% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@INPROCEEDINGS{Roehr:283075,
      author       = {Roehr, Susanne and Wittmann, Felix Georg and Luppa, Melanie
                      and Köhler, Sebastian and Deckers, Kay and Rosenau, Colin
                      and Kleineidam, Luca and Wagner, Michael and Berger, Klaus
                      and Pabst, Alexander and Riedel-Heller, Steffi G},
      title        = {{LI}festyle for {BRA}in health ({LIBRA}) and cognitive
                      functioning from young to old adulthood: {R}esults of the
                      {G}erman {N}ational {C}ohort ({NAKO})},
      journal      = {Alzheimer's and dementia},
      volume       = {21 Suppl 6},
      number       = {Suppl 6},
      issn         = {1552-5260},
      reportid     = {DZNE-2025-01482},
      pages        = {e106257},
      year         = {2025},
      abstract     = {The LIfestyle for BRAin Health (LIBRA) index is a
                      well-validated tool for assessing modifiable dementia risk
                      in midlife and older adults. Less is known about LIBRA in
                      younger adults. Thus, we investigated the occurrence of
                      LIBRA factors and associations between the LIBRA index and
                      cognitive functioning across adulthood, spanning ages 20 to
                      75. We considered variations by age decade, sex, and
                      socioeconomic status (SES).The data source was the
                      population-based mega-cohort 'German National Cohort'
                      (NAKO). Proportions and Cochran-Armitage trend tests were
                      calculated for 10 out of 12 LIBRA factors (coronary heart
                      disease, diabetes, hypercholesterolaemia, hypertension,
                      depression, obesity, smoking, physical inactivity, chronic
                      kidney disease, and low-to-moderate alcohol consumption; no
                      information available on healthy diet and high cognitive
                      activity). Cluster-adjusted (for study sites) linear
                      regression analysis was used to assess associations of LIBRA
                      scores and cognitive functioning (composite
                      neuropsychological test score), adjusted for age, age2, sex,
                      education, SES, employment status, marital status, household
                      size, migration status, and German language proficiency, for
                      the total and stratified samples.The analytical sample of
                      149,948 participants had a mean age of 50.1 (13.6) years;
                      $50.4\%$ were women, and education levels were high
                      $(56.2\%$ had tertiary education). Behavioural risk factors
                      (smoking, physical inactivity, depression) occurred more
                      frequently in younger adults, while risk factors related to
                      vascular health conditions (hypertension, diabetes, coronary
                      heart disease) were more common in older adults (Figure 1).
                      Higher LIBRA scores were consistently associated with lower
                      cognitive functioning across adulthood. An SES gradient in
                      LIBRA scores was observed across age decades and sexes
                      (Figure 2). Men had lower LIBRA scores, but associations
                      with cognitive functioning were more pronounced in women.Our
                      findings provide novel evidence suggesting that LIBRA is a
                      useful tool in younger adulthood (20-39 years), a group
                      still neglected in dementia risk research. Modifiable risk
                      factors were already frequent in this age range and
                      associated with lower cognitive functioning. The observed
                      sex/gender and socioeconomic disparities indicate compounded
                      disadvantages faced by lower SES groups and women,
                      emphasising the need for tailored, ideally early
                      interventions possibly targeting behavioural risk factors.
                      Longitudinal studies could help to disentangle life-course
                      dynamics of LIBRA factors and cognitive functioning.},
      month         = {Jul},
      date          = {2025-07-27},
      organization  = {Alzheimer’s Association
                       International Conference, Toronto
                       (Canada), 27 Jul 2025 - 31 Jul 2025},
      keywords     = {Humans / Male / Female / Middle Aged / Adult / Aged / Life
                      Style / Public Health / Risk Factors / Young Adult / Cohort
                      Studies / Germany: epidemiology / Neuropsychological Tests /
                      Dementia: epidemiology},
      cin          = {AG Wagner},
      ddc          = {610},
      cid          = {I:(DE-2719)1011201},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)1 / PUB:(DE-HGF)16},
      pubmed       = {pmid:41435134},
      pmc          = {pmc:PMC12726143},
      doi          = {10.1002/alz70860_106257},
      url          = {https://pub.dzne.de/record/283075},
}