Prevalence and population attributable fractions of potentially modifiable risk factors for dementia in Canada: A cross-sectional analysis of the Canadian Longitudinal Study on Aging.

IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2024-07-24 DOI:10.17269/s41997-024-00920-7
Yasaman Dolatshahi, Alexandra Mayhew, Megan E O'Connell, Teresa Liu-Ambrose, Vanessa Taler, Eric E Smith, David B Hogan, Susan Kirkland, Andrew P Costa, Christina Wolfson, Parminder Raina, Lauren Griffith, Aaron Jones
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Abstract

Objectives: We investigated the prevalence and population attributable fraction (PAF) of 12 potentially modifiable risk factors for dementia in middle-aged and older Canadians.

Methods: We conducted a cross-sectional study of 30,097 adults aged 45 to 85 with baseline data from the Canadian Longitudinal Study on Aging (2011‒2015). Risk factors and associated relative risks were taken from a highly cited systematic review. We calculated the prevalence of each risk factor using sampling weights. Individual PAFs were calculated both crudely and weighted for communality, and combined PAFs were calculated using both multiplicative and additive assumptions. Analyses were stratified by household income and repeated at CLSA's first follow-up (2015‒2018).

Results: The most prevalent risk factors were physical inactivity (63.8%; 95% CI, 62.8-64.9), hypertension (32.8%; 31.7-33.8), and obesity (30.8%; 29.7-31.8). The highest crude PAFs were physical inactivity (19.9%), traumatic brain injury (16.7%), and hypertension (16.6%). The highest weighted PAFs were physical inactivity (11.6%), depression (7.7%), and hypertension (6.0%). We estimated that the 12 risk factors combined accounted for 43.4% (37.3‒49.0) of dementia cases assuming weighted multiplicative interactions and 60.9% (55.7‒65.5) assuming additive interactions. There was a clear gradient of increasing prevalence and PAF with decreasing income for 9 of the 12 risk factors.

Conclusion: The findings of this study can inform individual- and population-level dementia prevention strategies in Canada. Differences in the impact of individual risk factors between this study and other international and regional studies highlight the importance of tailoring national dementia strategies to the local distribution of risk factors.

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加拿大痴呆症潜在可改变风险因素的流行率和人口可归因分数:加拿大老龄化纵向研究的横断面分析。
目的:我们调查了加拿大中老年人痴呆症的 12 个潜在可改变风险因素的患病率和人口可归因分数:我们调查了加拿大中老年人痴呆症的 12 个潜在可改变风险因素的患病率和人口可归因分数 (PAF):我们对 30,097 名 45 至 85 岁的成年人进行了横断面研究,基线数据来自加拿大老龄化纵向研究(2011-2015 年)。风险因素和相关的相对风险来自一篇引用率很高的系统综述。我们使用抽样权重计算了每个风险因素的患病率。单个 PAFs 采用粗略计算和社区加权计算,综合 PAFs 采用乘法和加法假设计算。分析按家庭收入进行分层,并在 CLSA 的首次随访(2015-2018 年)中重复进行:最普遍的风险因素是缺乏运动(63.8%;95% CI,62.8-64.9)、高血压(32.8%;31.7-33.8)和肥胖(30.8%;29.7-31.8)。粗PAF最高的是缺乏运动(19.9%)、脑外伤(16.7%)和高血压(16.6%)。加权 PAF 最高的是缺乏运动(11.6%)、抑郁(7.7%)和高血压(6.0%)。我们估计,假设加权乘法相互作用,12 个风险因素合计占痴呆病例的 43.4%(37.3-49.0),假设加法相互作用,则占 60.9%(55.7-65.5)。在12个风险因素中,有9个因素的患病率和PAF呈明显的梯度上升趋势,收入越低,患病率和PAF越高:本研究的结果可为加拿大的个人和人群痴呆症预防策略提供参考。本研究与其他国际和地区性研究在个体风险因素影响方面的差异凸显了根据风险因素在当地的分布情况调整国家痴呆症战略的重要性。
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来源期刊
Canadian Journal of Public Health-Revue Canadienne De Sante Publique
Canadian Journal of Public Health-Revue Canadienne De Sante Publique PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.10
自引率
4.70%
发文量
128
期刊介绍: The Canadian Journal of Public Health is dedicated to fostering excellence in public health research, scholarship, policy and practice. The aim of the Journal is to advance public health research and practice in Canada and around the world, thus contributing to the improvement of the health of populations and the reduction of health inequalities. CJPH publishes original research and scholarly articles submitted in either English or French that are relevant to population and public health. CJPH is an independent, peer-reviewed journal owned by the Canadian Public Health Association and published by Springer.   Énoncé de mission La Revue canadienne de santé publique se consacre à promouvoir l’excellence dans la recherche, les travaux d’érudition, les politiques et les pratiques de santé publique. Son but est de faire progresser la recherche et les pratiques de santé publique au Canada et dans le monde, contribuant ainsi à l’amélioration de la santé des populations et à la réduction des inégalités de santé. La RCSP publie des articles savants et des travaux inédits, soumis en anglais ou en français, qui sont d’intérêt pour la santé publique et des populations. La RCSP est une revue indépendante avec comité de lecture, propriété de l’Association canadienne de santé publique et publiée par Springer.
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