Chiara C Brück, Koen de Nijs, M Arfan Ikram, Frank J Wolters, Inge M C M de Kok
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引用次数: 0
Abstract
Approximately 30%-50% of dementia cases are attributable to modifiable risk factors, but the impact of risk reduction strategies on dementia incidence at a population level is uncertain. Reliable estimates of intervention effects require accounting for changes in life expectancy when intervening on risk factors, and model realistic reduction scenarios that consider co-occurrence of risk factors. Using the microsimulation model MISCAN-Dementia, we assessed the effect of interventions on mid-life hypertension and late-life smoking on dementia and mortality risk. We modeled risk factor reductions, from small reductions to complete elimination, and evaluated effects on dementia incidence and prevalence, number of cases, and life years with and without dementia. All risk factor reductions resulted in lower dementia incidence and prevalence, fewer dementia cases, and more dementia-free life years. Eliminating smoking resulted in 1.4% fewer dementia cases for women and 2.5% for men over their lifetime. Eliminating hypertension reduced dementia cases by 1.1% for women and 3.3% for men. The number of dementia cases and life years with dementia decreased until around age 90, after which a slight increase was observed due to prolonged life expectancy with the reductions. Reducing smoking and hypertension will result in additional life years without dementia and a modest reduction in overall dementia cases, with some additional dementia cases in the oldest old. These findings emphasize the potential of dementia risk reduction strategies and the importance of considering concurrent changes in mortality when evaluating risk factor reductions.
期刊介绍:
The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.