Karway George K, Krzyzanowski Brittany, Killion Jordan A, Faust Irene M, Laurido-Soto Osvaldo J, Sabbagh Marwan N, Racette Brad A
Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA.
Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA.
Alzheimers Dement. 2025 May;21(5):e70199. doi: 10.1002/alz.70199.
Understanding the impact of cardiometabolic diseases (CMDs) on dementia risk can inform primary preventative measures.
We leveraged a nationwide, population-based Medicare dataset of 20,789,037 beneficiaries (756,321 with incident dementia and 20,032,716 controls) from 2017 to compute the individual and combined population attributable fractions (PAFs) of dementia attributed to eight CMDs, adjusted for age, sex, and race. We mapped PAFs at the county level to investigate the geospatial patterns of CMD burden on dementia across the United States.
The nationwide combined weighted PAF for the eight CMDs was 37% overall, with hypertension (9.6%), ischemic heart disease (6.7%), and chronic heart failure (5.7%) associated with the greatest attributable fractions of dementia cases. The greatest fraction of county-level dementia cases attributed to CMDs were in the Southeastern United States.
A substantial proportion of incident dementia cases in the United States can be attributed to CMDs, especially in the Southeastern United States.
Investigated the combined effect of cardiometabolic diseases (CMDs) on dementia. Used novel geospatial techniques to map the burden of dementia attributed to CMDs. If eight CMDs are mitigated, 37% of incident dementia cases could be eliminated. Identified regions of the United States with high CMD burden on dementia.
了解心脏代谢疾病（CMD）对痴呆症风险的影响可为一级预防措施提供依据。
我们利用了2017年全国范围内基于人群的医疗保险数据集，该数据集包含20,789,037名受益人（756,321名患有新发痴呆症，20,032,716名对照），以计算归因于八种CMD的痴呆症的个体和综合人群归因分数（PAF），并对年龄、性别和种族进行了调整。我们在县一级绘制了PAF，以调查美国各地CMD负担对痴呆症的地理空间模式。
八种CMD的全国综合加权PAF总体为37%，其中高血压（9.6%）、缺血性心脏病（6.7%）和慢性心力衰竭（5.7%）与痴呆症病例的最大归因分数相关。归因于CMD的县级痴呆症病例比例最高的地区在美国东南部。
在美国，相当一部分新发痴呆症病例可归因于CMD，尤其是在美国东南部。
研究了心脏代谢疾病（CMD）对痴呆症的综合影响。使用新颖的地理空间技术绘制归因于CMD的痴呆症负担图。如果减轻八种CMD，37%的新发痴呆症病例可以消除。确定了美国痴呆症CMD负担高的地区。
