Modifiable Risk Factors for Prevention of Dementia in Midlife, Late Life and the Oldest-Old: Validation of the LIBRA Index

Stephanie J. B. Vos*, Martin P. J. van Boxtel, Olga J. G. Schiepers, Kay Deckers, Marjolein de Vugt, Isabelle Carriere, Jean-Francois Dartigues, Karine Peres, Sylvaine Artero, Karen Ritchie, Lucia Galluzzo, Emanuele Scafato, Giovanni B. Frison, Martijn Huisman, Hannie C. Comijs, Simona F. Sacuiu, Ingmar Skoog, Kate Irving, Catherine A. O'Donnell, Frans R. J. VerheyPieter Jelle Visser, Sebastian Köhler

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Recently, the LIfestyle for BRAin health (LIBRA) index was developed to assess an individual’s prevention potential for dementia.

Objective: We investigated the predictive validity of the LIBRA index for incident dementia in midlife, late life, and the oldest-old.

Methods: 9,387 non-demented individuals were recruited from the European population-based DESCRIPA study. An individual’s LIBRA index was calculated solely based on modifiable risk factors: depression, diabetes, physical activity, hypertension, obesity, smoking, hypercholesterolemia, coronary heart disease, and mild/moderate alcohol use. Cox regression was used to test the predictive validity of LIBRA for dementia at follow-up (mean 7.2 y, range 1–16).

Results: In midlife (55–69 y, n = 3,256) and late life (70–79 y, n = 4,320), the risk for dementia increased with higher LIBRA scores. Individuals in the intermediate- and high-risk groups had a higher risk of dementia than those in the low-risk group. In the oldest-old (80–97 y, n = 1,811), higher LIBRA scores did not increase the risk for dementia.

Conclusion: LIBRA might be a useful tool to identify individuals for primary prevention interventions of dementia in midlife, and maybe in late life, but not in the oldest-old.
Original languageEnglish
Pages (from-to)537-547
Number of pages11
JournalJournal of Alzheimer's Disease
Issue number2
Publication statusPublished - 2017


  • Aging
  • dementia
  • modifiable risk factors
  • prevention


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