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

for Cohort Studies of Memory in an International Consortium (COSMIC)

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)3972-3986
Number of pages15
JournalAlzheimer's and Dementia
Issue number6
StatePublished - Jun 2024


  • age
  • dementia
  • dementia risk reduction
  • education
  • effect modification
  • ethnicity
  • individual participant data meta-analysis
  • interaction
  • lifestyle
  • primary prevention
  • region
  • risk factor
  • risk personalization
  • sex
  • socioeconomic

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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