A cross-sectional analysis showed that eight correctable risk factors were associated with more than 1 in 3 cases of Alzheimer’s disease and related dementia in the United States.
Eight risk factors for middle-aged obesity, middle-aged hypertension, lack of exercise, depression, smoking, poor education, diabetes, and hearing loss are 36.9% (95% CI 36.5-) of Alzheimer’s disease and dementia cases. Roch reported that it was associated with 37.3). Nianogo, MD, PhD at the University of California, Los Angeles, Deborah Barnes, PhD, MPH, and co-author at the University of California, Los Angeles.
Notably, risk factors vary based on gender, race, and ethnicity, JAMA Neurology..
The most prominent factor associated with Alzheimer’s disease and dementia was middle-aged obesity, which was 17.7% (95% CI 17.5-18.0). Lack of exercise, 11.8% (95% CI 11.7-11.9); 11.7% (95% CI 11.5-12.0) low educational background.
“We published a similar study a little over a decade ago, and the most important risk factors were lack of exercise, depression, and smoking,” Burns said. Today’s MedPage..
“Today, the top three risk factors are middle-aged obesity, lack of exercise, and low education,” she observed. “This is important because it suggests that increasing the number of obese people in the United States can have a significant long-term impact on the incidence of dementia.”
“Our results also emphasize the importance of ensuring that everyone in our country has the right education,” Burns added. “COVID-19 had a devastating impact on education and graduation rates. It is important to help those students catch up, especially for Hispanic individuals where low education is the greatest risk factor. . “
Nianogo emphasized that prevention is very important because there is no effective cure for Alzheimer’s disease and dementia. He suggested that risk reduction strategies may be more effective when targeting risk factors with higher prevalence.
“Understanding which risk factors play a role in accelerating cognitive decline can help providers and individuals proactively address these risk factors early in their lives.” Nianogo said Today’s MedPage.. “We also wanted to understand what this meant for the various subpopulations defined by gender, race, and ethnicity. This was to design a coordinated and targeted intervention. Because it can be important. “
Almost two-thirds of People with Alzheimer’s disease and dementia I’m a woman in America. Older blacks are twice as likely to develop Alzheimer’s disease and dementia, and older Hispanics are 1.5 times more likely to develop Alzheimer’s disease and dementia than older whites.
Risk reduction may also provide important public health and preventive opportunities to help address the expected increase in dementia prevalence, Nianogo and Barnes said.
For this study, researchers collected risk factor prevalence information from 378,615 participants in the 2018 CDC. Behavioral risk factor monitoring system We extracted the relative risk of each factor from a recent meta-analysis.
In the survey sample, 171,161 (weighted 48.7%) were male and 134,693 (weighted 21.1%) were 65 years or older. Self-reported racial and ethnic data showed that 6,671 participants (weighted 0.9%) were Native Americans and Alaska Natives. 8,043 (weighted 5.1%) were Asian. 29,956 (weighted 11.7%) was black. 28,042 (weighted 16.0%) were Hispanic. 294,394 (weighted 64.3%) was white.
For each of the eight modifiable risk factors, the group contribution risk was:
- Deafness: 2.3%
- Current smoking: 6.0%
- Diabetes: 7.3%
- Depression: 8.5%
- Middle-aged hypertension: 8.8%
- Low education: 11.7%
- Lack of exercise: 11.8%
- Middle-aged obesity: 17.7%
Middle-aged hypertension and middle-aged obesity were the most common risk factors among all participants, but prevalence varied by race and ethnicity. Middle-aged obesity was more common in Native American and Alaska Native, black, and Hispanic populations. Low education was more common among Hispanic individuals.
The association between Alzheimer’s disease and the risk of dementia also varied by race and ethnicity. Among the black (21.7%), Native American and Alaska Natives (20.3%), and white (17.3%) populations, middle-aged obesity showed the strongest association between Alzheimer’s disease and dementia. Among Hispanic individuals, low education was the strongest link (26.5%), but among Asian participants, lack of exercise was at the top of the list (9.5%).
The total population-induced risk was higher in men (35.9%) than in women (30.1%). The risk associated with depression was higher in women (10.5%) than in men (6.4%).
The findings suggest that the most prominently modifiable risk factors associated with Alzheimer’s disease and dementia have changed over the last decade and differ based on gender, race, and ethnicity, the study said. They said.
“It’s important to note that these findings are primarily based on observational studies,” Nianogo pointed out.
“They were able to reflect what was actually happening, but they could also reflect the effects of other factors not explained in our study,” he admitted. “To shed more light on this important issue, we need a more rigorous study design.”
This study was supported by the California Department of Public Health Alzheimer’s Disease Program through the 2019 California Budget Act.
Nianogo, Barnes, and co-authors have not reported disclosure.
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