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Brain Health Group

Understanding drivers of global brain health using diverse data 

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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.

About Brain Health Group 2 columns
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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.


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Research Brain Health Group 2 columns
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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.



See our selected recent publications below

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.
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 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
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.
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.
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
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.
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.
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.
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
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.
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.
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.
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.
Clin Epidemiol. 2020; 12:907-916.
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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.