Lipnicki DM, et al. - Longitudinal data from 20 population-based cohorts from 15 countries (Australia, Brazil, Cuba, France, Germany, Greece, Hong Kong, Italy, Japan, Singapore, Spain, South Korea, The Netherlands, the United Kingdom, and the United States) over 5 continents, including 48,522 people (58.4% women) aged 54–105 (mean= 72.7) years and without dementia at baseline was assessed by the experts in order to examine correlations between risk factors and late-life cognitive decline on a global scale, including comparisons among ethno-regional groups. Cognitive performance was estimated as Mini-Mental State Examination (MMSE) and global cognition scores. The apolipoprotein E ε4 allele (APOE*4), depression, diabetes, current smoking, and history of stroke were correlated with poorer cognitive performance, and higher levels of education and energetic physical activity were related to better performance, when confounding risk factors were controlled. Age, APOE*4, and diabetes were related to quicker cognitive drop. Asian people exhibited stronger relations between having ever smoked and cognitive performance, and between diabetes and cognitive decline, in comparison to white people. Hence, education, smoking, physical activity, diabetes, and stroke were all concluded as modifiable factors related to cognitive drop. If these factors were discovered to be causal, controlling them could reduce worldwide levels of cognitive deterioration. However, any global prevention strategy may require to acknowledge ethno-regional variations.