Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
J Alzheimers Dis. 2022;89(2):563-570. doi: 10.3233/JAD-220278.
We recently estimated that 36.9% of Alzheimer's disease and related dementias (ADRD) cases in the US may be attributable to modifiable risk factors, but it is not known whether national estimates generalize to specific states or regions.
To compare national estimates of modifiable risk factors of ADRD to California, overall and by sex and race/ethnicity, and to estimate number of cases potentially preventable by reducing the prevalence of key risk factors by 25%.
Adults ≥18 years who participated in the Behavioral Risk Factor Surveillance Survey in California (n = 9,836) and the US (n = 378,615). We calculated population attributable risks (PARs) for eight risk factors (physical inactivity, current smoking, depression, low education, diabetes mellitus, midlife obesity, midlife hypertension, and hearing loss) and compared estimates in California and the U.S.
In California, overall, 28.9% of ADRD cases were potentially attributable to the combination of risk factors, compared to 36.9% in the U.S. The top three risk factors were the same in California and the U.S., although their relative importance differed (low education [CA:14.9%; U.S.:11.7% ], midlife obesity [CA:14.9%; U.S.:17.7% ], and physical inactivity [CA:10.3%; U.S.:11.8% ]). The number of ADRD cases attributable to the combined risk factors was 199,246 in California and 2,287,683 in the U.S. If the combined risk factors were reduced by 25%, we could potentially prevent more than 40,000 cases in California and 445,000 cases in the U.S.
Our findings highlight the importance of examining risk factors of ADRD regionally, and within sex and race/ethnic groups to tailor dementia risk reduction strategies.
我们最近估计，美国 36.9%的阿尔茨海默病及相关痴呆症（ADRD）病例可能归因于可改变的危险因素，但尚不清楚全国估计数是否适用于特定州或地区。
比较美国和加利福尼亚州可改变的 ADRD 危险因素的全国估计数，以及按性别和种族/族裔划分的估计数，并估计通过降低关键危险因素的流行率 25%可预防的病例数。
年龄≥18 岁，参加加利福尼亚州（n=9836）和美国（n=378615）行为风险因素监测调查的成年人。我们计算了 8 个危险因素（身体活动不足、当前吸烟、抑郁、低教育程度、糖尿病、中年肥胖、中年高血压和听力损失）的人群归因风险（PAR），并比较了加利福尼亚州和美国的估计数。
在加利福尼亚州，总体而言，28.9%的 ADRD 病例可能归因于危险因素的综合作用，而美国为 36.9%。加利福尼亚州和美国的前三大危险因素相同，但相对重要性不同（低教育程度[加利福尼亚州：14.9%；美国：11.7%]、中年肥胖[加利福尼亚州：14.9%；美国：17.7%]和身体活动不足[加利福尼亚州：10.3%；美国：11.8%]）。加利福尼亚州归因于综合危险因素的 ADRD 病例数为 199246 例，美国为 2287683 例。如果综合危险因素降低 25%，我们可能会在加利福尼亚州预防超过 40000 例，在美国预防超过 445000 例。
我们的研究结果强调了在区域内、按性别和种族/族裔群体检查 ADRD 危险因素的重要性，以便制定痴呆症风险降低策略。
