Predicting reductions in dementia from risk factor modification

January 01, 0001

Predicting reductions in dementia from risk factor modification

Dementia is a growing concern with the aging populations in many parts of the world. These French and UK researchers sought to estimate the reduction in incidence of dementia that could be obtained with specific risk factors modification. They performed a prospective seven year cohort study involving the general population of Montpellier, France over the age of 65 (n=1433). Diagnosis of mild cognitive impairment or dementia was made by neurological examination.

The researchers report: "Cox models were constructed to derive hazard ratios and determine confounding and interaction effects for potentially modifiable risk factors for dementia. Mean percentage population attributable fractions were calculated with 95% confidence intervals derived from bootstrapping for seven year incidence of mild cognitive impairment or dementia. The final model retained crystallised intelligence (population attributable fraction 18.11%), depression (10.31%), fruit and vegetable consumption (6.46%), diabetes (4.88%), and apolipoprotein E 4 allele (7.11%)."

The researchers concluded: "Increasing crystallised intelligence and fruit and vegetable consumption and eliminating depression and diabetes are likely to have the biggest impact on reducing the incidence of dementia, outweighing even the effect of removing the principal known genetic risk factor. Although causal relations cannot be concluded with certainty, the study suggests priorities that may inform public health programmes."

This study suggests that there could be significant benefit in reducing incident dementia via specific risk factor modification, though more study is required.

For the full abstract, click here.

BMJ 341:c3885, 5 August 2010
© 2010 Ritchie et al.
Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors. K Ritchie, I Carrière, C W Ritchie, C Berr, S Artero, M-L Ancelin. Correspondence to K Ritchie: [email protected]

Category: N. Neurological. Keywords: dementia, incidence, risk factor, fruits, vegetables, prospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 24 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.