TY  - JOUR
AU  - Tomata, Y
AU  - Li, X
AU  - Karlsson, IK
AU  - Mosing, MA
AU  - Pedersen, NL
AU  - Hagg, S
Y2  - 2020/11/27
Y1  - 2020/08
SN  - 0954-6820
UR  - http://hdl.handle.net/11343/252403
AB  - Background
As common risk factors of dementia, nine factors (low education, hearing loss, obesity, hypertension, smoking, depression, physical inactivity, diabetes and social isolation) were proposed. However, the joint impact of these factors on incident dementia is still uncertain; hence, we aimed to examine this impact.

Methods
We conducted a cohort study of 9017 cognitively intact individuals aged ≥ 65 years in the Swedish Twin Registry. The main exposure was the total number of reported risk factors (ranging from 0 to 9). Data on dementia diagnoses were based on clinical workup and national health registers. After estimating the adjusted hazard ratios of incident dementia, the population attributable fraction (PAF) was calculated. We then conducted additional analyses, including APOE ε4 status in a genotyped subsample (n = 2810) to check the relative impact of the main exposure and discordant twin pair (n = 1158) analysis to consider confounding by familial effects (shared genetic or familial environmental factors).

Results
The number of dementia cases was 1950 (21.6%). A dose‐response relationship between the number of risk factors and incident dementia was observed; hazard ratio (95% confidence interval) per one‐unit increment in number of risk factors was 1.07 (1.03 to 1.11). The PAF for the combination of the nine risk factors was 10.4%. The PAF of all nine risk factors was smaller than that of APOE ε4 genotype (20.8%) in the subsample. Discordant pair analysis suggested that the observed association was not likely explained by familial effects.

Conclusion
The nine risk factors may have considerable impact as modifiable factors on incident dementia.
LA  - English
PB  - Wiley
T1  - Joint impact of common risk factors on incident dementia: A cohort study of the Swedish Twin Registry
DO  - 10.1111/joim.13071
IS  - Journal of Internal Medicine
VL  - 288
IS  - 2
SP  - 234-247
L1  - /bitstream/handle/11343/252403/joim.13071.pdf?sequence=1&isAllowed=y
ER  -