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Therefore, this study aimed to examine the predictive accuracy of the \u201cLIfestyle for BRAin Health\u201d (LIBRA) score, a weighted compound score of 12 modifiable risk and protective factors, for dementia and mild cognitive impairment (MCI) in midlife and late\u2010life, and in individuals with high or low genetic risk based on presence of the apolipoprotein (APOE) \u03b54 allele.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The LIBRA score was calculated for participants from the Finnish Cardiovascular Risk Factors, Aging and Dementia (CAIDE) population\u2010based study examined in midlife (n = 1024) and twice in late\u2010life (n = 604) up to 30 years later. Diagnoses of MCI and dementia were made according to established criteria. Cox proportional hazards models were used to assess the association between LIBRA and risk of dementia and MCI in models adjusted for sex and education (age as timescale).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher midlife LIBRA scores were related to higher risk of dementia (hazard ratio [HR] = 1.27; 95% confidence interval [CI], 1.13\u20101.43) and MCI (unadjusted model: HR = 1.12; 95% CI, 1.03\u20101.22) up to 30 years later. Higher late\u2010life LIBRA scores were related to higher risk of MCI (HR = 1.11; 95% CI, 1.00\u20101.25), but not dementia (HR = 1.02; 95% CI, 0.84\u20101.24). Higher late\u2010life LIBRA scores were related to higher dementia risk among apolipoprotein E (APOE) \u03b54 non\u2010carriers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings emphasize the importance of modifiable risk and protective factors for dementia prevention.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.5235","type":"journal-article","created":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T04:49:49Z","timestamp":1574052589000},"page":"195-203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":97,"title":["Long\u2010term dementia risk prediction by the LIBRA score: A 30\u2010year follow\u2010up of the CAIDE study"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1339-2974","authenticated-orcid":false,"given":"Kay","family":"Deckers","sequence":"first","affiliation":[{"name":"Alzheimer Centrum Limburg, School for Mental Health and Neuroscience (MHeNS) Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariagnese","family":"Barbera","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine\/Neurology University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2398-0609","authenticated-orcid":false,"given":"Sebastian","family":"K\u00f6hler","sequence":"additional","affiliation":[{"name":"Alzheimer Centrum Limburg, School for Mental Health and Neuroscience (MHeNS) Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiia","family":"Ngandu","sequence":"additional","affiliation":[{"name":"Public Health Promotion Unit National Institute for Health and Welfare  Helsinki Finland"},{"name":"Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3221-2150","authenticated-orcid":false,"given":"Martin","family":"van Boxtel","sequence":"additional","affiliation":[{"name":"Alzheimer Centrum Limburg, School for Mental Health and Neuroscience (MHeNS) Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minna","family":"Rusanen","sequence":"additional","affiliation":[{"name":"Public Health Promotion Unit National Institute for Health and Welfare  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiina","family":"Laatikainen","sequence":"additional","affiliation":[{"name":"Public Health Promotion Unit National Institute for Health and Welfare  Helsinki Finland"},{"name":"Institute of Public Health and Clinical Nutrition University of Eastern Finland  Kuopio Finland"},{"name":"Hospital District of North Karelia  Joensuu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans","family":"Verhey","sequence":"additional","affiliation":[{"name":"Alzheimer Centrum Limburg, School for Mental Health and Neuroscience (MHeNS) Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilkka","family":"Soininen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine\/Neurology University of Eastern Finland  Kuopio Finland"},{"name":"Neurocenter, Department of Neurology Kuopio University Hospital  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miia","family":"Kivipelto","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine\/Neurology University of Eastern Finland  Kuopio Finland"},{"name":"Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society Karolinska Institutet  Stockholm Sweden"},{"name":"Institute of Public Health and Clinical Nutrition University of Eastern Finland  Kuopio Finland"},{"name":"Ageing Epidemiology (AGE) Research Unit, School of Public Health Imperial College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Solomon","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine\/Neurology University of Eastern Finland  Kuopio Finland"},{"name":"Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Dementia: a public health priority","author":"World Health Organization","year":"2012"},{"key":"e_1_2_8_3_1","first-page":"200","article-title":"Prevention of Alzheimer disease. 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