The policy exposome of dementia: Gaps, opportunities, and research agenda

Government policies targeting key risk factors for cognitive decline are potential levers for preventing or delaying dementia. Policy is therefore a central component of the exposome-the cumulative exposures shaping dementia risk across the life course. While extensive research links individual risk factors to dementia, less attention has been paid to how public policies structure these risks. We introduce the concept of the policy exposome and summarize findings from a structured expert consultation conducted by the Gateway Exposome Coordinating center (GECC) to identify priority policy research domains. We argue that systematic collection and harmonization of policy data across countries and sub-national regions can enable causal research on dementia. We propose a tiered research framework to guide policy data collection, prioritizing education, tobacco and alcohol control, air pollution, and old-age social assistance. Using tobacco control as a case study, we illustrate how policies can be operationalized as exposures linkable to dementia outcomes.

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Publication Details

Journal
Alzheimer s & Dementia
Published
2026-04-01
DOI
https://doi.org/10.1002/alz.71362
Primary Topic
Health, Environment, Cognitive Aging
Type
article
Field-Weighted Citation Impact
0.00

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article

The policy exposome of dementia: Gaps, opportunities, and research agenda

Sebastian Walsh, Samer Atshan, Irene Papanicolas, Ritu Sadana et al.
Alzheimer s & Dementia
Health, Environment, Cognitive Aging
article

The policy exposome of dementia: Gaps, opportunities, and research agenda

Sebastian Walsh, Samer Atshan, Irene Papanicolas, Ritu Sadana, Minhaj Mahmud, Survana Alladi, D. Knapp, Géraldine Marks, Elizabeth Platt, Nathalie Monnet, David Rehkopf, William Dow, Maria Glymour, Mauricio Avendano, Matheo Bourgeois, Lindsay Wallace, McKayla Wenner, Gill Livingston, Clémence Kieny, Carol Brayne
article en

Abstract

Government policies targeting key risk factors for cognitive decline are potential levers for preventing or delaying dementia. Policy is therefore a central component of the exposome-the cumulative exposures shaping dementia risk across the life course. While extensive research links individual risk factors to dementia, less attention has been paid to how public policies structure these risks. We introduce the concept of the policy exposome and summarize findings from a structured expert consultation conducted by the Gateway Exposome Coordinating center (GECC) to identify priority policy research domains. We argue that systematic collection and harmonization of policy data across countries and sub-national regions can enable causal research on dementia. We propose a tiered research framework to guide policy data collection, prioritizing education, tobacco and alcohol control, air pollution, and old-age social assistance. Using tobacco control as a case study, we illustrate how policies can be operationalized as exposures linkable to dementia outcomes.

Alzheimer s & DementiaVol. 22(4)
Boston University (US), University of Southern California (US), Dalhousie University (CA), Rhode Island Department of Health (US), Harvard University (US), Asian Development Bank Institute (JP), University of Cambridge (GB), Department of Health and Aged Care (AU), Office Of Health Economics (GB), Stanford Health Care (US), Temple University Health System (US), Stanford Medicine (US), Centre universitaire de médecine générale et santé publique, Lausanne (CH), University College London (GB), University of Neuchâtel (CH), National Institute of Mental Health and Neurosciences (IN), Temple University (US), London School of Economics and Political Science (GB), University of California, Berkeley (US), Camden and Islington NHS Foundation Trust (GB), Stanford University (US), University of Lausanne (CH)
World Health Organization, National Institute on Aging
Good health and well-being
Openalex Percentile: Top 21%
Health, Environment, Cognitive Aging
DOIOpen Access PDFOpenAlex
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