Potentially Modifiable Dementia Risk Factors in Canada: An Analysis of Canadian Longitudinal Study on Aging with a Multi-Country Comparison
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BACKGROUND
Previous estimates suggested that up to 40% of dementia cases worldwide are associated with modifiable risk factors, however, these estimates are not known in Canada. Furthermore, sleep disturbance, an emerging factor, has not been incorporated into the life-course model of dementia prevention.
Objective
To estimate the population impact of 12 modifiable risk factors in Canadian adults including sleep disturbance, by sex and age groups, and to compare with other countries.
Design
Cross-sectional analysis of Canadian Longitudinal Study on Aging Baseline data
Setting
Community
Participants
30,097 adults aged 45 years and older.
Measurements
Prevalence and Population Attributable Fraction (PAF) of less education, hearing loss, traumatic brain injury, hypertension, excessive alcohol, obesity, smoking, depression, social isolation, physical inactivity, diabetes, and sleep disturbance.
Results
The risk factors with the largest PAF were later life physical inactivity (10.2%; 95% CI, 6.8% to 13%), midlife hearing loss (6.5%; 3.7% to 9.3%), midlife obesity (6.4; 4.1% to 7.7%), and midlife hypertension (6.2%; 2.7% to 9.3%). The PAF of later life sleep disturbance was 3.0% (95% CI, 1.8% to 3.8%). The 12 risk factors accounted for 51.9% (32.2% to 68.0%) of dementia among men and 52.4% (32.5% to 68.7%) among women. Overall, the combined PAF of all risk factors was 49.2% (31.1% to 64.9%), and it increased with age.
Conclusion
Nearly up to 50% of dementia cases in Canada could be prevented by modifying the 12 risk factors across the lifespan. Canadian risk reduction strategies should prioritize targeting physical inactivity, hearing loss, obesity, and hypertension.
