Tony Bayer is Professor of Geriatric Medicine in the Division of Population Medicine in the School of Medicine at Cardiff University and Director of the Memory Team, based at University Hospital Llandough. He has a longstanding research and clinical interest in cognitive impairment and dementia associated with neurodegenerative and cerebrovascular diseases and in care of frail older people. He initiated one of the earliest multidisciplinary Memory Teams in the UK in 1986 and has an active research programme on various aspects of diagnosis and management of dementia. Other current research activity includes collaboration on the Caerphilly Prospective Study (CaPS) of stroke, heart disease and dementia, the EC-funded MidFrail and FRAILCLINIC studies and the NIHR-funded GREAT Study of cognitive rehabilitation and PRINCESS study of probiotics in care homes.
Areas of Expertise (4)
Cognitive impairment and dementia
Research Methods and Older People
Honorary Fellowship, Royal College of Physicians, London, 2009 (professional)
Editor in Chief, Reviews in Clinical Gerontology, Cambridge University Press (personal)
University Of Wales: MB BCh, Medicine 1977
- Institute of Primary Care & Public Health : Personal Chair
- Section of Geriatric Medicine : Head
- Cardiff University Memory Team : Director
- ImmunoClin Corporation (IMCL) : Advisory Board
Media Appearances (4)
Dementia is 'ticking time bomb' says sufferer from Cardiff
Professor Antony Bayer is featured in this article by BBC News.
'Memories corridor' for Bridgend dementia patients
Professor Antony Bayer is featured in this article for the BBC.
NHS in Wales 'will grind to a halt' unless problems with dementia care are tackled, university expert warns
Wales Online online
"Professor Antony Bayer from Cardiff University said dementia care is already posing a challenge to society"
'All over-50s should take daily aspirin'
The Telegraph online
Professor Antony Bayer is quoted in this article by The Telegraph.
Featured Articles (5)
Although there is some evidence that amnestic mild cognitive impairment (aMCI) can be characterized by significant deficits in visuospatial function, the cross-sectional design of the majority of these studies renders it impossible to determine whether such deficits occur in aMCI as a result of, or accompany, amnestic dysfunction per se or whether they are the result of disproportionately poorer performance in a sub-group of patients for whom aMCI represents prodromal dementia. Similarly, whether the absence of aMCI-related functional deficit stems from the masking of dementia-specific abnormality by the preserved performance of those with a different cause of aMCI cannot be ascertained. Here we report the outcome of a cross-sectional and 2.5-year longitudinal evaluation follow-up, computer-based study of visuospatial attention, specifically attentional disengagement and inhibition of return and the mean (RTSPEED) and intra-individual variability (IIVRT) of their component reaction times, in 45 patients with aMCI and 31 cognitively healthy older adults. Reduced inhibition of return (p = 0.01 and p = 0.037 in response to 400 and 800 ms cue to target interval conditions), slowed RTSPEED (p = 0.038 and p = 0.03 in response to 400 and 800 ms cue), and raised IIVRT at baseline testing (p = 0.003, p = 0.026, p = 0.013 in response to 200, 400 and 800 ms cue) were associated with the development of dementia within the 2.5-year follow-up period, whereas the performance of patients with aMCI who did not develop dementia did not differ significantly from that of the cognitively healthy controls. Attentional disengagement appeared insensitive to the presence of prodromal dementia or amnestic dysfunction per se. The results indicate that those patients for whom aMCI represents prodromal dementia may experience, in addition to amnestic dysfunction, a decline in the functional integrity of some fundamental aspects of visual information processing, an effect potentially capable of increasing disease burden and reducing quality of life.
Diabetes, a highly prevalent, chronic disease, is associated with increasing frailty and functional decline in older people, with concomitant personal, social, and public health implications. We describe the rationale and methods of the multi-modal intervention in diabetes in frailty (MID-Frail) study.
The MID-Frail study is an open, randomised, multicentre study, with random allocation by clusters (each trial site) to a usual care group or an intervention group. A total of 1,718 subjects will be randomised with each site enrolling on average 14 or 15 subjects. The primary objective of the study is to evaluate, in comparison with usual clinical practice, the effectiveness of a multi-modal intervention (specific clinical targets, education, diet, and resistance training exercise) in frail and pre-frail subjects aged ≥70 years with type 2 diabetes in terms of the difference in function 2 years post-randomisation. Difference in function will be measured by changes in a summary ordinal score on the short physical performance battery (SPPB) of at least one point. Secondary outcomes include daily activities, economic evaluation, and quality of life.
The MID-Frail study will provide evidence on the clinical, functional, social, and economic impact of a multi-modal approach in frail and pre-frail older people with type 2 diabetes.
Multi-disciplinary research has revealed evidence of significant abnormality in a much wider range and level of information processing than that currently definitive for amnestic mild cognitive impairment (MCI). This raises the possibility that the contemporary approach to MCI is inappropriately delimited, and the true nature and extent of brain dysfunction and thus disease burden, underestimated. It follows therefore that the closely related concept of subjective cognitive impairment (SCI) may be similarly constrained. Although research into the wider range of potential brain dysfunction in MCI and SCI is in its infancy, as yet precluding systematic reviews, we present here findings to prompt debate about SCI with respect to its clinical assessment and its personal and societal burden.
9 December 2013
Healthy lifestyles based on non-smoking, an acceptable BMI, a high fruit and vegetable intake, regular physical activity, and low/moderate alcohol intake, are associated with reductions in the incidence of certain chronic diseases, but to date there is limited evidence on cognitive function and dementia.
In 1979 healthy behaviours were recorded on 2,235 men aged 45–59 years in Caerphilly, UK. During the following 30 years incident diabetes, vascular disease, cancer and death were recorded, and in 2004 cognitive state was determined.
Men who followed four or five of the behaviours had an odds ratio (OR) and confidence intervals (CI) for diabetes, corrected for age and social class, of 0.50 (95% CI: 0.19, 1.31; P for trend with increasing numbers of healthy behaviours
4 March 2012
Background: delirium and frailty are common among hospitalised older people but delirium is often missed and frailty considered difficult to measure in clinical practice.
Objective: to explore the relationship between delirium and frailty in older inpatients and determine their impact on survival.
Design and setting: the prospective cohort study of 273 patients aged ≥75 years.
Measures: patients were screened for delirium at presentation and on alternate days throughout their hospital stay. Frailty status was measured by an index of accumulated deficits (FI), giving a potential score from 0 (no deficits) to 1.0 (all 33 deficits), with 0.25 used as the cut-off between ‘fit’ and ‘frail’.
Results delirium was detected in 102 patients (mean FI: 0.33) and excluded in 171 (mean FI: 0.18) (P < 0.005); 111 patients were frail. Among patients with delirium, the median survival in fit patients was 359 days (95% CI: 118–600) compared with 88 days for those who were frail (95% CI: 5–171; P < 0.05).
Conclusion: delirium was associated with higher levels of frailty: the identification of frail patients may help to target those at a greatest risk of delirium. Survival following delirium was poor with the combination of frailty and delirium conferring a particularly bleak prognosis.