The association between a parental family history of dementia and modifiable risk factors for dementia among middle‐aged individuals: A propensity score‐matched study: Public health: Innovative methods in ADRD research. (7th December 2020)

• Record Type: Journal Article
• Authors: Vrijsen, Joyce; Abu‐Hanna, Ameen; De Rooij, Sophia; Smidt, Nynke
• Is Part Of: Alzheimer's & dementia. Volume 16(2020)Supplement 10
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-07
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.042596
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Individuals with a positive parental family history (PFH) of dementia have an increased risk to develop dementia in the future. It is unclear whether this risk is caused by genetic factors or by modifiable‐risk‐factors for dementia, as parents and their children often share their psychosocial behavior. The aim of this study is to investigate the association between a positive PFH of late‐onset‐dementia and modifiable‐risk‐factors for dementia among middle‐aged individuals. Method: A subsample of Lifelines (n=89, 869; 35‐65years), a population‐based cohort study in The Netherlands, was used. Multiple‐imputation‐using‐Chained‐Equations (MICE) was used to replace missing values. We assessed in each imputed dataset, the association between modifiable‐risk‐factors (hypertension, cardiovascular diseases, obesity, diabetes, physical inactivity, smoking, depression, high cholesterol, unhealthy diet, excessive alcohol use, stress, social inactivity, renal dysfunction and the Lifestyle‐for‐Brain‐Health(LIBRA) score) and a PFH‐of‐dementia in two steps. First, each individual with a PFH‐of‐dementia was matched based on age, gender, education, and depending on the risk‐factor also on other potential confounders, to an individual without a PFH‐of‐dementia (ratio 1:1), using propensity‐score‐matching (PSM). Second, we used logistic, linear and multinomial regression analyses on the matched dataset to obtain the effect estimate. Effect estimates in the imputed datasets were then pooled using Rubin's rules. Results: After PMS, the study population consisted of 26, 604 individuals with a positive PFH‐of‐dementia (mean age=46.1years(7.6); 63% female; 3% low education) and 26, 604 participants without a PFH‐of‐dementia (mean age=45.1(5.1); 59% female; 1% low education). Individuals with a PFH‐of‐dementia had more often hypertension (OR=1.20;95%‐CI:1.14, 1.25), high cholesterol (OR=1.35;95%‐CI:1.25, 1.45), diabetes (OR=1.29;95%‐CI:1.14, 1.47), cardiovascular diseases (OR=1.54;95%‐CI:1.28, 1.84), depressive symptoms (OR=1.25;95%‐CI:1.09, 1.42), and obesity (OR=1.15;95%‐CI:1.08, 1.22) compared to individuals without a PFH‐of‐dementia. Although individuals with a PFH‐of‐dementia were more often physically active (OR=1.07;95%‐CI:1.03, 1.10), they were more often current‐smokers (OR=1.12;95%‐CI:1.07, 1.18). Conclusion: Middle‐aged individuals with a PFH of late‐onset‐dementia have more often modifiable‐risk‐factors for dementia compared to their peers without a PFH of late‐onset dementia. Middle‐aged individuals with a PFH of late‐onset‐dementia is a group at risk for dementia. Further research should explore whether this group is willing to assess their dementia risk and subsequently change their health behavior in order to prevent or postpone dementia and increase healthy ageing.