditions on vaccine uptake in high-income countries: a systematic review.
Suffel AM, Ojo-Aromokudu O, Carreira H, Mounier-Jack S, Osborn D, Warren-Gash C*, McDonald HI*. *joint senior authors
2023
BMC Psychiatry. 2023 Jan 7;23(1):15.
Herpes simplex virus and rates of cognitive decline or whole brain atrophy in the Dominantly Inherited Alzheimer Network.
Warren-Gash C, Cadogan SL, Nicholas JM, Breuer JM, Shah D, Pearce N, Shiekh S, Smeeth L, Farlow MR, Mori H, Gordon BA, Nuebling G, McDade E, Bateman RJ, Schofield PR, Lee JH, Morris JC, Cash DM, Fox NC, Ridha BH, Rossor MN; Dominantly Inherited Alzheimer Network.
2022
Ann Clin Transl Neurol. 2022; 9(11):1727-1738.
Are infections associated with cognitive decline and neuroimaging outcomes? A historical cohort study using data from the UK Biobank study linked to electronic health records.
Muzambi R, Bhaskaran K, Rentsch CT, Smeeth L, Brayne C, Garfield V, Williams DM, Chaturvedi N, Warren-Gash C.
2022
Transl Psychiatry. 2022 Sep 15;12(1):385.
No evidence that herpes zoster is associated with increased risk of dementia diagnosis.
Warren-Gash C, Williamson E, Shiekh SI, Borjas-Howard J, Pearce N, Breuer JM, Smeeth L.
2022
Ann Clin Transl Neurol. 2022 Mar;9(3):363-374.
Anticoagulant prescribing for atrial fibrillation and risk of incident dementia.
Cadogan SL, Powell E, Wing K, Wong AY, Smeeth L, Warren-Gash C
2021
Heart. 2021 Dec;107(23):1898-1904
Common infections and incident dementia: a historical cohort study using UK primary and secondary care data.
Muzambi R, Bhaskaran K, Smeeth L, Brayne C, Chaturvedi N, Warren-Gash C.
2021
Lancet Healthy Longevity 2021 Jul;2(7):e426-e435
Incidence of acute complications of herpes zoster among immunocompetent adults in England: a matched cohort study using routine health data
Forbes HJ, Bhaskaran K, Grint D, Hu VH, Langan SM, McDonald HI, Morton C, Smeeth L, Walker JL, Warren-Gash C.
2021
Br J Dermatol 2021 Jun;184(6):1077-1084
Ethnic differences in dementia risk: a systematic review and meta-analysis.
Shiekh SI, Cadogan SL, Lin LY, Mathur R, Smeeth L, Warren-Gash C.
2021
J Alz Dis. 2021; 80(1):337-355.
Association Between Common Infections and Incident Post-Stroke Dementia: A Cohort Study Using the Clinical Practice Research Datalink.
Morton CE, Forbes HJ, Pearce N, Smeeth L, Warren-Gash C.
2020
Clin Epidemiol. 2020; 12:907-916.
Updates
Brain Health Group updates
Updates List
Health Data Research UK Black Internship Programme
Blessed Dzarwo - internship
By Blessed Dzawo, pictured back row, middle

This summer, I had the incredible opportunity to complete an 8-week health data science internship at the London School of Hygiene and Tropical Medicine (LSHTM) within the Faculty of Epidemiology and Public Health. As an undergraduate student in Neuroscience and Psychology, I initially thought my academic background might not align perfectly with health data science. However, through this experience, I have been fascinated by how a single dataset can be used to answer a myriad of questions which is something I previously explored within my research methods modules.

My project

During my time at LSHTM, I worked on a project examining the impact of indoor air pollution on cognitive function in older adults in India. The data came from Wave 1 of the Longitudinal Ageing Study in India (LASI). After identifying a research question, the next challenge was determining the most appropriate methods of analysis; This step-by-step process taught me how to approach a dataset logically, starting with exploration and ending with practical applications.

One of the most fascinating aspects of this project was uncovering trends even before formal analysis began. For example, when exploring the characteristics of our sample, we observed that as education levels increased, the proportion of individuals exposed to indoor air pollution decreased. Exploring these demographic characteristics not only guided our analytical approach but also helped us determine the relevance of our research question.

Regular meetings with my supervisors provided valuable insights into the collaborative nature of research and the importance of diverse perspectives. Their feedback challenged me to consider angles and ideas I had not initially thought of which enhanced my understanding of the research process.

By the end of the analysis, our results suggested that indoor air pollution had a protective effect on impaired cognition—a finding contrary to our expectations. Our findings highlighted the importance of critically evaluating how data is collected and analyzed, and approaching unexpected results with a healthy amount of skepticism.

Exploring career paths

Beyond my project, I had the privilege of meeting with various experts within the faculty and gaining valuable insights into what a career in epidemiology looks like. I also had the chance to attend meetings with the Brain Health Group, which was particularly exciting as a Neuroscience and Psychology student. Witnessing current brain health research in action deepened my appreciation for how interdisciplinary approaches are shaping the field. Initially, I viewed my studies in Neuroscience and Psychology as distinct from fields like public health and epidemiology. However, my time at LSHTM revealed how interconnected these disciplines are and how easily they can be combined.   

Furthermore, I have gained increased confidence in using tools like RStudio for data analysis; This skill is highly relevant across various careers in public health, and I believe this internship has broadened the range of opportunities available to me in the future.

Final reflections

I thoroughly enjoyed my time at LSHTM. As well as enhancing my technical skills, I now have a clearer vision of my own career trajectory. The analytical skills, particularly with RStudio, and insights I gained at LSHTM have inspired me to explore opportunities where I can apply health data science techniques to research questions in brain health.

I am incredibly grateful to my supervisor, Charlotte Warren-Gash, as well as Georgia Gore-Langton, Kwabena Asare, and Kate Mansfield for their support throughout this project. Their dedication and expertise made this experience invaluable. 

Alzheimer’s Association International conference 2024
Brain Health Group team Alzheimer's Association Conference

We presented some of our research at the Alzheimer’s Association International conference in Philadelphia. One of our studies investigated links between the skin condition psoriasis and risk of developing dementia. Using large health records data from a cohort of adults in England, we compared risks of dementia between people with and without psoriasis. We found that psoriasis was associated with an increased risk of all-cause dementia. The association was stronger for vascular dementia than for Alzheimer’s disease.  We also found stronger associations in severe psoriasis compared to mild to moderate psoriasis.

Our research was quoted in the Washington post

We know that infections can affect the health of older adults in the short-term. However, we don’t fully understand long-term effects of infections on the brain. We studied the health of nearly one million adults in England aged 65 years or more. Using data from anonymous health records, we controlled for differences in factors such as age, sex, smoking and physical health. In our study, infections were linked to an increase in dementia cases. The more severe the infection, the higher the chance of developing dementia. Raised dementia risk persisted for more than 9 years after infections. We now need to find out more about why this happens and who is most at risk. Importantly, can preventing and treating infections help to preserve brain health?

Read the Washington Post article.

See the published paper.