Universität zu Köln

Ranson, Janice M., Rittman, Timothy ORCID: 0000-0003-1063-6937, Hayat, Shabina, Brayne, Carol ORCID: 0000-0001-5307-663X, Jessen, Frank, Blennow, Kaj, van Duijn, Cornelia, Barkhof, Frederik ORCID: 0000-0003-3543-3706, Tang, Eugene ORCID: 0000-0003-1030-9311, Mummery, Catherine J., Stephan, Blossom C. M., Altomare, Daniele, Frisoni, Giovanni B., Ribaldi, Federica ORCID: 0000-0001-9208-4472, Molinuevo, Jose Luis, Scheltens, Philip and Llewellyn, David J. (2021). Modifiable risk factors for dementia and dementia risk profiling. A user manual for Brain Health Services-part 2 of 6. Alzheimers Res. Ther., 13 (1). LONDON: BMC. ISSN 1758-9193

Full text not available from this repository.

Abstract

We envisage the development of new Brain Health Services to achieve primary and secondary dementia prevention. These services will complement existing memory clinics by targeting cognitively unimpaired individuals, where the focus is on risk profiling and personalized risk reduction interventions rather than diagnosing and treating late-stage disease. In this article, we review key potentially modifiable risk factors and genetic risk factors and discuss assessment of risk factors as well as additional fluid and imaging biomarkers that may enhance risk profiling. We then outline multidomain measures and risk profiling and provide practical guidelines for Brain Health Services, with consideration of outstanding uncertainties and challenges. Users of Brain Health Services should undergo risk profiling tailored to their age, level of risk, and availability of local resources. Initial risk assessment should incorporate a multidomain risk profiling measure. For users aged 39-64, we recommend the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) Dementia Risk Score, whereas for users aged 65 and older, we recommend the Brief Dementia Screening Indicator (BDSI) and the Australian National University Alzheimer's Disease Risk Index (ANU-ADRI). The initial assessment should also include potentially modifiable risk factors including sociodemographic, lifestyle, and health factors. If resources allow, apolipoprotein E e4 status testing and structural magnetic resonance imaging should be conducted. If this initial assessment indicates a low dementia risk, then low intensity interventions can be implemented. If the user has a high dementia risk, additional investigations should be considered if local resources allow. Common variant polygenic risk of late-onset AD can be tested in middle-aged or older adults. Rare variants should only be investigated in users with a family history of early-onset dementia in a first degree relative. Advanced imaging with 18-fluorodeoxyglucose positron emission tomography (FDG-PET) or amyloid PET may be informative in high risk users to clarify the nature and burden of their underlying pathologies. Cerebrospinal fluid biomarkers are not recommended for this setting, and blood-based biomarkers need further validation before clinical use. As new technologies become available, advances in artificial intelligence are likely to improve our ability to combine diverse data to further enhance risk profiling. Ultimately, Brain Health Services have the potential to reduce the future burden of dementia through risk profiling, risk communication, personalized risk reduction, and cognitive enhancement interventions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ranson, Janice M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rittman, Timothy UNSPECIFIED orcid.org/0000-0003-1063-6937 UNSPECIFIED Hayat, Shabina UNSPECIFIED UNSPECIFIED UNSPECIFIED Brayne, Carol UNSPECIFIED orcid.org/0000-0001-5307-663X UNSPECIFIED Jessen, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Blennow, Kaj UNSPECIFIED UNSPECIFIED UNSPECIFIED van Duijn, Cornelia UNSPECIFIED UNSPECIFIED UNSPECIFIED Barkhof, Frederik UNSPECIFIED orcid.org/0000-0003-3543-3706 UNSPECIFIED Tang, Eugene UNSPECIFIED orcid.org/0000-0003-1030-9311 UNSPECIFIED Mummery, Catherine J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stephan, Blossom C. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Altomare, Daniele UNSPECIFIED UNSPECIFIED UNSPECIFIED Frisoni, Giovanni B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ribaldi, Federica UNSPECIFIED orcid.org/0000-0001-9208-4472 UNSPECIFIED Molinuevo, Jose Luis UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheltens, Philip UNSPECIFIED UNSPECIFIED UNSPECIFIED Llewellyn, David J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-604886
DOI:	10.1186/s13195-021-00895-4
Journal or Publication Title:	Alzheimers Res. Ther.
Volume:	13
Number:	1
Date:	2021
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1758-9193
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ALZHEIMERS-DISEASE; NEUROFILAMENT LIGHT; PREDICTION; MRI; ASSOCIATION; PREVENTION; BIOMARKER; ATROPHY; SCORE; ONSET Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60488