16 In brief, the study focuses on the etiology, pathophysiology, complications, and comorbid conditions of type 2 diabetes (T2D) and is characterized by an extensive phenotyping approach.
In addition, we investigated biological plausible pathways by testing whether MRI markers mediated the association of LIBRA score with cognition.ĭata were used from The Maastricht Study, an observational population-based cohort study, the rationale and methodology of which have been described previously. Therefore, this study aimed to examine the association of LIBRA score with cognitive performance and impairment and evidence of neuroimaging abnormalities in the general adult population (age 40–75 years). 15 Whether LIBRA score is also related to brain markers, reflecting more direct neurobiological markers of brain health, remains to be elucidated. 9 Criterion validity has been established by several prospective studies relating higher LIBRA scores to steeper cognitive decline, incident cognitive impairment, and dementia in midlife and late life, 9, -, 14 as well as intervention effects in multifactorial randomized controlled trials. The Lifestyle for Brain Health (LIBRA) index is based on a systematic literature review and Delphi consensus on factors amendable to change, 9 thereby summarizing one's potential for brain health improvement. Some risk scores have been associated with structural brain changes and cognitive functioning, 4, -, 7 but most are based on single cohort studies or include factors that are not amenable to change, e.g., age, 4, -, 8 known to be highly correlated with brain markers. 3ĭementia risk scores, summarizing individual risks, might be useful for the selection of high-risk individuals and could serve as intermediate outcomes to monitor treatment adherence. 1, 2 Early detection of individuals at risk, allowing timely management, has great public health implications, 1 as echoed by recent reports of the Lancet Commission on Dementia Prevention, Intervention and Care 2 and the World Health Organization (WHO). Glossary CAIDE = Cardiovascular Risk Factors, Aging, and Incidence of Dementia CI = confidence interval CSVD = cerebral small vessel disease FFQ = food frequency questionnaire GM = gray matter LIBRA = Lifestyle for Brain Health OR = odds ratio T2D = type 2 diabetes WHO = World Health Organization WM = white matter WMH = WM hyperintensityĪ substantial proportion of dementia cases might be attributable to modifiable risk factors.
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