Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies

被引:363
作者
Deckers, Kay [1 ]
van Boxtel, Martin P. J. [1 ]
Schiepers, Olga J. G. [1 ]
de Vugt, Marjolein [1 ]
Munoz Sanchez, Juan Luis [2 ]
Anstey, Kaarin J. [3 ]
Brayne, Carol [4 ]
Dartigues, Jean-Francois [5 ]
Engedal, Knut [6 ,7 ]
Kivipelto, Miia [8 ]
Ritchie, Karen [9 ,10 ]
Starr, John M. [11 ]
Yaffe, Kristine [12 ,13 ]
Irving, Kate [14 ]
Verhey, Frans R. J. [1 ]
Kohler, Sebastian [1 ]
机构
[1] Maastricht Univ, Sch Mental Hlth & Neurosci, Alzheimer Ctr Limburg, NL-6200 MD Maastricht, Netherlands
[2] Dept Psychiat & Mental Hlth, Zamora, Spain
[3] Australian Natl Univ, Ctr Res Ageing Hlth & Wellbeing, Canberra, ACT, Australia
[4] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England
[5] Univ Bordeaux 2, INSERM, U897, F-33076 Bordeaux, France
[6] Oslo Univ Hosp, Norwegian Ctr Ageing & Hlth, Ullevaal, Norway
[7] Vestfold Mental Hlth Trust, Tonsberg, Norway
[8] Karolinska Inst, Alzheimer Dis Res Ctr, Stockholm, Sweden
[9] INSERM, U1061, Montpellier, France
[10] Univ London Imperial Coll Sci Technol & Med, London, England
[11] Univ Edinburgh, Ctr Cognit Ageing & Cognit Epidemiol, Edinburgh, Midlothian, Scotland
[12] Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA 94143 USA
[13] Univ Calif San Francisco, Sch Med, Dept Epidemiol & Biostat, San Francisco, CA USA
[14] Dublin City Univ, Sch Nursing & Human Sci, Dublin 9, Ireland
基金
澳大利亚国家健康与医学研究理事会;
关键词
epidemiology; risk factors; prevention; dementia; public health; MILD COGNITIVE IMPAIRMENT; CHRONIC KIDNEY-DISEASE; DENSITY-LIPOPROTEIN CHOLESTEROL; C-REACTIVE PROTEIN; LONG-TERM RISK; ALZHEIMERS-DISEASE; DEPRESSIVE SYMPTOMS; LATE-LIFE; ATRIAL-FIBRILLATION; INCIDENT DEMENTIA;
D O I
10.1002/gps.4245
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
ObjectiveDementia has a multifactorial etiology, but the importance of individual health and lifestyle related risk factors is often uncertain or based on few studies. The goal of this paper is to identify the major modifiable risk factors for dementia as a first step in developing an effective preventive strategy and promoting healthy late life cognitive functioning. MethodsA mixed-method approach combined findings from a systematic literature review and a Delphi consensus study. The literature search was conducted in PubMed and updated an earlier review by the United States National Institutes of Health from 2010. We reviewed the available evidence from observational epidemiological studies. The online Delphi study asked eight international experts to rank and weigh each risk factor for its importance for dementia prevention. ResultsOut of 3127 abstracts, 291 were included in the review. There was good agreement between modifiable risk factors identified in the literature review and risk factors named spontaneously by experts. After triangulation of both methods and re-weighting by experts, strongest support was found for depression, (midlife) hypertension, physical inactivity, diabetes, (midlife) obesity, hyperlipidemia, and smoking, while more research is needed for coronary heart disease, renal dysfunction, diet, and cognitive activity. ConclusionsFindings provide good support for several somatic and lifestyle factors and will be used to inform the design of a new multicenter trial into dementia prevention. Copyright (c) 2014 John Wiley & Sons, Ltd.
引用
收藏
页码:234 / 246
页数:13
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