Lifestyle and incident dementia: A COSMIC individual participant data meta‐analysis
Stephanie Van Asbroeck, Sebastian Köhler, Martin P.J. van Boxtel, Darren M. Lipnicki, John D. Crawford, Erico Castro‐Costa, Maria Fernanda Lima‐Costa, Sérgio Luís Blay, Xiao Shifu, Tao Wang, Ling Yue, Richard B. Lipton, Mindy J. Katz, Carol A. Derby, Maëlenn Guerchet, Pierre‐Marie Preux, Pascal Mbélesso, Joanna Norton, Karen Ritchie, Ingmar Skoog, Jenna Najar, Therese Rydberg Sterner, Nikolaos Scarmeas, Mary Yannakoulia, Themis Dardiotis, E Rolandi, Annalisa Davin, Michele Rossi, Oye Gureje, Akin Ojagbemi, Toyin Bello, Ki Woong Kim, Ji Won Han, Dae Jong Oh, Stella Trompet, Jacobijn Gussekloo, Steffi G. Riedel‐Heller, Susanne Röhr, Alexander Pabst, Suzana Shahar, Nurul Fatin Malek Rivan, Devinder Kaur Ajit Singh, Erin Jacobsen, Mary Ganguli, Tiffany F. Hughes, Mary N. Haan, Allison E. Aiello, Ding Ding, Qianhua Zhao, Zhenxu Xiao, Kenji Narazaki, Tao Chen, Sanmei Chen, Tze Pin Ng, Xinyi Gwee, Qi Gao, Henry Brodaty, Julian N. Trollor, Nicole A. Kochan, António Lobo, Javier Santabárbara, Patricia Gracia‐García, Perminder S. Sachdev, Kay Deckers
Abstract
INTRODUCTION: The 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. METHODS: We 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. RESULTS: A 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. DISCUSSION: Modifiable 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.