Demnitz-King, Harriet; (2023) The association between types of repetitive thinking and markers of Alzheimer's disease. Doctoral thesis (Ph.D), UCL (University College London).

Text Thesis_Final_Dec_11.pdf - Accepted Version Access restricted to UCL open access staff until 1 January 2025. Download (2MB)

Abstract

Alzheimer’s disease (AD) is a debilitating neurological condition characterised by cognitive impairment. With its prevalence projected to triple by 2050 and the absence of effective treatment strategies, the identification of potentially modifiable risk and protective factors is paramount for prevention. While physical health has received considerable attention, the exploration of psychological factors involved in AD risk is comparatively limited. Moreover, despite the growing focus on non-pharmacological interventions for AD prevention, few specifically target psychological processes. This thesis aims to address these gaps by (I) investigating the relationship between psychological factors, including anxiety and types of repetitive thinking, and cognitive and brain health; and (II) determining whether two 18-month non-pharmacological interventions, meditation training and non-native language training, can enhance cognition. This thesis comprises four studies addressing the two overarching objectives. The first study (Chapter 2) is a systematic review and meta-analysis examining the association between anxiety and AD pathology (amyloid-beta and tau). The second study (Chapter 3) is an evidence synthesis that explores the relationship between types of repetitive thinking (worry and rumination) and multiple markers of brain health (e.g., amyloid-beta, tau, grey matter volume). In the third study (Chapter 4), data from two independent cohorts are analysed to investigate the associations between maladaptive (worry and brooding) and adaptive (self-reflection) repetitive thinking with AD-sensitive markers of cognitive and brain health. Finally, in the fourth study (Chapter 5), data from a randomised controlled trial involving cognitively healthy older adults is analysed to assess the effects of 18 months of meditation training, non-native language training, or no intervention on multiple cognitive domains, including global cognition, episodic memory, executive function, and attention. In summary, this research contributes valuable insights into the association between novel psychological factors and AD-related cognitive and brain health. Further it provides high-quality evidence regarding the efficacy of two non-pharmacological interventions.

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