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Each participant gave written informed consent.ProceduresA neurologist examined all participants at baseline and at two, four, and seven year follow up by using a standardised interview incorporating cognitive testing to identify both dementia and mild cognitive impairment.38 Mild cognitive impairment is considered to be a prodrome of dementia; we have included it here to cover cases of slowly evolving dementia that may be diagnosed after the seven year follow up. We have previously shown that the application of the modified Peterson’s criteria for mild cognitive impairment in this population identifies people with cognitive difficulties with a very high likelihood of later developing dementia.38 These participants cannot be considered not to have dementia, and their removal would risk biasing results. We therefore make the assumption that a public health intervention should target both diagnosed and prodromal dementia, and we included incident cases of mild cognitive impairment with dementia in our analyses.

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