Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
Medical Informatics, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
BMJ Open. 2021 Dec 20;11(12):e049918. doi: 10.1136/bmjopen-2021-049918.
Individuals with a parental family history (PFH) of dementia have an increased risk to develop dementia, regardless of genetic risks. The aim of this study is to investigate the association between a PFH of dementia and currently known modifiable risk factors for dementia among middle-aged individuals using propensity score matching (PSM).
A cross-sectional study.
A subsample of Lifelines (35-65 years), a prospective population-based cohort study in the Netherlands was used.
Fourteen modifiable risk factors for dementia and the overall Lifestyle for Brain Health (LIBRA) score, indicating someone's potential for dementia risk reduction (DRR).
The study population included 89 869 participants of which 10 940 (12.2%) had a PFH of dementia (mean (SD) age=52.95 (7.2)) and 36 389 (40.5%) without a PFH of dementia (mean (SD) age=43.19 (5.5)). Of 42 540 participants (47.3%), PFH of dementia was imputed. After PSM, potential confounding variables were balanced between individuals with and without PFH of dementia. Individuals with a PFH of dementia had more often hypertension (OR=1.19; 95% CI 1.14 to 1.24), high cholesterol (OR=1.24; 95% CI 1.18 to 1.30), diabetes (OR=1.26; 95% CI 1.11 to 1.42), cardiovascular diseases (OR=1.49; 95% CI 1.18 to 1.88), depression (OR=1.23; 95% CI 1.08 to 1.41), obesity (OR=1.14; 95% CI 1.08 to 1.20) and overweight (OR=1.10; 95% CI 1.05 to 1.17), and were more often current smokers (OR=1.20; 95% CI 1.14 to 1.27) and ex-smokers (OR=1.21; 95% CI 1.16 to 1.27). However, they were less often low/moderate alcohol consumers (OR=0.87; 95% CI 0.83 to 0.91), excessive alcohol consumers (OR=0.93; 95% CI 0.89 to 0.98), socially inactive (OR=0.84; 95% CI 0.78 to 0.90) and physically inactive (OR=0.93; 95% CI 0.91 to 0.97). Having a PFH of dementia resulted in a higher LIBRA score (RC=0.15; 95% CI 0.11 to 0.19).
We found that having a PFH of dementia was associated with several modifiable risk factors. This suggests that middle-aged individuals with a PFH of dementia are a group at risk and could benefit from DRR. Further research should explore their knowledge, beliefs and attitudes towards DRR, and whether they are willing to assess their risk and change their lifestyle to reduce dementia risk.
有痴呆家族病史（PFH）的个体发生痴呆的风险增加，无论遗传风险如何。本研究的目的是通过倾向评分匹配（PSM），调查中年个体 PFH 痴呆与目前已知的痴呆可改变风险因素之间的关联。
这是一项横断面研究。
使用 Lifelines（35-65 岁）的一个亚样本，这是荷兰一项前瞻性基于人群的队列研究。
14 个痴呆可改变风险因素和整体生活方式对大脑健康（LIBRA）评分，表明某人降低痴呆风险的潜力（DRR）。
研究人群包括 89869 名参与者，其中 10940 名（12.2%）有 PFH 痴呆（平均（SD）年龄=52.95（7.2）），36389 名（40.5%）无 PFH 痴呆（平均（SD）年龄=43.19（5.5））。在 42540 名参与者（47.3%）中，PFH 痴呆被推断。在 PSM 后，个体有和没有 PFH 痴呆之间的潜在混杂变量得到平衡。有 PFH 痴呆的个体更常见高血压（OR=1.19；95%CI 1.14-1.24）、高胆固醇（OR=1.24；95%CI 1.18-1.30）、糖尿病（OR=1.26；95%CI 1.11-1.42）、心血管疾病（OR=1.49；95%CI 1.18-1.88）、抑郁（OR=1.23；95%CI 1.08-1.41）、肥胖（OR=1.14；95%CI 1.08-1.20）和超重（OR=1.10；95%CI 1.05-1.17），并且更常见当前吸烟者（OR=1.20；95%CI 1.14-1.27）和前吸烟者（OR=1.21；95%CI 1.16-1.27）。然而，他们更常见低/中度饮酒者（OR=0.87；95%CI 0.83-0.91）、过度饮酒者（OR=0.93；95%CI 0.89-0.98）、社交不活跃者（OR=0.84；95%CI 0.78-0.90）和身体不活跃者（OR=0.93；95%CI 0.91-0.97）。有 PFH 痴呆会导致更高的 LIBRA 评分（RC=0.15；95%CI 0.11-0.19）。
我们发现 PFH 痴呆与几种可改变的风险因素有关。这表明有 PFH 痴呆的中年个体处于危险之中，可以从 DRR 中受益。进一步的研究应该探索他们对 DRR 的知识、信念和态度，以及他们是否愿意评估自己的风险并改变生活方式以降低痴呆风险。
