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The Kerala Einstein Study: Protocol
Sanish Sathyan;
Emmeline Ayers;
Helena M Blumen;
Dristi Adhikari;
Marnina Stimmel;
Kizhakkaniyakath A Salam;
Mohan L Noone;
Roy K George;
Mirnova E Ceide;
Anne Felicia Ambrose;
Poornima Narayanan;
Cuiling Wang;
Sachin Sureshbabu;
Kunnukatil S Shaji;
Alben Sigamani;
Pavagada S Mathuranath;
Vayyattu G Pradeep;
Joe Verghese
ABSTRACT
Background:
The epidemiology and pathogenesis of cognitive decline and dementia is not well established in India. The southern India state of Kerala has among the highest proportion of older adults in its population in the country.
Objective:
The Kerala Einstein Study (KES) is a community-based cohort study that aims to establish risk factors and brain substrates of pre-dementia syndromes. This protocol paper describes the study design and procedures for KES.
Methods:
The KES is recruiting a sample of 1000 adults ≥ 60 years from urban and rural areas in the Kozhikode district of Kerala state. Motoric cognitive risk syndrome (MCR), a pre-dementia syndrome characterized by presence of slow gait and subjective cognitive concerns, will be the cognitive phenotype of primary interest. The association of established risk factors for dementia as well as novel risk factors (apathy and traumatic brain injury) with MCR will be examined in KES. Risk factors for MCR will also be compared in urban and rural residents. Cognitive and physical function, medical histories and medications, sociodemographic, lifestyle patterns, and activities of daily living, will be evaluated. Participants will also undergo magnetic resonance imaging and electrocardiogram investigations. Longitudinal follow-up is planned in a subset of participants.
Results:
The Kerala-Einstein study (2R01AG039330-07) was funded by NIH in September 2019 and received approval from the Indian Medical Council of Research (ICMR) to start the study in June 2021. We have recruited 433 participants as of May 17, 2023. Enrollment is actively ongoing at all the recruitment sites.
Conclusions:
The Kerala Einstein study will provide new insights into risk factors and brain substrates associated with MCR syndrome in India and will help guide development of regionally specific preventive interventions for dementia.
Citation
Please cite as:
Sathyan S, Ayers E, Blumen HM, Adhikari D, Stimmel M, Salam KA, Noone ML, George RK, Ceide ME, Ambrose AF, Narayanan P, Wang C, Sureshbabu S, Shaji KS, Sigamani A, Mathuranath PS, Pradeep VG, Verghese J
Epidemiology of Motoric Cognitive Risk Syndrome in the Kerala Einstein Study: Protocol for a Prospective Cohort Study
