Population Attributable Fraction of Modifiable Risk Factors for Dementia in Turkey.

Abstract

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.