Prevention of dementia by targeting risk factors

Lead Research Organisation: University College London
Department Name: Epidemiology and Public Health

Abstract

Lack of understanding of the drivers of neurodegeneration and confusion of the causes and consequences of the disease due to the long latent phase of dementia have been major contributors to the large number of unsuccessful drug and lifestyle trials for dementia. The Lancet 2017 Commission on dementia prevention recommended targeting 9 risk factors to prevent dementia, but the expert group acknowledge that limitations in evidence, such as reverse causation bias, may affect these conclusions. We propose an ambitious programme of work which will evaluate risk factors that can be used to prevent dementia via health policy interventions, and will examine a wide range of plasma metabolites that can be used as early dementia biomarkers and candidates for disease-modifying dementia treatments. The objectives of our multi-cohort research programme are to: (1) examine associations of the Lancet 2017 Commission risk factors with cognitive decline, clinically-verified Alzheimer's disease and dementia using the largest individual-participant dataset in this field and a novel analytic strategy to account for bias due to reverse causation; (2) expand analyses to examine how trajectories of chronic diseases over the adult lifecourse shape risk of dementia; and (3) evaluate 233 metabolite biomarkers, singly and in combination, as early predictors of cognitive function, Alzheimer's disease and dementia, with a focus on biomarkers assessed at least 10 years before dementia diagnosis. The sources of data used in the analysis include the IPD-Work consortium of 43 cohort studies, the Dementia Platform UK cohort data resource, UK Biobank, the US-European metabolomics-dementia consortium of 11 studies, and the University College London-London School of Hygiene and Tropical Medicine-Edinburgh-Bristol (UCLEB) Consortium, in total of >1.5 million adults from the UK and elsewhere. This programme is timely because robust evidence must be generated before progress toward effective therapeutic interventions can be made.

Technical Summary

The objectives of our multi-cohort research programme are to: (1) examine associations of the Lancet 2017 Commission risk factors with cognitive decline, clinically-verified Alzheimer's disease and dementia using the largest individual-participant dataset in this field and a novel analytic strategy to account for bias due to reverse causation; (2) expand analyses to examine how trajectories of chronic diseases over the adult lifecourse shape risk of dementia; and (3) evaluate 233 metabolite biomarkers, singly and in combination, as early predictors of cognitive function, Alzheimer's disease and dementia, with a focus on biomarkers assessed at least 10 years before dementia diagnosis. This programme is based on existing data related to very large numbers of people with long follow-up (N up to 1.5 million), allowing to examine the temporality underpinning the established associations between risk factors, biomarkers and dementia. The sources of data include the IPD-Work consortium, DPUK, UK Biobank, the US-European metabolomics-dementia consortium, and the UCLEB consortium. Our analytic approach emphasises the importance of "time windows" when considering the role of risk factors and biomarkers for dementia. Thus, we stratify analyses by length of time between risk factor assessment and onset of dementia, assuming that the closer the risk factor/biomarker assessment is to the onset of clinical dementia, the greater the possibility the risk factors are a consequence of preclinical dementia rather than a cause. Resources are requested for research data curation and harmonisation across cohort studies, data analysis, administration and travel.

Planned Impact

We will seek to maximise our project's impact by involving lay and professional partners in steering and shaping the research, disseminating the findings to academic and non-academic beneficiaries, and working with beneficiaries to support changes to policy and practice.

Dementia patients, carers and the public: The benefits to the public of the proposed multi-cohort analysis relate to the generation of robust evidence on modifiable risk factors for dementia and biomarkers for cognitive impairment, Alzheimer's disease and dementia than has been available previously. The datasets represent diverse populations, including occupational and general-population samples, different age groups, white- and non-white ethnicities, a wide range of socioeconomic statuses, those with high and low education, and individuals with and without genetic susceptibility to dementia. This diversity will allow us to provide evidence on the generalisability of new findings.

Policy and public health guidelines: With detailed analyses separating risk factor and biomarker assessments at a healthy state and at preclinical and clinical stages of dementia and, in addition, taking into account trajectories of diseases, the project will increase understanding of the drivers of ageing outcomes with major public health relevance, such as cognitive impairment, Alzheimer's disease, dementia and multimorbidity. This in turn will inform the development of preventative interventions and health policies across the adult life course that will expand healthy life span, and reduce the burden of ill health, disease and disability at older ages.

Beneficiaries of our programme of work will be the National Institute for Health and Care Excellence (NICE) and other organisations with guidance, advice and information services for health, public health and social care professionals; national policymakers such as those in the Department of Health, Public Health England, NHS Commissioning, Clinical Commissioning Groups, Health and Wellbeing Boards, and the Association of Directors of Public Health; Charities, such as the Alzheimer's Society; as well as those in local government, who require evidence on where to invest vital resources (e.g., the relative benefit to investment in behaviour change at different life stages); third-sector campaigning agencies (representing the older population, patient groups); and medical practitioners.

Academic capacity and funders: Large-scale epidemiological studies, such as this, have been used as primary evidence of international and national guidelines for prevention of major chronic diseases. Findings from longitudinal population studies may also highlight directions for further interventional and experimental research by identifying risk factors and biomarkers that may be important even at a population level. Such work will provide valuable information about relevant targets for prevention as well as about which stages in the adult life course remediation of the risks is possible. A further advantage is that with large data sets it is also possible to show (and publish) absence of associations convincingly and in this way help reduce investments on research and interventions that are unlikely to be successful. All this information, in combination with subsequent evidence from trials and mechanistic studies, may ultimately enable highly cost-effective dementia prevention measures to be developed.

Industry: The paradigm that has dominated dementia research to date revolves around the amyloid cascade hypothesis. After hundreds of failed trials of potential disease-modifying drugs, major pharmaceutical companies are withdrawing from research on neurodegenerative diseases. Our research aimed at identifying early (non-amyloid) biomarkers for Alzheimer's disease and dementia might provide new targets for research on disease-modifying drugs.

Publications

10 25 50
 
Guideline Title ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD).
Description Citation in 2019 ESC Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Disease
Geographic Reach Europe 
Policy Influence Type Citation in clinical guidelines
Impact Our pooled evidence from 1.7 million men and women, published in the Lancet, is used by European Society of Cardiology guidelines to emphasise the importance of considering socioeconomic adversity in prevention of premature death. Failure to do so was estimated to be associated with a 2.1-year reduction in life expectancy between ages 40 and 85 years.
URL https://pubmed.ncbi.nlm.nih.gov/29453200/
 
Description Citation in 2021 Scientific Statement from the American Heart Association
Geographic Reach North America 
Policy Influence Type Citation in clinical reviews
URL https://www.ahajournals.org/doi/10.1161/CIR.0000000000000947
 
Description Citation in Health Equity in England Report
Geographic Reach National 
Policy Influence Type Citation in other policy documents
Impact Our life course analysis of all main causes of hospitalisations in relation to socioeconomic status is used as evidence in the 'Marmot Review 10 Years On' to demonstrate how coping with day-to-day shortages, facing inconveniences and adversity affect physical and mental health in negative ways.
URL https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on
 
Description Citation in Health Equity in England Report
Geographic Reach National 
Policy Influence Type Citation in other policy documents
Impact Our life course analysis of all main causes of hospitalisations in relation to socioeconomic status is used as evidence in the 'Marmot Review 10 Years On' to demonstrate how coping with day-to-day shortages, facing inconveniences and adversity affect physical and mental health in negative ways.
URL https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on
 
Description Citation in Public Health England COVID-19 prevention recommendations
Geographic Reach National 
Policy Influence Type Citation in other policy documents
Impact TBA
URL https://www.gov.uk/government/publications/excess-weight-and-covid-19-insights-from-new-evidence
 
Guideline Title Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review
Description Citation in Recommendations for Primary Prevention of Cardiovascular Disease
Geographic Reach North America 
Policy Influence Type Citation in clinical guidelines
Impact Our multicohort analyses and state-of-the-art review are used to justify American College of Cardiology recommendation to assess psychological factors in primary prevention of cardiovascular disease among women. The estimated reduction of cardiovascular disease attributable to successful interventions of these risk factors is approximately 3%.
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/31374073/
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/28642251/
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/28679494/
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/30068508/
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/28943197/
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/30995986/
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/29901708/
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/30860560/
 
Description Citation in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/31391187/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/29213140/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/19544749/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/25262544/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/23297662/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/22952309/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/30276493/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/25587065/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/25654401/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/26298822/
 
Description Citation in WHO/ILO Review on Work-related Burden of Disease and Injury (Stroke): Environment International 142 (2020) 105746.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our systematic review and individual-level meta-analysis provides the main evidence base for the WHO/ILO Joint Estimates on the adverse effects of extensive working hours on the risk of stroke. WHO/ILO Joint Estimates are used in international and national recommendations and policies to reduce work-related hazards.
URL https://pubmed.ncbi.nlm.nih.gov/22473079/
 
Description Citations in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/28588063/
 
Description Citations in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/28514478/
 
Description Citations in The Lancet Commission on Dementia: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Our individual-level meta-analyses of up to 1.3 million people and data from 2- to 3-decade follow-up of UK men and women are used as key evidence to justify recommendations to maintain normal weight, keep systolic blood pressure below 130mmHg and avoid consuming alcohol more than 21 units per week in midlife to prevent old-age dementia, a disease for which there is no disease-modifying medication. The estimated reduction of dementia attributable to the elimination of these risk factors is 3.4%.
URL https://pubmed.ncbi.nlm.nih.gov/29169013/
 
Description Collaborative Award in Science
Amount £4,000,200 (GBP)
Funding ID 221854/Z/20/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 02/2021 
End 01/2026
 
Description Integrated research on prevention, treatment and care for dementia - formulation of OU-UCL international joint research centre
Amount ¥60,000,000 (JPY)
Organisation Osaka University 
Sector Academic/University
Country Japan
Start 09/2019 
End 03/2022
 
Description Association of non-diabetic hyperglycaemia and microvascular and macrovascular complications of type 2 diabetes: a retrospective cohort study. 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Barcelona, SPAIN. Adam Tabak 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation sparking questions and discussion.
Year(s) Of Engagement Activity 2019
 
Description BMJ Opinion Blog: Séverine Sabia and Archana Singh-Manoux: The implications of cardiovascular health for dementia. 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Media coverage ensuring that study results were available to a wider audience, including the general public and resulting in increased interest in the study.
Year(s) Of Engagement Activity 2019
URL https://blogs.bmj.com/bmj/2019/08/07/severine-sabia-archana-singh-manoux-the-implications-of-cardiov...
 
Description Conference presentation: 'Integrated central blood pressure-aortic stiffness risk categories and cardiovascular mortality in end-stage renal disease' 29th European Meeting of Hypertension and Cardiovascular Protection of the European-Society-of-Hypertension (ESH), Milan. Adam Tabak. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation: 'Integrated central blood pressure-aortic stiffness risk categories and cardiovascular mortality in end-stage renal disease'. 29th European Meeting of Hypertension and Cardiovascular Protection of the European-Society-of-Hypertension (ESH), Milan, ITALY, JUN 21-24, 2019. Research findings presented sparking questions and discussion.
Year(s) Of Engagement Activity 2019
 
Description Editorial: BMJ Editorial The determinants of cognitive decline and dementia. BMJ 2019;366:l4946 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact BMJ editorial regarding two linked Whitehall II research papers. The editorial recognised the 'tremendous power of the Whitehall study' increasing the reputation of the study.
Year(s) Of Engagement Activity 2019
URL https://www.bmj.com/content/366/bmj.l4946
 
Description International Workshop: A focus on statistical methods to analyse accelerometer-measured physical activity 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Attendance at a workshop learning about statistical methods to analyse accelerometer-measured physical activity giving the opportunity to liaise with top experts from different countries in the approaches to analyse physical activity data.
Year(s) Of Engagement Activity 2019
URL https://www.granadacongresos.com/aiw2019
 
Description Interview with Medpage Today about 'Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Interviewed by Medpage Today about 'Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study. Kivimaki et al. Lancet Public Health. 2020 Mar;5(3):e140-e149. 'Cascade' of Disease ID'd in Poorer Socioeconomic Groups - Later development of physical diseases tied to mental, behavioral disorders' February 5, 2020. High level of media coverage ensuring that study results were available to a wider audience, including the general public
Year(s) Of Engagement Activity 2020
URL https://www.medpagetoday.com/psychiatry/generalpsychiatry/84723
 
Description Invited speech: Treating patients with type 1 diabetes from adolescence to senility - workshop. Adam Tabak 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Invited speech at workshop for post grad students generating interest in study data.
Year(s) Of Engagement Activity 2019
 
Description Media coverage for '5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study' BBC article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interviewed for BBC News article 'Targeted checks 'prevent one-in-10 heart attacks' regarding '5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study' Lancet Public Health. 2019;4(4):e189-e199. Widespread media coverage which increased awareness of the study.
Year(s) Of Engagement Activity 2019
URL https://www.bbc.co.uk/news/health-47981644
 
Description Media coverage for '5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study' Docwire article 'Individualizing the Screening Interval for High-risk CVD Patients,. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Report and interviewed for Docwire. High level of media coverage ensuring that study results were available to a wider audience, including the general public.
Year(s) Of Engagement Activity 2019
URL https://www.docwirenews.com/docwire-pick/cardiology-picks/screening-interval-cvd-patients/
 
Description Media coverage for '5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study'. Telegraph. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Extensive media coverage for '5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study'. High level of media coverage ensuring that study results were available to a wider audience, including the general public.
Year(s) Of Engagement Activity 2019
URL https://www.telegraph.co.uk/news/2019/04/20/almost-one-ten-heart-attacks-strokes-could-prevented-hig...
 
Description Media coverage for '5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study'. The USA Times report and interview. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Report and interview in The USA Times 'Focused checks forestall one in 10 coronary heart assaults'. High level of media coverage ensuring that study results were available to a wider audience, including the general public.
Year(s) Of Engagement Activity 2019
URL https://theusatimes.net/lifestyle/health/focused-checks-forestall-one-in-10-coronary-heart-assaults/
 
Description Media coverage for '5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study'. US news report and interview. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Report and interview in The US News 'Work Stress, Poor Sleep, High Blood Pressure a Deadly Trio'. High level of media coverage ensuring that study results were available to a wider audience, including the general public.
Year(s) Of Engagement Activity 2019
URL https://theusatimes.net/lifestyle/health/focused-checks-forestall-one-in-10-coronary-heart-assaults/
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. Daily Express news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.express.co.uk/life-style/health/1333720/Dementia-warning-drinking-alcohol-university-coll...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. Daily Mail news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.dailymail.co.uk/health/article-8714025/Passing-drunk-DOUBLE-risk-later-developing-dementi...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. Daily Telegraph news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.dailytelegraph.com.au/technology/science/getting-blind-drunk-may-double-your-risk-of-deve...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. DrugFree.org news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://drugfree.org/drug-and-alcohol-news/passing-out-after-drinking-linked-to-increased-risk-of-dem...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. InterestingEngineering.com article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL https://interestingengineering.com/large-study-reveals-excessive-drinking-doubles-the-risk-of-dement...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. Science Alert news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL https://www.sciencealert.com/drinking-until-you-pass-out-linked-to-doubled-risk-of-dementia-giant-st...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. Science times news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.sciencetimes.com/articles/27248/20200910/passing-out-drunk-double-risks-dementia-includin...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. The Irish Sun news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.thesun.ie/news/5887647/passing-out-drunk-could-double-risk-dementia/
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. The News Pocket article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://thenewspocket.com/passing-drunk-out-might-double-check-your-dementia-risk
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. Trendwide.com news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. United Press International news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.upi.com/Health_News/2020/09/09/Drinking-to-the-point-of-passing-out-increases-dementia-ri...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. Weekly Times Now news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.weeklytimesnow.com.au/breaking-news/getting-blind-drunk-may-double-your-risk-of-developin...
 
Description Media coverage for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. Worldnewj.com news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
 
Description Media coverage for 'Association of healthy lifestyle with years lived free of major chronic diseases: A prospective multicohort study'. Daily Mail news article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.dailymail.co.uk/sciencetech/article-8200241/Sticking-three-good-habits-add-10-years-disea...
 
Description Media coverage for 'Association of healthy lifestyle with years lived free of major chronic diseases: A prospective multicohort study'. TCTMD news article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.tctmd.com/news/adherence-healthy-habits-linked-years-free-chronic-disease
 
Description Media coverage for 'Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study. Times article 'Good heart health in middle age may lower your risk of dementia'. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage ensuring study results were available to a wider audience, including the general public. Further interest generated in the study.
Year(s) Of Engagement Activity 2019
URL https://www.thetimes.co.uk/article/good-heart-health-in-middle-age-may-lower-your-risk-of-dementia-p...
 
Description Media coverage for 'Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study. • ITV News 'Good heart health in middle age linked to lower dementia risk - study' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage ensuring study results were available to a wider audience, including the general public. Further interest generated in the study.
Year(s) Of Engagement Activity 2019
URL https://www.itv.com/news/2019-08-07/good-heart-health-in-middle-age-linked-to-lower-dementia-risk-st...
 
Description Media coverage for 'Association of social contact with dementia and cognition: 28-year follow-up of the Whitehall II cohort study'. The Guardian article 'Health social life could ward off dementia' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage ensuring study results were available to a wider audience, including the general public. Further interest generated in the study.
Year(s) Of Engagement Activity 2019
URL https://www.theguardian.com/society/2019/aug/02/healthy-social-life-could-ward-off-dementia-study-sh...
 
Description Media coverage for 'Association of social contact with dementia and cognition: 28-year follow-up of the Whitehall II cohort study'. The Independent article 'Seeing friends regularly lowers dementia risk, study suggests' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage ensuring that study results were available to a wider audience, including the general public. Further interest in the study generated.
Year(s) Of Engagement Activity 2019
URL https://www.independent.co.uk/news/health/dementia-prevention-retirement-health-old-age-socialise-ac...
 
Description Media coverage for 'Association of social contact with dementia and cognition: 28-year follow-up of the Whitehall II cohort study'. The Telegraph article 'How a healthy social life in middle age could protect against dementia' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage ensuring that study results were available to a wider audience, including the general public. Further interest in the study generated.
Year(s) Of Engagement Activity 2019
URL https://www.telegraph.co.uk/science/2019/08/02/healthy-social-life-middle-age-could-protect-against-...
 
Description Media coverage for 'Sex differences and the role of education in cognitive ageing: analysis of two UK-based prospective cohort studies'. Mail on Sunday news article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2021
URL http://www.mailonsunday.co.uk/news/article-9199611/Women-75-risk-dementia-men-generation.html
 
Description Media coverage for 'Sex differences and the role of education in cognitive ageing: analysis of two UK-based prospective cohort studies'. McKnights.com news article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2021
URL https://www.mcknights.com/news/clinical-news/education-changes-may-account-for-reduced-sex-differenc...
 
Description Media coverage for 'Sex differences and the role of education in cognitive ageing: analysis of two UK-based prospective cohort studies'. Neuroscience.com news article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2021
URL http://neurosciencenews.com/women-aging-dementia-education-17644/
 
Description Media coverage for 'Sex differences and the role of education in cognitive ageing: analysis of two UK-based prospective cohort studies'. Telegraph news article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2021
URL http://www.telegraph.co.uk/news/2021/01/29/older-women-greater-risk-dementia-due-poor-access-educati...
 
Description Oral presentation 'Change in heart rate and heart rate variability is not related to cardiovascular events or death, irrespective of dysglycaemia: Downfall of risk markers?' Adam Tabak 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Oral presentation at the EASD 'Change in heart rate and heart rate variability is not related to cardiovascular events or death, irrespective of dysglycaemia: Downfall of risk markers? The Whitehall II study' Hansen C.
Year(s) Of Engagement Activity 2019
URL https://www.easd.org/virtualmeeting/home.html#!resources/change-in-heart-rate-and-heart-rate-variabi...
 
Description Poster presentation 'Association of Social Network Contact with Risk of Dementia and Cognitive Decline: 28-Year Follow-up of the Whitehall II Cohort Study'. Alzheimer's Association International Conference July 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation generated a high level of interest and sparked questions and discussion from observers.
Year(s) Of Engagement Activity 2019
 
Description Presentation: The effect of diabetic sensory peripheral neuropathy on mortality - a meta-analysis. 54th Annual EDEG Meeting, Luxembourg, 11-14 May 2019. Adam Tabak 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation sparked questions and discussions and generated interest in the data.
Year(s) Of Engagement Activity 2019
 
Description Presentation: The effect of diabetic sensory peripheral neuropathy on mortality: a meta-analysis. 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Barcelona. Adam Tabak. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation sparking questions and answers and generating interest in results.
Year(s) Of Engagement Activity 2019
 
Description Press release by the University of Exeter on 'Genetic studies of accelerometer-based sleep measures in 85,670 individuals yield new insights into human sleep behaviour'. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Press Release: 'Research identifies genetic causes of poor sleep' on Genetic studies of accelerometer-based sleep measures in 85,670 individuals yield new insights into human sleep behaviour. High level of media coverage generating interest in the study.
Year(s) Of Engagement Activity 2019
URL https://www.eurekalert.org/pub_releases/2019-04/uoe-rig040419.php
 
Description Press release for 'Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption with Risk for Dementia'. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL https://www.eurekalert.org/pub_releases/2020-09/jn-aoa090420.php
 
Description UK-JAPAN ESRC funded symposium on ageing and health 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Launch of research networking activity on ageing and health.
Year(s) Of Engagement Activity 2019
 
Description Virtual EASD Annual Meeting 2020 Poster Presentation. The effect of occupational position on aging trajectories of glycaemic measures in non-diabetic individuals: The Whitehall II study Poster 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The effect of occupational position on aging trajectories of glycaemic measures in non-diabetic individuals: The Whitehall II study Poster #335. Poster generated further interest in the Whitehall II Study.
Year(s) Of Engagement Activity 2020
URL https://www.abstractsonline.com/pp8/#!/9143/presentation/1518
 
Description media coverage for 'A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study'. Daily Mail news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.dailymail.co.uk/sciencetech/article-8172473/Drinking-middle-age-add-nearly-TWO-INCHES-wai...
 
Description media coverage for 'A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study'. ITV.com news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.itv.com/news/2020-04-01/heavy-drinking-into-older-age-adds-4cm-to-waistline/
 
Description media coverage for 'A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study'. Irish News news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.irishnews.com/magazine/science/2020/03/31/news/heavy-drinking-into-older-age-adds-4cm-to-...
 
Description media coverage for 'A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study'. Telegraph news article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://www.telegraph.co.uk/news/2020/03/31/heaving-drinking-adds-four-centimeters-waistline-ucl-stud...
 
Description media coverage for 'A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study'. lnews article. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact High level of media coverage.
Year(s) Of Engagement Activity 2020
URL http://inews.co.uk/news/health/mps-civil-servants-drinking-alcohol-2524704