title: Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies.
abstract: OBJECTIVE
  Dementia has a multifactorial etiology, but the importance of individual health and lifestyle related risk factors is often uncertain or based on few studies. The goal of this paper is to identify the major modifiable risk factors for dementia as a first step in developing an effective preventive strategy and promoting healthy late life cognitive functioning.
  
  
  METHODS
  A mixed-method approach combined findings from a systematic literature review and a Delphi consensus study. The literature search was conducted in PubMed and updated an earlier review by the United States National Institutes of Health from 2010. We reviewed the available evidence from observational epidemiological studies. The online Delphi study asked eight international experts to rank and weigh each risk factor for its importance for dementia prevention.
  
  
  RESULTS
  Out of 3127 abstracts, 291 were included in the review. There was good agreement between modifiable risk factors identified in the literature review and risk factors named spontaneously by experts. After triangulation of both methods and re-weighting by experts, strongest support was found for depression, (midlife) hypertension, physical inactivity, diabetes, (midlife) obesity, hyperlipidemia, and smoking, while more research is needed for coronary heart disease, renal dysfunction, diet, and cognitive activity.
  
  
  CONCLUSIONS
  Findings provide good support for several somatic and lifestyle factors and will be used to inform the design of a new multicenter trial into dementia prevention.
authors.affiliation: Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht, The Netherlands.
authors.forename: Kay
authors.initials: K
authors.lastname: Deckers
authors.forename: Martin P J
authors.initials: MP
authors.lastname: van Boxtel
authors.forename: Olga J G
authors.initials: OJ
authors.lastname: Schiepers
authors.forename: Marjolein
authors.initials: M
authors.lastname: de Vugt
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Muñoz Sánchez
authors.forename: Kaarin J
authors.initials: KJ
authors.lastname: Anstey
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Dartigues
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
authors.forename: Miia
authors.initials: M
authors.lastname: Kivipelto
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.forename: John M
authors.initials: JM
authors.lastname: Starr
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.forename: Kate
authors.initials: K
authors.lastname: Irving
authors.forename: Frans R J
authors.initials: FR
authors.lastname: Verhey
authors.forename: Sebastian
authors.initials: S
authors.lastname: Köhler
mesh_terms: D003071:Cognition; D015897:Comorbidity; D003697:Delphi Technique; D003704:Dementia / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008019:Life Style; D009043:Motor Activity; D064887:Observational Studies as Topic; D012307:Risk Factors
keywords: dementia; epidemiology; prevention; public health; risk factors