Senff Jasper, Tack Reinier Willem Pieter, Mallick Akashleena, Gutierrez-Martinez Leidys, Duskin Jonathan, Kimball Tamara N, Tan Benjamin Y Q, Chemali Zeina N, Newhouse Amy, Kourkoulis Christina, Rivier Cyprien, Falcone Guido J, Sheth Kevin N, Lazar Ronald M, Ibrahim Sarah, Pikula Aleksandra, Tanzi Rudolph E, Fricchione Gregory L, Brouwers Hens Bart, Rinkel Gabriel J E, Yechoor Nirupama, Rosand Jonathan, Anderson Christopher D, Singh Sanjula D
McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.
J Neurol Neurosurg Psychiatry. 2025 May 14;96(6):515-527. doi: 10.1136/jnnp-2024-334925.
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.
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 ()-coefficients were calculated for a composite outcome. The -coefficients were normalised to assess relative impact.
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 -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).
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.
CRD42023476939.
至少60%的中风、40%的痴呆症和35%的老年期抑郁症（LLD）可归因于可改变的风险因素，由于共同的病理生理学，这些因素存在很大重叠。本研究旨在系统识别这些疾病的重叠风险因素，并计算它们对复合结局的相对影响。
于2000年1月至2023年9月在PubMed、Embase和PsycInfo数据库中进行了系统的文献综述。我们纳入了报告可改变风险因素对中风、痴呆症和/或LLD发病率影响大小的荟萃分析。选择了最相关的荟萃分析，并计算了复合结局的残疾调整生命年（DALY）加权β（β）系数。对β系数进行标准化以评估相对影响。
我们的检索共得到182项符合纳入标准的荟萃分析，其中59项被选来计算复合结局的DALY加权风险因素。确定的风险因素包括酒精（标准化β系数最高类别：-34）、血压（130）、体重指数（70）、空腹血糖（94）、总胆固醇（22）、休闲时间认知活动（-91）、抑郁症状（57）、饮食（51）、听力损失（60）、肾功能（101）、疼痛（42）、身体活动（-56）、生活目的（-50）、睡眠（76）、吸烟（91）、社交参与（53）和压力（55）。
本研究识别出了重叠的可改变风险因素，并计算了这些因素对中风、痴呆症和LLD复合结局风险的相对影响。这些发现可为预防策略提供指导，并为未来开发能够帮助人们降低这些疾病风险的工具提供实证基础。
PROSPERO注册号：CRD42023476939。
