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Röhr, S.* ; Wittmann, F.* ; Luppa, M.* ; Köhler, S.* ; Deckers, K.* ; Rosenau, C.* ; Betker, P.* ; Bohmann, P.* ; Brenner, H.* ; Flöel, A.* ; 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.* ; Wagner, M.* ; Berger, K.* ; Pabst, A.* ; Riedel-Heller, S.G.*

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).

Alzheimers Dement. 22:e71477 (2026)
Publ. Version/Full Text DOI
Open Access Hybrid
Creative Commons Lizenzvertrag
INTRODUCTION: 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). METHODS: 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. RESULTS: 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. DISCUSSION: Dementia risk factors were frequent and already associated with poorer cognition in younger adults, underscoring the need for early, targeted, and equity-oriented prevention.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Adulthood ; Aging ; Cognitive Functioning ; Cohort Study ; Dementia ; Dementia Risk ; German National Cohort ; Lifespan ; Lifestyle ; Lifestyle For Brain Health ; Prevention ; Risk Factor ; Risk Reduction ; Younger Adults; Dementia Prevention; Risk-factors; Validity; Old
ISSN (print) / ISBN 1552-5260
e-ISSN 1552-5279
Journal Alzheimer's & Dementia
Quellenangaben Volume: 22, Issue: 5, Pages: , Article Number: e71477 Supplement: ,
Publisher Wiley
Publishing Place New York, NY [u.a.]
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology (EPI)
Grants federal states of Germany
Helmholtz Association
Leibniz Association
Bundesministerium fr Bildung und Forschung
Hans and Ilse Breuer Foundation