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Predicting Dementia Risk

We have good tools these days to predict dementia risk in a person using risk calculators that collect lifestyle and medical history data. Blood tests and imaging studies can also be used, but they often only add more color to the substance.

For those who are quite healthy, their biggest health risk may be aging with dementia. And if you’re reading this, are older, and quite healthy, then your biggest risk might be dementia as most cancers in older age tend to behave less aggressively.

Dementia Risk Calculator – LIBRA

LIBRA (LIfestyle for BRAin health) is one of the many dementia risk calculators available for those starting at age 55. The actual calculator can be found here.

a screen shot of the LIBRA dementia risk calculator showing age, BMI, smoking, diabetes, coronary heart disease, and other related risk factors used in the calculation

It takes into account all the factors we address here at DNH with our patients:

  • BMI
  • Alcohol consumption
  • Tobacco
  • Exercise
  • Diabetes
  • Coronary heart disease
  • Hypertension
  • High cholesterol
  • Depression

Recent evidence suggests that one in three up to one in two Alzheimer’s disease cases are potentially attributable to modifiable risk factors. The LIBRA score was developed as a useful tool to identify individuals for primary prevention interventions of dementia and monitor individuals risk-change over time.

What this calculator tells is that in order to prevent the future risk of dementia or mild cognitive impairment (MCI) it’s necessary to modify those lifestyle or disease factors listed above.

As we always say here at DNH, perfection is the enemy, any change in the right direction will be highly valuable.

COGDrisk Calculator

CogDrisk (Cognitive Health and Dementia Risk) assesses your dementia risk and is a 20-minute questionnaire diving deep into your lifestyle habits:

  • Alcohol consumption
  • Fish consumption
  • Diabetes
  • Hypertension
  • Stroke
  • Insomnia
  • Depression
  • Tobacco
  • Inactivity
  • Social engagement
  • Cognitive engagement

It shares many of the traits above but can be more nuanced for someone who wants to dial in their lifestyle adjustments. And as with any such tool, it’s only a tool. Actual outcomes can’t be predicted, but we’d consider this a solid, educated guess.

UK Biobank Dementia Risk Calculator

The final dementia risk calculator we’ll mention is the UK Biobank, which performs quite well. Again, it shares a lot of the characteristics from above. And we don’t get too caught up with the numbers but in which direction our patients are able to modify their lifestyle to improve their risk scores.

You can link to the Excel sheet here to play around with the numbers and risk factors. Their GitHub link is available as well, listing the following factors for risk of dementia:

  • Age
  • Family history of dementia
  • Education
  • Socioeconomic disadvantage
  • Diabetes
  • Depression
  • Stroke or TIA
  • Hypertension
  • High cholesterol
  • Sex
  • Living alone
  • APOE4 carrier

Digital Nomad Health’s mission is to keep you healthy by preventing chronic diseases and helping you maximize your wellness metrics. We’ll help you think through your tough medical decisions!

Value of Dementia Risk Prediction

Let’s say that you do the math and see that you are at high risk; what’s next? These kinds of tools are less effective in the clinical setting when used purely as numerical values. Instead, it’s better to play around with them and see how much your risk can be affected by making a certain lifestyle change.

RISK/PROTECTIVE FACTORSRR
High cognitive activity0.38
Healthy or Mediterranean Diet0.60
Low/moderate alcohol intake0.74
Coronary heart disease1.36
Physical inactivity1.39
Chronic kidney disease1.39
Diabetes1.47
Cholesterol1.54
Smoking1.59
Midlife obesity1.60
Midlife hypertension1.61
Depression1.85
LIBRA

The table above shows the first 3 items which are protective against developing dementia. While the RR (relative risk) of depression is the highest, it is the biggest contributor to developing dementia.

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