Table 1.

Definition of risk and protective factors in the LIBRA score and corresponding scores

Modifiable risk factors		Definition	Score
Protective factors
1	Healthy diet	LLDS ≥5th quintile (score of 30 and higher)	−1.7
2	No to low/moderate alcohol consumption	Average number of alcohol units per day ≤1 without binge drinking (ie, >3 units per day for women; >4 units per day for men)	−1.0
Risk factors
3	Cardiovascular diseases	The presence of at least one cardiovascular disease (myocardial infarction, stroke or peripheral arterial diseases)	+1.0
4	Physical inactivity	Not fulfilling the Dutch norm for physical activity (ie, ≥150 min/week physical activity of moderate to vigorous intensity, measured with the SQUASH questionnaire)	+1.1
5	Renal dysfunction	eGFR <60 mL/min/1.73 m2	+1.1
6	Diabetes	Glucose (capillary blood) ≥7.0 mmol/L or HbA1c >53 mmol/mol	+1.3
7	High cholesterol	TC/HDL >5	+1.4
8	Smoking	Current smoker	+1.5
9	Obesity	BMI ≥30	+1.6
10	Hypertension	SBP >140 mm Hg or DBP >90 mm Hg	+1.6
11	Depression	At least 1 key symptom and 4 additional symptoms measured with the MINI	+2.1

BMI, body mass index; DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; HDL, high-density lipoprotein; LDL, low-density lipoprotein; LIBRA, Lifestyle for Brain Health; LLDS, Lifelines Diet Score; MINI, Mini-International Neuropsychiatric Interview; SBP, systolic blood pressure; SQUASH, Short Questionnaire to Assess Health-enhancing Physical Activity; TC, total cholesterol.