Jasper Senff, Reinier Willem Pieter Tack, Akashleena Mallick, Leidys Gutierrez-Martinez, Jonathan Duskin, Tamara N Kimball, Benjamin Y Q Tan, Zeina N Chemali, Amy Newhouse, Christina Kourkoulis, Cyprien Rivier, Guido J Falcone, Kevin N Sheth, Ronald M Lazar, Sarah Ibrahim, Aleksandra Pikula, Rudolph E Tanzi, Gregory L Fricchione, Hens Bart Brouwers, Gabriel J E Rinkel, Nirupama Yechoor, Jonathan Rosand, Christopher D Anderson, Sanjula D Singh
{"title":"中风、痴呆症和晚年抑郁症的可改变风险因素：系统综述和综合结果的 DALY 加权风险因素。","authors":"Jasper Senff, Reinier Willem Pieter Tack, Akashleena Mallick, Leidys Gutierrez-Martinez, Jonathan Duskin, Tamara N Kimball, Benjamin Y Q Tan, Zeina N Chemali, Amy Newhouse, Christina Kourkoulis, Cyprien Rivier, Guido J Falcone, Kevin N Sheth, Ronald M Lazar, Sarah Ibrahim, Aleksandra Pikula, Rudolph E Tanzi, Gregory L Fricchione, Hens Bart Brouwers, Gabriel J E Rinkel, Nirupama Yechoor, Jonathan Rosand, Christopher D Anderson, Sanjula D Singh","doi":"10.1136/jnnp-2024-334925","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>At least 60% of stroke, 40% of dementia and 35% of late-life depression (LLD) are attributable to modifiable risk factors, with great overlap due to shared pathophysiology. This study aims to systematically identify overlapping risk factors for these diseases and calculate their relative impact on a composite outcome.</p><p><strong>Methods: </strong>A systematic literature review was performed in PubMed, Embase and PsycInfo, between January 2000 and September 2023. We included meta-analyses reporting effect sizes of modifiable risk factors on the incidence of stroke, dementia and/or LLD. The most relevant meta-analyses were selected, and disability-adjusted life year (DALY) weighted beta (<i>β</i>)-coefficients were calculated for a composite outcome. The <i>β</i>-coefficients were normalised to assess relative impact.</p><p><strong>Results: </strong>Our search yielded 182 meta-analyses meeting the inclusion criteria, of which 59 were selected to calculate DALY-weighted risk factors for a composite outcome. Identified risk factors included alcohol (normalised <i>β</i>-coefficient highest category: -34), blood pressure (130), body mass index (70), fasting plasma glucose (94), total cholesterol (22), leisure time cognitive activity (-91), depressive symptoms (57), diet (51), hearing loss (60), kidney function (101), pain (42), physical activity (-56), purpose in life (-50), sleep (76), smoking (91), social engagement (53) and stress (55).</p><p><strong>Conclusions: </strong>This study identified overlapping modifiable risk factors and calculated the relative impact of these factors on the risk of a composite outcome of stroke, dementia and LLD. These findings could guide preventative strategies and serve as an empirical foundation for future development of tools that can empower people to reduce their risk of these diseases.</p><p><strong>Prospero registration number: </strong>CRD42023476939.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":"515-527"},"PeriodicalIF":8.7000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Modifiable risk factors for stroke, dementia and late-life depression: a systematic review and DALY-weighted risk factors for a composite outcome.\",\"authors\":\"Jasper Senff, Reinier Willem Pieter Tack, Akashleena Mallick, Leidys Gutierrez-Martinez, Jonathan Duskin, Tamara N Kimball, Benjamin Y Q Tan, Zeina N Chemali, Amy Newhouse, Christina Kourkoulis, Cyprien Rivier, Guido J Falcone, Kevin N Sheth, Ronald M Lazar, Sarah Ibrahim, Aleksandra Pikula, Rudolph E Tanzi, Gregory L Fricchione, Hens Bart Brouwers, Gabriel J E Rinkel, Nirupama Yechoor, Jonathan Rosand, Christopher D Anderson, Sanjula D Singh\",\"doi\":\"10.1136/jnnp-2024-334925\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>At least 60% of stroke, 40% of dementia and 35% of late-life depression (LLD) are attributable to modifiable risk factors, with great overlap due to shared pathophysiology. This study aims to systematically identify overlapping risk factors for these diseases and calculate their relative impact on a composite outcome.</p><p><strong>Methods: </strong>A systematic literature review was performed in PubMed, Embase and PsycInfo, between January 2000 and September 2023. We included meta-analyses reporting effect sizes of modifiable risk factors on the incidence of stroke, dementia and/or LLD. The most relevant meta-analyses were selected, and disability-adjusted life year (DALY) weighted beta (<i>β</i>)-coefficients were calculated for a composite outcome. The <i>β</i>-coefficients were normalised to assess relative impact.</p><p><strong>Results: </strong>Our search yielded 182 meta-analyses meeting the inclusion criteria, of which 59 were selected to calculate DALY-weighted risk factors for a composite outcome. Identified risk factors included alcohol (normalised <i>β</i>-coefficient highest category: -34), blood pressure (130), body mass index (70), fasting plasma glucose (94), total cholesterol (22), leisure time cognitive activity (-91), depressive symptoms (57), diet (51), hearing loss (60), kidney function (101), pain (42), physical activity (-56), purpose in life (-50), sleep (76), smoking (91), social engagement (53) and stress (55).</p><p><strong>Conclusions: </strong>This study identified overlapping modifiable risk factors and calculated the relative impact of these factors on the risk of a composite outcome of stroke, dementia and LLD. 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Modifiable risk factors for stroke, dementia and late-life depression: a systematic review and DALY-weighted risk factors for a composite outcome.
Background: At least 60% of stroke, 40% of dementia and 35% of late-life depression (LLD) are attributable to modifiable risk factors, with great overlap due to shared pathophysiology. This study aims to systematically identify overlapping risk factors for these diseases and calculate their relative impact on a composite outcome.
Methods: A systematic literature review was performed in PubMed, Embase and PsycInfo, between January 2000 and September 2023. We included meta-analyses reporting effect sizes of modifiable risk factors on the incidence of stroke, dementia and/or LLD. The most relevant meta-analyses were selected, and disability-adjusted life year (DALY) weighted beta (β)-coefficients were calculated for a composite outcome. The β-coefficients were normalised to assess relative impact.
Results: Our search yielded 182 meta-analyses meeting the inclusion criteria, of which 59 were selected to calculate DALY-weighted risk factors for a composite outcome. Identified risk factors included alcohol (normalised β-coefficient highest category: -34), blood pressure (130), body mass index (70), fasting plasma glucose (94), total cholesterol (22), leisure time cognitive activity (-91), depressive symptoms (57), diet (51), hearing loss (60), kidney function (101), pain (42), physical activity (-56), purpose in life (-50), sleep (76), smoking (91), social engagement (53) and stress (55).
Conclusions: This study identified overlapping modifiable risk factors and calculated the relative impact of these factors on the risk of a composite outcome of stroke, dementia and LLD. These findings could guide preventative strategies and serve as an empirical foundation for future development of tools that can empower people to reduce their risk of these diseases.
期刊介绍：
The Journal of Neurology, Neurosurgery & Psychiatry (JNNP) aspires to publish groundbreaking and cutting-edge research worldwide. Covering the entire spectrum of neurological sciences, the journal focuses on common disorders like stroke, multiple sclerosis, Parkinson’s disease, epilepsy, peripheral neuropathy, subarachnoid haemorrhage, and neuropsychiatry, while also addressing complex challenges such as ALS. With early online publication, regular podcasts, and an extensive archive collection boasting the longest half-life in clinical neuroscience journals, JNNP aims to be a trailblazer in the field.
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