Population attributable fraction of modifiable risk factors for dementia in Chile

Abstract

Introduction Projected dementia incidence in Latin America and the Caribbean for the next decades is overwhelming. Access to local data, stratified by sex, is imperative for planning precise dementia‐prevention strategies. Methods We analyzed the individual and overall weighted population attributable fraction (PAF) of nine modifiable risk factors for dementia, in dementia‐free subjects ≥45‐years‐old, using the 2016‐2017 Chilean National Health Survey. Results The overall weighted PAF for modifiable risk factors was 45.8% (42.2% to 49.3%). Variables with the highest PAF were lower education, high blood pressure, hearing loss, and obesity. Women showed a greater overall weighted PAF: 50.7% (45.3% to ‐56.1%), compared to men: 40.2% (35.4% to 45.0%), driven by a higher PAF for physical inactivity and depression in women. Discussion The PAF for modifiable risk factors for dementia in Chile is higher than in previous world reports, due to a greater prevalence of cardiovascular risk factors. Women have a higher potential for dementia prevention. HIGHLIGHTS The proportion of dementia associated to modifiable risk factors in Chile is 45.8%. The main modifiable risk factors are high blood pressure, obesity, and hearing loss. Women had a greater prevalence of physical inactivity and depression than men. Chile had a greater prevalence of metabolic risk factors than other world regions.

Risk factors for dementia in Brazil: Differences by region and race

“…Since then, other studies have provided estimates for other specific regions, including for LMIC. [9][10][11][12] The potential for dementia prevention was estimated in India, China, and LA using data for the 10/66 study, with the highest population attributable fraction (PAF) in LA (56%), using data from six LA countries (Cuba, Dominican Republic, Mexico, Peru, Puerto Rico, and Venezuela) but these data were not nationally representative. One study estimated that 32% of dementia cases in Brazil could be attributable to seven risk factors (low educational attainment, midlife hypertension, midlife obesity, diabetes, physical inactivity, depression, and smoking).…”

Cochlear dysfunction as an early biomarker for cognitive decline in normal hearing and mild hearing loss

“…Regarding DPOAE, we calculated the total number of detected DPOAE in eight different frequencies in both ears (range between 0 and 16, bigger is better, see methods section), yielding an average number of 8. 4 surements and PTA audiogram thresholds partly converge (Spearman's rank correlation ρ = -0.64, p-value < 0.0001; Figure 2A), suggesting that they capture similar but not equal auditory characteristics. In relation to cognitive and neurological variables, the mean Mini-Mental State Examination (MMSE) score was 27 ± 3.4, while the mean CDR SoB was 0.94 ± 2.3.…”

“…A key challenge is the identification of reliable biomarkers for early diagnosis that could allow the implementation of prevention strategies for cognitive decline. In the last five years, hearing loss has emerged as one of the most relevant modifiable risk factors for dementia (1)(2)(3)(4). The World Health Organization defines hearing loss as a 25 dB elevation in hearing thresholds, which are usually measured using perceptual audiometry, estimating a global prevalence of around 500 million people (WHO,2021).…”

The aging brain: risk factors and interventions for long term brain health in women

“…In particular, exercise may impact amyloid burden more in men [15], and more positively change hippocampal blood flow in individuals with hypertension who are APOE ε4 carriers [85]. Prevalence of physical inactivity, and importance of this factor for long term cognitive outcomes may also vary by geographical region and culture, and this difference may in turn have implications for where exercise interventions have most impact [57 ▪ ,86].…”