Evidence Hub
(all articles below are freely available to view at the specified weblinks)
Articles from members of this research group
Population-level interventions for the primary prevention of dementia: a complex evidence review
Walsh S, Wallace L, Kuhn I, Mytton O, Lafortune L, Wills W, Mukadam N*, Brayne C* *joint last-authors
Lancet eClinical Medicine, 2024
https://doi.org/10.1016/j.eclinm.2024.102538
Complex, multi-stage, evidence review to identify empirical evidence on population-level interventions for each of the modifiable risk factors identified by the Lancet Commission on dementia (2020). Derives a population-level intervention framework for dementia risk reduction, containing 26 high- and moderate-confidence policy recommendations, supported by relevant information on effect sizes, sources of evidence, contextual information, and implementation guidance.
Dementia Prevention and Individual and Socioeconomic Barriers: Avoiding “Lifestyle” Stigma
Wilson, N-A. & Anstey, K.J.
The Gerontologist, 2024
https://doi.org/10.1093/geront/gnad130
Selected as Editor’s Choice, this Forum article discusses the need for greater awareness of individual and socioeconomic barriers to behavior change-oriented dementia risk reduction. Drawing on dementia stigma research and other stigmatized non-communicable diseases, we highlight the potential negative implications from the oversimplification of dementia as a disease caused by poor lifestyle choices. We call for a more balanced approach to dementia health messaging and policy which addresses both individual-level health behaviors and provides more equitable systemic support.
Walsh S, Wallace L, Kuhn I, Mytton O, Lafortune L, Wills W, Mukadam N*, Brayne C* *joint last-authors
Lancet eClinical Medicine, 2024
https://doi.org/10.1016/j.eclinm.2024.102538
Complex, multi-stage, evidence review to identify empirical evidence on population-level interventions for each of the modifiable risk factors identified by the Lancet Commission on dementia (2020). Derives a population-level intervention framework for dementia risk reduction, containing 26 high- and moderate-confidence policy recommendations, supported by relevant information on effect sizes, sources of evidence, contextual information, and implementation guidance.
Dementia Prevention and Individual and Socioeconomic Barriers: Avoiding “Lifestyle” Stigma
Wilson, N-A. & Anstey, K.J.
The Gerontologist, 2024
https://doi.org/10.1093/geront/gnad130
Selected as Editor’s Choice, this Forum article discusses the need for greater awareness of individual and socioeconomic barriers to behavior change-oriented dementia risk reduction. Drawing on dementia stigma research and other stigmatized non-communicable diseases, we highlight the potential negative implications from the oversimplification of dementia as a disease caused by poor lifestyle choices. We call for a more balanced approach to dementia health messaging and policy which addresses both individual-level health behaviors and provides more equitable systemic support.
The Nairobi Declaration—Reducing the burden of dementia in low- and middle-income countries (LMICs): Declaration of the 2022 Symposium on Dementia and Brain Aging in LMICs
Maestre G, Carrillo M, Kalaria R et al.
Alzheimer’s & Dementia, 2023
https://doi.org/10.1002/alz.13025
Position paper from the Symposium on Dementia and Brain Aging in Low- and Middle-Income Countries. Calls for engaging and influence of policymakers and advocacy organisations to encourage implementation and evaluation of population-level dementia risk reduction interventions at a more diverse, global level
What is a population-level approach to prevention, and how could we apply it to dementia risk reduction?
Walsh S, Wallace L, Mukadam N, Mytton O, Lafortune L, Wills W, Brayne C
Public Health, 2023
https://doi.org/10.1016/j.puhe.2023.09.019
Compares and contrasts key concepts of ‘population-level prevention’ from the literature, explores related theoretical models and policy frameworks, and applies this to dementia risk reduction. Proposes a definition of population-level risk reduction of dementia, which focusses on the need to change societal conditions such that the population is less likely to develop modifiable risk factors known to be associated with dementia, without the need for high-agency behaviour change by individuals
Are Population-Level Approaches to Dementia Risk Reduction Under-Researched? A Rapid Review of the Dementia Prevention Literature
Walsh S, Wallace L, Mytton O, Lafortune L, Wills W, Mukadam N, Brayne C
The Journal of Prevention of Alzheimer’s Disease, 2023
https://link.springer.com/article/10.14283/jpad.2023.57
Rapid review, quantifying the proportion of contributing interventional evidence to the dementia primary prevention literature that is concerned with either approach. Finding that existing systematic reviews of dementia primary prevention include almost exclusively evidence concerning individual-level interventions, and almost no evidence concerning population-level interventions
Exploring English policymakers’ attitudes towards dementia risk reduction: A qualitative study
Walsh S, Roscoe H, Mattie E, Wallace L, Govia I, Brayne C
International Journal of Geriatric Psychiatry, 2023
https://doi.org/10.1002/gps.6009
Qualitative study involving semi-structured interviews with dementia prevention policymakers to explore their attitudes towards dementia risk reduction, and the balance between individual- and population-level approaches
What would a population-level approach to dementia risk reduction look like, and how would it work?
Walsh S, Govia I, Peters R, Stephan B, Wilson N, Wallace L, Anstey K, Brayne C
Alzheimer’s & Dementia, 2023
https://doi.org/10.1002/alz.12985
Describes what a population-level dementia risk reduction approach could look like, barriers and facilitators to success, and how we should go about achieving it. Includes 10 strategic goals to achieve population-level dementia risk reduction and protection enhancement, targeted at researchers, professionals, funders, science communicators, governments, businesses, and policy makers
Maestre G, Carrillo M, Kalaria R et al.
Alzheimer’s & Dementia, 2023
https://doi.org/10.1002/alz.13025
Position paper from the Symposium on Dementia and Brain Aging in Low- and Middle-Income Countries. Calls for engaging and influence of policymakers and advocacy organisations to encourage implementation and evaluation of population-level dementia risk reduction interventions at a more diverse, global level
What is a population-level approach to prevention, and how could we apply it to dementia risk reduction?
Walsh S, Wallace L, Mukadam N, Mytton O, Lafortune L, Wills W, Brayne C
Public Health, 2023
https://doi.org/10.1016/j.puhe.2023.09.019
Compares and contrasts key concepts of ‘population-level prevention’ from the literature, explores related theoretical models and policy frameworks, and applies this to dementia risk reduction. Proposes a definition of population-level risk reduction of dementia, which focusses on the need to change societal conditions such that the population is less likely to develop modifiable risk factors known to be associated with dementia, without the need for high-agency behaviour change by individuals
Are Population-Level Approaches to Dementia Risk Reduction Under-Researched? A Rapid Review of the Dementia Prevention Literature
Walsh S, Wallace L, Mytton O, Lafortune L, Wills W, Mukadam N, Brayne C
The Journal of Prevention of Alzheimer’s Disease, 2023
https://link.springer.com/article/10.14283/jpad.2023.57
Rapid review, quantifying the proportion of contributing interventional evidence to the dementia primary prevention literature that is concerned with either approach. Finding that existing systematic reviews of dementia primary prevention include almost exclusively evidence concerning individual-level interventions, and almost no evidence concerning population-level interventions
Exploring English policymakers’ attitudes towards dementia risk reduction: A qualitative study
Walsh S, Roscoe H, Mattie E, Wallace L, Govia I, Brayne C
International Journal of Geriatric Psychiatry, 2023
https://doi.org/10.1002/gps.6009
Qualitative study involving semi-structured interviews with dementia prevention policymakers to explore their attitudes towards dementia risk reduction, and the balance between individual- and population-level approaches
What would a population-level approach to dementia risk reduction look like, and how would it work?
Walsh S, Govia I, Peters R, Stephan B, Wilson N, Wallace L, Anstey K, Brayne C
Alzheimer’s & Dementia, 2023
https://doi.org/10.1002/alz.12985
Describes what a population-level dementia risk reduction approach could look like, barriers and facilitators to success, and how we should go about achieving it. Includes 10 strategic goals to achieve population-level dementia risk reduction and protection enhancement, targeted at researchers, professionals, funders, science communicators, governments, businesses, and policy makers
A whole-population approach is required for dementia risk reduction
Walsh S, Govia I, Wallace L, Richard E, Peters R, Anstey K, Brayne C
Lancet Healthy Longevity, Jan 2022
https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(21)00301-9/fulltext
A summary of the rationale for population-level approaches to dementia risk reduction from the founding members of this research group. Includes direct comparisons of what individual-level and population-level policies against each of the modifiable risk factors can look like.
What do we mean by population-based approaches to dementia risk reduction?
Transcript of the IRNDP Symposium at ADI 2022
Walsh S, Anstey K, Peters R, Wilson N-A, Lin F, Stephan B, Richard E, Govia I, Brayne C
IRNDP symposium at ADI transcript
This is a summary of the key points raised at the symposium sponsored by IRNDP at ADI 2022 entitled: ‘What do we mean by population-based approaches to dementia risk reduction?’, held on the 10th of June 2022.
From Plan to Impact V. WHO Global Action Plan: The Time to Act is Now
Alzheimer’s Disease International, May 2022
https://www.alzint.org/u/From-Plan-to-Impact-V.pdf
The chapter on risk reduction (chapter 3), of this major global report on dementia research, opens with an essay from members of the PLADRR research group. The essay explains the importance of population-level approaches to dementia risk reduction, and explores how we might apply such approaches moving forwards.
A systematic review of the cost-effectiveness of population-level and community-level interventions to reduce the modifiable risk factors of dementia
Walsh S, Brain J, Mukadam N, Anderson R, Greene L, Govia I, Kuhn I, Anstey K, Knapp M, Stephan B, Brayne C
Maturitas, September 2022
https://www.maturitas.org/article/S0378-5122(22)00197-9/fulltext
A systematic review describing economic evaluations of population-level interventions that reduce dementia’s risk factors
World Alzheimer’s Report 2022, Expert Essay: Population-based approaches to prevention
Walsh S, Wallace L, Brayne C
https://www.alzint.org/resource/world-alzheimer-report-2022/
The chapter on dementia risk reduction (chapter 23), of this major global report on dementia research, includes an expert essay from members of the PLADRR research group. The essay explains the importance of population-level approaches to dementia risk reduction, and explores how we might apply such approaches moving forwards.
The relevance of social and commercial determinants for neurological health
Walsh S*, Merrick R*, Brayne C. *Joint first authors
The Lancet Neurology, 2022
https://doi.org/10.1016/S1474-4422(22)00428-8
Summarises theory and evidence about how social and commercial determinants affect neurological health, including dementia, across the lifecourse
Walsh S, Govia I, Wallace L, Richard E, Peters R, Anstey K, Brayne C
Lancet Healthy Longevity, Jan 2022
https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(21)00301-9/fulltext
A summary of the rationale for population-level approaches to dementia risk reduction from the founding members of this research group. Includes direct comparisons of what individual-level and population-level policies against each of the modifiable risk factors can look like.
What do we mean by population-based approaches to dementia risk reduction?
Transcript of the IRNDP Symposium at ADI 2022
Walsh S, Anstey K, Peters R, Wilson N-A, Lin F, Stephan B, Richard E, Govia I, Brayne C
IRNDP symposium at ADI transcript
This is a summary of the key points raised at the symposium sponsored by IRNDP at ADI 2022 entitled: ‘What do we mean by population-based approaches to dementia risk reduction?’, held on the 10th of June 2022.
From Plan to Impact V. WHO Global Action Plan: The Time to Act is Now
Alzheimer’s Disease International, May 2022
https://www.alzint.org/u/From-Plan-to-Impact-V.pdf
The chapter on risk reduction (chapter 3), of this major global report on dementia research, opens with an essay from members of the PLADRR research group. The essay explains the importance of population-level approaches to dementia risk reduction, and explores how we might apply such approaches moving forwards.
A systematic review of the cost-effectiveness of population-level and community-level interventions to reduce the modifiable risk factors of dementia
Walsh S, Brain J, Mukadam N, Anderson R, Greene L, Govia I, Kuhn I, Anstey K, Knapp M, Stephan B, Brayne C
Maturitas, September 2022
https://www.maturitas.org/article/S0378-5122(22)00197-9/fulltext
A systematic review describing economic evaluations of population-level interventions that reduce dementia’s risk factors
World Alzheimer’s Report 2022, Expert Essay: Population-based approaches to prevention
Walsh S, Wallace L, Brayne C
https://www.alzint.org/resource/world-alzheimer-report-2022/
The chapter on dementia risk reduction (chapter 23), of this major global report on dementia research, includes an expert essay from members of the PLADRR research group. The essay explains the importance of population-level approaches to dementia risk reduction, and explores how we might apply such approaches moving forwards.
The relevance of social and commercial determinants for neurological health
Walsh S*, Merrick R*, Brayne C. *Joint first authors
The Lancet Neurology, 2022
https://doi.org/10.1016/S1474-4422(22)00428-8
Summarises theory and evidence about how social and commercial determinants affect neurological health, including dementia, across the lifecourse
Estimating Dementia Risk Using Multifactorial Prediction Models
Kivimaki M, Livingston G, Singh-Manoux A et al.,
JAMA Network Open, 2023
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805965
Examines the performance of four dementia risk prediction models in the UK Biobank Cohort. Finds that, at a 5% false-positive rate, 84%-91% of incident dementia cases occurring over the next 10 years were missed by the models
The structural and social determinants of Alzheimer’s disease related dementias
Adkins-Jackson, George K, Besser L.
Alzheimer’s & Dementia, 2023
https://doi.org/10.1002/alz.13027
Employ Bronfenbrenner’s ecological systems theory as a framework to posit how social determinants impact dementia risk and outcomes
A blueprint for dementia research
World Health Organization, 2022
https://iris.who.int/bitstream/handle/10665/363341/9789240058248-eng.pdf?sequence=1
This strategy document from WHO calls explicitly for more evidence into population-level dementia risk reduction research, citing work from PLADRR. It also sets out a strategic goal: “By 2030, to have established evidence of efficient interventions on health, environmental and social determinants that reduce the risk for dementia throughout the life course.”
Optimising brain health across the life course: WHO Position Paper
World Health Organization, 2022
https://iris.who.int/bitstream/handle/10665/361251/9789240054561-eng.pdf?sequence=1
This position paper from WHO outlines key determinants of brain health across the lifecourse, such as healthy environments, which are recognised social determinants of health that would require population-level interventions to address.
Twenty-seven-year time trends in dementia incidence in Europe and the United States
Wolters F, Chibnik L, Waziry R et al.
Neurology, August 2020
https://n.neurology.org/content/neurology/95/5/e519.full.pdf
This pooled analysis of several cohorts across Europe and the USA shows that dementia incidence rate declined by 13% over the preceding 25 years. This is a key finding that indicates dementia risk can be reduced at a population level.
Dementia Prevention, Intervention, and Care: 2020 Report of the Lancet Commission
Livingston G, Huntley J, Sommerlad A et al.
The Lancet, July 2020
https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext
This widely cited review includes identification of 12 potentially modifiable risk factors for dementia: education, hearing loss, traumatic brain injury, hypertension, excess alcohol, obesity, smoking, depression, social isolation, physical inactivity, air pollution, and diabetes. Combined, these factors could account for up to 40% of dementia worldwide (a higher proportion in resource-constrained settings).
Tackling NCDs: ‘best buys’ and other recommended interventions for the prevention and control of noncommunicable diseases
The World Health Organization, 2017
https://apps.who.int/iris/handle/10665/259232
In this document, the World Health Organization summarise the interventions which have the best evidence for being cost-effective for the protection of non-communicable diseases. Though dementia itself is not a direct target of this work, several of the proposed modifiable risk factors from the Lancet Commission (including: obesity, physical inactivity, smoking, excess alcohol, diabetes, and hypertension) are directly considered here. The majority of the interventions labelled as ‘best buys’ are population-level interventions.
Kivimaki M, Livingston G, Singh-Manoux A et al.,
JAMA Network Open, 2023
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805965
Examines the performance of four dementia risk prediction models in the UK Biobank Cohort. Finds that, at a 5% false-positive rate, 84%-91% of incident dementia cases occurring over the next 10 years were missed by the models
The structural and social determinants of Alzheimer’s disease related dementias
Adkins-Jackson, George K, Besser L.
Alzheimer’s & Dementia, 2023
https://doi.org/10.1002/alz.13027
Employ Bronfenbrenner’s ecological systems theory as a framework to posit how social determinants impact dementia risk and outcomes
A blueprint for dementia research
World Health Organization, 2022
https://iris.who.int/bitstream/handle/10665/363341/9789240058248-eng.pdf?sequence=1
This strategy document from WHO calls explicitly for more evidence into population-level dementia risk reduction research, citing work from PLADRR. It also sets out a strategic goal: “By 2030, to have established evidence of efficient interventions on health, environmental and social determinants that reduce the risk for dementia throughout the life course.”
Optimising brain health across the life course: WHO Position Paper
World Health Organization, 2022
https://iris.who.int/bitstream/handle/10665/361251/9789240054561-eng.pdf?sequence=1
This position paper from WHO outlines key determinants of brain health across the lifecourse, such as healthy environments, which are recognised social determinants of health that would require population-level interventions to address.
Twenty-seven-year time trends in dementia incidence in Europe and the United States
Wolters F, Chibnik L, Waziry R et al.
Neurology, August 2020
https://n.neurology.org/content/neurology/95/5/e519.full.pdf
This pooled analysis of several cohorts across Europe and the USA shows that dementia incidence rate declined by 13% over the preceding 25 years. This is a key finding that indicates dementia risk can be reduced at a population level.
Dementia Prevention, Intervention, and Care: 2020 Report of the Lancet Commission
Livingston G, Huntley J, Sommerlad A et al.
The Lancet, July 2020
https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext
This widely cited review includes identification of 12 potentially modifiable risk factors for dementia: education, hearing loss, traumatic brain injury, hypertension, excess alcohol, obesity, smoking, depression, social isolation, physical inactivity, air pollution, and diabetes. Combined, these factors could account for up to 40% of dementia worldwide (a higher proportion in resource-constrained settings).
Tackling NCDs: ‘best buys’ and other recommended interventions for the prevention and control of noncommunicable diseases
The World Health Organization, 2017
https://apps.who.int/iris/handle/10665/259232
In this document, the World Health Organization summarise the interventions which have the best evidence for being cost-effective for the protection of non-communicable diseases. Though dementia itself is not a direct target of this work, several of the proposed modifiable risk factors from the Lancet Commission (including: obesity, physical inactivity, smoking, excess alcohol, diabetes, and hypertension) are directly considered here. The majority of the interventions labelled as ‘best buys’ are population-level interventions.
How many future dementia cases would be missed by a high-risk screening programme? A retrospective cohort study in a population-based cohort
Estimated publication date, 2024
Benefits of population-level interventions for dementia risk factors: an economic modelling study
Estimated publication date, 2024
Prevention and risk reduction in Canadian dementia strategies: a scoping review
Estimated publication date, 2024
A systematic review of the association between lifecourse socio-economic status and dementia
Estimated publication date, 2024/25
A scoping review of social determinants of dementia
Estimated publication date, 2024/25
Estimated publication date, 2024
Benefits of population-level interventions for dementia risk factors: an economic modelling study
Estimated publication date, 2024
Prevention and risk reduction in Canadian dementia strategies: a scoping review
Estimated publication date, 2024
A systematic review of the association between lifecourse socio-economic status and dementia
Estimated publication date, 2024/25
A scoping review of social determinants of dementia
Estimated publication date, 2024/25