Umbrella Review and Delphi Study on Modifiable Factors for Dementia Risk Reduction

Overview

Journal Alzheimers Dement

Specialties Neurology
Psychiatry

Date 2023 Dec 30

PMID 38159267

Authors

Colin Rosenau

Sebastian Kohler

Lion M Soons

Kaarin J Anstey

Carol Brayne

Henry Brodaty

Knut Engedal

Francesca R Farina

Mary Ganguli

Gill Livingston

Constantine G Lyketsos

Francesca Mangialasche

Laura E Middleton

Marcel G M Olde Rikkert

Ruth Peters

Perminder S Sachdev

Nikolaos Scarmeas

Geir Salbaek

Martin P J van Boxtel

Kay Deckers

Affiliations

Soon will be listed here.

Abstract

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.

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