Walsh Sebastian, Wallace Lindsay, Kuhn Isla, Mytton Oliver, Lafortune Louise, Wills Wendy, Mukadam Naaheed, Brayne Carol
Cambridge Public Health, University of Cambridge, Cambridge CB2 0SR, UK.
University of Cambridge Medical School Library, School of Clinical Medicine, Cambridge CB2 0SP, UK.
EClinicalMedicine. 2024 Mar 10;70:102538. doi: 10.1016/j.eclinm.2024.102538. eCollection 2024 Apr.
UNLABELLED: Dementia risk reduction is a global public health priority. Existing primary prevention approaches have favored individual-level interventions, with a research and policy gap for population-level interventions. We conducted a 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). Through a comprehensive series of targeted searches, we identified 4604 articles, of which 135 met our inclusion criteria. We synthesized evidence from multiple sources, including existing non-communicable disease prevention frameworks, and graded the consistency and comprehensiveness of evidence. We derived 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. This review provides policymakers with the evidence they need, in a useable format, to address this critical public health policy gap. FUNDING: SW is funded by a National Institute for Health and Care Research (NIHR) Doctoral Fellowship. WW and LF are part funded by the NIHR Applied Research Collaboration East of England. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
未标注:降低痴呆症风险是全球公共卫生的优先事项。现有的一级预防方法倾向于个人层面的干预措施,而在人群层面的干预措施方面存在研究和政策差距。我们进行了一项复杂的多阶段循证审查,以确定关于《柳叶刀》痴呆症委员会(2020年)确定的每个可改变风险因素的人群层面干预措施的实证证据。通过一系列全面的定向检索,我们识别出4604篇文章,其中135篇符合我们的纳入标准。我们综合了包括现有非传染性疾病预防框架在内的多个来源的证据,并对证据的一致性和全面性进行了分级。我们得出了一个降低痴呆症风险的人群层面干预框架,其中包含26条高可信度和中等可信度的政策建议,并辅以关于效应大小、证据来源、背景信息和实施指南的相关信息。本综述以一种可用的形式为政策制定者提供了他们所需的证据,以填补这一关键的公共卫生政策空白。 资金:SW由国家卫生与保健研究所(NIHR)博士奖学金资助。WW和LF部分由NIHR东英格兰应用研究合作项目资助。所表达的观点是作者的观点,不一定代表NIHR或卫生与社会保健部的观点。
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