Umbrella review and Delphi study on modifiable factors for dementia risk reduction

被引：27

作者：

Rosenau, Colin ^{[1
]}

Kohler, Sebastian ^{[1
]}

Soons, Lion M. ^{[1
]}

Anstey, Kaarin J. ^{[2
,3
,4
]}

Brayne, Carol ^{[5
]}

Brodaty, Henry ^{[6
]}

Engedal, Knut ^{[7
]}

Farina, Francesca R. ^{[8
]}

Ganguli, Mary ^{[9
,10
,11
,12
]}

Livingston, Gill ^{[13
]}

Lyketsos, Constantine G. ^{[14
]}

Mangialasche, Francesca ^{[15
,16
]}

Middleton, Laura E. ^{[17
,18
]}

Rikkert, Marcel G. M. Olde ^{[19
,20
]}

Peters, Ruth ^{[4
,21
,22
]}

Sachdev, Perminder S. ^{[6
]}

Scarmeas, Nikolaos ^{[23
,24
]}

Salbaek, Geir ^{[7
,25
,26
]}

van Boxtel, Martin P. J. ^{[1
]}

Deckers, Kay ^{[1
,27
]}

机构：

[1] Maastricht Univ, Sch Mental Hlth & Neurosci MHeNS, Dept Psychiat & Neuropsychol, Alzheimer Ctr Limburg, Maastricht, Netherlands

[2] Univ New South Wales, Sch Psychol, Kensington, NSW, Australia

[3] Neurosci Res Australia NeuRA, Sydney, NSW, Australia

[4] UNSW Ageing Futures Inst, Kensington, NSW, Australia

[5] Univ Cambridge, Cambridge Publ Hlth, Cambridge, England

[6] Univ New South Wales, Ctr Hlth Brain Ageing CHeBA, Sch Clin Med, Discipline Psychiat & Mental Hlth, Sydney, NSW, Australia

[7] Vestfold Hosp Trust, Norwegian Natl Ctr Ageing & Hlth, Tonsberg, Norway

[8] Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL USA

[9] Univ Pittsburgh, Dept Psychiat, Sch Med, Pittsburgh, PA USA

[10] Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA USA

[11] Univ Pittsburgh, Sch Med, Dept Epidemiol, Pittsburgh, PA USA

[12] Univ Pittsburgh, Sch Publ Hlth, Pittsburgh, PA USA

[13] UCL, Div Psychiat, London, England

[14] Richman Family Precis Med Ctr Excellence Alzheimer, Johns Hopkins Bayview, Johns Hopkins Med, Baltimore, MD USA

[15] Karolinska Inst, Div Clin Geriatr, Ctr Alzheimer Res, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden

[16] Karolinska Univ Hosp, Med Unit Aging, Theme Inflammat & Aging, Stockholm, Sweden

[17] Univ Waterloo, Dept Kinesiol & Hlth Sci, Waterloo, ON, Canada

[18] Schlegel UW Res Inst Aging, Waterloo, ON, Canada

[19] Radboud Univ Nijmegen, Med Ctr, Dept Geriatr Med, Nijmegen, Netherlands

[20] Radboudumc Alzheimer Ctr, Donders Ctr Med Neurosci, Nijmegen, Netherlands

[21] George Inst Global Hlth, Newtown, NSW, Australia

[22] Univ New South Wales, Sch Biomed Sci, Kensington, NSW, Australia

[23] Natl & Kapodistrian Univ Athens, Med Sch, Aiginit Hosp, Dept Neurol 1, Athens, Greece

[24] Columbia Univ, Dept Neurol, New York, NY USA

[25] Oslo Univ Hosp, Dept Geriatr Med, Oslo, Norway

[26] Univ Oslo, Inst Clin Med, Oslo, Norway

[27] Maastricht Univ, Sch Mental Hlth & Neurosci, POB 616 DRT12, NL-6200MD Maastricht, Netherlands

来源：

ALZHEIMERS & DEMENTIA | 2024年 / 20卷 / 03期

关键词：

brain health; cognitive decline; cognitive impairment; Delphi study; dementia; etiological risk factors; hearing impairment; lifestyle; prevention; protective factors; risk prediction; risk reduction; sleep; social contact; umbrella review; CENTRAL AUDITORY DYSFUNCTION; MILD COGNITIVE IMPAIRMENT; REPORTED HEARING-LOSS; ATRIAL-FIBRILLATION; OLDER-ADULTS; ALCOHOL-CONSUMPTION; ALZHEIMERS-DISEASE; INCIDENT DEMENTIA; ELDERLY ADULTS; PSYCHOLOGICAL STRESS;

D O I：

10.1002/alz.13577

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

A 2013 systematic review and Delphi consensus study identified 12 modifiable risk and protective factors for dementia, which were subsequently merged into the "LIfestyle for BRAin health" (LIBRA) score. We systematically evaluated whether LIBRA requires revision based on new evidence. To identify modifiable risk and protective factors suitable for dementia risk reduction, we combined an umbrella review of systematic reviews and meta-analyses with a two-round Delphi consensus study. The review of 608 unique primary studies and opinions of 18 experts prioritized six modifiable factors: hearing impairment, social contact, sleep, life course inequalities, atrial fibrillation, and psychological stress. Based on expert ranking, hearing impairment, social contact, and sleep were considered the most suitable candidates for inclusion in updated dementia risk scores. As such, the current study shows that dementia risk scores need systematic updates based on emerging evidence. Future studies will validate the updated LIBRA score in different cohorts.Highlights An umbrella review was combined with opinions of 18 dementia experts. Various candidate targets for dementia risk reduction were identified. Experts prioritized hearing impairment, social contact, and sleep. Re-assessment of dementia risk scores is encouraged. Future work should evaluate the predictive validity of updated risk scores.

引用

页码：2223 / 2239

页数：17

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