NEDICES is an observational socio-medical study of a census cohort (65 years and over) in three populations in central Spain, investigating health and various neurological diseases (mainly degenerative diseases such as Alzheimer's and Parkinson's) that analyzed 5,278 participants in 1994, and their evolution and mortality until 2018 (data from the National Mortality Registry and INE). This study was financed mainly with public aid, and was directed by Dr. Félix Bermejo-Pareja and the Neurology team of the University Hospital “12 de Octubre” (UH12o) in Madrid.
This CIBERNED website displays the main data on this cohort, including monographies (see the history of the NEDICES study) and the main scientific publications (see the appendix of publications). Any researcher for new studies with a specific project can use its database (officially registered) (see Dr. Félix Bermejo-Pareja contacts)
The Neurology team at the UH12o has designed a new study, similar to the previous one, called NEDICES-2, which will add biological data (biobank, to the study of the participants in the new cohort).
In the initial design (in 1993), the aims were to conduct a prospective study of an elderly cohort (65 years old and above) with state of health, lifestyle (including cardiovascular risk factors –RF-) data. Its neurological aims were to analyze the epidemiological aspects (prevalence, incidence and RF) of several chronic neurological disorders: dementia and its subtypes (including Alzheimer disease), and mild cognitive impairment (MCI), Parkinson disease and parkinsonisms, stroke and transient cerebral ischemia, and senile tremor. During the time the study was carried out (1994-2005), a number of sub-studies were designed, and later on the analysis of the mortality rate of the cohort and its determining factors.
Only census population of the three areas of different socioeconomic level: two urban, Lista neighborhood in Madrid, and Margaritas in Getafe and one rural, 38 villages of Arévalo in Ávila) were the target population of the study. 6,395 citizens were the target population, of which 5,278 met the inclusion criteria that required signing an informed consent (IC) that included the name and address of their primary care physician. (For more information see, Bermejo et al, 2001, and Morales et al, 2004 in the publications).
The study was approved by the ethics committees of the three participating areas, and specifically by the University Hospitals (HU), H12o, and “Princesa” of Madrid. Likewise, the HU Ethics Committee approved the linkage of the mortality bases of the National Institute of Statistics (INE) with those of the NEDICES cohort, which was officially registered in accordance with the Spanish laws of the time.
Two complete cross-sectional studies were carried out, the baseline (1994-5) and the incidence (1997-98) in the three areas of the cohort and another with success only in the rural area (2004-2006). The mortality studies have been carried out with the mortality databases of the INE on the dates of 12-31-2006 and 12-31-2017.
To Research grants
Pre-NEDICES funding: WHO-AAD-SPRA collaboration for the dementia.
The NEDICES survey have funded mainly by research grants of Spanish Public Research Funding Agencies. Fondo de Investigaciones Sanitarias (FIS 93/0773; 96/1993; 00-0011-01), Community of Madrid (CAM 94/0032 and 05/010/96), Ministry of Education and Science and Technology (PB 1225-C04), Castilla and León Community in 2004 (Arévalo survey). In addition, private research foundations: Fundación Pfizer, and Fundación Neurociencias y Envejecimiento have contributed to several specific aspects of this survey (vascular risk factors analysis) and to several the meeting presentations. The scientific association AEINN granted research bourses to travel to study areas (meetings and neurological evaluations).
Also, Mutua Madrileña Foundation (2006-9) and FIS (07-9/pi061580) funded the research of several aspects of cohort mortality.
The CIEN investigation network funded granters. The CIBER Institution (investigation of the neurodegenerative disorders of the Research Institute Carlos III) has granted research personnel (biostatistician and others) for this survey. Also, the Imas12 (Research Institution of the UH12O collaborated with personnel and funding to the last mortality study
Foreign grants: Columbia University Project from NIH; Dr ED Louis for the research of several aspects of essential tremor
To the municipal authorities, general practitioners (GP), nurses and healthcare workers from the healthcare areas in the study who collaborated with the team, as well as the participating population (and their relatives) from the municipalities of Getafe, Lista, and the rural area de Arévalo for their collaboration. As well as to the many interviewers, since their work (with the WHO strategy) was not paid, their collaboration was voluntary and their only financial compensation was for transportation and subsistence expenses.
To all the collaborators (from various medical specialties, sociologists, psychologists, epidemiologists and many others) of the NEDICES study for their often persistent and inconspicuous effort. I do not want to fail to mention in gratitude the public and private (non-profit) research agencies listed that have kept faith in the study even though the MEDLINE publications took several years to appear.
Initial research team and evolution
Study design: Félix Bermejo-Pareja (FBP) y A Portera-Sánchez (APS), neurologists were the principal investigators (PI) of the survey, who have the support of the WHO collaboration (WHO-AAD). (see Bermejo-Pareja et al, 20008).
Rafael Gabriel Sánchez (RGS), Francisco Pozo (FP) y José Manuel Morales (JMM), were the consultant epidemiologists.
The initial EPICARDIAN survey (IP, RGS) comparted many aspects of the evaluation of citizens in the three NEDICES areas, although EPICARDIAN survey had different aims and populations.
Foreign advisers: DW Anderson (DWA), W Rocca (WR) y J Rosario (JR), epidemiologists
Investigator team of the basal wave (first cross sectional survey): FBP; Area managers: Lista (RGS), Margaritas (FBP) y Arévalo, Saturio Vega Quiroga (SVQ).
Supervisors: Margarita Alonso (MA), F Pérez del Molino (FPM): C. Gómez (CG), L. López (LL), Jesús Rivera (JR), sociologists.Computer experts: (data manager) MA, CG, LL, G. Fernández (GF); Rocío Trincado (RT), statistician.
Lay interviewers were almost exclusively social work or nursing students. In Arévalo, the general practitioners screened some subjects who were difficult to contact.
Field study: Two full-time neurologists: Jaime Díaz Guzmán (JDG) and Cristina Fernández (CF). Many neurologists contributed part-time: J Benito-León (JBL), JA Molina (JAM), J Olazarán-Rodríguez (JOR), SVQ y FBP.
Investigator team in the second and third wave
The research team was essentially that of the first cut with the incorporation of two FIS (granted): JG Castilla-Rilo (JGC) y F Sánchez-Sánchez, sociologists; new epidemiologists: A Gómez de la Cámara (AGC), J de Pedro-Cuesta (JdePC) y MJ Medrano (MJM); and new neurologists: A Berbel (AB), M de Toledo (Mde T), A Martínez-Salio (AMT) A, D Muñoz-García (DMG), J Porta-Etessam (JPE), IJ Posada (IJP), P. Rodríguez (PR), J Rodriguez (JR), JP Romero (JPR), F Sierra-Hidalgo (FSH), A Villarejo-Galende (AVS) and others specialists: C. Saiz (CS) cardiologist; and geriatricians: ME Carrillo-Alcalá (MEC), V Domingo-Santos (VDS); and psychologists V Puertas-Martín (VPM), C Villanueva-Iza (CVI) e Israel Contador (IC). (The vast majority of team members are listed in the various publications)
Current situation (2022)
Many new investigators collaborated in the analysis of the data including new statistics from the Imas12 (Cristina Martín-Arriscado and David Lora) and from the UH Clínico San Carlos de Madrid and others (see publications)
The last revision of the cohort mortality was on 31-12-2018 from INE data (it is not yet analyzed)