期刊
BMC MEDICINE
卷 13, 期 -, 页码 -出版社
BIOMED CENTRAL LTD
DOI: 10.1186/s12916-015-0377-5
关键词
Dementia; Epidemiology; Population attributable risk; Risk factors
资金
- Erasmus MC
- University Medical Center
- Erasmus University Rotterdam
- Netherlands Organisation of Scientific Research (NWO)
- Netherlands Organisation for Health Research and Development (ZonMW)
- Research Institute for Diseases in the Elderly
- Ministry of Education, Culture, and Science
- Ministry of Health, Welfare, and Sports
- European Commission (DG-XII)
- Municipality of Rotterdam
- NWO ZonMW [916.13.054]
- Netherlands Heart Foundation [2012 T008, 2009B102]
- Internationale Stichting Alzheimer Onderzoek [12533]
- Netherlands Consortium for Healthy Ageing (NCHA)
- NWO (ZonMw) [80-82500-98-10208]
- Netherlands Organisation for Scientific Research
- Netherlands Genomics Initiative
- Netherlands Ministry of Health
- European Commission
- Nestle Nutrition (Nestec Ltd.)
- Metagenics Inc.
- AXA
- Netherlands Organization for Health Research and Development [ZonMW: 916.13.054]
- Internationaal Parkinson Fonds
Background: Cardiovascular factors and low education are important risk factors of dementia. We provide contemporary estimates of the proportion of dementia cases that could be prevented if modifiable risk factors were eliminated, i.e., population attributable risk (PAR). Furthermore, we studied whether the PAR has changed across the last two decades. Methods: We included 7,003 participants of the original cohort (starting in 1990) and 2,953 participants of the extended cohort (starting in 2000) of the Rotterdam Study. Both cohorts were followed for dementia until ten years after baseline. We calculated the PAR of overweight, hypertension, diabetes mellitus, cholesterol, smoking, and education. Additionally, we assessed the PAR of stroke, coronary heart disease, heart failure, and atrial fibrillation. We calculated the PAR for each risk factor separately and the combined PAR taking into account the interaction of risk factors. Results: During 57,996 person-years, 624 participants of the original cohort developed dementia, and during 26,177 person-years, 145 participants of the extended cohort developed dementia. The combined PAR in the original cohort was 0.23 (95 % CI, 0.05-0.62). The PAR in the extended cohort was slightly higher at 0.30 (95 % CI, 0.06-0.76). The combined PAR including cardiovascular diseases was 0.25 (95 % CI, 0.07-0.62) in the original cohort and 0.33 (95 % CI, 0.07-0.77) in the extended cohort. Conclusions: A substantial part of dementia cases could be prevented if modifiable risk factors would be eliminated. Although prevention and treatment options of cardiovascular risk factors and diseases have improved, the preventive potential for dementia has not declined over the last two decades.
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