Martin Jissa, Gordon Emily Hannah, Reid Natasha, Hubbard Ruth Eleanor, Ward David Denston
Centre for Health Services Research, Faculty of Health, Medicine and Behavioural Sciences, Princess Alexandra Hospital, The University of Queensland, Woolloongabba, Queensland, Australia.
Australian Frailty Network, Level 2, Building 33, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Alzheimers Dement. 2025 Jul;21(7):e70506. doi: 10.1002/alz.70506.
We aimed to calculate population attributable fractions (PAFs) for incident dementia and examine sex differences in individuals with no cognitive impairment (NCI) or mild cognitive impairment (MCI).
Longitudinal data from the Rush University Memory and Aging Project (MAP) were analyzed. Cox proportional-hazards models were used to estimate covariate-adjusted hazard ratios for incident dementia and calculate weighted PAFs within each cognitive status/sex subgroup.
The analytical sample comprised 1481 NCI (76.7% female) and 515 MCI (69.7% female) participants. Overall PAFs were similar for NCI (18.2%) and MCI (18.6%) subgroups, however, sex differences were evident. Males had higher PAFs than females in both NCI (42.5% vs. 25.1%) and MCI (51.5% vs. 12.4%), with differing risk factor profiles.
These findings support the notion that dementia risk is modifiable after the onset of MCI and that the number of potentially preventable dementia cases may be higher in males than in females.
The proportion of potentially preventable dementia cases was similar for no cognitive impairment (NCI) and mild cognitive impairment (MCI) individuals. For both cognitive states, a higher proportion of potentially preventable dementia cases was observed in males compared to females. The profiles of modifiable risk factors contributing to dementia differed between males and females. Lifestyle related risk factors were more prominent contributors to preventable dementia in males. Psychosocial risk factors, such as depression and social isolation, were important contributors in females.
我们旨在计算新发痴呆症的人群归因分数(PAF),并研究无认知障碍(NCI)或轻度认知障碍(MCI)个体中的性别差异。
对拉什大学记忆与衰老项目(MAP)的纵向数据进行分析。采用Cox比例风险模型估计新发痴呆症的协变量调整风险比,并计算每个认知状态/性别亚组内的加权PAF。
分析样本包括1481名NCI参与者(女性占76.7%)和515名MCI参与者(女性占69.7%)。NCI(18.2%)和MCI(18.6%)亚组的总体PAF相似,然而,性别差异明显。在NCI(42.5%对25.1%)和MCI(51.5%对12.4%)中,男性的PAF均高于女性,且风险因素特征不同。
这些发现支持以下观点,即痴呆症风险在MCI发病后是可改变的,并且男性中潜在可预防的痴呆症病例数可能高于女性。
无认知障碍(NCI)和轻度认知障碍(MCI)个体中潜在可预防的痴呆症病例比例相似。对于这两种认知状态,男性中潜在可预防的痴呆症病例比例高于女性。导致痴呆症的可改变风险因素特征在男性和女性之间存在差异。与生活方式相关的风险因素在男性可预防痴呆症中是更突出的因素。心理社会风险因素,如抑郁和社会隔离,在女性中是重要因素。