Abstract 062: Racial And Ethnic Differences In The Population Burden Of Dementia Attributable To Modifiable Risk Factors In The United States

Introduction: Modifiable risk factors (including cardiovascular traits) are associated with dementia risk. However, it is unknown which risk factors have the greatest influence on dementia rates in the United States, or how that varies by race/ethnicity. Objective: For all Americans and separately by race and ethnicity, we calculated population attributable fractions (PAFs) of dementia for 12 potentially modifiable risk factors: low education, hearing loss, traumatic brain injury, hypertension, excessive alcohol consumption, obesity, smoking, depression, social isolation, physical inactivity, diabetes, and air pollution. Methods: Assuming a causal relationship between risk factors and dementia, we calculated PAFs for dementia using relative risks and prevalence estimates for each risk factor. We used relative risks from recent meta-analyses and prevalence estimates from nationally representative cross-sectional survey data (e.g., NHANES). We estimated prevalence separately by race/ethnicity. We calculated the PAF (for all Americans and separately by race and ethnicity) for each dementia risk factor and a combined PAF accounting for correlations between exposures. Results: In the total population, 42.6% of dementia cases were attributable to the 12 risk factors we considered. The estimated PAF of these risk factors was greater for Black and Hispanic Americans (47.5% and 47.3%, respectively) than it was for White and Asian Americans (41.3% and 37.8%, respectively). The greatest fractions of dementia cases were attributable to key cardiovascular traits: hypertension (20.2%), obesity (20.9%), and physical inactivity (20.1%). These factors were highest within each racial and ethnic group, though the proportions varied (Figure 1). Conclusions: A large fraction of dementia cases are attributable to potentially modifiable factors, especially for Black and Hispanic Americans. Further research is needed to test whether intervening on these factors reduces dementia risk.