Mona Ageing and Wellness Centre, University of the West Indies, Kingston, Jamaica.
J Alzheimers Dis. 2020;78(2):603-609. doi: 10.3233/JAD-200601.
Dementia has no known cure and age is its strongest predictor. Given that populations in the Caribbean are aging, a focus on policies and programs that reduce the risk of dementia and its risk factors is required.
To estimate the proportion of dementia in the Jamaican setting attributable to key factors.
We analyzed the contribution of five modifiable risk factors to dementia prevalence in Jamaica using a modified Levin's Attributable Risk formula (low educational attainment, diabetes, smoking status, depression, and physical inactivity). Four sources of data were used: risk factor prevalence was obtained from the Jamaica Health and Lifestyle Survey, 2008, relative risk data were sourced from published meta-analyses, shared variance among risk factors was determined using cross-sectional data from the Health and Social Status of Older Persons in Jamaica Study. Estimated future prevalence of dementia in Jamaica was sourced from a published ADI/BUPA report which focused on dementia in the Americas. We computed the number of dementia cases attributable to each risk factor and estimated the effect of a reduction in these risk factors on future dementia prevalence.
Accounting for the overlapping of risk factors, 34.46% of dementia cases in Jamaica (6548 cases) were attributable to the five risk factors under study. We determined that if each risk factor were to be reduced by 5% -10% per decade from 2010-2050, dementia prevalence could be reduced by up to 14.0%.
As the risk factors for dementia are shared with several of the main causes of death in Jamaica, a reduction in risk factors by even 5% can result in considerable public health benefit.
痴呆症尚无已知的治愈方法，年龄是其最强的预测因素。鉴于加勒比地区的人口正在老龄化，需要关注可以降低痴呆症及其风险因素风险的政策和计划。
估计在牙买加环境中导致痴呆症的主要因素所占的比例。
我们使用改良的 Levin 归因风险公式（受教育程度低、糖尿病、吸烟状况、抑郁和身体活动不足）分析了五个可改变的风险因素对牙买加痴呆症患病率的贡献。使用了四个来源的数据：风险因素的患病率来自 2008 年的牙买加健康和生活方式调查，相对风险数据来自已发表的荟萃分析，使用来自牙买加老年人健康和社会地位研究的横断面数据确定风险因素之间的共享方差。估计未来牙买加痴呆症的患病率来自一份已发表的 ADI/BUPA 报告，该报告专注于美洲的痴呆症。我们计算了每个风险因素归因于痴呆症的病例数，并估计了这些风险因素的减少对未来痴呆症患病率的影响。
考虑到风险因素的重叠，牙买加 34.46%（6548 例）的痴呆症病例归因于研究中的五个风险因素。我们确定，如果每个风险因素从 2010 年至 2050 年每十年减少 5%-10%，痴呆症的患病率最多可降低 14.0%。
由于痴呆症的风险因素与牙买加的几种主要死因重叠，如果风险因素减少 5%，就可以带来相当大的公共卫生效益。
