Modifiable Risk Factors For Dementia Research Articles

Impact of the COVID-19 pandemic on some modifiable risk factors of dementia in an aging, rural Indian population.

The impact of the COVID-19 pandemic and associated lockdowns is likely to have caused adverse changes in lifestyle-related/cardiovascular risk factors and other such modifiable risk factors of dementia. We aimed to examine the pandemic's impact on some modifiable risk factors of dementia among rural Indians belonging to a large, prospective aging cohort-Srinivaspura Aging, NeuoSenescence, and COGnition (SANSCOG). This was a cross-sectional study among adults aged ≥ 45 years (n = 3,148; 1,492 males and 1,656 females) residing in the villages of Srinivaspura in Karnataka state, India. SANSCOG study data (clinical and biochemical assessments) of these participants were obtained from three distinct periods: (i) the "pre-COVID period"-before India's nationwide lockdown on 24 March 2020, (ii) the "COVID period"-during the first and second waves of the pandemic, wherein the social restrictions were prominent (25 March 2020 to 30 September 2021), and (iii) the "post-COVID period"-after easing of restrictions (from 1 October 2021 onward). Proportions of participants with diabetes, hypertension, obesity, dyslipidemia (diagnosed using standard criteria), and depression (diagnosed using the Geriatric Depression Scale) were compared between the above three periods. The odds of having obesity, abnormal triglycerides, and depression among individuals in the COVID period were 1.42 times, 1.38 times, and 2.65 times more than the odds in the pre-COVID period, respectively. The odds of having hypertension, obesity, abnormal total cholesterol, abnormal triglycerides, abnormal LDL, and depression among individuals in the post-COVID period were 1.27 times, 1.32 times, 1.58 times, 1.95, 1.23, and 3.05 times more than the odds in the pre-COVID period, respectively. The odds of diabetes did not differ between any of the three periods. We found significantly higher odds of some of the studied risk factors in the COVID and post-COVID periods compared to the pre-COVID period, suggesting that the pandemic adversely impacted the physical and psychological health of this marginalized, rural Indian population. We call for urgent public health measures, such as multimodal, lifestyle-based, and psychosocial interventions, to mitigate this negative impact and reduce the future risk of dementia.

Hearing Loss and Dementia: A Population-Based Cohort Study

Introduction: Hearing loss (HL) is considered a potentially modifiable risk factor for dementia. We aimed to examine the relationship between HL and incident dementia diagnosis in a province-wide population-based cohort study with matched controls. Methods: Administrative healthcare databases were linked to generate a cohort of patients who were aged ≥40 years at their first claimed hearing amplification devices (HAD) between April 2007 and March 2016 through the Assistive Devices Program (ADP) (257,285 with claims and 1,005,010 controls). The main outcome was incident dementia diagnosis, ascertained using validated algorithms. Dementia incidence was compared between cases and controls using Cox regression. Patient, disease, and other risk factors were examined. Results: Dementia incidence rates (per 1,000 person-years) were 19.51 (95% confidence interval [CI]: 19.26–19.77) and 14.15 (95% CI: 14.04–14.26) for the ADP claimants and matched controls, respectively. In adjusted analyses, risk of dementia was higher in ADP claimants compared with controls (hazard ratio [HR]: 1.10 [95% CI: 1.09–1.12, p < 0.001]). Subgroup analyses showed a dose-response gradient, with risk of dementia higher among patients with bilateral HADs (HR: 1.12 [95% CI: 1.10–1.14, p < 0.001]), and an exposure-response gradient, with increasing risk over time from April 2007-March 2010 (HR: 1.03 [95% CI: 1.01–1.06, p = 0.014]), April 2010-March 2013 (HR: 1.12 [95% CI: 1.09–1.15, p < 0.001]), and April 2013-March 2016 (HR: 1.19 [95% CI: 1.16–1.23, p < 0.001]). Conclusion: In this population-based study, adults with HL had an increased risk of being diagnosed with dementia. Given the implications of HL on dementia risk, understanding the effect of hearing interventions merits further investigation.

Managing comorbid cognitive impairment and hearing loss in older adults: a UK survey of audiology and memory services.

midlife hearing loss is a potentially modifiable risk factor for dementia. Addressing comorbid hearing loss and cognitive impairment in services for older adults may offer opportunities to reduce dementia risk. to explore current practice and views amongst UK professionals regarding hearing assessment and care in memory clinics and cognitive assessment and care in hearing aid clinics. national survey study. Between July 2021 and March 2022, we distributed the online survey link via email and via QR codes at conferences to professionals working in National Health Service (NHS) memory services and audiologists working in NHS and private adult audiology services. We present descriptive statistics. 135 professionals working in NHS memory services and 156 audiologists (68% NHS, 32% private sector) responded. Of those working in memory services, 79% estimate that >25% of their patients have significant hearing difficulties; 98% think it useful to ask about hearing difficulties and 91% do so; 56% think it useful to perform a hearing test in clinic but only 4% do so. Of audiologists, 36% estimate that >25% of their older adult patients have significant memory problems; 90% think it useful to perform cognitive assessments, but only 4% do so. Main barriers cited are lack of training, time and resources. although professionals working in memory and audiology services felt addressing this comorbidity would be useful, current practice varies and does not generally address it. These results inform future research into operational solutions to integrating memory and audiology services.

Cataract, Cataract Surgery, and Risk of Incident Dementia: A Prospective Cohort Study of 300,823 Participants

BackgroundVisual impairment and interventions to preserve vision may impact dementia risk. Thus, we aimed to explore the associations of cataract and cataract surgery with the risk of dementia. MethodsProspective data from 300,823 individuals in the UK Biobank were used. We used multivariate Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals for associations, with healthy control subjects as a reference. The same method was used to explore the effects of surgery on dementia outcomes of patients with cataract. One-way analysis of variance was performed to examine the associations between cataract and brain morphometric measures. ResultsAfter a mean follow-up of 8.4 years, 3226 individuals were diagnosed with dementia. The nonsurgical cataract group had increased risk of all-cause dementia (HR, 1.214; 95% CI, 1.012–1.456; p = .037) and Alzheimer’s disease (HR, 1.479; 95% CI, 1.105–1.981; p = .009). However, there was no difference in dementia risk between the cataract surgery group and the healthy control group. Cataract surgery was associated with decreased risk of all-cause dementia (HR, 0.632; 95% CI, 0.421–0.947; p = .026) and Alzheimer’s disease (HR, 0.399; 95% CI, 0.196–0.812; p = .011) compared with the nonsurgical group. Additionally, cataract was negatively associated with cortical volumes, aging-related subcortical volumes, and fractional anisotropy of white matter fibers. ConclusionsCataract patients who did not receive surgical treatment had an increased risk of dementia. However, cataract surgery could reverse the risk of dementia. Our findings on brain structures and pathways in patients with cataract also provided evidence for the mechanism. Reversible visual impairment, such as cataract, is a promising modifiable risk factor for dementia.

What does the population know about risk and protective factors for dementia? An international review of the current state of knowledge in various countries

The scientific state of knowledge on modifiable risk factors for dementia has greatly improved in recent years. The established risk and protective factors include physical and social inactivity, hypertension, diabetes mellitus, excessive alcohol consumption and smoking; however, it is assumed that this knowledge is so far insufficiently disseminated among the general population, indicating untapped potential for primary prevention of dementia. To assess the state of knowledge on established risk and protective factors for dementia in the general population. Based on a systematic literature search in the PubMed database, international studies that investigated the knowledge on modifiable risk and/or protective factors for dementia in samples from the general population were identified. A total of 21publications were included in the review. The majority of publications (n = 17) collated risk and protective factors using closed questions, while n = 4studies used open questions. Lifestyle factors, e.g. cognitive, social and physical activity, were most frequently named as protective against dementia. Furthermore, many participants recognized depression as arisk factor for dementia. Knowledge of cardiovascular risk constellations for dementia, such as hypertension, hypercholesterolemia or diabetes mellitus were much less known among the participants. The results indicate that there is a need for a targeted clarification of the role of pre-existing cardiovascular diseases as risk factors for dementia. Studies assessing the state of knowledge on social and environmental risk and protective factors for dementia are currently scarce.

Alcohol use, dementia risk, and sex: a systematic review and assessment of alcohol-attributable dementia cases in Europe

BackgroundHigh-risk alcohol use is an established modifiable risk factor for dementia. However, prior reviews have not addressed sex differences in alcohol-related dementia risk. In this systematic review, we take a sex-specific perspective towards the alcohol-dementia link, taking into account the age of dementia onset.MethodsWe searched electronic databases for original cohort or case–control studies investigating the association between alcohol use and dementia. Two restrictions were considered: First, studies had to report results stratified by sex. Second, given the fact that the age at dementia onset seems to affect the alcohol-dementia link, studies were required to distinguish between early-onset and late-onset dementia (cut-off: 65 years). Additionally, the contribution of alcohol to dementia incidence was quantified for a set of 33 European countries for the year 2019.ResultsWe reviewed 3,157 reports, of which 7 publications were finally included and summarised narratively. A lower dementia risk when drinking alcohol infrequent or at moderate levels was found in men (three studies) and women (four studies). High-risk use and alcohol use disorders increased the risk of mild cognitive impairment and dementia, particularly early-onset dementia. Estimating the alcohol-attributable share of incident dementia cases revealed that 3.2% and 7.8% of incident dementia cases were estimated to be attributable to high-risk alcohol use (at least 24 g of pure alcohol per day) in 45-to-64-year-old women and men, respectively.ConclusionsResearch to date has paid little attention to the sex-specific link of alcohol and dementia. In the absence of sex-specific research, the established recommendations on high-risk alcohol use should be employed to communicate the alcohol-attributable dementia risk.

Severe Obesity in Women Can Lead to Worse Memory Function and Iron Dyshomeostasis Compared to Lower Grade Obesity

Obesity is one of the modifiable risk factors for dementia. Insulin resistance, the abundance of advanced glycated end-products, and inflammation are some of the mechanisms associated with the lower cognitive performance observed in obesity. This study aims to evaluate the cognitive function of subjects with distinct degrees of obesity, comparing class I and II obesity (OBI/II) to class III obesity (OBIII), and to investigate metabolic markers that can distinguish OBIII from OBI/II. Study Design. This is a cross-sectional study, in which 45 females with BMI varying from 32.8 to 51.9 kg/m2 completed a set of 4 cognitive tests (verbal paired-associate test, stroop color, digit span, and Toulouse-Pieron cancellation test) and their plasma metabolites, enzymes, and hormones related to glycemia, dyslipidemia, and liver function, as well as the biomarkers of iron status, were concomitantly analyzed. OBIII showed lower scores in the verbal paired-associate test compared to OBI/II. In other cognitive tests, both groups showed similar performance. OBIII presented a lower iron status compared to OBI/II based on total iron binding capacity, degree of transferrin saturation, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin. The levels of indicators for glycemia, liver function, and lipid metabolism were similar in both groups. Analysis of plasma metabolites showed that OBIII had lower levels of pyroglutamic acid, myoinositol, and aspartic acid and higher levels of D-ribose than OBI/II. Iron is an essential micronutrient for several metabolic pathways. Thus, iron dyshomeostasis observed in severe obesity may aggravate the cognitive impairment by altering metabolic homeostasis and enhancing oxidative stress. These findings can contribute to searching for biomarkers that indicate cognitive performance in the population with obesity.

Validation of the CogDrisk Instrument as Predictive of Dementia in Four General Community-Dwelling Populations

BackgroundLack of external validation of dementia risk tools is a major limitation for generalizability and translatability of prediction scores in clinical practice and research.ObjectivesWe aimed to validate a new dementia prediction risk tool called CogDrisk and a version, CogDrisk-AD for predicting Alzheimer’s disease (AD) using cohort studies.Design, Setting, Participants and MeasurementsFour cohort studies were identified that included majority of the dementia risk factors from the CogDrisk tool. Participants who were free of dementia at baseline were included. The predictors were component variables in the CogDrisk tool that include self-reported demographics, medical risk factors and lifestyle habits. Risk scores for Any Dementia and AD were computed and Area Under the Curve (AUC) was assessed. To examine modifiable risk factors for dementia, the CogDrisk tool was tested by excluding age and sex estimates from the model.ResultsThe performance of the tool varied between studies. The overall AUC and 95% CI for predicting dementia was 0.77 (0.57, 0.97) for the Swedish National study on Aging and Care in Kungsholmen, 0.76 (0.70, 0.83) for the Health and Retirement Study - Aging, Demographics and Memory Study, 0.70 (0.67,0.72) for the Cardiovascular Health Study Cognition Study, and 0.66 (0.62,0.70) for the Rush Memory and Aging Project.ConclusionsThe CogDrisk and CogDrisk-AD performed well in the four studies. Overall, this tool can be used to assess individualized risk factors of dementia and AD in various population settings.

Prevention and health promotion in dementia: motivation for change within preventive interventions-Empirical results

Aging healthily and prevention of diseases are statutory and a national health target. There is convincing evidence that describes the modifiable risk factors, which are principally suitable for preventive measures. Definition of terms, presentation of the roots of prevention in laws, strategies and guidelines. Presentation of the risk factors for dementia, outline of effective preventive measures and their promising components. Prevention is systematically described. The available evidence on risk factors, health behavior and preventive measures is analyzed. A multimodal intervention is presented and the influence of motivation on a change in behavior is outlined, exemplified by physical activity. Aging healthily is a national health target and prevention of disease is rooted and defined in both the legislation and guidelines. The current evidence on modifiable risk factors for dementia originates from 12 factors. These include behavior-associated factors, such as inactivity, diabetes and smoking. The efficacy of preventive measures can be described by their effectiveness, the utilization when available and the principal availability for all people for whom they are indicated. Changing a health behavior is complex and dependent among other things on the motivation to want to change a behavior. Currently, multimodal prevention programs appear to be very promising for the prevention of cognitive disorders and dementia.

Cognitive reserve and dementia risk management in people with an intellectual disability.

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Cognitive activity at work and the risk of dementia.

Dementia prevalence is projected to rise steeply in coming decades, producing tremendous burdens on families, and health and social services. Motivated by the need for further robust evidence on modifiable risk factors, we investigate the relationship between cognitive activity at work and later-life dementia. Using data from the US Health and Retirement Study matched to the O*NET occupational database, we find that a one standard deviation increase in the cognitive activity associated with one's longest held occupation is associated with a 0.9 percentage point reduction in (predicted) dementia, or a 24% reduction relative to the mean. This relationship is consistently found across model specifications and robustness tests. When controlling for individual fixed-effects we find that the association between dementia and work cognitive activity increases with age. Overall, our results provide some evidence in support of the inclusion of cognitive activity at work as a recognized modifiable risk factor for dementia.

Preventive Strategies for Cognitive Decline and Dementia: Benefits of Aerobic Physical Activity, Especially Open-Skill Exercise.

As there is no curative treatment for dementia, including Alzheimer's disease (AD), it is important to establish an optimal nonpharmaceutical preventive intervention. Physical inactivity is a representative modifiable risk factor for dementia, especially for AD in later life (>65 years). As physical activity and exercise are inexpensive and easy to initiate, they may represent an effective nonpharmaceutical intervention for the maintenance of cognitive function. Several studies have reported that physical activity and exercise interventions are effective in preventing cognitive decline and dementia. This review outlines the effects of physical activity and exercise-associated interventions in older adults with and without cognitive impairment and subsequently summarizes their possible mechanisms. Furthermore, this review describes the differences between two types of physical exercise-open-skill exercise (OSE) and closed-skill exercise (CSE)-in terms of their effects on cognitive function. Aerobic physical activity and exercise interventions are particularly useful in preventing cognitive decline and dementia, with OSE exerting a stronger protective effect on cognitive functions than CSE. Therefore, the need to actively promote physical activity and exercise interventions worldwide is emphasized.

Blood pressure and dementia risk by physical frailty in the elderly: a nationwide cohort study

BackgroundMidlife hypertension has been recognized as a modifiable risk factor for dementia, but association between blood pressure (BP) in late life and dementia has been inconclusive. In addition, few studies have investigated effects of BP control on dementia incidence in the frail elderly. Thus, this study aimed to investigate the association of BP and dementia incidence with concomitant consideration of physical frailty in the young elderly population.MethodsUsing the Korean National Health Information Database, we identified 804,024 subjects without history of dementia at age 66. Dementia diagnosis was defined with prescription records of anti-dementia drugs and dementia-related diagnostic codes. Physical frailty was measured using the Timed Up and Go test. Association of BP and dementia incidence with concomitant consideration of physical frailty was investigated using Cox hazards analyses.ResultsThe risks of Alzheimer’s and vascular dementia increased from systolic BP ≥ 160 and 130–139 mmHg, respectively; a significant association of dementia incidence with low BP was not observed. In the analyses stratified by the physical frailty status, low BP was not associated with increased risks of dementia within the groups both with and without physical frailty.ConclusionsHigh BP was associated with increased risks of dementia, especially for vascular dementia, while low BP was not associated with increased risks of any type of dementia in young elderly people, even in those with physical frailty. This study suggests the need for tight BP control in young elderly people, irrespective of frailty status, to prevent dementia and supports the current clinical guidelines of hypertension treatment.

Potential for prevention of dementia in Denmark.

According to previous estimates, 40% of dementia cases globally may be attributed to 12 potentially modifiable risk factors. We 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. The 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. Estimates 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. 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.

Elevated late-life blood pressure may maintain brain oxygenation and slow amyloid-β accumulation at the expense of cerebral vascular damage.

Hypertension in midlife contributes to cognitive decline and is a modifiable risk factor for dementia. The relationship between late-life hypertension and dementia is less clear. We have investigated the relationship of blood pressure and hypertensive status during late life (after 65 years) to post-mortem markers of Alzheimer's disease (amyloid-β and tau loads); arteriolosclerosis and cerebral amyloid angiopathy; and to biochemical measures of ante-mortem cerebral oxygenation (the myelin-associated glycoprotein:proteolipid protein-1 ratio, which is reduced in chronically hypoperfused brain tissue, and the level of vascular endothelial growth factor-A, which is upregulated by tissue hypoxia); blood-brain barrier damage (indicated by an increase in parenchymal fibrinogen); and pericyte content (platelet-derived growth factor receptor β, which declines with pericyte loss), in Alzheimer's disease (n = 75), vascular (n = 20) and mixed dementia (n = 31) cohorts. Systolic and diastolic blood pressure measurements were obtained retrospectively from clinical records. Non-amyloid small vessel disease and cerebral amyloid angiopathy were scored semiquantitatively. Amyloid-β and tau loads were assessed by field fraction measurement in immunolabelled sections of frontal and parietal lobes. Homogenates of frozen tissue from the contralateral frontal and parietal lobes (cortex and white matter) were used to measure markers of vascular function by enzyme-linked immunosorbent assay. Diastolic (but not systolic) blood pressure was associated with the preservation of cerebral oxygenation, correlating positively with the ratio of myelin-associated glycoprotein to proteolipid protein-1 and negatively with vascular endothelial growth factor-A in both the frontal and parietal cortices. Diastolic blood pressure correlated negatively with parenchymal amyloid-β in the parietal cortex. In dementia cases, elevated late-life diastolic blood pressure was associated with more severe arteriolosclerosis and cerebral amyloid angiopathy, and diastolic blood pressure correlated positively with parenchymal fibrinogen, indicating blood-brain barrier breakdown in both regions of the cortex. Systolic blood pressure was related to lower platelet-derived growth factor receptor β in controls in the frontal cortex and in dementia cases in the superficial white matter. We found no association between blood pressure and tau. Our findings demonstrate a complex relationship between late-life blood pressure, disease pathology and vascular function in dementia. We suggest that hypertension helps to reduce cerebral ischaemia (and may slow amyloid-β accumulation) in the face of increasing cerebral vascular resistance, but exacerbates vascular pathology.

Beneficial and Impeding Factors for the Implementation of Health-Promoting Lifestyle Interventions-A Gender-Specific Focus Group Study.

(1) Background: The prevalence of dementia increases and so does the number of interventions that address modifiable risk factors for dementia. Recent evidence suggests that there are gender differences in the prevalence of those lifestyle factors as well as in the effectiveness of interventions. This study aims to identify differences in factors that benefit or hinder the effectiveness of interventions since a target group's perspective gets more relevant. (2) Methods: Two focus groups, a female (n = 11) and a male (n = 8) group, were interviewed, audio recorded and transcribed. Qualitative analyses were performed and main- and subcategories were identified. (3) Results: Main differences were observed including aspects of lifestyle changes (e.g., respective diet and importance of an active lifestyle) and gender-typical behavior and perception by relevant healthcare actors. (4) Conclusions: Identified differences might help to address and raise the efficiency of lifestyle interventions. Further, the importance of social aspects and retirement as an auspicious moment to start interventions were identified as relevant by study participants.

Contributions of modifiable risk factors to increased dementia risk in depression

AbstractBackgroundIndividuals with depression have an increased dementia risk, which might be due to modifiable risk factors for dementia. This study investigated the extent to which the increased risk for dementia in depression is explained by modifiable dementia risk factors.MethodsWe used data from the English Longitudinal Study of Ageing (2008–2009 to 2018–2019), a prospective cohort study. A total of 7460 individuals were included [mean(standard deviation) age, 65.7 ± 9.4 years; 3915(54.7%) were women]. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale-8 (score ≥3) or self-reported doctor's diagnosis. Ten modifiable risk factors for dementia were combined in the ‘LIfestyle for BRAin health’ (LIBRA) score. Dementia was determined by physician diagnosis, self-reported Alzheimer's disease or the shortened version of the Informant Questionnaire on Cognitive Decline in the Elderly (average score ≥3.38). Structural equation modelling was used to test mediation of LIBRA score.ResultsDuring 61 311 person-years, 306 individuals (4.1%) developed dementia. Participants aged 50–70 years with depressive symptoms had higher LIBRA scores [difference(s.e.) = 1.15(0.10)] and a 3.59 times increased dementia risk [HR(95% CI) = 3.59(2.20–5.84)], adjusted for age, sex, education, wealth and clustering at the household level. In total, 10.4% of the dementia risk was mediated by differences in LIBRA score [indirect effect: HR = 1.14(1.03–1.26)], while 89.6% was attributed to a direct effect of depressive symptoms on dementia risk [direct effect: HR = 3.14(2.20–5.84)].ConclusionsModifiable dementia risk factors can be important targets for the prevention of dementia in individuals with depressive symptoms during midlife. Yet, effect sizes are small and other aetiological pathways likely exist.

Associations of healthy lifestyle with depression and post-depression dementia: A prospective cohort study

BackgroundDepressive symptoms may be a risk factor or prodrome of dementia, but the modifiable risk factors for dementia after onset of depression has not been fully elucidated. The current study aimed to investigate the associations of lifestyle factors with depression and post-depression dementia. MethodsOur analysis was based on data from the ongoing UK Biobank study, which included 497,533 participants (age 37–73 years) between 2006 and 2010, and thereafter followed up to 2020. High-risk lifestyle factors included current smoking, heavy alcohol intaking, poor diet pattern, physically inactive. Multistate models were used to estimate the transition-specific hazard ratios (HRs) and 95 % confidence intervals (CIs). ResultsDuring a 14.8-year follow-up, 23,164 participants developed depression, and 989 developed post-depression dementia. The incidence rate of dementia in people with depression was far more than those who were free of depression. In multistate model, high-risk lifestyle factors were substantially associated with higher risks of incident depression (HR = 2.14, 95 % CI: 1.95–2.35), dementia (HR = 1.87, 95 % CI: 1.51–2.31), and post-depression dementia (HR = 1.72, 95 % CI: 1.13–2.62). When the analyses were divided by individual lifestyle factors, we found that only physically inactive contributed significantly to the development of dementia after the onset of depression (HR = 1.15, 95 % CI: 1.01–1.30). ConclusionOur study found that high-risk lifestyle factors were associated with higher risk of transition from depression to dementia, highlighting the great significance of integrating comprehensive behavioral interventions, particularly for regular physical activity, for prevention of both depression and post-depression dementia.

Examining the Lancet Commission risk factors for dementia using Mendelian randomisation

BackgroundDementia incidence is increasing across the globe and currently there are no disease-modifying pharmaceutical treatments. The Lancet Commission on dementia identified 12 modifiable risk factors which explain 40% of dementia...

Examination of potentially modifiable dementia risk factors across the adult life course: The Framingham Heart Study.

We examined for associations between potentially modifiable risk factors across the adult life course and incident dementia. Participants from the Framingham Heart Study were included (n=4015). Potential modifiable risk factors included education, alcohol intake, smoking, body mass index (BMI), physical activity, social network, diabetes, and hypertension. Cox models were used to examine associations between each factor and incident dementia, stratified by early adult life (33-44 years), midlife (45-65 years), and late life (66-80 years). Increased dementia risk was associated with diabetes (hazard ratio [HR]=1.62; 95% confidence interval [CI]=1.07-2.46) and physical inactivity (HR=1.57; 95% CI=1.12-2.20) in midlife, and with obesity (HR=1.76; 95% CI=1.08-2.87) in late life. Having multiple potential modifiable risk factors in midlife and late life was associated with greater risk. Potentially modifiable risk factors individually have limited impact on dementia risk in this population across the adult life course, although in combination they may have a synergistic effect. Diabetes and physical inactivity in midlife is associated with increased dementia risk. Obesity in late life is associated with increased dementia risk. Having more potentially modifiable risk factors in midlife and late life is associated with greater dementia risk.