How can population‐based studies best be utilized to reduce the global impact of dementia? Recommendations for researchers, funders, and policymakers

Abstract

In the last two decades, there has been in-depth investigation into understanding the pathogenesis, epidemiological profiling, and clinical characterization of dementia. However, these investigations have not led to successful interventions to prevent, delay, or reverse the pathological processes underlying dementia. Recent findings of a decrease in dementia risk in high-income countries such as the UK, USA and the Netherlands highlight that dementia, at least in some cases, is preventable. This article includes a synthesis of current knowledge on dementia epidemiology, biological underpinnings, risk factors, and current prevention programs, with the aim to set the path for research, funding, and policy initiatives to address the global public health challenge of how to prevent dementia or reduce risk within the framework of population-based studies. We advocate for development of novel approaches for intelligent data synthesis that go well beyond single approaches to enable powerful risk stratification analyses. An integrated approach is needed where researchers, funders, policymakers, and stakeholders contribute to and work together to formulate effective strategies for the global monitoring and development of population-based risk reduction, treatment, and prevention programs for dementia.

Probing the Pre-diagnostic Phase of Parkinson's Disease in Population-Based Studies

“…For example, population-based studies have provided crucial insights into the role of vascular factors in the etiology of AD (68,69). Taking a broader perspective and recognizing similarities between PD and AD will help to make further progress in PD research (70)(71)(72).…”

“…Additionally, several studies have calculated the population-attributable fraction for each modifiable risk factor separately as well as for all risk factors combined, which shows the prevention potential of improving lifestyle (67,74). In the AD field, moreover, a greater emphasis is placed on life course determinants and differences in risk factors in early-, mid, and late-life (67,68,70). Such a holistic approach to modifiable risk factors in population-based studies could help PD research in moving toward prevention and diseasemodification trials.…”

“…Finally, both the PD and AD field have recognized the importance of harmonization of measurements and data sharing (47,70,80,82). Data sharing enables population-based studies to study small effects, to perform subgroup analyses and to replicate findings (47,70,80,82).…”

“…Finally, both the PD and AD field have recognized the importance of harmonization of measurements and data sharing (47,70,80,82). Data sharing enables population-based studies to study small effects, to perform subgroup analyses and to replicate findings (47,70,80,82). Harmonization of measurements and subsequent data pooling is of particular importance in PD research given the low disease incidence, which requires a large study population and long follow-up period for sufficient study power (14,18,83).…”

“…Good examples of harmonization of measurements and data sharing include the Parkinson's Progression Markers Initiative (PPMI) (20,84), including more than 30 centers across different countries, the Global Parkinson's Genetics Program (GP2), including 150,000 volunteers around the world (85), and the Alzheimers Cohorts Consortium, including nine population-based cohort studies in the United States and Europe (86). In addition to data sharing, several initiatives have been launched in the AD field to promote knowledge and expertise sharing (47,87), including Methods for Longitudinal Studies in Dementia (MELODEM) (88) and Alzheimer's Association Professional Interest Areas (PIAs) (70). Both initiatives promote knowledge sharing, either through recommendations for dealing with common methodological difficulties, or through networking, mentoring and collaborations.…”