School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China.
CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
Eur J Epidemiol. 2023 Jan;38(1):83-93. doi: 10.1007/s10654-022-00952-8. Epub 2023 Jan 3.
Dementia constitutes a worldwide concern. To characterize the age- and sex-specific modifiable risk factor profiles of dementia, we included 497,401 UK Biobank participants (mean age = 56.5 years) without dementia at baseline (2006-2010) and followed them until March 2021. Cox proportional hazard models were used to estimate the age- and sex-specific hazard ratios (HRs) of incident dementia associated with socioeconomic (less education and high Townsend deprivation index), lifestyle (non-moderate alcohol intake, current smoking, suboptimal diet, physical inactivity, and unhealthy sleep duration), and health condition factors (hypertension, diabetes, cardiovascular diseases, and depressive symptoms). We also calculated the population attributable fractions (PAFs) of these factors. During follow-up (mean = 11.6 years), we identified 6564 dementia cases. HRs for the risk factors were similar between the sexes, while most factors showed stronger associations among younger participants. For example, the HRs of smoking were 1.74 (95% CI: 1.23, 2.47) for individuals aged < 50 years, and 1.18 (1.05, 1.33) for those aged ≥ 65 years. Overall, 46.8% (37.4%, 55.2%) of dementia cases were attributable to the investigated risk factors. The PAFs of the investigated risk factors also decreased with age, but that for health condition risk factors decreased with lower magnitude than socioeconomic and lifestyle risk factors. The stronger associations and greater PAFs of several modifiable risk factors for dementia among younger adults than older participants underscored the importance of dementia prevention from an earlier stage across the adult life course.
痴呆症是一个全球性的问题。为了描述痴呆症的年龄和性别特异性可改变风险因素特征，我们纳入了 497401 名无痴呆症的英国生物库参与者（平均年龄为 56.5 岁），这些参与者在基线时（2006-2010 年）没有痴呆症，并随访至 2021 年 3 月。我们使用 Cox 比例风险模型来估计与社会经济因素（受教育程度较低和高汤森贫困指数）、生活方式（非适度饮酒、当前吸烟、饮食不佳、缺乏身体活动和不健康的睡眠时间）和健康状况因素（高血压、糖尿病、心血管疾病和抑郁症状）相关的痴呆症发病的年龄和性别特异性风险比（HR）。我们还计算了这些因素的人群归因分数（PAF）。在随访期间（平均为 11.6 年），我们确定了 6564 例痴呆症病例。风险因素的 HR 在性别之间相似，而大多数因素在年轻参与者中表现出更强的关联。例如，吸烟的 HR 对于年龄<50 岁的个体为 1.74（95%CI：1.23，2.47），对于年龄≥65 岁的个体为 1.18（1.05，1.33）。总体而言，46.8%（37.4%，55.2%）的痴呆症病例归因于所调查的风险因素。所调查的风险因素的 PAF 也随年龄的增加而降低，但健康状况风险因素的 PAF 降低幅度小于社会经济和生活方式风险因素。与年龄较大的参与者相比，年轻成年人的几个可改变的痴呆症风险因素具有更强的关联和更大的 PAF，这突显了从成年生命全程的早期开始进行痴呆症预防的重要性。
