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Comparative Study
. 2024;11(5):1490-1499.
doi: 10.14283/jpad.2024.105.

Potentially Modifiable Dementia Risk Factors in Canada: An Analysis of Canadian Longitudinal Study on Aging with a Multi-Country Comparison

S Son  1 , M Speechley, G Y Zou, M Kivipelto, F Mangialasche, H H Feldman, H Chertkow, S Belleville, H Nygaard, V Hachinski, F Pieruccini-Faria, M Montero-Odasso
Affiliations
Comparative Study

Potentially Modifiable Dementia Risk Factors in Canada: An Analysis of Canadian Longitudinal Study on Aging with a Multi-Country Comparison

S Son et al. J Prev Alzheimers Dis. 2024.

Abstract

Background: It has been 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 disturbances, 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 disturbances, 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.

Measuremments: Prevalence and Population Attributable Fractions (PAFs) associated with less education, hearing loss, traumatic brain injury, hypertension, excessive alcohol, obesity, smoking, depression, social isolation, physical inactivity, diabetes, and sleep disturbances.

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 disturbances 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 are attributable to 12 modifiable risk factors across the lifespan. Canadian risk reduction strategies should prioritize targeting physical inactivity, hearing loss, obesity, and hypertension.

Keywords: CLSA; Dementia; lifestyle; prevention; risk reduction.

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Conflict of interest statement

Dr. Montero-Odasso reports grants from the CIHR including the Institute of Aging (MOP211220, PJT153100), the CCNA (FRN CAN 137794), Weston Foundation (BH210118), and Ontario Neurodegenerative Disease Research Initiative (OBI34739). He is on advisory boards for the Canadian Geriatrics Society (CGS) (serving as president) and the CIHR Institute of Aging, and the Research Executive Council of the CCNA. Prof. Kivipelto and Dr. Mangialasche are supported by FORTE grant 2023-01125, and are both part of the WW-FINGERS Network Global Scientific Coordinating Center, which is supported by the Alzheimer Disease Data Initiative. Dr. Feldman reports grant funding from CIHR to the CCNA (CNA- 163902) and Annovis (QR Pharma), Vivoryon (Probiodrug), AC Immune, and LuMind; service agreements for consulting activities with LuMind, Genentech (DSMB), Roche/Banner (DMC), Tau Consortium (SAB), Samus Therapeutics, Biosplice Therapeutics, Axon Neurosciences, Novo Nordisk Inc., Janssen Research and Development LLC; and travel funding from World Events Forum (ADDF) with no personal funds received and all payments to UCSD. He also reports a philanthropic donation from the Epstein Family Alzheimer’s Disease Collaboration for therapeutic research in AD with no personal funds received and all payments to UCSD. Dr. Belleville reports grant funding to CCNA from CIHR and ASC. She also reports consulting fees and participation on an advisory board for Lucilab and an unpaid role of scientific advisor for the Quebec Federation of Alzheimer’s Societies. Dr. Nygaard reports consulting fees from Hoffman-La Roche and Biogen. As Scientific Director of CCNA, Dr. Chertkow reports grants from CIHR, Baycrest Health Sciences Foundation, Women’s Brain Health Initiative, Alzheimer Society of Canada, Brain Canada, Saskatchewan Health Research Foundation, Alberta Innovates, and Weston Foundation (Weston Brain Institute). As a site investigator for clinical trials, he also receives support from Roche, Lilly, Anavex, and Alector. He reports being a member of the Ministerial Advisory Board on Dementia (2019-2022) and part of the membership organizing committee for Canadian Conference on Dementia. Drs. Montero-Odasso, Chertkow, Belleville, Feldman, and Nygaard are co-principal investigators of CAN-THUMB UP. Dr. Speechley is part of the steering committee for CAN-THUMBS UP. Son, Drs. Zou, Hachinski, and Peruccini-Faria have no competing interests to declare.

Figures

Figure 1
Figure 1
Weighted population attributable fraction for 12 potentially modifiable risk factors for dementia in Canada
See this image and copyright information in PMC

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