Journal Article

DZNE-2026-00543

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Associations of the Lifestyle for Brain Health (LIBRA) index with cognitive functioning across adulthood: Variation by sex and socioeconomic status in the German National Cohort (NAKO).

Röhr, S. ; Wittmann, F. ; Luppa, M. ; Köhler, S. ; Deckers, K. ; Rosenau, C. ; Betker, P. ; Bohmann, P. ; Brenner, H. ; Flöel, A.DZNE* ; Heise, J.-K. ; Karch, A. ; Keil, T. ; Leitzmann, M. ; Lieb, W. ; Meinke-Franze, C. ; Mikolajczyk, R. ; Mons, U. ; Nimptsch, K. ; Övermöhle, C. ; Peters, A. ; Pischon, T. ; Schikowski, T. ; Schulze, M. B. ; Tüscher, O. ; Willich, S. N. ; Kleineidam, L.DZNE* ; Wagner, M.DZNE* ; Berger, K. ; Pabst, A. ; Riedel-Heller, S. G.

2026
Wiley Hoboken, NJ

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Please use a persistent id in citations: doi:10.1002/alz.71477

Abstract: The Lifestyle for Brain Health (LIBRA) index evaluates modifiable dementia risk, mainly in midlife and older adults. We examined the frequency of LIBRA factors and their individual and combined associations with cognitive functioning across adulthood (20-75 years), considering age, sex, and socioeconomic status (SES).Data came from the population-based German National Cohort (NAKO baseline; n = 149,948). We calculated proportions for LIBRA factors, tested frequency trends, and analyzed cross-sectional associations with cognitive functioning using cluster-adjusted regression controlling for confounders.Behavioral and psychosocial risks (smoking, physical inactivity, depression) were more common in younger adults, while cardiovascular risks (hypertension, coronary heart disease, hypercholesterolemia) predominated in older age. Men had higher LIBRA scores. Higher scores were consistently linked to lower cognitive functioning and lower SES across age groups.Dementia risk factors were frequent and already associated with poorer cognition in younger adults, underscoring the need for early, targeted, and equity-oriented prevention.

Keyword(s): Humans (MeSH) ; Male (MeSH) ; Female (MeSH) ; Middle Aged (MeSH) ; Germany: epidemiology (MeSH) ; Adult (MeSH) ; Aged (MeSH) ; Life Style (MeSH) ; Social Class (MeSH) ; Cognition: physiology (MeSH) ; Cross-Sectional Studies (MeSH) ; Cohort Studies (MeSH) ; Risk Factors (MeSH) ; Sex Factors (MeSH) ; Young Adult (MeSH) ; Dementia: epidemiology (MeSH) ; German National Cohort ; Lifestyle for Brain Health ; adulthood ; aging ; cognitive functioning ; cohort study ; dementia ; dementia risk ; lifespan ; lifestyle ; prevention ; risk factor ; risk reduction ; younger adults

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Contributing Institute(s):

1. Dementia Prevention – Mechanisms and Clinical Implementation (AG Flöel)
2. Neuropsychology (AG Wagner)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Wiley ; Essential Science Indicators ; IF >= 10 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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