Potential for prevention of dementia in Denmark

Abstract

IntroductionAccording to previous estimates, 40% of dementia cases globally may be attributed to 12 potentially modifiable risk factors.MethodsWe calculated national population attributable fractions (PAFs) for each risk factor and modeled the effects of proportional reductions in risk factor prevalence on dementia prevalence by calculating potential impact fractions (PIFs) for each factor.ResultsThe overall adjusted PAF for all risk factors was 35.2%. Physical inactivity, hearing loss, hypertension, and obesity accounted for 64% of the total prevention potential. The overall adjusted PIF was 4.1% at 10% risk factor prevalence reduction and 8.1% at 20% risk factor reduction.DiscussionEstimates of the potential for the prevention of dementia should be based on country‐specific data on risk factor prevalence, as estimates based on global risk factor prevalence have limited relevance from a national perspective. Physical inactivity, hearing loss, hypertension, and obesity could be primary targets for prevention of dementia in Denmark.Highlights Overall adjusted PAF for potentially modifiable dementia risk factors was 35%. Physical inactivity, hearing loss, hypertension, and obesity had the largest prevention potential. Estimates of prevention potential should be based on national risk factor prevalence.

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

“…The life-course model obtained from CLSA was qualitatively compared to the global estimate 5 and other countries – USA, 7 India, 9 Latin America, 9 China, 9 New Zealand, 8 Brazil, 11 Australia, 10 and Denmark. 12 A total of 9 risk factors were available across all the studied countries – less education, hearing loss, hypertension, obesity, smoking, depression, social isolation, physical inactivity, and diabetes – and were measured using similar definitions across studies.…”

“…Following the Lancet series, 5,6 the population impact of dementia risk factors has been estimated in other countries with differences in risk factor profiles. [7][8][9][10][11][12] Given that the same analytical approach and risk ratio were used to estimate PAF in all the studies, the differences in PAF across countries are mainly driven by differences in risk factor prevalence. For instance, less education is a greater contributing factor to dementia than social isolation in low-income countries as they tend to have stronger social ties and social support but have limited access to education compared to high-income countries.…”

Proton pump inhibitors and dementia: A nationwide population‐based study

“…Health‐related confounders included (1) the presence of cardiovascular disease (CVD) defined as a diagnosis of stroke, the presence of ischemic heart disease including acute myocardial infarction, or use of oral antithrombotic medication including anticoagulants; (2) diabetes mellitus type 1 or 2 defined from diagnoses or use of antidiabetics; (3) hypertension defined from diagnoses or use of antihypertensive drugs; and (4) dyslipidemia defined from diagnoses or use of statins. The health‐related confounders were included since they are acknowledged risk factors for dementia 33 , 34 as well as associated to use of PPI. 35 Variables were assessed at the beginning of the lag time window.…”

“…(3) hypertension defined from diagnoses or use of antihypertensive drugs; and (4) dyslipidemia defined from diagnoses or use of statins. The health-related confounders were included since they are acknowledged risk factors for dementia 33,34 as well as associated to use of PPI. 35 Variables were assessed at the beginning of the lag time window.…”