Text of Dementias prevention and the lancet commission
Prevention of Dementia and the Lancet Commission
Email :An invitation from The Lancet
I am one of the editors at The Lancet and I am writing to invite you to participate in an exciting project that we are planning…We would like to invite you to be the Chair of the Commission and take the lead on this project.The content is entirely up to you but our initial thoughts are…
Gill Livingston Andrew Sommerlad Vasiliki Orgeta Sergi Costafreda Jonathan Huntley David Ames Clive Ballard Sube Banerjee Alistair Burns Jiska Cohen-Mansfield Claudia Cooper Nick Fox Laura Gitlin Robert Howard Helen Kales Eric Larson Karen Ritchie Kenneth Rockwood Elizabeth Sampson Quincy Samus Lon Schneider Geir Selbӕk Linda Teri, Naaheed Mukadam https://www.ucl.ac.uk/psychiatry/research/olderpeople/lancet-international-commission
Lancet analysisLifecourse analysis- when should intervene
Taking into account new risk factors with evidence
Midlife aged 45-65 years
Late life as aged > 65.
Risk factors from
UK National Institute of Health and Care Excellence (NICE) US National Institute of Health (NIH)
Used systematic reviews and meta-analyses and when there was not one we calculated.
PAF depends on relative risk and prevalence
People have lots of risks factors together
So we had to adjust for communality
Formula for individual Population Attributable Fraction (PAF)PAF = Pe (RRe-1) / [1 + Pe (RRe-1)]Pe = prevalence of the exposure RRe = relative risk of disease due to that exposureCalculation of communalityInput data on all nine risk factors in our model - Calculate tetrachoric correlation to generate correlation coefficients and a correlation matrix. Conduct a principal-component analysis on the correlation matrix to generate eigenvectors, which are directions mapped onto the data points and from which variance to the data is measured. These represent unobserved factors underlying all the variables that explain the variance observed.Components with eigenvalues ≥1 were retained in the model Communality was calculated as the sum of the square of all factor loadings (i.e. how much each unobserved component explained each measured variable).
Calculation of overall Population Attributable Fraction (PAF)We then calculated overall PAF: PAF = 1-[(1-PAF1)(1-PAF2)(1-PAF3)…] Each individual risk factor’s PAF was weighted according to its communality using the formula:Weight (w) = 1-communalityWeighting was included in the calculation of overall PAF using the formula:PAF = 1-[(1-w*PAF1)(1-w*PAF2)(1-w*PAF3)...]
So we calculated life course potentially modifiable risk factors
through the life coursrSorry can’t give you new meta-analysis and life course model today