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Background: Modifiable risk factors for dementia account for 40% of cases worldwide and exert impacts on risk across the life course. To have maximal public health impact, dementia risk-reduction initiatives need to reach a large and diverse audience, including people from a wide range of ages and socioeconomic backgrounds. Currently, dementia risk-reduction interventions primarily reach a narrow audience, consisting largely of highly educated older adults from high income countries. Methods: In this commentary, we review established dissemination models to identify strategies that could be used to extend and broaden the reach of dementia risk-reduction initiatives. Three potential reach-broadening strategies can be identified from these models: engaging with distinct user groups; focusing on interpersonal communication; and utilising dissemination agents. Results: Engaging with distinct user groups and utilising dissemination agents show promise for broadening the reach of dementia risk-reduction initiatives, while interpersonal communication has received limited attention in this context. Further evaluation of the impact of interpersonal communication may provide avenues to take advantage of this dissemination method. Conclusions: Based on the reviewed models and data from current risk-reduction initiatives, we suggest that utilising all three of these strategies may most effectively broaden the reach of dementia risk-reduction initiatives. This may promote risk reduction among a larger and more diverse audience, more equitably reducing the global impact of dementia. [ABSTRACT FROM AUTHOR]

Cognitive reserve (CR) is a theoretical construct describing the underlying cognitive capacity of an individual that confers differential levels of resistance to, and recovery from, brain injuries of various types. To date, estimates of an individual's level of CR have been based on single proxy measures that are retrospective and static in nature. To develop a measure of dynamic change in CR across a lifetime, we previously identified a latent factor, derived from an exploratory factor analysis of a large sample of healthy older adults, as current CR (cCR). In the present study, we examined the longitudinal results of a sample of 272 older adults enrolled in the Tasmanian Healthy Brain Project. Using results from 12-month and 24-month reassessments, we examined the longitudinal validity of the cCR factor using confirmatory factor analyses. The results of these analyses indicate that the cCR factor structure is longitudinally stable. These results, in conjunction with recent results from our group demonstrating dynamic increases in cCR over time in older adults undertaking further education, lend weight to this cCR measure being a valid estimate of dynamic change in CR over time. [ABSTRACT FROM AUTHOR]