The Cohort Studies of Memory in an International Consortium (COSMIC) is perfectly positioned to achieve
the goals of “evidence-based practice for dementia risk reduction”, “early and appropriate diagnosis”, “research
and innovation” and “transnational equity” endorsed by the World Health Assembly’s Global Action Plan on
the public health response to dementia, 2017-2025. COSMIC brings together multiple well-characterized
population-based longitudinal cohort studies of cognitive aging and dementia from around the world to address
the analytical epidemiology of dementia and pre-dementia syndromes, using harmonized data to conduct pooled
analyses and individual participant data meta-analyses. Since its initial funding by the NIA/NIH in Sep 2017,
COSMIC’s membership has grown to 54 studies from 39 nations, including 35 studies from low- and middle-
income countries (LMIC), with an additional 25 in negotiation, and a combined sample size of 175,199 (85,186
White and 90,013 non-White - 39,610 Asian, 15,476 Black, 34,832 Hispanic, 96 other), expected to grow to
300,000. A large international community of researchers has thus been enabled to collaboratively investigate the
global epidemiology of mild cognitive impairment (MCI) and dementia. In the next five years, the power of this
unique consortium will be harnessed to map the 12 modifiable risk factors of dementia identified by the 2020
Lancet Commission. Some novel risk and resilience factors will be studied in-depth, the built and economic
environments, air pollution, social health, and frailty. The incidence of MCI and dementia will be determined in
diverse regions and risk models for dementia in specific populations developed. COSMIC will examine the role
of cerebrovascular disease by harmonizing neuroimaging biomarkers. It will study the predictive utility of
genetic markers in non-European populations. It will investigate the diagnostic and disease-monitoring potential
of plasma biomarkers for Alzheimer’s disease in diverse populations. COSMIC is forging new collaborations. It
is collaborating with the Davos Alzheimer’s Collaborative (DAC) to develop digital, genetic, and fluid
biomarker-based dementia phenotypes in under-represented populations. In collaboration with Dementias
Platform UK (DPUK), COSMIC is developing the Dementias Platform Australia (DPAU) for sharing
participant level data from COSMIC studies with researchers world-wide. With DPUK and the Alzheimer’s
Disease Data Initiative (ADDI), it is developing an ontology for the curation and harmonization of dementia
related variables for international data-sharing. In collaboration with the Institute of Health Metrics and
Evaluation, COSMIC will document the global burden of risk factors for dementia. In collaboration with the
DAC, DPUK, ADDI and the Global Brain Health Institute (GBHI), it is developing a training and education
program to increase research capacity in LMICs. With its collaborative approach, data sharing, and global
network, COSMIC is creating a demonstrably global epidemiology of dementia that is needed to meet the
ambitious goals of the 2017 World Health Assembly and the hopes of people at risk of dementia everywhere.
