Up to 44% of Dementia Diagnoses Attributable to Modifiable Vascular Risk Factors
Maintaining optimal vascular health throughout life may substantially reduce the risk of dementia before age 80 years, suggest study findings published in JAMA Neurology.
“In this cohort analysis including up to 12,274 participants with up to 33 years of follow-up, 22% to 44% of dementia risk by age 80 years could be attributed to vascular risk factors measured in midlife and early late life, after accounting for concurrence and interactions between risk factors,” wrote first author Jason R. Smith, PhD, ScM, of the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and study coauthors.
Participants in the study were from the Atherosclerosis Risk in Communities cohort, which was followed from 1987 through 2020. Researchers looked for the presence of modifiable vascular risk factors, including hypertension, diabetes, and smoking, among participants at various ages, and incident dementia by age 80 years. The analysis estimated fractions of incident dementia attributable to vascular risk factors.
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Among 7731 participants with risk factors measured at age 45 to 54 years, 801 developed dementia by age 80 years. Among 12,274 participants with risk factors measured at age 55 to 64 years, 995 developed dementia, according to the study. Among 6787 participants measured at age 65 to 74 years, 422 developed dementia,
Fractions of dementia by 80 years that were attributable to at least 1 vascular factor were an estimated 21.8% at age 45 to 54 years, 26.4% at age 55 to 64 years, and 44.0% at age 65 to 74 years.
Fractions attributable to vascular risk factors were even higher in certain groups. Attributable fractions ranged from 33.3% to 61.4% in apolipoprotein ε4 noncarriers age 55 years and older, 25.5% to 52.9% in self-identified Black individuals age 45 years and older, and 29.2% to 51.3% in female individuals age 55 years and older.
After age 80 years, the study found, fractions of incident dementia attributable to vascular risk factors fell to between 2% and 8%.
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