Umbrella review and Delphi study on modifiable factors for dementia risk reduction Link to DOI → Authors: Rosenau, C. and Köhler, S. and Soons, L. M. and Anstey, K. J. and Brayne, C. and Brodaty, H. and Engedal, K. and Farina, F. R. and Ganguli, M. and Livingston, G. and Lyketsos, C. G. and Mangialasche, F. and Middleton, L. E. and Rikkert, Mgmo and Peters, R. and Sachdev, P. S. and Scarmeas, N. and Salbaek, G. and van Boxtel, M. P. J. and Deckers, K. Year: 2024 Journal: Alzheimers Dement Vol/Issue: Vol. 20, No. 3 Pages: 2223-2239 Study Characteristics Lifestyle Pillars ConnectednessRestorative SleepStress Management Study Design Meta-analysis/Sys 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.