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Age- and sex-specific modifiable risk factor profiles of dementia: evidence from the UK Biobank

  • NEURO-EPIDEMIOLOGY
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Abstract

Dementia constitutes a worldwide concern. To characterize the age- and sex-specific modifiable risk factor profiles of dementia, we included 497,401 UK Biobank participants (mean age = 56.5 years) without dementia at baseline (2006–2010) and followed them until March 2021. Cox proportional hazard models were used to estimate the age- and sex-specific hazard ratios (HRs) of incident dementia associated with socioeconomic (less education and high Townsend deprivation index), lifestyle (non-moderate alcohol intake, current smoking, suboptimal diet, physical inactivity, and unhealthy sleep duration), and health condition factors (hypertension, diabetes, cardiovascular diseases, and depressive symptoms). We also calculated the population attributable fractions (PAFs) of these factors. During follow-up (mean = 11.6 years), we identified 6564 dementia cases. HRs for the risk factors were similar between the sexes, while most factors showed stronger associations among younger participants. For example, the HRs of smoking were 1.74 (95% CI: 1.23, 2.47) for individuals aged < 50 years, and 1.18 (1.05, 1.33) for those aged ≥ 65 years. Overall, 46.8% (37.4%, 55.2%) of dementia cases were attributable to the investigated risk factors. The PAFs of the investigated risk factors also decreased with age, but that for health condition risk factors decreased with lower magnitude than socioeconomic and lifestyle risk factors. The stronger associations and greater PAFs of several modifiable risk factors for dementia among younger adults than older participants underscored the importance of dementia prevention from an earlier stage across the adult life course.

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Data availability

Data used in this study from the UK Biobank are all available upon application (www.ukbiobank.ac.uk/).

Abbreviations

BMI:

Body mass index

HR:

Hazard ratio

CI:

Confidence interval

PAF:

Population attributable fraction

TDI:

Townsend deprivation index

UKB:

UK Biobank

CVD:

Cardiovascular disease

RS:

Risk score

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Acknowledgements

Data share statement This research was conducted using the UK Biobank (UKB) (Application Number 55005). Data and codebooks used in this study are all available upon application (www.ukbiobank.ac.uk/). The authors thank the participants of the UKB for their contributions to this work.

Funding

This work was supported by the Zhejiang University Global Partnership Fund (Granted to CY), the National Science Fund for Excellent Young Scholars (81922060, Granted to GZ), and the Talent Introduction Program of the Chinese Academy of Sciences (Granted to GZ). The funding agencies had no role in study design, data collection, analysis, decision to publish, or manuscript preparation.

Author information

Authors and Affiliations

  1. School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China

    Hui Chen & Changzheng Yuan

  2. CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China

    Yaying Cao & Geng Zong

  3. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA

    Yuan Ma

  4. Department of Neurobiology, Care Sciences and Society, Aging Research Centre, Karolinska Institutet and Stockholm University, Stockholm, Sweden

    Weili Xu

  5. Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China

    Weili Xu

  6. Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA

    Changzheng Yuan

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  1. Hui Chen
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Contributions

CY, GZ, and HC designed the study; HC performed the statistical analyses; HC drafted and YM, YC, WX, and GZ revised the manuscript; CY supervised the data analysis and interpretation; CY had the primary responsibility for the final content. All authors critically reviewed the manuscript and approved the final draft.

Corresponding authors

Correspondence to Geng Zong or Changzheng Yuan.

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Chen, H., Cao, Y., Ma, Y. et al. Age- and sex-specific modifiable risk factor profiles of dementia: evidence from the UK Biobank. Eur J Epidemiol 38, 83–93 (2023). https://doi.org/10.1007/s10654-022-00952-8

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  • DOI: https://doi.org/10.1007/s10654-022-00952-8

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