Potentially Modifiable Dementia Risk Factors in Canada: An Analysis of Canadian Longitudinal Study on Aging with a Multi-Country Comparison

S. Son, M. Speechley, G. Y. Zou, M. Kivipelto, F. Mangialasche, H. H. Feldman, H. Chertkow, S. Belleville, H. Nygaard, V. Hachinski, F. Pieruccini-Faria, Manuel Montero-Odasso
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Abstract

Background

It has been suggested that up to 40% of dementia cases worldwide are associated with modifiable risk factors; however, these estimates are not known in Canada. Furthermore, sleep disturbances, an emerging factor, has not been incorporated into the life-course model of dementia prevention.

Objective

To estimate the population impact of 12 modifiable risk factors in Canadian adults including sleep disturbances, by sex and age groups, and to compare with other countries.

Design

Cross-sectional analysis of Canadian Longitudinal Study on Aging baseline data.

Setting

Community.

Participants

30,097 adults aged 45 years and older.

Measuremments

Prevalence and Population Attributable

Fractions (PAFs) associated with less education, hearing loss, traumatic brain injury, hypertension, excessive alcohol, obesity, smoking, depression, social isolation, physical inactivity, diabetes, and sleep disturbances

Results

The risk factors with the largest PAF were later life physical inactivity (10.2%; 95% CI, 6.8% to 13%), midlife hearing loss (6.5%; 3.7% to 9.3%), midlife obesity (6.4%; 4.1% to 7.7%), and midlife hypertension (6.2%; 2.7% to 9.3%). The PAF of later life sleep disturbances was 3.0% (95% CI, 1.8% to 3.8%). The 12 risk factors accounted for 51.9% (32.2% to 68.0%) of dementia among men and 52.4% (32.5% to 68.7%) among women. Overall, the combined PAF of all risk factors was 49.2% (31.1% to 64.9%), and it increased with age.

Conclusion

Nearly up to 50% of dementia cases in Canada are attributable to 12 modifiable risk factors across the lifespan. Canadian risk reduction strategies should prioritize targeting physical inactivity, hearing loss, obesity, and hypertension.

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加拿大潜在的可改变的痴呆症风险因素:加拿大老龄化纵向研究分析与多国比较
背景有研究表明,全球多达 40% 的痴呆症病例与可改变的风险因素有关;然而,这些估计数字在加拿大并不为人所知。目标按性别和年龄组估算包括睡眠障碍在内的12个可改变的风险因素对加拿大成年人的人口影响,并与其他国家进行比较。设计对加拿大老龄化纵向研究的基线数据进行横断面分析。测量与教育程度较低、听力损失、脑外伤、高血压、过量饮酒、肥胖、吸烟、抑郁、社会隔离、缺乏运动、糖尿病和睡眠障碍相关的患病率和人口可归因分数(PAFs)结果PAFs最大的风险因素是晚年缺乏运动(10.2%;95% CI,6.8% 至 13%)、中年听力损失(6.5%;3.7% 至 9.3%)、中年肥胖(6.4%;4.1% 至 7.7%)和中年高血压(6.2%;2.7% 至 9.3%)。晚年睡眠障碍的 PAF 为 3.0%(95% CI,1.8% 至 3.8%)。在男性痴呆症患者中,这12个风险因素占51.9%(32.2%至68.0%),在女性痴呆症患者中,这12个风险因素占52.4%(32.5%至68.7%)。总体而言,所有风险因素的综合PAF为49.2%(31.1%至64.9%),并且随着年龄的增长而增加。加拿大的降低风险战略应优先针对缺乏运动、听力损失、肥胖和高血压。
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The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
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9.20
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期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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