Population-attributable fractions of risk factors for all-cause dementia in China rural and urban areas: a cross-sectional study

Hu, Feifei; Cheng, Guirong; Liú, Dan; Liu, Qian; Gan, Xu-Guang; Li, Lin; Wang, Xiaodan; Zhang, Bo; An, Li-Na; Chen, Cong; Zou, Mingjun; Xu, Li‐Yan; Ou, Yangming; Chen, Yu‐Shan; Li, Jinquan; Wei, Zhen; Wang, Yueyi; Wu, Qiong; Chen, Xing‐Xing; Yang, Xifei; Wu, Qingming; Feng, Lei; Zhang, Jingjing; Xu, Heng; Yu, Ya-Fu; Yang, Mengliu; Qian, Jin; Lian, Pengfei; Fu, Li-Yan; Duan, Tingting; Tian, Yuan; Cheng, Xi; Li, Xinwen; Yan, Pin-ting; Huang, Guowei; Dong, Hongxin; Ji, Yong; Zeng, Yan

doi:10.1007/s00415-021-10886-y

Cited by 21 publications

(22 citation statements)

References 41 publications

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“…The PAF of low education level (lower than primary school) was 6.8%, which was lower than previous studies on the Chinese population [12][13][14]. Mechanically, it is believed that lifelong education and mental stimulation can help build a "cognitive reserve" to reduce the risk of dementia, which enables individuals to continue to work at a "normal level" even though they experience neurodegenerative changes [25].…”

Section: Discussionmentioning

confidence: 69%

“…The definition and odds ratio (OR) of each risk factor are presented in the Supplemental Table 1. The OR value for individual risk factors according to the definition of each risk factor comes from previously published studies in the Chinese population [2,14,18,19]. Except for obesity, which was measured by body mass index (BMI), the other factors were all reported by participants or their first-degree relatives or primary caregivers.…”

Section: Pafmentioning

confidence: 99%

“…The first adjusted PAF estimate for dementia related to China was calculated by the 10/66 Dementia Research Group study conducted in 2004-2006, but the use of relative risk (RR) comes from systematic reviews and meta-analyses from predominantly Western countries [13]. A recent study based on the China Multicenter Dementia Survey (CMDS) evaluated the PAFs of eight potentially modifiable risk factors for dementia in China and revealed that China had a unique risk profile owing to its rural-urban disparity [14]. In these studies, the participants were mainly from Beijing municipality [13], Hubei Province [14], Hebei Province [14], and Tianjin municipality [14], with a relatively older population, while the share of people aged 60 and over in many regions (including Jiangxi Province) was lower than the national average [15].…”

Section: Introductionmentioning

confidence: 99%

“…A recent study based on the China Multicenter Dementia Survey (CMDS) evaluated the PAFs of eight potentially modifiable risk factors for dementia in China and revealed that China had a unique risk profile owing to its rural-urban disparity [14]. In these studies, the participants were mainly from Beijing municipality [13], Hubei Province [14], Hebei Province [14], and Tianjin municipality [14], with a relatively older population, while the share of people aged 60 and over in many regions (including Jiangxi Province) was lower than the national average [15]. Health problems and access to health care providers and services remain heterogeneous between the provinces in mainland China [16].…”

Section: Introductionmentioning

confidence: 99%

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Population attributable fractions for risk factors and disability burden of dementia in Jiangxi Province, China: a cross-sectional study

Zheng

Xu³

et al. 2022

BMC Geriatr

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Background In view of the fact that there is no effective treatment for dementia, the number of years that dementia patients have to live with dementia will gradually increase for the rest of their lives, and the disability loss caused by dementia will increase. It is urgent to study the influence of risk factors on dementia by making use of the potential of prevention. The purpose of this study is to quantify the burden of dementia disability attributable to risk factors by assessing the population attributable fractions (PAFs) in Jiangxi Province, which is one of the regions of moderate aging process of China. Methods The prevalence data of nine risk factors were obtained through the Sixth National Health Service Survey in 2018, which covered 2713 older people. Levin’s formula was used to calculate the PAF for each risk factor for dementia. We adjusted the PAF for communality between risk factors, and used these values to calculate overall weighted PAFs and the years lived with disability (YLDs), which were attributable to nine risk factors. Results The number of dementia cases and their proportions that can theoretically be prevented by nine identified risk factors were 111636 (99595-120877) and 66.8% (59.6-72.3), respectively. The total YLDs of dementia were estimated to be 61136 (46463-78369) (males: 36434 [24100-49330], females: 23956 [14716-34589]). Physical inactivity (11639 [8845-14920]), low social contact (9324 [7086-11952]), and hearing loss (5668 [4307-7265] were the top three contributors to dementia. Conclusions The moderate aging areas represented by Jiangxi Province have great potential in the prevention of dementia. Targeted interventions and management of risk factors can effectively reduce the disability burden of dementia.

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Section: Discussionmentioning

confidence: 69%

Section: Pafmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Population attributable fractions for risk factors and disability burden of dementia in Jiangxi Province, China: a cross-sectional study

Zheng

Xu³

et al. 2022

BMC Geriatr

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“…In China, adults in rural areas are still heavily reliant on solid fuel (Chan et al 2017). Moreover, the prevalence of dementia in rural areas is higher than that in urban China (Hu et al, 2021) (Hu et al 2021). Adults in rural areas might be more vulnerable to air pollutants caused by solid fuel use, due to their relatively poor health in comparison to their counterparts in urban (Zhang 2017).…”

Section: Discussionmentioning

confidence: 99%

Solid fuel use in relation to dementia risk in middle-aged and older adults: A prospective cohort study

et al. 2022

Preprint

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Objectives: It remains unknown whether household air pollution is associated with dementia risk. This study examined the associations between solid fuel use for cooking and heating (the main source of household air pollution) and dementia risk. Methods: This analysis included data on 11,352 participants (aged 45+ years) from the 2011 wave of China Health and Retirement Longitudinal Study, with follow-up to 2018. Dementia risk was assessed by a risk score using the Rotterdam Study Basic Dementia Risk Model (BDRM) and then standardized for analysis. Household fuel types of cooking and heating were categorized as solid (e.g., coal, crop residue) and clean (e.g., central heating, solar). Multivariable analyses were performed using generalized estimating equations. Moreover, we examined the joint associations of solid fuel use for cooking and heating with the BDRM score. Results: We found an independent and significant association of solid (vs. clean) fuel use for cooking and heating with a higher BDRM score after adjusting for potential confounders (e.g., β = 0.14 for solid fuel for cooking; 95% CI: 0.12, 0.17). Participants who used solid (vs. clean) fuel for both cooking and heating had the highest BDRM score (β = 0.20; 95%CI: 0.16, 0.23). Subgroup analysis suggested stronger associations in participants living in rural areas. Conclusions: Solid fuel use for cooking and heating was independently associated with increased dementia risk in Chinese middle-aged and older adults, particularly among those living in rural areas. Our findings call for more efforts to facilitate universal access to clean energy for dementia prevention.

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Predicting functional impairment trajectories in amyotrophic lateral sclerosis: a probabilistic, multifactorial model of disease progression

et al. 2022

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Objective To employ Artificial Intelligence to model, predict and simulate the amyotrophic lateral sclerosis (ALS) progression over time in terms of variable interactions, functional impairments, and survival. Methods We employed demographic and clinical variables, including functional scores and the utilisation of support interventions, of 3940 ALS patients from four Italian and two Israeli registers to develop a new approach based on Dynamic Bayesian Networks (DBNs) that models the ALS evolution over time, in two distinct scenarios of variable availability. The method allows to simulate patients’ disease trajectories and predict the probability of functional impairment and survival at different time points. Results DBNs explicitly represent the relationships between the variables and the pathways along which they influence the disease progression. Several notable inter-dependencies were identified and validated by comparison with literature. Moreover, the implemented tool allows the assessment of the effect of different markers on the disease course, reproducing the probabilistically expected clinical progressions. The tool shows high concordance in terms of predicted and real prognosis, assessed as time to functional impairments and survival (integral of the AU-ROC in the first 36 months between 0.80–0.93 and 0.84–0.89 for the two scenarios, respectively). Conclusions Provided only with measurements commonly collected during the first visit, our models can predict time to the loss of independence in walking, breathing, swallowing, communicating, and survival and it can be used to generate in silico patient cohorts with specific characteristics. Our tool provides a comprehensive framework to support physicians in treatment planning and clinical decision-making.

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Population-attributable fractions of risk factors for all-cause dementia in China rural and urban areas: a cross-sectional study

Cited by 21 publications

References 41 publications

Population attributable fractions for risk factors and disability burden of dementia in Jiangxi Province, China: a cross-sectional study

Population attributable fractions for risk factors and disability burden of dementia in Jiangxi Province, China: a cross-sectional study

Solid fuel use in relation to dementia risk in middle-aged and older adults: A prospective cohort study

Predicting functional impairment trajectories in amyotrophic lateral sclerosis: a probabilistic, multifactorial model of disease progression

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