Claudia K Suemoto, Wyllians V Borelli, Ismael L Calandri, Laiss Bertola, Raphael M Castilhos, Paulo Caramelli, Ricardo Nitrini, Sonia M D Brucki, Jerson Laks, Naaheed Mukadam, Gill Livingston, Cleusa P Ferri
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This study aims to provide the first LMIC figure for the potential for dementia prevention in Brazil attributed to 14 modifiable risk factors.</p><p><strong>Methods: </strong>Data was retrieved from 9949 participants aged 50 years or older from the nationally representative second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) conducted between 2019 and 2021. The prevalence of modifiable risk factors was estimated, and principal component analysis was used to account for factor communalities. Overall and individual population attributable fractions (PAF) were calculated using relative risks from the 2024 Lancet Commission report. Stratified analyses by sex, race, and Brazilian macro regions were performed to assess disparities in dementia risk.</p><p><strong>Findings: </strong>The overall PAF for the 14 modifiable risk factors was 59.5% (95% CI = 58.5-60.5). The three risk factors with the highest PAFs were less education (9.5%, 95% CI = 8.9-10.1), untreated visual loss (9.2%, 95% CI = 8.6-9.8), and midlife depression (6.3%, 95% CI = 5.8-6.8). The overall PAF was similar across race and region but was higher among women (61.1%, 95% CI = 59.9-62.4) compared to men (58.2%, 95% CI = 56.7-59.8).</p><p><strong>Interpretation: </strong>Almost 60% of dementia cases in Brazil could potentially be prevented by addressing 14 modifiable risk factors. Public health strategies could further reduce the dementia burden in Brazil.</p><p><strong>Funding: </strong>CKS, PC, and CPF received productivity fellowships from the National Council for Scientific and Technological Development (CNPq). ELSI-Brazil was supported by the Brazilian Ministry of Health: DECIT/SCTIE (Grants: 404965/2012-1 and TED 28/2017); COPID/DECIV/SAPS (Grants: 20836, 22566, 23700, 25560, 25552, and 27510).</p>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"49 ","pages":"101209"},"PeriodicalIF":7.0000,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355584/pdf/","citationCount":"0","resultStr":"{\"title\":\"The potential for dementia prevention in Brazil: a population attributable fraction calculation for 14 modifiable risk factors.\",\"authors\":\"Claudia K Suemoto, Wyllians V Borelli, Ismael L Calandri, Laiss Bertola, Raphael M Castilhos, Paulo Caramelli, Ricardo Nitrini, Sonia M D Brucki, Jerson Laks, Naaheed Mukadam, Gill Livingston, Cleusa P Ferri\",\"doi\":\"10.1016/j.lana.2025.101209\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The Lancet Commission on dementia prevention, intervention, and care 2024 updated the list of modifiable risk factors to include 14 factors. 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引用次数: 0
摘要
背景：2024年《柳叶刀》痴呆预防、干预和护理委员会更新了可改变的危险因素清单，包括14个因素。在低收入和中等收入国家（LMIC），由于这些因素的患病率较高，预防痴呆症的潜力似乎更大。这项研究的目的是提供第一个LMIC数据，表明巴西预防痴呆症的潜力归因于14个可改变的风险因素。方法：从2019年至2021年进行的巴西老龄化纵向研究（ELSI-Brazil）第二波全国代表性的9949名50岁或以上的参与者中检索数据。估计可改变危险因素的流行程度，并使用主成分分析来解释因素群落。总体和个体人群归因分数（PAF）是根据2024年《柳叶刀》委员会报告中的相对风险计算的。按性别、种族和巴西宏观地区进行分层分析，以评估痴呆风险的差异。结果：14种可改变危险因素的总PAF为59.5% （95% CI = 58.5-60.5）。paf最高的三个危险因素是受教育程度较低（9.5%,95% CI = 8.9-10.1）、未经治疗的视力丧失（9.2%,95% CI = 8.6-9.8）和中年抑郁（6.3%,95% CI = 5.8-6.8）。不同种族和地区的总体PAF相似，但女性（61.1%,95% CI = 59.9-62.4）高于男性（58.2%,95% CI = 56.7-59.8）。解释：巴西近60%的痴呆病例可以通过解决14个可改变的风险因素来预防。公共卫生战略可以进一步减轻巴西的痴呆症负担。资助：中国科学院、中国科学院和中国科学院获得了国家科学技术发展委员会（CNPq）的生产力奖学金。ELSI-Brazil得到了巴西卫生部的支持：DECIT/SCTIE（赠款：404965/2012-1和TED 28/2017）；COPID/DECIV/SAPS（资助：20836、22566、23700、25560、25552和27510）。
The potential for dementia prevention in Brazil: a population attributable fraction calculation for 14 modifiable risk factors.
Background: The Lancet Commission on dementia prevention, intervention, and care 2024 updated the list of modifiable risk factors to include 14 factors. The potential for dementia prevention seems to be greater in low- and middle-income countries (LMIC) due to the higher prevalence of these factors. This study aims to provide the first LMIC figure for the potential for dementia prevention in Brazil attributed to 14 modifiable risk factors.
Methods: Data was retrieved from 9949 participants aged 50 years or older from the nationally representative second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) conducted between 2019 and 2021. The prevalence of modifiable risk factors was estimated, and principal component analysis was used to account for factor communalities. Overall and individual population attributable fractions (PAF) were calculated using relative risks from the 2024 Lancet Commission report. Stratified analyses by sex, race, and Brazilian macro regions were performed to assess disparities in dementia risk.
Findings: The overall PAF for the 14 modifiable risk factors was 59.5% (95% CI = 58.5-60.5). The three risk factors with the highest PAFs were less education (9.5%, 95% CI = 8.9-10.1), untreated visual loss (9.2%, 95% CI = 8.6-9.8), and midlife depression (6.3%, 95% CI = 5.8-6.8). The overall PAF was similar across race and region but was higher among women (61.1%, 95% CI = 59.9-62.4) compared to men (58.2%, 95% CI = 56.7-59.8).
Interpretation: Almost 60% of dementia cases in Brazil could potentially be prevented by addressing 14 modifiable risk factors. Public health strategies could further reduce the dementia burden in Brazil.
Funding: CKS, PC, and CPF received productivity fellowships from the National Council for Scientific and Technological Development (CNPq). ELSI-Brazil was supported by the Brazilian Ministry of Health: DECIT/SCTIE (Grants: 404965/2012-1 and TED 28/2017); COPID/DECIV/SAPS (Grants: 20836, 22566, 23700, 25560, 25552, and 27510).
期刊介绍：
The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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