Long-term dementia risk prediction by the LIBRA score: A 30-year follow-up of the CAIDE study

Kay Deckers*, Mariagnese Barbera, Sebastian Kohler, Tiia Ngandu, Martin van Boxtel, Minna Rusanen, Tiina Laatikainen, Frans Verhey, Hilkka Soininen, Miia Kivipelto, Alina Solomon

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

15 Citations (Web of Science)


Objective As no causal treatment for dementia is available yet, the focus of dementia research is slowly shifting towards prevention strategies. Therefore, this study aimed to examine the predictive accuracy of the "LIfestyle for BRAin Health" (LIBRA) score, a weighted compound score of 12 modifiable risk and protective factors, for dementia and mild cognitive impairment (MCI) in midlife and late-life, and in individuals with high or low genetic risk based on presence of the apolipoprotein (APOE) epsilon 4 allele. Methods The LIBRA score was calculated for participants from the Finnish Cardiovascular Risk Factors, Aging and Dementia (CAIDE) population-based study examined in midlife (n = 1024) and twice in late-life (n = 604) up to 30 years later. Diagnoses of MCI and dementia were made according to established criteria. Cox proportional hazards models were used to assess the association between LIBRA and risk of dementia and MCI in models adjusted for sex and education (age as timescale). Results Higher midlife LIBRA scores were related to higher risk of dementia (hazard ratio [HR] = 1.27; 95% confidence interval [CI], 1.13-1.43) and MCI (unadjusted model: HR = 1.12; 95% CI, 1.03-1.22) up to 30 years later. Higher late-life LIBRA scores were related to higher risk of MCI (HR = 1.11; 95% CI, 1.00-1.25), but not dementia (HR = 1.02; 95% CI, 0.84-1.24). Higher late-life LIBRA scores were related to higher dementia risk among apolipoprotein E (APOE) epsilon 4 non-carriers. Conclusions Findings emphasize the importance of modifiable risk and protective factors for dementia prevention.

Original languageEnglish
Pages (from-to)195-203
Number of pages9
JournalInternational Journal of Geriatric Psychiatry
Issue number2
Early online date6 Dec 2019
Publication statusPublished - Feb 2020


  • cognitive aging
  • cohort study
  • dementia
  • epidemiology
  • lifestyle
  • prevention
  • risk factors

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