학술논문

Importance of Accounting for Regional Differences in Modifiable Risk Factors for Alzheimer’s Disease and Related Dementias: The Case for Tailored Interventions
Document Type
article
Source
Journal of Alzheimer's Disease. 89(2)
Subject
Biomedical and Clinical Sciences
Neurosciences
Clinical Sciences
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Acquired Cognitive Impairment
Dementia
Alzheimer's Disease
Brain Disorders
Aging
Prevention
Clinical Research
Neurodegenerative
Aetiology
2.1 Biological and endogenous factors
Alzheimer Disease
Diabetes Mellitus
Humans
Hypertension
Obesity
Risk Factors
United States
Alzheimer's disease
dementia
public health
prevention
risk factors
Alzheimer’s disease
risk factors
Cognitive Sciences
Neurology & Neurosurgery
Clinical sciences
Biological psychology
Language
Abstract
BackgroundWe recently estimated that 36.9% of Alzheimer's disease and related dementias (ADRD) cases in the US may be attributable to modifiable risk factors, but it is not known whether national estimates generalize to specific states or regions.ObjectiveTo compare national estimates of modifiable risk factors of ADRD to California, overall and by sex and race/ethnicity, and to estimate number of cases potentially preventable by reducing the prevalence of key risk factors by 25%.MethodsAdults ≥18 years who participated in the Behavioral Risk Factor Surveillance Survey in California (n = 9,836) and the US (n = 378,615). We calculated population attributable risks (PARs) for eight risk factors (physical inactivity, current smoking, depression, low education, diabetes mellitus, midlife obesity, midlife hypertension, and hearing loss) and compared estimates in California and the U.S.ResultsIn California, overall, 28.9% of ADRD cases were potentially attributable to the combination of risk factors, compared to 36.9% in the U.S. The top three risk factors were the same in California and the U.S., although their relative importance differed (low education [CA:14.9%; U.S.:11.7% ], midlife obesity [CA:14.9%; U.S.:17.7% ], and physical inactivity [CA:10.3%; U.S.:11.8% ]). The number of ADRD cases attributable to the combined risk factors was 199,246 in California and 2,287,683 in the U.S. If the combined risk factors were reduced by 25%, we could potentially prevent more than 40,000 cases in California and 445,000 cases in the U.S.ConclusionOur findings highlight the importance of examining risk factors of ADRD regionally, and within sex and race/ethnic groups to tailor dementia risk reduction strategies.