Summary population attributable fraction of dementia prevalence associated with sensory risk factors

Abstract

BackgroundHearing and vision loss can be treatable sensory risk factors for dementia. Nationally-representative estimates of the proportion of dementia prevalence associated with sensory risk factors in late-life are needed for dementia prevention strategies.ObjectiveTo estimate the fraction of dementia prevalence associated with treatable sensory risk factors (hearing and vision loss) and to evaluate differences by age, race/ethnicity, income, and sex.MethodsThis was a cross-sectional analysis of Round 12 (2022) of the National Health and Aging Trends Study, a population-based study nationally representative of US Medicare beneficiaries. Among community-living adults aged ≥65 years eligible for cognitive, hearing, and vision assessments (n = 4623), the summary population attributable fraction (PAF) of dementia from at least one objectively-measured sensory risk factor was estimated.ResultsThe prevalence of at least one sensory risk factor was 66% and dementia was 9%. The PAF of dementia from at least one sensory risk factor was 57% (95% CI: 8%-61%). PAFs were larger for individuals who were aged <80 years compared to ≥80 years (59% [95% CI: 42%-74%] versus 33% [95% CI: -6%-68%), non-Hispanic White compared to Hispanic and non-Hispanic Black (63% [95% CI: 41%-80%] versus 50% [95% CI: 16%-80%] and 32% [95% CI: -1%-64%]), and had higher income versus lower income (57% [95% CI: 36%-74%] versus 47% [95% CI: 7%-81%]). PAFs were consistent by sex.ConclusionsUp to 57% of dementia prevalence in the US was associated with clinically-significant sensory risk factors. Addressing sensory impairments could play an important role in national dementia risk reduction strategies.

Keywords: Alzheimer's disease; dementia risk; hearing loss; population attributable fraction; vision loss.