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@article{Peters:2019:10.1136/bmjopen-2018-022846,
author = {Peters, R and Booth, A and Rockwood, K and Peters, J and D'Este, C and Anstey, KJ},
doi = {10.1136/bmjopen-2018-022846},
journal = {BMJ Open},
title = {Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1136/bmjopen-2018-022846},
volume = {9},
year = {2019}
}

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TY  - JOUR
AB  - OBJECTIVE: To systematically review the literature relating to the impact of multiple co-occurring modifiable risk factors for cognitive decline and dementia. DESIGN: A systematic review and meta-analysis of the literature relating to the impact of co-occurring key risk factors for incident cognitive decline and dementia. All abstracts and full text were screened independently by two reviewers and each article assessed for bias using a standard checklist. A fixed effects meta-analysis was undertaken. DATA SOURCES: Databases Medline, Embase and PsycINFO were searched from 1999 to 2017. ELIGIBILITY CRITERIA: For inclusion articles were required to report longitudinal data from participants free of cognitive decline at baseline, with formal assessment of cognitive function or dementia during follow-up, and an aim to examine the impact of additive or clustered comorbid risk factor burden in with two or more core modifiable risk factors. RESULTS: Seventy-nine full-text articles were examined. Twenty-two articles (18 studies) were included reporting data on >40 000 participants. Included studies consistently reported an increased risk associated with greater numbers of intraindividual risk factors or unhealthy behaviours and the opposite for healthy or protective behaviours. A meta-analysis of studies with dementia outcomes resulted in a pooled relative risk for dementia of 1.20 (95% CI 1.04 to 1.39) for one risk factor, 1.65 (95% CI 1.40 to 1.94) for two and 2.21 (95% CI 1.78 to 2.73) for three or more, relative to no risk factors. Limitations include dependence on published results and variations in study outcome, cognitive assessment, length of follow-up and definition of risk factor exposure. CONCLUSIONS: The strength of the reported associations, the consistency across studies and the suggestion of a dose response supports a need to keep modifiable risk factor exposure to a minimum and to avoid exposure to additional modifiable risks. Further research is ne
AU  - Peters,R
AU  - Booth,A
AU  - Rockwood,K
AU  - Peters,J
AU  - D'Este,C
AU  - Anstey,KJ
DO  - 10.1136/bmjopen-2018-022846
PY  - 2019///
SN  - 2044-6055
TI  - Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2018-022846
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30782689
UR  - http://hdl.handle.net/10044/1/68781
VL  - 9
ER  -

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