Qays Alhorani, Akram Al-Ibraheem, Mohammad Rawashdeh, Essam Alkhybari, Akmal Sabarudin, Rukiah A Latiff, Mazlyfarina Mohamad
Investigating knowledge of DRLs, image quality and radiation dose in PET/CT and CT imaging among medical imaging professionals
Heliyon
dementia global health priority current cure around 50 million people worldwide currently live dementia number expected treble 2050 health conditions lifestyle behaviours increase decrease risk dementia known predictors prognostic models combine predictors measure risk future dementia models accurately predict future dementia would help clinicians select highrisk adults middle age implement targeted risk reduction primary objective identify multidomain prognostic models used middleaged adults aged 45 65 years predicting dementia cognitive impairment eligible multidomain prognostic models involved two modifiable dementia predictors identified 2020 lancet commission report 2019 world health organization report less education hearing loss traumatic brain injury hypertension excessive alcohol intake obesity smoking depression social isolation physical inactivity diabetes mellitus air pollution poor diet cognitive inactivity secondary objectives summarise prognostic models appraise predictive accuracy discrimination calibration reported development validation studies identify implications using dementia prognostic models management people higher risk future dementia searched medline embase psycinfo cinahl isi web science core collection inception 6 june 2022 performed forwards backwards citation tracking included studies using web science platform selection criteria included development validation studies multidomain prognostic models minimum eligible followup five years primary outcome incident clinical diagnosis dementia based validated diagnostic criteria secondary outcome dementia cognitive impairment determined method two review authors independently screened references extracted data using template based checklist critical appraisal data extraction systematic reviews prediction modelling studies charms assessed risk bias applicability included studies using prediction model risk bias assessment tool probast synthesised cstatistics models externally validated least three comparable studies main results identified 20 eligible studies eight development studies 12 validation studies 14 unique prognostic models seven models validation studies seven models developmentonly studies models included median nine predictors range 6 34 median number modifiable predictors five range 2 11 common modifiable predictors externally validated models diabetes hypertension smoking physical activity obesity developmentonly models common modifiable predictors obesity diabetes hypertension smoking models included hearing loss air pollution predictors nineteen studies high risk bias according probast assessment mainly inappropriate analysis methods particularly lack reported calibration measures applicability concerns low 12 studies population predictors outcomes consistent interest review applicability concerns high nine studies lacked baseline cognitive screening excluded age group within range 45 65 years one model cardiovascular risk factors ageing dementia caide externally validated multiple studies allowing metaanalysis caide model included eight predictors four modifiable predictors age education sex systolic blood pressure body mass index bmi total cholesterol physical activity apoe4 status overall confidence prediction accuracy caide low main reasons downgrading certainty evidence high risk bias across studies high concern applicability nonoverlapping confidence intervals cis high degree heterogeneity summary cstatistic 071 95 ci 066 076 3 studies lowcertainty evidence incident clinical diagnosis dementia 067 95 ci 061 073 3 studies lowcertainty evidence dementia cognitive impairment based cognitive scores metaanalysis calibration measures possible studies provided data identified 14 unique multidomain prognostic models used middleaged adults predicting subsequent dementia diabetes hypertension obesity smoking common modifiable risk factors used predictors models performed metaanalyses cstatistics one model caide summary values unreliable owing lack data unable metaanalyse calibration measures caide review highlights need robust external validations multidomain prognostic models predicting future risk dementia middleaged adults