The epidemiology is promising, but the trial evidence is weak. Why pharmacological dementia risk reduction trials haven't lived up to expectations, and where do we go from here?

2021 ◽  
Author(s):  
Ruth Peters ◽  
Hiroko H. Dodge ◽  
Sarah James ◽  
Gregory A. Jicha ◽  
Pierre‐Francois Meyer ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Dementia Risk ◽  
Trial Evidence

scholarly journals Increasing knowledge on dementia risk reduction in the general population: Results of a public awareness campaign

2021 ◽  
Vol 147 ◽  
pp. 106522
Author(s):  
Stephanie Van Asbroeck ◽  
Martin P.J. van Boxtel ◽  
Jan Steyaert ◽  
Sebastian Köhler ◽  
Irene Heger ◽  
...  
Keyword(s):  
General Population ◽  
Risk Reduction ◽  
Public Awareness ◽  
Awareness Campaign ◽  
Public Awareness Campaign ◽  
Dementia Risk ◽  
Increasing Knowledge

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 Cross-cultural validation of the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction scale in the Dutch general population

2020 ◽  
Author(s):  
Tessa Joxhorst ◽  
Joyce Vrijsen ◽  
Jacobien Niebuur ◽  
Nynke Smidt
Keyword(s):  
Risk Reduction ◽  
Health Beliefs ◽  
Health Behaviours ◽  
Motivation To Change ◽  
Cronbach’S Alpha ◽  
Online Questionnaire ◽  
Confirmatory Factor Analyses ◽  
Cronbach's Alpha ◽  
Dementia Risk ◽  
Confirmatory Factor

Abstract BACKGROUND: This study aimed to translate and validate the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) scale in the Dutch general population.METHODS: A random sample of Dutch residents aged between 30 and 80 years old were invited to complete an online questionnaire including the translated MCLHB-DRR scale. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to assess construct validity. Cronbach’s alpha was calculated to assess internal consistency.RESULTS: 618 participants completed the questionnaire. EFA and Cronbach’s alpha showed that four items were candidate for deletion. CFA confirmed that deleting these items led to an excellent fit (RMSEA = 0.043, CFI = 0.960, TLI = 0.951, χ²/df = 2.130). Cronbach’s alpha ranged from 0.69 to 0.93, indicating good internal consistency.CONCLUSION: The current study demonstrated that the Dutch MCLHB-DRR scale is a valid scale for assessing health beliefs and attitudes towards dementia risk reduction among Dutch adults aged between 30 and 80 years old.

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.

Intensity and Types of Physical Exercise in Relation to Dementia Risk Reduction in Community-Living Older Adults

2015 ◽  
Vol 16 (10) ◽  
pp. 899.e1-899.e7 ◽  
Author(s):  
Allen T.C. Lee ◽  
Marcus Richards ◽  
Wai C. Chan ◽  
Helen F.K. Chiu ◽  
Ruby S.Y. Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Exercise ◽  
Risk Reduction ◽  
Community Living ◽  
Dementia Risk
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