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. 2025 Mar;12(3):100032.
doi: 10.1016/j.tjpad.2024.100032. Epub 2025 Jan 14.

Modifiable risk factors for early- and late-onset dementia using the Korean national health insurance service database

Dougho Park  1 , Myeonghwan Bang  2 , Hyoung Seop Kim  3 , Jong Hun Kim  4
Affiliations

Modifiable risk factors for early- and late-onset dementia using the Korean national health insurance service database

Dougho Park et al. J Prev Alzheimers Dis. 2025 Mar.

Abstract

Background: Early-onset dementia (EOD) and late-onset dementia (LOD) may have distinct modifiable risk-factor profiles.

Objective: To identify and compare factors associated with EOD and LOD using a nationwide cohort database.

Design: Nationwide two nested case-control studies.

Setting: We used the National Health Insurance Service-National Sample Cohort database (2004-2019).

Participants: The initial sample size was 514,866; 5157 EOD and 39,326 LOD cases were matched 1:1 with controls based on age, sex, and the Charlson Comorbidity Index.

Measurements: Socioeconomic status, residential area, body mass index, alcohol consumption, smoking status, physical activity, blood pressure, and laboratory findings were analyzed. Multivariable logistic regression models were used to identify the risk factors.

Results: Higher socioeconomic status and increased frequency of physical activity were associated with a lower risk of both EOD and LOD. Rural residence, heavy alcohol consumption, and higher fasting blood sugar levels were associated with an increased risk of LOD, although there was no significant association with EOD. Overall, these factors impacted LOD more strongly than EOD. Demographic and lifestyle factors had a greater effect on LOD than blood pressure and relevant laboratory findings.

Conclusion: Modifiable risk factors were associated with LOD and EOD. The influence of some modifiable risk factors was more pronounced in the LOD group than in the EOD group. Identifying modifiable risk factors associated with dementia can aid in the development of preventive strategies, underscoring the clinical importance of our findings.

Keywords: Early-onset dementia; Late-onset dementia; Modifiable risk factors; Physical activity; Socioeconomic status.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1
Fig. 1
A forest plot summarizing the risk of environmental and lifestyle factors on the occurrence of early- and late-onset dementia. Models were adjusted for age, sex, and Charlson comorbidity index. The modifiable risk factors are less strongly related to early-onset dementia than late-onset dementia. Abbreviations: aOR, adjusted odds ratio; BMI, body mass index; CI, confidence interval; DBP, diastolic blood pressure; EOD, early onset dementia; FBS, fasting blood sugar; LOD, late-onset dementia; PA, physical activity; SBP, systolic blood pressure; TC, total cholesterol.
See this image and copyright information in PMC

References

    1. Arvanitakis Z., Shah R.C., Bennett D.A. Diagnosis and management of dementia: review. JAMA. 2019;322(16):1589–1599. doi: 10.1001/jama.2019.4782. - DOI - PMC - PubMed
    1. Li X., Feng X., Sun X., Hou N., Han F., Liu Y. Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2019. Front Aging Neurosci. 2022;14 doi: 10.3389/fnagi.2022.937486. - DOI - PMC - PubMed
    1. Yokota O., Sasaki K., Fujisawa Y., Takahashi J., Terada S., Ishihara T., et al. Frequency of early and late-onset dementias in a Japanese memory disorders clinic. Eur J Neurol. 2005;12(10):782–790. doi: 10.1111/j.1468-1331.2005.01072.x. - DOI - PubMed
    1. Sa F., Pinto P., Cunha C., Lemos R., Letra L., Simoes M., et al. Differences between early and late-onset Alzheimer's disease in neuropsychological tests. Front Neurol. 2012;3:81. doi: 10.3389/fneur.2012.00081. - DOI - PMC - PubMed
    1. Killin L.O., Starr J.M., Shiue I.J., Russ T.C. Environmental risk factors for dementia: a systematic review. BMC Geriatr. 2016;16(1):175. doi: 10.1186/s12877-016-0342-y. - DOI - PMC - PubMed

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