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Modifiable risk factors for dementia and dementia risk profiling. A user manual for Brain Health Services-part 2 of 6.

التفاصيل البيبلوغرافية
العنوان: Modifiable risk factors for dementia and dementia risk profiling. A user manual for Brain Health Services-part 2 of 6.
المؤلفون: Ranson JM; College of Medicine and Health, University of Exeter, Exeter, UK.; Deep Dementia Phenotyping (DEMON) Network, Exeter, UK., Rittman T; Deep Dementia Phenotyping (DEMON) Network, Exeter, UK.; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK., Hayat S; Department of Public Health and Primary Care, Cambridge Public Health, University of Cambridge, Cambridge, UK., Brayne C; Department of Public Health and Primary Care, Cambridge Public Health, University of Cambridge, Cambridge, UK., Jessen F; Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany., Blennow K; Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden., van Duijn C; Nuffield Department of Population Health, University of Oxford, Oxford, UK., Barkhof F; Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK.; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Tang E; Deep Dementia Phenotyping (DEMON) Network, Exeter, UK.; Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK., Mummery CJ; Deep Dementia Phenotyping (DEMON) Network, Exeter, UK.; Dementia Research Centre, Institute of Neurology, University College London, and National Hospital for Neurology and Neurosurgery, University College London Hospital, London, UK., Stephan BCM; Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, Nottingham University, Nottingham, UK., Altomare D; Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.; Memory Clinic, Geneva University Hospitals, Geneva, Switzerland., Frisoni GB; Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.; Memory Clinic, Geneva University Hospitals, Geneva, Switzerland., Ribaldi F; Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.; Memory Clinic, Geneva University Hospitals, Geneva, Switzerland.; Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy.; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy., Molinuevo JL; Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain., Scheltens P; Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.; Life Science Partners, Amsterdam, The Netherlands., Llewellyn DJ; College of Medicine and Health, University of Exeter, Exeter, UK. david.llewellyn@exeter.ac.uk.; Deep Dementia Phenotyping (DEMON) Network, Exeter, UK. david.llewellyn@exeter.ac.uk.; Alan Turing Institute, London, UK. david.llewellyn@exeter.ac.uk.; 2.04 College House, St Luke's Campus, University of Exeter Medical School, Exeter, EX1 2 LU, UK. david.llewellyn@exeter.ac.uk.
مؤلفون مشاركون: European Task Force for Brain Health Services
المصدر: Alzheimer's research & therapy [Alzheimers Res Ther] 2021 Oct 11; Vol. 13 (1), pp. 169. Date of Electronic Publication: 2021 Oct 11.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
اللغة: English
بيانات الدورية: Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 101511643 Publication Model: Electronic Cited Medium: Internet ISSN: 1758-9193 (Electronic) NLM ISO Abbreviation: Alzheimers Res Ther Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central Ltd.
مواضيع طبية MeSH: Alzheimer Disease* , Dementia*/diagnostic imaging , Dementia*/epidemiology , Dementia*/genetics, Aged ; Artificial Intelligence ; Australia ; Biomarkers ; Brain/diagnostic imaging ; Health Services ; Humans ; Middle Aged ; Positron-Emission Tomography ; Risk Factors
مستخلص: 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 ɛ4 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.
(© 2021. The Author(s).)
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معلومات مُعتمدة: G0601022 United Kingdom MRC_ Medical Research Council; G9901400 United Kingdom MRC_ Medical Research Council; RF1 AG055654 United States AG NIA NIH HHS; United Kingdom DH_ Department of Health
فهرسة مساهمة: Investigator: M Abramowicz; D Altomare; F Barkhof; M Berthier; M Bieler; K Blennow; C Brayne; A Brioschi; E Carrera; G Chételat; C Csajka; JF Demonet; A Dodich; B Dubois; GB Frisoni; V Garibotto; J Georges; S Hurst; F Jessen; M Kivipelto; D J Llewellyn; L McWhirter; R Milne; C Minguillón; C Miniussi; JL Molinuevo; PM Nilsson; JM Ranson; F Ribaldi; C Ritchie; P Scheltens; A Solomon; W van der Flier; C van Duijn; B Vellas; L Visser
Keywords: Aging; Alzheimer’s disease; Brain health services; Dementia; Prevention; Public health; Risk factors; Risk profiling
المشرفين على المادة: 0 (Biomarkers)
تواريخ الأحداث: Date Created: 20211012 Date Completed: 20211028 Latest Revision: 20240403
رمز التحديث: 20240403
مُعرف محوري في PubMed: PMC8507172
DOI: 10.1186/s13195-021-00895-4
PMID: 34635138
قاعدة البيانات: MEDLINE
الوصف
تدمد:1758-9193
DOI:10.1186/s13195-021-00895-4