Gulle Bugra Taygun, Tozduman Busra
Izmir Provincial Health Directorate, Public Health Services Department, Izmir, Turkey.
Dokuz Eylul University, Faculty of Medicine, Department of Public Health, Division of Epidemiology, Izmir, Turkey.
Dementia (London). 2025 Jun 29:14713012251357162. doi: 10.1177/14713012251357162.
Dementia affects approximately 55 million people globally, with modifiable risk factors contributing significantly to its prevalence. While global studies have explored these factors, no research has applied the Lancet Commission's framework to the Turkish population. This study aims to estimate the population attributable fractions (PAFs) of 14 modifiable dementia risk factors in Turkey, using the updated 2024 Lancet Commission framework. Data from the 2022 Turkey Health Survey, a nationally representative dataset, were used to calculate prevalences. The 14 risk factors were categorized into early life (low education), midlife (e.g., physical inactivity, obesity, depression), and later life (e.g., social isolation, air pollution, untreated vision loss). PAFs were computed using relative risks from meta-analyses and the Lancet Commission report. Principal Component Analysis and communalities were applied to account for intercorrelations between factors. The overall weighted PAF for Turkey was 49.9%, indicating that nearly half of dementia cases could be prevented through targeted interventions. Physical inactivity was the leading midlife factor, while social isolation and low education were the most significant contributors in later and early life stages, respectively. Gender-specific analysis revealed higher PAFs in women (54.2%) compared to men (44.3%), driven by differences in physical inactivity, depression, and social isolation. This study highlights the significant preventable burden of dementia in Turkey and underscores the importance of culturally tailored, gender-sensitive interventions. Addressing modifiable risk factors, particularly physical inactivity and social isolation, is critical to reducing dementia prevalence and informing public health strategies.
痴呆症在全球约影响5500万人，可改变的风险因素对其患病率有重大影响。虽然全球研究已探讨了这些因素，但尚无研究将《柳叶刀》委员会的框架应用于土耳其人群。本研究旨在使用更新后的2024年《柳叶刀》委员会框架，估算土耳其14种可改变的痴呆症风险因素的人群归因分数（PAF）。来自具有全国代表性的数据集——2022年土耳其健康调查的数据用于计算患病率。这14种风险因素被分为早年（低教育程度）、中年（如缺乏身体活动、肥胖、抑郁）和晚年（如社会孤立、空气污染、未治疗的视力丧失）。PAF使用荟萃分析和《柳叶刀》委员会报告中的相对风险进行计算。应用主成分分析和共同度来解释因素之间的相互关系。土耳其的总体加权PAF为49.9%，这表明通过有针对性的干预措施，近一半的痴呆症病例可以得到预防。缺乏身体活动是主要的中年因素，而社会孤立和低教育程度分别是晚年和早年阶段的最重要因素。按性别分析显示，女性的PAF（54.2%）高于男性（44.3%），这是由缺乏身体活动、抑郁和社会孤立方面的差异导致的。本研究凸显了土耳其痴呆症可预防的重大负担，并强调了文化上量身定制、对性别敏感的干预措施的重要性。解决可改变的风险因素，特别是缺乏身体活动和社会孤立，对于降低痴呆症患病率和为公共卫生战略提供信息至关重要。
