scholarly journals Knowledge of Modifiable Dementia Risk Factors among Slovenian Adolescents

2020 ◽  
Vol 3 (5) ◽  
Author(s):  
Zlata Felc ◽  
Brina Felc
Keyword(s):  
Risk Factors ◽  
Dementia Risk

scholarly journals Development of the First WHO Guidelines for Risk Reduction of Cognitive Decline and Dementia: Lessons Learned and Future Directions

2021 ◽  
Vol 12 ◽  
Author(s):  
Ruth Stephen ◽  
Mariagnese Barbera ◽  
Ruth Peters ◽  
Nicole Ee ◽  
Lidan Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Decline ◽  
Risk Reduction ◽  
Individual Risk ◽  
Who Guidelines ◽  
Dementia Risk ◽  
Dementia Prevention ◽  
Multidomain Intervention ◽  
Intervention Trials ◽  
Individual Risk Factors

The first WHO guidelines for risk reduction of cognitive decline and dementia marked an important milestone in the field of dementia prevention. In this paper, we discuss the evidence reviewed as part of the guidelines development and present the main themes emerged from its synthesis, to inform future research and policies on dementia risk reduction. The role of intervention effect-size; the mismatch between observational and intervention-based evidence; the heterogeneity of evidence among intervention trials; the importance of intervention duration; the role of timing of exposure to a certain risk factor and interventions; the relationship between intervention intensity and response; the link between individual risk factors and specific dementia pathologies; and the need for tailored interventions emerged as the main themes. The interaction and clustering of individual risk factors, including genetics, was identified as the overarching theme. The evidence collected indicates that multidomain approaches targeting simultaneously multiple risk factors and tailored at both individual and population level, are likely to be most effective and feasible in dementia risk reduction. The current status of multidomain intervention trials aimed to cognitive impairment/dementia prevention was also briefly reviewed. Primary results were presented focusing on methodological differences and the potential of design harmonization for improving evidence quality. Since multidomain intervention trials address a condition with slow clinical manifestation—like dementia—in a relatively short time frame, the need for surrogate outcomes was also discussed, with a specific focus on the potential utility of dementia risk scores. Finally, we considered how multidomain intervention could be most effectively implemented in a public health context and the implications world-wide for other non-communicable diseases targeting common risk factors, taking into account the limited evidence in low-middle income countries. In conclusion, the evidence from the first WHO guidelines for risk reduction of cognitive decline and dementia indicated that “one size does not fit all,” and multidomain approaches adaptable to different populations and individuals are likely to be the most effective. Harmonization in trial design, the use of appropriate outcome measures, and sustainability in large at-risk populations in the context of other chronic disorders also emerged as key elements.

scholarly journals The frequency and influence of dementia risk factors in prodromal Alzheimer's disease

2017 ◽  
Vol 56 ◽  
pp. 33-40 ◽  
Author(s):  
Isabelle Bos ◽  
Stephanie J. Vos ◽  
Lutz Frölich ◽  
Johannes Kornhuber ◽  
Jens Wiltfang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dementia Risk ◽  
Prodromal Alzheimer’S Disease

scholarly journals Future Directions for Dementia Risk Reduction and Prevention Research: An International Research Network on Dementia Prevention Consensus

2020 ◽  
Vol 78 (1) ◽  
pp. 3-12
Author(s):  
Kaarin J. Anstey ◽  
Ruth Peters ◽  
Lidan Zheng ◽  
Deborah E. Barnes ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Reduction ◽  
International Research ◽  
Large Body ◽  
Geographical Location ◽  
Evidence Base ◽  
Research Network ◽  
Future Research ◽  
Dementia Risk ◽  
Dementia Prevention

In the past decade a large body of evidence has accumulated on risk factors for dementia, primarily from Europe and North America. Drawing on recent integrative reviews and a consensus workshop, the International Research Network on Dementia Prevention developed a consensus statement on priorities for future research. Significant gaps in geographical location, representativeness, diversity, duration, mechanisms, and research on combinations of risk factors were identified. Future research to inform dementia risk reduction should fill gaps in the evidence base, take a life-course, multi-domain approach, and inform population health approaches that improve the brain-health of whole communities.

CARE MANAGEMENT TO PROMOTE TREATMENT ADHERENCE IN PATIENTS WITH COGNITIVE IMPAIRMENT AND VASCULAR RISK FACTORS: A DEMONSTRATION PROJECT

2017 ◽  
pp. 1-6
Author(s):  
L.M. Bonner ◽  
A. Hanson ◽  
G. Robinson ◽  
E. Lowy ◽  
S. Craft
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Care Management ◽  
Intervention Group ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Management Intervention ◽  
Dementia Risk ◽  
Dementia Prevention ◽  
Management Protocol

Dementia prevention is highly important. Improved control of vascular risk factors has the potential to decrease dementia risk, but may be difficult. Therefore, we developed and piloted a care management protocol for Veterans at risk for dementia. We enrolled 32 Veterans with diabetes and hypertension, at least one of which was poorly controlled, and cognitive impairment. Participants were randomly assigned to a 6-month care management intervention or to usual care. At enrollment, 6-months and 12-months, we assessed cognitive performance, mood, and diabetes and hypertension control. At follow-up, diastolic blood pressure was lower in intervention participants at 6 months (p=.041) and 12 months (p=.022); hemoglobin A1c, global mental status and mood did not differ between groups. Recall of a distractor list (p=.006) and logical memory long-delay recall (p=.036) were better at 6 months in the intervention group (p=.006). Care management may contribute to improved control of dementia risk factors.

scholarly journals Assessing the Predictive Validity of Simple Dementia Risk Models in Harmonized Stroke Cohorts

Stroke ◽  
2020 ◽  
Vol 51 (7) ◽  
pp. 2095-2102
Author(s):  
Eugene Y.H. Tang ◽  
Christopher I. Price ◽  
Louise Robinson ◽  
Catherine Exley ◽  
David W. Desmond ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Risk Prediction ◽  
Prediction Models ◽  
Disease Risk ◽  
Risk Index ◽  
Area Under The Curve ◽  
Risk Prediction Models ◽  
C Statistic ◽  
Dementia Risk

Background and Purpose: Stroke is associated with an increased risk of dementia. To assist in the early identification of individuals at high risk of future dementia, numerous prediction models have been developed for use in the general population. However, it is not known whether such models also provide accurate predictions among stroke patients. Therefore, the aim of this study was to determine whether existing dementia risk prediction models that were developed for use in the general population can also be applied to individuals with a history of stroke to predict poststroke dementia with equivalent predictive validity. Methods: Data were harmonized from 4 stroke studies (follow-up range, ≈12–18 months poststroke) from Hong Kong, the United States, the Netherlands, and France. Regression analysis was used to test 3 risk prediction models: the Cardiovascular Risk Factors, Aging and Dementia score, the Australian National University Alzheimer Disease Risk Index, and the Brief Dementia Screening Indicator. Model performance or discrimination accuracy was assessed using the C statistic or area under the curve. Calibration was tested using the Grønnesby and Borgan and the goodness-of-fit tests. Results: The predictive accuracy of the models varied but was generally low compared with the original development cohorts, with the Australian National University Alzheimer Disease Risk Index (C-statistic, 0.66) and the Brief Dementia Screening Indicator (C-statistic, 0.61) both performing better than the Cardiovascular Risk Factors, Aging and Dementia score (area under the curve, 0.53). Conclusions: Dementia risk prediction models developed for the general population do not perform well in individuals with stroke. Their poor performance could have been due to the need for additional or different predictors related to stroke and vascular risk factors or methodological differences across studies (eg, length of follow-up, age distribution). Future work is needed to develop simple and cost-effective risk prediction models specific to poststroke dementia.

scholarly journals Pulse-wave velocity is associated with cognitive impairment in haemodialysis patients

2017 ◽  
Vol 131 (13) ◽  
pp. 1495-1498 ◽  
Author(s):  
Eve Miller-Hodges ◽  
Neeraj Dhaun
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Arterial Stiffness ◽  
Pulse Wave ◽  
The Elderly ◽  
Dialysis Patients ◽  
Maintenance Haemodialysis ◽  
Dementia Risk ◽  
Independent Association ◽  
Recent Demonstration

Chronic kidney disease (CKD) is common, its prevalence increasing with age. Cognitive impairment is common in the elderly, in CKD and in those on maintenance haemodialysis. As cognitive impairment is the precursor to dementia, the identification of reversible risk factors for cognitive decline is the key to reducing dementia risk. Arterial stiffness is one such potential risk factor. It is independently associated with cardiovascular outcome in dialysis patients. Importantly, the recent demonstration of an independent association between arterial stiffness and cognitive impairment in these patients suggests that vascular stiffness might be potentially causative in the development of cognitive impairment and also be an opportune target for interventions. Whether unstiffening of blood vessels in patients on maintenance haemodialysis can reduce the incidence of cognitive impairment or indeed slow its progression to dementia, remain unanswered questions. In this issue of the Clinical Science, Angermann and colleagues present thought-provoking data related to cognitive impairment in haemodialysis patients.

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