Lifestyle and incident dementia: A COSMIC individual participant data meta‐analysis

Author:

Van Asbroeck Stephanie1ORCID,Köhler Sebastian1,van Boxtel Martin P. J.1,Lipnicki Darren M.2,Crawford John D.2,Castro‐Costa Erico3,Lima‐Costa Maria Fernanda3,Blay Sergio Luis4,Shifu Xiao5,Wang Tao567,Yue Ling5,Lipton Richard B.8910,Katz Mindy J.8,Derby Carol A.89,Guerchet Maëlenn11,Preux Pierre‐Marie11,Mbelesso Pascal12,Norton Joanna13,Ritchie Karen1314,Skoog Ingmar151617,Najar Jenna15161718,Sterner Therese Rydberg151619,Scarmeas Nikolaos2021,Yannakoulia Mary22,Dardiotis Themis23,Rolandi Elena2425,Davin Annalisa24,Rossi Michele24,Gureje Oye26,Ojagbemi Akin27,Bello Toyin27,Kim Ki Woong282930,Han Ji Won2829,Oh Dae Jong31,Trompet Stella32,Gussekloo Jacobijn3233,Riedel‐Heller Steffi G.34,Röhr Susanne343536,Pabst Alexander34,Shahar Suzana37,Rivan Nurul Fatin Malek37,Singh Devinder Kaur Ajit37,Jacobsen Erin38,Ganguli Mary3839,Hughes Tiffany40,Haan Mary41,Aiello Allison E.42,Ding Ding43,Zhao Qianhua43,Xiao Zhenxu43,Narazaki Kenji44,Chen Tao45,Chen Sanmei46,Ng Tze Pin47,Gwee Xinyi47,Gao Qi47,Brodaty Henry2,Trollor Julian248,Kochan Nicole2,Lobo Antonio495051,Santabárbara Javier505152,Gracia‐Garcia Patricia495051,Sachdev Perminder S.253,Deckers Kay1,

Affiliation:

1. Alzheimer Centrum Limburg Department of Psychiatry and Neuropsychology Mental Health and Neuroscience (MHeNs) Research Institute Maastricht University Maastricht The Netherlands

2. Centre for Healthy Brain Ageing (CHeBA) Discipline of Psychiatry and Mental Health School of Clinical Medicine, University of New South Wales Sydney New South Wales Australia

3. René Rachou Institute, Fiocruz Minas Belo Horizonte Minas Gerais Brazil

4. Department of Psychiatry Federal University of São Paulo São Paulo Brazil

5. Department of Geriatric Psychiatry Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine Shanghai China

6. Department of Psychiatry & Affective Disorders Center Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai China

7. Alzheimer's Disease and Related Disorders Center Shanghai Jiao Tong University Shanghai China

8. Saul R. Korey Department of Neurology Albert Einstein College of Medicine Bronx New York USA

9. Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx New York USA

10. Department of Psychiatry and Behavioral Medicine Albert Einstein College of Medicine Bronx New York USA

11. Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth Limoges France

12. Department of Neurology Amitié Hospital Bangui Central African Republic

13. Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm Montpellier France

14. Institut du Cerveau Trocadéro Paris France

15. Department of Psychiatry and Neurochemistry Neuropsychiatric Epidemiology Unit Institute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of Gothenburg Gothenburg Sweden

16. Centre for Ageing and Health (AGECAP), University of Gothenburg Gothenburg Sweden

17. Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic Gothenburg Sweden

18. Department of Clinical Genetics Section Genomics of Neurodegenerative Diseases and Aging, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam The Netherlands

19. Department of Neurobiology Aging Research Center Care Sciences and Society, Karolinska Institute and Stockholm University Stockholm Sweden

20. 1st Department of Neurology Aiginition Hospital, Medical School, National and Kapodistrian University of Athens Athens Greece

21. Department of Neurology Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University New York New York USA

22. Department of Nutrition and Dietetics Harokopio University Athens Greece

23. School of Medicine University of Thessaly Larissa Greece

24. Golgi Cenci Foundation Milan Italy

25. Department of Brain and Behavioral Sciences University of Pavia Pavia Italy

26. Department of Psychiatry WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience and Substance Abuse, University of Ibadan Ibadan Nigeria

27. Department of Psychiatry College of Medicine University of Ibadan Ibadan Nigeria

28. Department of Neuropsychiatry Seoul National University Bundang Hospital Seongnam Republic of Korea

29. Department of Psychiatry Seoul National University College of Medicine Seoul Republic of Korea

30. Department of Brain and Cognitive Sciences Seoul National University College of Natural Sciences Seoul Republic of Korea

31. Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul Republic of Korea

32. Department of Internal Medicine section of Gerontology and Geriatrics Leiden University Medical Center Leiden the Netherlands

33. Department of Public Health and Primary Care Leiden University Medical Center Leiden the Netherlands

34. Institute of Social Medicine Occupational Health and Public Health Medical Faculty University of Leipzig Leipzig Germany

35. Health and Ageing Research Team (HART), School of Psychology, Massey University Palmerston North Aotearoa New Zealand

36. Global Brain Health Institute (GBHI), Trinity College Dublin Dublin Ireland

37. Center for Healthy Ageing & Wellness (H‐CARE) Faculty of Health Sciences University Kebangsaan Malaysia Kuala Lumpur Malaysia

38. Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA

39. Departments of Neurology, and Epidemiology University of Pittsburgh School of Medicine and School of Public Health Pittsburgh Pennsylvania USA

40. Department of Graduate Studies in Health and Rehabilitation Sciences Bitonte College of Health and Human Services, Youngstown State University Youngstown Ohio USA

41. Department of Epidemiology and Biostatistics School of Medicine, University of California San Francisco San Francisco California USA

42. Columbia Aging Center and the Department of Epidemiology Mailman School of Public Health, Columbia University New York New York USA

43. Institute of Neurology National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University Shanghai China

44. Center for Liberal Arts, Fukuoka Institute of Technology Higashi‐ku Fukuoka Japan

45. Department of Physical Education Sports and Health Research Center Tongji University Shanghai China

46. Graduate School of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan

47. Department of Psychological Medicine Gerontology Research Programme, Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore

48. Department of Developmental Disability Neuropsychiatry Discipline of Psychiatry and Mental Health, University of New South Wales Sydney New South Wales Australia

49. Department of Medicine and Psychiatry Universidad de Zaragoza Zaragoza Spain

50. Instituto de Investigación Sanitaria Aragón (IIS Aragón) Zaragoza Spain

51. CIBERSAM, Instituto de Salud Carlos III Madrid Spain

52. Department of Public Health Universidad de Zaragoza Zaragoza Spain

53. Neuropsychiatric Institute, The Prince of Wales Hospital Sydney New South Wales Australia

Abstract

AbstractINTRODUCTIONThe LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics.METHODSWe combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort‐specific Cox proportional hazard regression analyses in a two‐step individual participant data meta‐analysis.RESULTSA one‐standard‐deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow‐up. No interactions with sex, education, or socioeconomic position were observed.DISCUSSIONModifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups.Highlights A two‐step individual participant data meta‐analysis was conducted. This was done at a global scale using data from 21 ethno‐regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.

Funder

National Institute on Aging

National Institutes of Health

Wellcome Trust

Gobierno de Aragón

Alzheimer's Association

National Medical Research Council

Agence Nationale de la Recherche

AXA Research Fund

Riksbankens Jubileumsfond

Forskningsrådet om Hälsa, Arbetsliv och Välfärd

Swedish Brain Power

Vetenskapsrådet

Stiftelsen för Gamla Tjänarinnor

Instituto de Salud Carlos III

Publisher

Wiley

Reference63 articles.

1. World Health Organisation (WHO).Global status report on the public health response to dementia.2021.

2. World Health Organization (WHO).Risk reduction of cognitive decline and dementia: WHO guidelines.2019.

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