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

Colin Rosenau; Sebastian Koehler; 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

doi:10.1002/alz.13577

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

Colin Rosenau, Sebastian Koehler, 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^*

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

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.HIGHLIGHTSAn 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.

Original language	English
Pages (from-to)	2223-2239
Number of pages	17
Journal	Alzheimer's & Dementia
Volume	20
Issue number	3
Early online date	1 Dec 2023
DOIs	https://doi.org/10.1002/alz.13577
Publication status	Published - Mar 2024

Keywords

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

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Cite this

Rosenau, C., Koehler, S., Soons, L. M., Anstey, K. J., Brayne, C., Brodaty, H., Engedal, K., Farina, F. R., Ganguli, M., Livingston, G., Lyketsos, C. G., Mangialasche, F., Middleton, L. E., Rikkert, M. G. M. O., Peters, R., Sachdev, P. S., Scarmeas, N., Salbaek, G., van Boxtel, M. P. J., & Deckers, K. (2024). Umbrella review and Delphi study on modifiable factors for dementia risk reduction. Alzheimer's & Dementia, 20(3), 2223-2239. https://doi.org/10.1002/alz.13577

@article{197995f3f0594f90a0de7dc6385fc0ac,

title = "Umbrella review and Delphi study on modifiable factors for dementia risk reduction",

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.HIGHLIGHTSAn 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.",

keywords = "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",

author = "Colin Rosenau and Sebastian Koehler and Soons, {Lion M.} and Anstey, {Kaarin J.} and Carol Brayne and Henry Brodaty and Knut Engedal and Farina, {Francesca R.} and Mary Ganguli and Gill Livingston and Lyketsos, {Constantine G.} and Francesca Mangialasche and Middleton, {Laura E.} and Rikkert, {Marcel G. M. Olde} and Ruth Peters and Sachdev, {Perminder S.} and Nikolaos Scarmeas and Geir Salbaek and {van Boxtel}, {Martin P. J.} and Kay Deckers",

year = "2024",

month = mar,

doi = "10.1002/alz.13577",

language = "English",

volume = "20",

pages = "2223--2239",

journal = "Alzheimer's & Dementia",

issn = "1552-5260",

publisher = "Elsevier Science",

number = "3",

}

Rosenau, C , Koehler, S , Soons, LM, Anstey, KJ, Brayne, C, Brodaty, H, Engedal, K, Farina, FR, Ganguli, M, Livingston, G, Lyketsos, CG, Mangialasche, F, Middleton, LE, Rikkert, MGMO, Peters, R, Sachdev, PS, Scarmeas, N, Salbaek, G, van Boxtel, MPJ & Deckers, K 2024, 'Umbrella review and Delphi study on modifiable factors for dementia risk reduction', Alzheimer's & Dementia, vol. 20, no. 3, pp. 2223-2239. https://doi.org/10.1002/alz.13577

TY - JOUR

T1 - Umbrella review and Delphi study on modifiable factors for dementia risk reduction

AU - Rosenau, Colin

AU - Koehler, Sebastian

AU - Soons, Lion M.

AU - Anstey, Kaarin J.

AU - Brayne, Carol

AU - Brodaty, Henry

AU - Engedal, Knut

AU - Farina, Francesca R.

AU - Ganguli, Mary

AU - Livingston, Gill

AU - Lyketsos, Constantine G.

AU - Mangialasche, Francesca

AU - Middleton, Laura E.

AU - Rikkert, Marcel G. M. Olde

AU - Peters, Ruth

AU - Sachdev, Perminder S.

AU - Scarmeas, Nikolaos

AU - Salbaek, Geir

AU - van Boxtel, Martin P. J.

AU - Deckers, Kay

PY - 2024/3

Y1 - 2024/3

N2 - 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.HIGHLIGHTSAn 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.

AB - 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.HIGHLIGHTSAn 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.

KW - brain health

KW - cognitive decline

KW - cognitive impairment

KW - Delphi study

KW - dementia

KW - etiological risk factors

KW - hearing impairment

KW - lifestyle

KW - prevention

KW - protective factors

KW - risk prediction

KW - risk reduction

KW - sleep

KW - social contact

KW - umbrella review

KW - CENTRAL AUDITORY DYSFUNCTION

KW - MILD COGNITIVE IMPAIRMENT

KW - REPORTED HEARING-LOSS

KW - ATRIAL-FIBRILLATION

KW - OLDER-ADULTS

KW - ALCOHOL-CONSUMPTION

KW - ALZHEIMERS-DISEASE

KW - INCIDENT DEMENTIA

KW - ELDERLY ADULTS

KW - PSYCHOLOGICAL STRESS

U2 - 10.1002/alz.13577

DO - 10.1002/alz.13577

M3 - (Systematic) Review article

SN - 1552-5260

VL - 20

SP - 2223

EP - 2239

JO - Alzheimer's & Dementia

JF - Alzheimer's & Dementia

IS - 3

ER -