Wednesday, May 11, 2022

Alzheimer’s and Dementia Linked to Eight Modifiable Risk Factors

More than a third of all individuals with Alzheimer’s disease and related dementias living in the United States had one or more of eight modifiable risk factors, according to a report in JAMA Neurology.

The eight risk factors—midlife obesity, physical inactivity, low education, smoking, depression, diabetes, midlife hypertension, and hearing loss—were associated with 36.9% of Alzheimer’s and related dementia cases. The proportion of Alzheimer’s disease and related dementias associated with these risk factors was higher among men compared with women and among Black, American Indian and Alaska Native, and Hispanic individuals compared with White and Asian individuals.

“Policymakers and clinicians should … consider increasing efforts to prevent [Alzheimer’s disease and related dementias] by focusing on midlife obesity, physical inactivity, and low education, especially in higher-risk groups,” wrote Roch Nianogo, M.D., Ph.D., of the Fielding School of Public Health at the University of California, Los Angeles, and colleagues.

Nianogo and colleagues used the U.S. Behavioral Risk Factor Surveillance Survey (BRFSS) to look at the prevalence of the eight modifiable risk factors among 378,615 non-institutionalized individuals with Alzheimer’s and related dementias between January 2018 and December 2018. The BRFSS is a system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services.

The researchers calculated population-attributable risk between the eight risk factors and Alzheimer’s disease and related dementias. Such “estimates take into account the strength of the association between the risk factor and the outcome as well as the prevalence of the risk factor,” they noted.

The most prominent risk factors among all participants were midlife obesity (17.7%), physical inactivity (11.8%), and low educational attainment (11.7%). The combined population-attributable risk was higher among men (35.9%) than women (30.1%); it was also higher among Black individuals (39.8%), American Indian and Alaska Native individuals (39.2%), and Hispanic individuals (34.2%) compared with White individuals (28.5%) and Asian individuals (15.8%).

“Understanding the sex-specific and race and ethnicity–specific associations with [Alzheimer’s disease and related dementias] burden may guide public health strategies,” Nianogo and colleagues concluded.

For related information, see the Psychiatric News article “Racial Disparities in Dementia Rate Linger.”

(Image: iStock/Yaraslau Saulevich)

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