Prevention of dementia in midlife using the Lifestyle for Brain Health (LIBRA) score
The LIfestyle for BRAin health (LIBRA) score was developed to assess an individual’s room for prevention of dementia in midlife. The dementia risk score is defined based on empirical evidence from the existing literature and expert consensus.
Research authors: Olga J.G. Schiepers, Sebastian Köhler, Kay Deckers , Kate Irving, Catherine A. O'Donnell, Marjan van den Akker, Frans R.J. Verhey, Stephanie J.B. Vos, Marjolein de Vugt, Martin P.J. van Boxtel
Version: 1.31
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Calculated LIBRA score: points

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Conditional information

How this model should be used:
Recent evidence suggests that one in three up to one in two Alzheimer’s disease cases are potentially attributable to modifiable risk factors. The LIBRA score was developed as a useful tool to identify individuals for primary prevention interventions of dementia and monitor individuals risk-change over time.

Context information:
The LIBRA index is unique in that it reflects an individual’s prevention potential for dementia. The predictive accuracy of the LIBRA index for dementia is somewhat lower compared to that of other prediction indices.1 This is not unexpected, given that previous indices were maximized for risk prediction by including major predictors for dementia such as age, gender, education, and APOE genotype that are not amenable to change.

Important note:
Notably, the current model lacks three of the original LIBRA factors (i.e., cognitive activity, renal dysfunction, and adherence to a Mediterranean diet), because these factors were not available upon external validation. This might have influenced the predictive validity of the LIBRA index.


  1. Schiepers OJ, Köhler S, Deckers K, et al. Lifestyle for Brain Health (LIBRA): a new model for dementia prevention. Int J Geriatr Psychiatry. 2017 Feb 28. doi: 10.1002/gps.4700. [Epub ahead of print].
  2. Tang EY , Harrison SL , Errington L , et al. Current developments in dementia risk prediction modelling: An updated systematic review. PLoS One. 2015;10(9):e0136181.
  3. Vos SJ, van Boxtel MP, Schiepers OJ, et al.  Modifiable Risk Factors for Prevention of Dementia in Midlife, Late Life and the Oldest-Old: Validation of the LIBRA Index. J Alzheimers Dis. 2017;58(2):537-547.

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This model is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

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