The most prominent modifiable risk factors for Alzheimer’s disease and related dementias (ADRD) in the US have changed over the past decade, with midlife obesity overtaking physical inactivity at the top of the list .
An analysis of data from 378,615 respondents to the 2018 US Behavioral Risk Factor Surveillance System annual survey assessed the relative contribution of 8 modifiable risk factors - physical inactivity, current smoking, depression, low educational attainment , diabetes, midlife obesity, midlife hypertension, and hearing loss—to the risk of ADRD.
About a third of cases of Alzheimer’s and related dementias (ADRD) were associated with a combination of these factors, with midlife obesity followed by physical inactivity and low educational attainment being the most prominent. In 2011, the most prominent risk factors were physical inactivity, depression and smoking.
Men had a higher proportion of ADRD cases associated with all 8 risk factors than women. The excess cases of ADRD due to the 8 modifiable risk factors were relatively higher among American Indians and Alaska Natives, blacks, and Hispanics compared with Asians and whites.
Obesity in midlife was the most important modifiable risk factor for American Indians and Alaska Natives, blacks and whites, while for Asians, physical inactivity and for Hispanics, low education, were the more important.
The authors wrote in JAMA Neurology that "Alzheimer’s risk reduction strategies may be more effective if they target higher risk groups and consider current risk factor profiles."
Key points Have modifiable risk factors associated with Alzheimer’s disease and related dementias (ADRD) changed in the US over the past decade, and do they differ by sex, race, and ethnicity? Findings In this cross-sectional study, the modifiable risk factors most prominently associated with ADRD were midlife obesity , physical inactivity, and low education. The proportion of ADRD cases associated with modifiable risk factors was higher in men and in American Indians and Alaska Natives, blacks, and Hispanics (any race) compared with Asians and whites. Meaning Findings suggest that the most prominent modifiable risk factors associated with ADRD have changed over the past decade and differed by sex, race, and ethnicity; Alzheimer’s risk reduction strategies may be more effective if they target higher risk groups and more prevalent risk factors. |
