Characterization of Risk Factors Using Lifestyle for Brain Health (LIBRA) Index Scores Among Filipino Patients with Mild Cognitive Impairment and Dementia.

INTRODUCTION: Dementia prevention focuses on modifiable lifestyle risks which can be summarized by the Lifestyle for Brain Health (LIBRA) index. This index has limited evaluation in Southeast Asian clinical samples. This study aims to characterize LIBRA scores in a Filipino clinical population with mild cognitive impairment (MCI) and all cause dementia and assess associations with dementia etiologies and cognitive severity. METHODS: Cross sectional analysis of patients from the Philippine Neurological Association One Database - Dementia registry. LIBRA was operationalized from nine available modifiable factors. Group comparisons used nonparametric tests and binary logistic regression to estimate odds ratios with 95% confidence intervals. RESULTS: The study included 552 individuals, including 97 (17.6%) with MCI and 455 (82.4%) with dementia. The mean age was 73.9 ± 11.47 years, and 62.7% were female. Total LIBRA scores did not differ between MCI and dementia (p = 0.855). In unadjusted logistic regression models, physical inactivity showed an association with higher odds of dementia (OR 3.85, 95% CI 1.81-8.18, p < 0.001), while obesity showed an inverse association with dementia (OR 0.61, 95% CI 0.38-0.98, p = 0.040). Compared with Alzheimer's disease (AD), vascular dementia (VaD) (OR 1.28, 95% CI 1.13-1.46, p < 0.001) and mixed AD+VaD (OR 1.33, 95% CI 1.17-1.50, p < 0.001) had significantly higher LIBRA scores. Total LIBRA scores were not associated with cognitive impairment severity in dementia. These associations should be interpreted cautiously given the descriptive cross-sectional design. CONCLUSION: LIBRA captures modifiable vascular and lifestyle burden which can be associated with vascular-related dementias. The index is more useful for risk stratification and prevention counseling than for cross sectional diagnosis or severity assessment.