Ministerio_de_Economia_y_Competitividad
Ministerio_de_Economia_y_Competitividad

NEDICES (Neurological Disorders in Central Spain) Cohort

It is a socio-medial survey of a closed census based elderly (65 years and over) cohort form the centre of Spain. The cohort was established from the municipal census of three population areas from the centre of Spain, two urban and one rural; urban: the district of Margaritas (Getafe) on the outskirts of Madrid; the district of Lista, in the centre of Madrid; and rural: 38 villages in the rural area of Arévalo (Ávila)

The neurological evaluations of this survey have been mainly performed by the neurologists of the University Hospital “12 de Octubre”. And the coordinating center was established in the 16th and 18th floor of this Hospital (Neurology Department).

 

Main Objectives

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 being carried out (1995-2005) a number of sub-studies were designed, including some that sought to investigate these and other neurological diseases (headaches, epilepsy) and later on the analysis of the mortality rate of the cohort and its determining factors.

 

Participant Population

Only census-based from the three selected areas was the target population. To be included in the cohort the elderly subjects of the selected areas must signed an informed consent statement. The screened participants in the basal wave was 5,278

 

Study implementation

Two completed cross-sectional surveys were performed; prevalence or baseline wave (1994-5) and incidence wave (1997-8) and other non-total cross-sectional surveys. A mortality study along 12 years (1994-2006) has been performed according to the data of the Spanish Mortality National Registry ant the causes of mortality of cohort participants by the Instituto Nacional de Estadística (Statistics National Institute)

 

Legal and Ethical aspects

The study was approved by the ethical review boards of the “12 de Octubre” and “Princesa” of Madrid. The database has been officially registered.

 

Research Team

Study design

F Bermejo-Pareja performed the design (principal investigator of the FIS projects of the NEDICES cohort). Contributors to this design were R Gabriel Sánchez (epidemiologist, principal investigator of the EPICARDIAN Project, whicht studied some cardiovascular aspects of the NEDICES populations, S Vega (family physician and geriatrician) and F Pozo (research adviser of the FIS Institute).

Foreign advisers of the study design were DW Anderson and J. Rosario, epidemiologists, from the NIH, Bethesda, EEUU), and W Rocca (neuroepidemiologist, from Mayo Clinic, Rochester. EEUU)

 

 

Field study: collaborators and granters team

Area coordinators or monitors, M. Alonso (sociologist), C. Gómez (physician), F. Pérez del Molino and J Rivera (sociologists), 

J.G. Castilla, F. Sánchez-Sánchez, V Puertas-Martín, P Vale (psychologists);

  1. Fernández (computer expert)
  2. Trincado, P. Rodríguez (statistician)

Other collaborators: L. López, C. Saiz, C Rodriguez-Rodriguez.

 

Physicians

Neurologists: F Bermejo-Pareja, J Díaz-Guzmán, C. Fernández, A. Martínez-Salio, JA Molina, T Moreno, J. Olazarán, J. Porta-Etessam, J. Rodríguez, M. de Toledo 

Geriatricians: E. Carrillo, M.T. Jiménez, V. Domingo, S Vega

Advisers: A. Portera-Sánchez (neurologist), Gómez de la Cámara, J de Pedro, MJ. Medrano, R Boix (epidemiologists); J.I. González-Montalvo (geriatrician), ED. Louis, and G Román (neurologists and epidemiologists).

Many family doctors, nurses, health, and Municipal authorities of the Survey Health Areas had collaborated hardly and anonymously in several work aspects of the survey

 

(In this list are not included investigators that after the cross-sectional surveys are now working in several focus researches and papers based in the NEDICES cohort. Many of them have been authors of published papers from NEDICES).

 

Main funding and research grants

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.

Foreign grants: WHO-AAD, SPRA Study for the dementia screening.

Columbia University Project from NIH; Dr ED Louis for the research of several aspects of essential tremor

 

Evolution

Along the evolution of the NEDICES cohort, many new investigators collaborated in the analysis of the data (see publications).

The last revision of the cohort mortality was on 31-12-2018 from INE data (not yet analyzed)

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