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Every row of the evidence table
One row per finding: what was tested, which way the result went, and how the study was built. The answer by area, and where the studies disagree, are on the main page.
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Showing 18 of 382 rows. One row per study per exposure: a study that tested two different things appears twice, once for each.
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| Exposure | Question | Direction | Outcome measured | Design | People | Effect size, as the source reported it | Source |
|---|---|---|---|---|---|---|---|
| Alcohol Alcohol, tobacco and cannabis | Prevention |
Mixed
whySustained mild and moderate drinking carried lower risk than not drinking, sustained heavy drinking higher risk, and cutting down from heavy to moderate lower risk. Observational, with the same abstainer problem. |
Incident all-cause dementia over a mean 6.3 years | cohort study | 3,933,382 | Sustained heavy drinking aHR 1.08 (95% CI 1.03-1.12); heavy-to-moderate reduction aHR 0.92 (0.86-0.99) |
JAMA Network Open
2023 ✓ Peer-reviewed PMID 36745453 |
| Alcohol Alcohol, tobacco and cannabis | Prevention |
Mixed
whyU-shaped: long-term abstainers had 47% higher risk than moderate drinkers, and above 14 units a week each extra 7 units raised risk by 17%. Neither end of the range looks like a benefit of drinking. |
Incident dementia over 23 years | cohort study | 9,087 | Abstinence in midlife vs 1-14 units/week: hazard ratio 1.47 (95% CI 1.15 to 1.89). Among those drinking >14 units/week, "a 7 unit increase in alcohol consumption was associated with a 17% (95% confidence interval 4% to 32%) increase in risk of dementia". CAGE score >2: HR 2.19 (1.29 to 3.71); alcohol-related hospital admission: 4.28 (2.72 to 6.73) |
BMJ
2018 ✓ Peer-reviewed PMID 30068508 |
| Birth cohort and calendar period (secular trend in dementia) All modifiable factors together | Prevention |
Mixed
whyThe two measures moved in opposite directions over 2015-2021: standardised incidence fell from 3.5% to 2.8% per year while prevalence rose from 10.5% to 11.8%; gaps between Black or Hispanic and White beneficiaries narrowed. |
Age- and sex-standardised incidence and prevalence of diagnosed dementia among US Medicare fee-for-service beneficiaries, 2015-2021 | cohort study | not stated | The overall age and sex standardized incidence decreased between 2015 and 2021 from 3.5% to 2.8%. Prevalence increased during this time from 10.5% to 11.8% |
BMJ
2025 ✓ Peer-reviewed PMID 40393738 |
| Blood biomarkers (GFAP, NfL, p-tau217) for staging and prognosis Care, carers and services | Prevention |
Mixed
whyThe findings point different ways: lower eGFR raised every blood biomarker except Aβ42/40 (a test-interpretation caveat), yet impaired kidney function did not itself raise dementia risk (HR 0.93), while the association between high NfL and dementia was about twice as strong in people with impaired kidneys. |
Blood AD biomarker levels by kidney function (eGFR), and incident dementia over a mean 8.3 years by kidney function and NfL | cohort study | 2,279 | At eGFR = 30 mL/min/1.73 m2, estimated differences were as follows: p-tau181: β, 0.22 [95% CI 0.09-0.35]; p-tau217: β, 0.20 [95% CI 0.10-0.31]; t-tau: β, 0.24 [95% CI 0.05-0.42]; NfL: β, 0.88 [95% CI 0.80-0.95]; GFAP: β, 0.10 [95% CI 0.03-0.16] ... impaired kidney function (eGFR < 60 mL/min/1.73 m2) was not associated with an increased hazard of dementia compared with preserved kidney function (eGFR ≥ 60 mL/min/1.73 m2) (hazard ratio [HR], 0.93 [95% CI 0.72-1.21]). The relationship between increased (high vs low) NfL and dementia was stronger among individuals with impaired (vs preserved) kidney function (HR, 3.85 [95% CI 1.87-7.95] vs HR, 1.84 [95% CI 1.34-2.53], respectively) |
Neurology
2026 ✓ Peer-reviewed PMID 41337685 |
| Blood biomarkers (GFAP, NfL, p-tau217) for staging and prognosis Care, carers and services | Prevention |
Mixed
whyThe two measures behaved differently: baseline plasma p-tau217 predicted later cognitive decline about as well as entorhinal tau PET (ρ -0.47 vs -0.55), but over time p-tau217 rose then decelerated and tracked concurrent cognitive change only weakly (ρ -0.24) or not at all in the PET substudy, whereas regional tau PET change correlated strongly with concurrent decline. |
Prognostic association with, and concurrent tracking of, cognitive change in preclinical AD: plasma p-tau217 versus tau PET | cohort study | 1,707 | Baseline associations with longitudinal change in PACC score in Aβ+ participants were strongest in the entorhinal cortex (correlation [ρ] = -0.55; 95% CI, -0.63 to -0.45) and plasma p-tau217 levels (ρ = -0.47; 95% CI, -0.56 to -0.37) ... Levels of plasma p-tau217 increased significantly in Aβ+ participants before showing significant deceleration (χ2 = 21.7; P < .001) and were not associated with concurrent cognitive change in the tau PET substudy (ρ = -0.03; 95% CI, -0.23 to 0.16) but were modestly associated with concurrent cognitive changes in the full plasma sample (n = 1119; ρ = -0.24; 95% CI, -0.34 to -0.14) |
JAMA Neurology
2025 ✓ Peer-reviewed PMID 40853684 |
| Cost of dementia care Care, carers and services | Prevention |
Mixed
whyThe two comparisons point different ways: overall utilization and payments were similar between amyloid-positive (A4) and amyloid-negative (LEARN) participants, but among A4 participants claims indicators of progression carried 45-103% higher payments. |
Healthcare utilization and Medicare payments in cognitively unimpaired amyloid-positive versus amyloid-negative people, and by claims indicators of AD progression | cohort study | 367 | 45% payment increase for cognitive impairment (p=0.035) with a mean incremental cost of $140 per person per month (PPPM) (95% confidence interval [CI] $125-$155), 66% payment increase for AD (p=0.011) with a mean incremental cost of $207 PPPM (95% CI $188-$226), and 103% payment increase for high frailty (p<0.001) with a mean incremental cost of $303 PPPM (95% CI $283-$323) |
Journal of Prevention of Alzheimer's Disease
2026 ✓ Peer-reviewed PMID 41926844 |
| Cost-effectiveness of multidomain prevention programme Care, carers and services | Prevention |
Mixed
whyDirection is for value for money: APPLE-Tree had a 96% probability of being cost-effective per cognition point at a £30 000 threshold but only 12% on QALYs, which were slightly lower in the intervention arm. Post hoc subgroups suggested better value in non-White and socioeconomically disadvantaged participants. |
QALYs over 24 months (primary) and cost per 1-point NTB cognition gain | randomised trial | 746 | Mean adjusted QALYs were 1.511 (intervention) and 1.520 (control), an adjusted difference of -0.010 (95%CI -0.04 to -0.022). Mean adjusted (SD) costs were £2966 (3629) and £2551 (4439), respectively. Cost per 1-point NTB change z-score was £6809. At a £30 000 threshold, the probability of cost-effective was 12% and 96% based on QALYs and cognition, respectively |
Age and ageing
2026 ✓ Peer-reviewed PMID 42328805 |
| Omega-3 / fish and fish oil Diet and supplements | Prevention |
Mixed
whyThe biochemical primary outcome was met (DHA raised the CSF DHA-to-arachidonic-acid ratio versus placebo), but there was no difference in cognition or brain volume over 24 months. The authors recommend against further supplementation trials of this kind. |
CSF DHA/AA ratio at 6 months (primary, target engagement); cognition and brain volumes at 24 months | phase 2 trial | 365 | DHA supplementation increased CSF DHA/AA ratio at 6 months vs placebo (0.17 [95% CI 0.15-0.18] vs -0.02 [95% CI -0.04 to -0.0004]; difference 0.19 [95% CI 0.16-0.21]; p < 0.0001), independent of APOE ε4 status (interaction p = 0.71). Dropout was 38%, mainly due to COVID-19. No treatment differences were observed in brain volumes or cognitive performance over 24 months |
EBioMedicine
2026 ✓ Peer-reviewed PMID 42315445 |
| Air pollution Environment | Prevention |
Mixed
whyThe overall PM2.5 estimate includes no effect (HR 1.04, 95% CI 0.99-1.09). Only the studies that actively assessed everyone for dementia showed a clear effect (HR 1.42, 95% CI 1.00-2.02). Most studies were at high risk of bias. |
Clinically diagnosed dementia | meta-analysis | not stated | PM2.5 HR 1.04 per 2 ug/m3 (95% CI 0.99-1.09) overall; 1.42 (1.00-2.02) with active case ascertainment |
BMJ
2023 ✓ Peer-reviewed PMID 37019461 |
| Physical activity (general / dose) Exercise and activity | Prevention |
Mixed
whyHigh overall and leisure-time activity were associated with lower dementia risk, but occupational and commuting activity were associated with higher risk. Certainty of evidence was very low to low. |
All-cause dementia, Alzheimer's disease and vascular dementia by physical activity domain | meta-analysis | 4,227,297 | high physical activity levels were associated with reduced risks of all-cause dementia (n=146 effect sizes; RR 0·80 [95% CI 0·75-0·86]; I2=97·4%), Alzheimer's disease (n=59; 0·79 [0·70-0·90]; I2=91·3%), and vascular dementia (n=21; 0·71 [0·58-0·87]; I2=77·5%); however, associations varied by domain. Leisure-time (k=20 studies; n=33 effect sizes; RR 0·76 [95% CI 0·65-0·88]; I2=96·6%) and household (k=1; 0·85 [0·74-0·98]) physical activity were associated with a reduced risk of all-cause dementia. By contrast, occupational (k=5; 1·20 [1·01-1·42]; I2=85·6%) and commuting (k=2; 1·10 [1·03-1·18]; I2=0·0%) physical activity were associated with an increased risk |
The Lancet. Public health
2026 ✓ Peer-reviewed PMID 42612650 |
| APOE genotype Genes (not modifiable) | Prevention |
Mixed
whyDirection is for APOE genotype after 90: ε2 carriers had lower dementia risk, while the ε4 association was not statistically significant. Women and Black participants had higher risk than men and Asian participants. Age-standardised incidence was 116.82 per 1000 person-years. |
Incident all-cause dementia after age 90 by APOE genotype, sex and race | cohort study | 805 | The age-standardised incidence rate was 116·82 cases per 1000 person-years (95% CI 93·69-139·96). In Fine-Gray models, dementia risk was higher in female than in male participants (subdistribution hazard ratio [sHR] 1·89, 95% CI 1·30-2·76) and Black than Asian participants (sHR 1·75, 1·07-2·88), lower in APOE ε2 carriers than in non-carriers (sHR 0·39, 0·17-0·88), and not significantly higher in APOE ε4 carriers than in non-carriers (sHR 1·51, 0·92-2·47) |
The lancet. Healthy longevity
2026 ✓ Peer-reviewed PMID 42551464 |
| Polygenic risk / GWAS loci Genes (not modifiable) | Prevention |
Mixed
whyThe intervention-control cognitive difference was statistically significant in the higher-genetic-risk halves and not in the lower halves, but neither genetic score significantly modified the intervention effect overall (P > 0.46); an exploratory sex difference emerged for the Alzheimer score. |
Annual change in overall cognition (modified NTB) with a 2-year multidomain lifestyle intervention, by Alzheimer and coronary genetic risk score | randomised trial | 1,177 | The intervention-control difference in annual overall cognition change (95% confidence interval) for participants with AD-GRS above/below the median (i.e. higher/lower risk) was 0.032 (0.002-0.063) versus 0.017 (-0.011 to 0.045), and for CAD-GRS above/below the median was 0.031 (0.002 to 0.059) versus 0.016 (-0.012 to 0.044). AD-GRS or CAD-GRS were not significantly related to the intervention effect overall (P > 0.46), but for AD-GRS there were differences between females and males (P = 0.024) |
Brain : a journal of neurology
2026 ✓ Peer-reviewed PMID 40747850 |
| Polygenic risk / GWAS loci Genes (not modifiable) | Prevention |
Mixed
whyThe study's own results point different ways: the polygenic score added to APOE for predicting AD/MCI and for progression from amyloid-positive MCI to AD, but amyloid deposition was predicted by APOE alone. |
Prediction of AD, MCI, amyloid deposition and MCI-to-AD progression (AUC) by polygenic risk score with and without APOE | case-control study | 770 | AD and MCI are predicted by both APOE genotype and PRS (area under the curve [AUC] = 0.82% and 68%, respectively). Amyloid deposition is predicted by APOE only (AUC = 79%). Further progression to AD of individuals with MCI and amyloid-positive status is predicted by PRS over and above APOE (AUC = 67%) |
Annals of Neurology
2019 ✓ Peer-reviewed PMID 31199530 |
| Rare copy-number variants (22q11.21 dosage, ABCA1 / ABCA7 deletions) Genes (not modifiable) | Prevention |
Mixed
whyThe two kinds of variant point opposite ways: deletions and loss-of-function alleles in ABCA1 and ABCA7 and 22q11.21 deletions raised AD risk, while 22q11.21 duplication lowered it (odds ratio 0.34 at exome-wide significance in replication). Not modifiable. |
Alzheimer's disease case status (early- and late-onset) by rare copy-number variant burden and 22q11.21 dosage | case-control study | 22,319 | ABCA1 (odds ratio [OR] = 5.77 [95% confidence interval 2.25; 17.06], p = 0.0002) and ABCA7 deletions contribute to this deletion burden (OR = 2.29 [1.44; 3.65], p = 0.0006), while CTSB LoF alleles appear as candidates (OR = 5.03 [1.50; 20.71], p = 0.0089) ... Replication in 33,977 affected individuals and 362,322 control subjects confirmed association for 22q11.21 dosage with exome-wide significance (ORSCARF2 = 0.34 [0.21; 0.53]; mega-p value = 5.52 × 10-7) |
American Journal of Human Genetics
2026 ✓ Peer-reviewed PMID 42648288 |
| Antihypertensives / BP lowering Medicines | Prevention |
Mixed
whyAntihypertensive treatment improved cognitive scores by a small amount (SMD 0.06, moderate certainty) but the reduction in dementia incidence was not statistically significant (OR 0.89, low certainty). The drug-class rankings rest on one trial per class and are described as highly uncertain. |
Cognitive function scores and incident dementia in hypertensive older adults (four RCTs) | meta-analysis | 16,823 | Antihypertensive treatment significantly improved cognitive function scores (SMD, 0.06; 95% CI, 0.03-0.09; P < .001, GRADE moderate certainty) and showed a nonsignificant trend toward reduced dementia incidence (OR, 0.89; 95% CI, 0.76-1.05; P = .172, GRADE low certainty) |
Journal of the American Medical Directors Association
2026 ✓ Peer-reviewed PMID 41962914 |
| Antihypertensives / BP lowering Medicines | Prevention |
Mixed
whyAntihypertensive use tracked lower Alzheimer's risk but not lower non-Alzheimer dementia risk, where treated and untreated hypertension looked the same. A single baseline blood pressure reading predicted neither. |
Alzheimer's and non-Alzheimer dementia | meta-analysis | 31,250 | Untreated vs treated hypertension: Alzheimer's dementia HR 1.42 (95% CI 1.08-1.87) |
Neurology
2024 ✓ Peer-reviewed PMID 39141884 |
| Metformin / antidiabetic Medicines | Prevention |
Mixed
whyThe split inside this one paper is the finding: the 41 observational studies show large benefits (SGLT2i OR 0.56, GLP-1RA OR 0.58) while the 23 randomised trials show no difference. When design and result disagree this cleanly, the trials are the ones to believe. |
Incident dementia | meta-analysis | 3,462,926 | Observational: SGLT2i OR 0.56 (95% CI 0.45-0.69), GLP-1RA OR 0.58 (0.46-0.73) vs non-users; RCTs: no difference |
Alzheimer's Research & Therapy
2024 ✓ Peer-reviewed PMID 39716328 |
| Sleep Sleep, mood and social life | Prevention |
Mixed
whyTwo findings point opposite ways: synchronised norepinephrine, blood-volume and CSF oscillations during natural NREM sleep were the strongest predictors of glymphatic clearance, while the sleep aid zolpidem suppressed those oscillations and glymphatic flow. Mouse work with no human outcome. |
Glymphatic clearance during NREM sleep in mice, its drivers (norepinephrine and vasomotion oscillations) and its suppression by zolpidem | None | not stated | not established — pubmed abstract reports no numeric effect size. |
Cell
2025 ✓ Peer-reviewed PMID 39788123 |