Projecting Burden of Dementia in Spain, 2010-2050: Impact of Modifying Risk Factors

Abstract

Risk and protective factors such as obesity, hypercholesterolemia, physical activity, and hypertension can play a role in the development of dementia. Our objective was to measure the effect of modification of risk and protective factors on the prevalence and economic burden of dementia in the aging Spanish population during 2010-2050. A discrete event simulation model including risk and protective factors according to CAIDE (Cardiovascular Risk Factors, Aging and Incidence of Dementia) Risk Score was built to represent the natural history of dementia. Prevalence of dementia was calculated from 2010 to 2050 according to different scenarios of risk factor prevalence to assess the annual social and health care costs of dementia. The model also supplied hazard ratios for dementia. Aging will increase between 49% and 16% each decade in the number of subjects with dementia. The number of working-age individuals per person with dementia will decrease to a quarter by 2050. An intervention leading to a 20% change in risk and protective factors would reduce dementia by 9% , prevent over 100,000 cases, and save nearly 4,900 million euros in 2050. Switching individuals from a group with a specific risk factor to one without it nearly halved the risk of the development of dementia. Dementia prevalence will grow unmanageable if effective prevention strategies are not developed. Interventions aiming to reduce modifiable risk factor prevalence represent valid and effective alternatives to reduce dementia burden. However, further research is needed to identify causal relationships between dementia and risk factors.

Keywords: Alzheimer’s disease; dementia; hypercholesterolemia; hypertension; obesity; physical activity; primary prevention; projections; risk factors.