BACKGROUND AND PURPOSE:

• The 2021 National Plan to Address Alzheimer’s Disease aims to delay or slow the progression of dementia through lifestyle interventions addressing modifiable risk factors
  • The national status of modifiable risk factors is unknown
• Omura et al. (CDC MMWR, 2022) assess the status of eight potential modifiable risk factors in the US

METHODS:

• Cross-sectional, random, annual telephone survey
• Participants
  • US adults ≥18 years
• Study design
  • Cognitive decline module was administered to adults 45 years of age or older in 31 states
  • Eight risk factors assessed
    • High blood pressure | Not meeting the aerobic physical activity guideline | Obesity | Diabetes | Depression | Current cigarette smoking | Hearing loss | Binge drinking
  • Respondents were classified as experiencing subjective cognitive decline (SCD) if they responded “yes” when asked if they had experienced worsening or more frequent confusion or memory loss in the previous 12 months
• Primary outcome
  • Risk factor prevalence
  • SCD prevalence

RESULTS:

• 161,941 respondents
• Prevalence of SCD: 11.3%
• Prevalence of modifiable risk factors in survey population
  • High blood pressure: 49.9%
  • Not meeting the aerobic physical activity guideline: 49.7%
  • Obesity: 35.3%
  • Diabetes: 18.6%
  • Depression: 18.0%
  • Current cigarette smoking: 14.9%
  • Hearing loss: 10.5%
  • Binge drinking: 10.3%
• Compared to non-Hispanic White adults, the prevalence of several risk factors was higher among adults who were
  • American Indian or Alaska Native
  • Non-Hispanic Black or African American
  • Hispanic
• Adults with SCD were more likely to report ≥4 risk factors
  • SCD: 34.3%
  • Without SCD: 13.1%
• Adults with each modifiable risk factor, except for binge drinking, were more likely to report SCD than were those without the risk factor
• SCD prevalence increased from 3.9% among those with no risk factors to 25.0% among those with ≥4 risk factors

CONCLUSION:

• In adults ≥45 years the prevalence of subjective cognitive decline is 11.3%
• Individuals with modifiable risk factors were more likely to report cognitive decline
• High blood pressure was the most common modifiable risk factor for dementia
• Prevalence of risk factors varied by race/ethnicity

The authors state

…in addition to helping patients discuss concerns about memory loss, health care professionals should also screen patients for modifiable risk factors, counsel patients with risk factors, and refer them to effective programs and interventions where recommended

Additional resources are available from the Building Our Largest Dementia Infrastructure Public Health Center of Excellence on Dementia Risk Reduction

Learn More – Primary Sources:

Modifiable Risk Factors for Alzheimer Disease and Related Dementias Among Adults Aged ≥45 Years — United States, 2019

CDC: Accelerating Risk Reduction and Promoting Brain Health

CDC: BOLD Infrastructure for Alzheimer’s Act

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