Abstract P006: Prevalence And Social Determinants Of Modifiable Risk Factors Of Dementia: An Analysis Of The National Health And Nutrition Examination Survey (nhanes) 2013-2018

Abstract

Introduction: Dementia causes significant morbidity and mortality. 40% of worldwide cases can be delayed or prevented with risk factor modification. The patterning of modifiable risk factors among US adults remain unknown. Methods: We determined the prevalence of total, mid-life, and late-life modifiable risk factors for dementia among US adults > 18 years of age using NHANES from 2013-2018. Mid-life (45-65 years) risk factors included: self-reported hearing loss, hypertension (via self-report or exam), excess alcohol intake (≥14 alcoholic drinks per week), and BMI > 30 mg/kg 2 . Late-life (>65 years) risk factors included: self-reported cigarette smoking, depression (PHQ-9 ≥ 10), social isolation, physical inactivity (<150 minutes/week of moderate activity), and diabetes (via self-report or HgBA1C ≥ 6.5) . Having less than a high school degree was included as both a mid- and late-life risk factor. Poisson regressions were used to determine age-adjusted associations between the exposures of race-ethnicity, sex, and poverty-income ratio (PIR, 6-level ordinal variable, higher numbers reflecting more income relative to poverty level) with total number of risk factors, mid-life risks factors among those in midlife, and late-life risks factors among those in late-life. Results: After applying survey weights, the sample consisted of 241,727,544 individuals composed of 48.2% male participants, 9.20% identifying as Mexican-American, 6.35% non-Mexican Hispanic, 11.4% non-Hispanic Black, 5.67% non-Hispanic Asian, 3.74% as ‘other,’ and 63.6% as non-Hispanic white. Mid-life and late-life individuals made up 35.70% and 17.85% of the sample respectively. The median (IQR) number of risk factors overall was 2 (1-3). Among mid-life participants, the median number (IQR) of mid-life risk factors was 1 (0-2). Among late-life participants, the median number (IQR) of late-life risk factors was 1 (1-2). Hypertension was the most prevalent risk factor at 42.8%. Mexican-Americans, non-Mexican Hispanic Americans, and non-Hispanic Black Americans had significantly more age-adjusted total risk factors, mid-life risk factors, and late-life risk factors relative to non-Hispanic white Americans. Non-Hispanic Asian Americans had less age-adjusted total and midlife risk factors relative to non-Hispanic white-Americans, but more late-life risk factors. Male sex was associated with a greater prevalence of age-adjusted mid-life risk factors (β =0.18, 95% CI: 0.05 – 0.18), compared to female sex. A 1-level higher PIR was associated with less age-adjusted total, mid-life, and late-life risk factors, with late-life being most pronounced (β = -0.19, 95% CI: -0.21 to -0.17) Conclusion: Dementia risk factors seem to be patterned by social determinants, including race-ethnicity and PIR. Given known disparities in dementia, more focus should be given to mitigating risk factors among at-risk populations.