Debora Rizzuto

Acrylamide, a widespread food-processing contaminant, poses a major public health concern due to its high exposure level in the general population and its toxicity. While animal evidence shows that acrylamide causes neurological alterations and may play a role in cardiovascular disease, evidence in humans is lacking. Our project aims to investigate whether dietary acrylamide exposure, measured in blood, increases the risk of dementia, Alzheimer´s and Parkinson´s diseases and myocardial infarction. In addition, we aim to improve the understanding of the biological mechanisms underlying these associations integrating small compounds in blood (i.e., OMICS).In two population-based cohorts, the Cohort of 60-Year-Olds and the Swedish Mammography Cohort, acrylamide will be assessed in blood samples using a case-cohort design (around 1,740 individuals, 20-year follow-up). The results will be presented in four scientific publications using adequate data analysis. The project will run from 2024-2028.The project´s findings will help improve public health through safer food and better nutrition. If findings indicate that acrylamide increases the risk of these diseases, this will urge interventions to decrease acrylamide exposure via food production and consumption. In turn, this will help to reduce the burden of these diseases. Even findings showing null association will be equally relevant to avoid unnecessary and costly preventive measures.

Research problem and specific questions: This project aims to contribute key knowledge for optimizing prevention, intervention, and care management of old-age depression by disentangling the complexities of this common and burdensome condition. Compared to earlier in life, old-age depression is characterized by distinct symptom patterns and a more complex clinical course, precipitating intricate care needs and increased healthcare use among older adults. The drivers of these complexities remain poorly understood, and we aim to conduct three interconnected sub-projects scrutinizing them. Specifically, we will: 1) investigate the role of psychosocial, behavioral, and socioeconomic determinants of diverse depressive symptom patterns and transitions between them

2) assess health and survival consequences of different depressive symptom patterns

and 3) evaluate healthcare utilization in people with old-age depression, focusing on complex and avoidable transitions across care settings.Data and method: Longitudinal data on more than 7,000 older adults from four population-based cohorts included in the Swedish National Study on Aging and Care (SNAC) and harmonized via the National E-Infrastructure for Aging Research (NEAR) will be used. We will exploit more than 20 years of already-collected follow-up data, gathered using shared instruments across cohorts. Multi-state transition models will be used to capture diverse shifts across depressive states (no depression, subsyndromal depression, major depression) and care settings (home, formal care, hospital, institution), as well as their associated determinants and consequences.Relevance and utilization: Depression in older adults is a cause of major distress for patients, their families, and the healthcare system. A better understanding of its fluctuating course is required to identify strategies promoting prevention, recovery, and care continuity. Planned in close connection with patient organizations and care provider networks, this project will bring about knowledge sought by multiple stakeholders, ensuring that older adults with depression experience old age with the dignity they deserve.Plan for project realization: The project will be carried out by a multidisciplinary team with expertise in geriatric mental health, epidemiology, and care sciences. Its results will be deployed through the National Association for Social and Mental Health (RSMH). Researcher salaries constitute key budgetary items.

Traffic noise is an environmental exposure of growing concern with mounting evidence of serious adverse health effects. At least one in five Europeans (113 million people) are exposed to noise levels exceeding the European Environment Agency indicator level linked to harmful health effects. Besides the increased risk of cardiovascular and metabolic effects, hearing loss, and sleep disturbance, recent studies have indicated that prolonged exposure to noise might accelerate the risk of cognitive impairment, dementia, anxiety, and depression.We take advantage of the pre-existing data within the Nordic Studies on Occupational and Traffic Noise in Relation to Disease (NordSOUND) project, comprising over 185 000 adults from 5 Swedish and 2 Danish cohorts, to investigate whether exposure to traffic and occupational noise is related to dementia and mental health (depression, and anxiety) and to reveal potential mechanisms. We will adjust for individual- and area-level covariates to enable increased precision in the assessment of associations. We will also adjust for residential air pollution exposure and lack of greenness to explore the potential interactions.This collaborative research effort will address a considerable knowledge gap regarding noise exposure, dementia and mental health. Our results may have significant implications for risk assessment and public health policy, especially considering the recently relaxed noise guidelines in Sweden and the rapid urban growth.

Research problem and specific questions. Traffic noise is an environmental exposure of growing concern with mounting evidence of serious adverse health effects. At least one in five Europeans (approximately 113 million people) are exposed to noise levels exceeding the European Environment Agency indicator level linked to harmful health effects. Besides the increased risk of cardiovascular and metabolic effects, hearing loss, and sleep disturbance, more recent studies have indicated that prolonged exposure to noise might accelerate the risk of cognitive impairment, degenerative dementia, anxiety, and depression.  Data and Methods. We take advantage of the pre-existing data within the Nordic Studies on Occupational and Traffic Noise in Relation to Disease (NordSOUND) project, comprising over 185 000 adults from five Swedish and two Danish cohorts, to investigate whether exposure to traffic and occupational noise is related to dementia and mental health (depression, and anxiety) and to reveal potential mechanisms. We will adjust for individual- and area-level covariates to enable increased precision in the assessment of associations. We will also adjust for residential air pollution exposure and lack of greenness to explore the potential interactions.  Plan for project realization. The research group involved in the project is multidisciplinary, and the complementary expertise of the team members will guarantee a broad perspective considering clinical, social, and public health relevance as well as adequate methodological and management skills. A postdoc research fellow will implement the study plan, coordinated and supervised by project leader and senior researchers. Relevance. This collaborative research effort will address a considerable knowledge gap regarding noise exposure, dementia and mental health. Our results may have significant implications for risk assessment and public health policy, especially considering the recently relaxed noise guidelines in Sweden and the rapid urban growth.

This project aims at increasing our knowledge concerning care needs and patterns of care utilization of frail and clinically complex older adults, to identify timely actions towards a more proactive and integrated healthcare. An increased rate of transition of frail individuals between healthcare (primary care, hospital) and social care providers (home care services, institutions) has been observed but not well characterized. At the same time, fragmented and idiosyncratic care transitions are arguably responsible for a quicker functional decline, which accelerates frailty development. Finally, patients’ perspective and experiences have been rarely taken into consideration when designing care paths, especially when frailty is at play. Taking advantage of three well-characterized Swedish population-based studies part of the Swedish National Study on Aging and Care (SNAC), and of the National E-Infrastructure on Aging Research (NEAR) we will analyze data of over 7,000 individuals 60+, living in both urbanized and rural areas of four different Regions. We plan to develop three interconnected subprojects having the following aims: 1) To characterize seniors’ care transition patterns while considering their underlying clinical conditions, frailty, and the availability of formal and informal social care

2) To quantify the impact of unplanned and avoidable healthcare episodes, and the fast transition through different care settings, on the clinical trajectories and frailty

and 3) To better understand patients’ experiences and preferences in relation to their history of healthcare utilization and care transition episodes, while considering their clinical and frailty trajectories. Through this project, we expect to identify relevant risk profiles and harmful care utilization patterns as a basis for more integrated and person-centered care, which hopefully will delay or postpone frailty, reduce morbidity burden, and improve patients’ experiences and quality of life.