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. 2022 Jun 20;22(1):507.
doi: 10.1186/s12877-022-02955-2.

Mapping the complexity of dementia: factors influencing cognitive function at the onset of dementia

Imke Seifert  1 , Henrik Wiegelmann  2 , Marta Lenart-Bugla  3 , Mateusz Łuc  3 , Marcin Pawłowski  3 , Etienne Rouwette  4 , Joanna Rymaszewska  3 , Dorota Szcześniak  3 , Myrra Vernooij-Dassen  5 , Marieke Perry  6 , René Melis  6 , Karin Wolf-Ostermann  2 , Ansgar Gerhardus  7 ; SHARED consortium
Affiliations

Mapping the complexity of dementia: factors influencing cognitive function at the onset of dementia

Imke Seifert et al. BMC Geriatr. .

Abstract

Background: Dementia is a multi-factorial condition rather than a natural and inevitable consequence of ageing. Some factors related to dementia have been studied much more extensively than others. To gain an overview of known or suspected influential factors is a prerequisite to design studies that aim to identify causal relationships and interactions between factors. This article aims to develop a visual model that a) identifies factors related to cognitive decline that signal the onset of dementia, b) structures them by different domains and c) reflects on and visualizes the possible causal links and interactions between these factors based on expert input using a causal loop diagram.

Method: We used a mixed-method, step-wise approach: 1. A systematic literature review on factors related to cognitive decline; 2. A group model building (GMB) workshop with experts from different disciplines; 3. Structured discussions within the group of researchers. The results were continuously synthesized and graphically transformed into a causal loop diagram.

Results: The causal loop diagram comprises 73 factors that were structured into six domains: physical (medical) factors (23), social health factors (21), psychological factors (14), environmental factors (5), demographic factors (5) and lifestyle factors (3). 57 factors were identified in the systematic literature review, additionally 16 factors, mostly of the social health cluster, were identified during the GMB session and the feedback rounds.

Conclusion: The causal loop diagram offers a comprehensive visualisation of factors related to cognitive decline and their interactions. It supports the generation of hypotheses on causal relationships and interactions of factors within and between domains.

Keywords: Cognition; Dementia; Model; Risk factors; Theory.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Illustration of the applied methodical process (Step 1 – Step 3)
Fig. 2
Fig. 2
Causal loop diagram of responsible factors in the development and trajectory of dementia. To see higher resolution of this causal loop diagram, go to https://kumu.io/ImkeBremen/causal-loop-diagram-of-factors-associated-with-dementia
Fig. 3
Fig. 3
Illustrative example: Stigma and its relationship with other factors
See this image and copyright information in PMC

References

    1. World Health Organization . Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva: World Health Organization; 2019. - PubMed
    1. Pinquart M, Sörensen S. Associations of caregiver stressors and uplifts with subjective well-being and depressive mood: a meta-analytic comparison. Aging Ment Health. 2004;8(5):438–449. doi: 10.1080/13607860410001725036. - DOI - PubMed
    1. Volicer L. Caregiver burden in dementia care: Prevalence and health effects. Current Psychosis & Therapeutics Reports. 2005;3(1):20–25. doi: 10.1007/BF02629405. - DOI
    1. Wimo A, Jönsson L, Bond J, Prince M, Winblad B. The worldwide economic impact of dementia 2010. Alzheimers Dement. 2013;9(1):1–11.e13. doi: 10.1016/j.jalz.2012.11.006. - DOI - PubMed
    1. Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population-based perspective. Alzheimers Dement. 2015;11(6):718–726. doi: 10.1016/j.jalz.2015.05.016. - DOI - PubMed

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