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Area All 382 Care, carers and services 140 Medicines 85 Genes (not modifiable) 35 All modifiable factors together 27 Diet and supplements 23 Exercise and activity 21 Sleep, mood and social life 19 Hearing and vision 8 Alcohol, tobacco and cannabis 6 Infection and vaccination 5 Heart and metabolic health 4 Injury, delirium and falls 4 Environment 3 Cognitive activity 2

Question Both Prevention 190 Treatment 192

Direction Any Benefit 144 Harm 105 No effect 38 Mixed 37 No direction reported 58

Design Any meta-analysis 57 randomised trial 44 phase 3 trial 15 systematic review 9 phase 2 trial 10 cohort study 136 phase 1 trial 2 cross-sectional study 31 case-control study 14 modelling study 20 regulatory decision 7 company announcement 1 coverage determination 1 None 35

Showing 13 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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Research and outcomes, 13 rows. Every row links to its source.
Exposure	Question	Direction	Outcome measured	Design	People	Effect size, as the source reported it	Source
Blood biomarkers (GFAP, NfL, p-tau217) for staging and prognosis Care, carers and services	Treatment	Harm why Direction is for higher baseline plasma GFAP: it detected abnormal CSF amyloid (AUC 0.79, 0.86 with APOE4) and predicted later conversion to Alzheimer's dementia (AUC 0.84); GFAP slopes were steeper in those who progressed.	Detection of CSF-defined amyloid pathology and prediction of conversion to Alzheimer's dementia	cohort study	160	Baseline plasma GFAP could detect abnormal CSF Aβ42/40 and CSF Aβ42/T-tau with an AUC of 0.79 (95% CI 0.72-0.86) and 0.80 (95% CI 0.72-0.86), respectively. When also including APOE ε4 status as a predictor, the accuracy of the model to detect abnormal CSF Aβ42/40 status improved (AUC = 0.86, p = 0.02). Plasma GFAP predicted subsequent conversion to AD dementia with an AUC of 0.84 (95% CI 0.77-0.91)	Alzheimer's Research & Therapy 2021 ✓ Peer-reviewed PMID 33773595
Caregiving itself (exposure to the carer) Care, carers and services	Treatment	Harm why Only STRAINED carers were at higher risk (RR 1.63, 95% CI 1.00-2.65, with the interval touching 1). Carers who reported no strain showed nothing (RR 1.08), so it is the strain rather than the caregiving that carries the signal.	4-year mortality in the carer	cohort study	819	RR 1.63 (95% CI 1.00-2.65) for strained caregivers vs. non-caregivers	JAMA 1999 ✓ Peer-reviewed PMID 10605972
Cost of dementia care Care, carers and services	Treatment	Harm why Direction is for having AD dementia: lifetime formal-care costs of 2,440,000 SEK against 510,000 SEK for matched controls, with prescriptions and social care rising and specialist outpatient visits falling as the disease advanced. A cost result, not a health outcome.	Lifetime formal-care costs after an AD dementia diagnosis versus matched controls, and care utilization by stage	cohort study	20,366	The estimated lifetime costs of formal care for AD dementia were 2,440,000 SEK (€212,174; $US230,189; 95% CI 2,088,000-2,793,000 SEK), compared with 510,000 SEK (€44,348; $US48,113; 95% CI 482,000-539,000 SEK) for matched controls	PharmacoEconomics 2026 ✓ Peer-reviewed PMID 41920501
Cost of dementia care Care, carers and services	Treatment	Harm why Direction is for greater disease severity: mean annual costs rose from SEK 99,906 in MCI to SEK 795,617 in severe AD (SEK 57,625 to 668,073 in the amyloid-confirmed subset), driven by institutionalisation, home care and daytime support while outpatient costs fell. A cost result, not a health outcome.	Mean annual direct medical and social costs by AD severity (MCI to severe), overall and in amyloid-confirmed patients, versus matched controls	cohort study	95,853	Mean annual costs for individuals with clinically diagnosed AD were SEK 99,906, SEK 290,972, SEK 479,524, and SEK 795,617 in mild cognitive impairment (MCI), mild, moderate, and severe AD. The mean annual costs for the population with both clinical diagnosis and amyloid-positive AD confirmation (N = 5610) were SEK 57,625, SEK 179,153, SEK 333,095, and SEK 668,073 in MCI, mild, moderate, and severe AD, respectively	PharmacoEconomics 2025 ✓ Peer-reviewed PMID 39485581
Cost of dementia care Care, carers and services	Treatment	Harm why Direction is for being non-Hispanic Black or Hispanic rather than non-Hispanic White: disease-course Medicare spending was higher ($165,730 and $160,442 versus $136,326), highest for Black beneficiaries in every phase and driven by high-cost services in the last year of life. A disparities result, not a biological effect of race.	Disease-course Medicare expenditures (year before diagnosis to last year of life) by race and ethnicity	cohort study	not stated	Adjusted mean total Medicare expenditures for non-Hispanic (NH) Black ($165,730) and Hispanic beneficiaries with dementia ($160,442) exceeded corresponding expenditures for NH Whites ($136,326) ... The last year of life was responsible for the greatest cost contribution: $51,294 (NH Blacks), $47,469 (Hispanics), and $39,499 (NH Whites)	Journal of the American Geriatrics Society 2024 ✓ Peer-reviewed PMID 38504583
Cost of dementia care Care, carers and services	Treatment	Harm why Direction is for dying with dementia rather than heart disease, cancer or other causes: total cost was higher ($287,038) and out-of-pocket spending 81% higher, consuming 32% of household wealth versus 11%.	Total social cost and out-of-pocket spending in the last 5 years of life	cohort study	1,702	Average total cost per decedent with dementia ($287 038) was significantly greater than that of those who died of heart disease ($175 136), cancer ($173 383), or other causes ($197 286) (P < 0.001). Although Medicare expenditures were similar across groups, average out-of-pocket spending for patients with dementia ($61 522) was 81% higher than that for patients without dementia ($34 068)	Annals of Internal Medicine 2015 ✓ Peer-reviewed PMID 26502320
Cost of dementia care Care, carers and services	Treatment	Harm why Direction is for having dementia: the attributable yearly cost per person was $41,689-$56,290 depending on how informal care is valued, a burden the authors call similar to heart disease and cancer.	Yearly monetary cost per person attributable to dementia, and total US cost in 2010	cohort study	10,903	The yearly monetary cost per person that was attributable to dementia was either $56,290 (95% confidence interval [CI], $42,746 to $69,834) or $41,689 (95% CI, $31,017 to $52,362), depending on the method used to value informal care. These individual costs suggest that the total monetary cost of dementia in 2010 was between $157 billion and $215 billion. Medicare paid approximately $11 billion of this cost	New England Journal of Medicine 2013 ✓ Peer-reviewed PMID 23550670
Glymphatic function (MRI DTI-ALPS index) Care, carers and services	Treatment	Harm why Direction is for a lower (worse) glymphatic index: it was lowest in AD dementia and predicted faster amyloid accumulation, amyloid-positive transition, atrophy, clinical progression and cognitive decline, with the cognitive effect fully mediated by amyloid PET and atrophy.	Amyloid PET accumulation, amyloid-positive transition, atrophy, clinical progression and cognitive decline by baseline DTI-ALPS index	cohort study	419	not established — pubmed abstract reports no numeric effect size.	Alzheimer's & Dementia 2024 ✓ Peer-reviewed PMID 38501315
Lewy body co-pathology (CSF seed amplification) Care, carers and services	Treatment	Harm why Direction is for co-existing Lewy body pathology in people with Alzheimer pathology: worse baseline cognition, faster global cognitive decline and more posterior hypometabolism than Alzheimer pathology alone. The seed amplification assay itself agreed closely with autopsy (96.3% sensitivity, 96.4% specificity in 61 cases).	Baseline cognition, rate of global cognitive decline and cortical hypometabolism in people with Alzheimer pathology	cohort study	795	184 (23.1%) had no biomarker evidence of AD/LB pathology, 39 (4.9%) had isolated LB pathology (AD-LB+), 395 (49.7%) had only AD pathology (AD+LB-), and 177 (22.3%) had both pathologies (AD+LB+) ... Neuropathological examination (n = 61) showed high sensitivity (26/27, 96.3%) and specificity (27/28, 96.4%) of the SAA-test	Nature Communications 2024 ✓ Peer-reviewed PMID 39277604
Tau PET imaging (natural history of tau) Care, carers and services	Treatment	Harm why Direction is for amyloid: it induced hyperconnectivity from tau epicentres to posterior tau-vulnerable regions, present already in preclinical AD, and this hyperconnectivity mediated amyloid's effect on faster tau accumulation.	Amyloid-related functional hyperconnectivity of temporal-lobe tau epicentres, and its mediation of amyloid's effect on longitudinal tau accumulation	cohort study	609	not established — pubmed abstract reports no numeric effect size.	Science Translational Medicine 2025 ✓ Peer-reviewed PMID 39841807
Tau PET imaging (natural history of tau) Care, carers and services	Treatment	Harm why Direction is for greater spatial extent of tau: it tracked memory in unimpaired people and executive function in MCI and dementia better than a temporal meta-ROI, and tau spread fastest in unimpaired and MCI participants. Most amyloid-positive participants followed Braak staging, with substantial regional heterogeneity within each stage.	Spatial extent of abnormal tau over time and its association with cognition	cohort study	832	More than 80% of amyloid-beta positive participants across diagnostic groups followed typical Braak staging, both cross-sectionally and longitudinally. Within each Braak stage, however, the pattern of abnormality demonstrated significant heterogeneity such that the overlap of abnormal regions across participants averaged less than 50% ... Accumulation of tau progressed more rapidly among cognitively unimpaired and participants with mild cognitive impairment (1.2 newly abnormal regions per year) compared to participants with Alzheimer's disease dementia (less than 1 newly abnormal region per year)	Brain Communications 2024 ✓ Peer-reviewed PMID 38410618
Undiagnosed or delayed diagnosis Care, carers and services	Treatment	Harm why Direction is for going undiagnosed. Whether the diagnosis itself would change survival is not tested here.	4-year mortality	cohort study	13,142	45.1% (US) and 76.1% (Brazil) of dementia cases undiagnosed; the abstract states undiagnosed dementia was associated with increased 4-year mortality compared with no dementia in both countries, without giving a hazard ratio	Alzheimer's & Dementia 2026 ✓ Peer-reviewed PMID 42056069
Antipsychotics (harms / discontinuation) Medicines	Treatment	Harm why Wider range of harms than regulatory alerts had flagged, with the highest risks soon after starting. No increase in ventricular arrhythmia.	Stroke, pneumonia, venous thromboembolism, MI, heart failure, fracture, acute kidney injury	cohort study	173,910	Pneumonia HR 2.19 (95% CI 2.10-2.28); stroke HR 1.61 (1.52-1.71); absolute 90-day pneumonia risk difference 2.99%	BMJ 2024 ✓ Peer-reviewed PMID 38631737

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