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The most prominent modifiable risk factors for Alzheimer disease and related dementias (ADRD) in the US changed during the past decade, with midlife obesity overtaking physical inactivity at the top of the list.
An analysis of data from 378 615 respondents in the 2018 US Behavioral Risk Factor Surveillance System annual survey evaluated the relative contribution of 8 modifiable risk factors—physical inactivity, current smoking, depression, low education, diabetes, midlife obesity, midlife hypertension, and hearing loss—to ADRD risk.
About a third of ADRD cases were associated with a combination of these factors, with midlife obesity followed by physical inactivity and low educational attainment being the most prominent. In 2011, the most prominent risk factors were physical inactivity, depression, and smoking.
Men had a greater proportion of ADRD cases associated with the 8 risk factors than did women. The excess caseload of ADRD due to all 8 modifiable risk factors was relatively higher among American Indian and Alaska Native, Black, and Hispanic individuals compared with Asian and White individuals. Midlife obesity was the most important modifiable risk factor for American Indian and Alaska Native, Black, and White individuals, whereas for Asian individuals, physical inactivity, and for Hispanic individuals, low education, were most important.
The authors wrote in JAMA Neurology that “Alzheimer risk reduction strategies may be more effective if they target higher-risk groups and consider current risk factor profiles.”
