Fruit of the tropical vine Monstera deliciosa undergo a pronounced climacteric during ripening with the concomitant large increase in ethylene production. The ripe fruit contains 19.1% soluble solids and 0.41% oxalic acid; the juice is considered safe for human consumption with respect to the levels of saponin, hydrocyanic acid and oxalic acid.

BackgroundObservational studies indicate U‐shaped associations of blood pressure (BP) and incident dementia in older age, but randomised controlled trials of BP lowering treatment show mixed results on this outcome in hypertensive patients. We undertook a pooled individual participant data analysis of five seminal double‐blind placebo‐controlled randomised trials to better define the effects of BP lowering treatment for the prevention of dementia and cognitive decline.MethodsMultilevel logistic regression was used to evaluate the treatment effect on incident dementia. Effect modification was assessed for key population characteristics including age, baseline systolic BP, sex, and presence of prior stroke. Mediation analysis was used to quantify the contribution of trial medication and changes in systolic and diastolic BP on risk of dementia.ResultsThe total sample included 28,008 individuals recruited from 20 countries. After a median follow‐up of 4.3 years, there were 861 cases of incident dementia. Multilevel logistic regression reported an adjusted odds ratio 0.87 (95% confidence interval 0.75, 0.99) in favour of antihypertensive treatment reducing risk of incident dementia with a mean BP lowering of 10/4mmHg. Further multinomial regression taking account of death as a competing risk found similar results. There was no effect modification by age or sex. Mediation analysis confirmed the greater fall in BP in the actively treated group was associated with a greater reduction in dementia risk.ConclusionUsing data from double‐blind placebo‐controlled clinical trials, we provide evidence in the first single‐stage individual participant meta‐analysis to support benefits of antihypertensive treatment in late‐mid and later life to lower the risk of dementia. Questions remain as to the potential for additional BP lowering in those with already well‐controlled hypertension and of antihypertensive treatment commenced earlier in the life‐course to reduce the long‐term risk of dementia.

We developed a comprehensive risk assessment tool for dementia – Cognitive Health and Dementia Risk Assessment (CogDrisk) and a version specifically for Alzheimer’s disease called CogDrisk-AD that could be applicable in low and high-resource settings. This tool incorporates risk and protective factors identified through systematic synthesis of observational studies that report risk ratios. Risk and protective factors included in the tool were selected on the strength of evidence as well as the availability of measures that are practicable in a range of clinical and research contexts. Seventeen risk/protective factors were identified for inclusion in the dementia algorithm to estimate the risk of dementia while sixteen factors were identified for the AD model, with an overlap in the majority of the factors. CogDrisk and the CogDrisk-AD were predictive of dementia and AD when validated across four high-quality international cohort studies. To enable the CogDrisk tool to be implemented in practice our team has developed an interactive website where individuals 18 years and above can complete the CogDrisk questionnaire, obtain a personalised risk profile, and receive feedback on their risk profile. The website was developed with the capacity to collect and store data. We anticipate that the tool can be used by members of the public, in clinical settings and as a screening or outcome measure for clinical trials.