Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts

ObjectiveThis study aims to assess the relationship between modifiable dementia risk factors and both dementia and cognitive decline.MethodsData were obtained from the Health and Retirement Study (HRS) [2008–2020], the China Health and Retirement Longitudinal Study (CHARLS) [2011–2020], and the Engl...

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Main Authors: Mengzhao Wang, Changming Fan, Yanbai Han, Yifei Wang, Hejia Cai, Wanying Zhong, Xin Yang, Zhenshan Wang, Hongli Wang, Yiming Han
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1529969/full
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author Mengzhao Wang
Changming Fan
Yanbai Han
Yifei Wang
Hejia Cai
Wanying Zhong
Xin Yang
Zhenshan Wang
Hongli Wang
Yiming Han
author_facet Mengzhao Wang
Changming Fan
Yanbai Han
Yifei Wang
Hejia Cai
Wanying Zhong
Xin Yang
Zhenshan Wang
Hongli Wang
Yiming Han
author_sort Mengzhao Wang
collection DOAJ
description ObjectiveThis study aims to assess the relationship between modifiable dementia risk factors and both dementia and cognitive decline.MethodsData were obtained from the Health and Retirement Study (HRS) [2008–2020], the China Health and Retirement Longitudinal Study (CHARLS) [2011–2020], and the English Longitudinal Study of Ageing (ELSA) [2010–2020]. After adjusting for confounding factors, multivariable logistic regression was utilized to analyze the relationship between modifiable dementia risk factors and dementia, while multivariable linear regression was employed to examine the relationship between these risk factors and cognitive decline. Additionally, the Cox proportional hazards model was used to assess the relationship between the number of risk factor events, clusters, and dementia risk.ResultsA total of 30,113 participants from HRS, CHARLS, and ELSA were included (44.6% male, mean age 66.04 years), with an average follow-up period of 7.29 years. A low education level was significantly associated with an increased risk of dementia and accelerated cognitive decline (Overall, OR = 2.93, 95% CI: 2.70–3.18; Overall, β = −0.25, 95% CI: −0.60 to-0.55). The presence of multiple dementia risk factors correlated with a higher dementia risk; Specifically, compared with more than 5 risk factor events, both having no dementia risk factors and having only one dementia risk factor were associated with a significantly lower risk of dementia (Overall, HR = 0.15, 95% CI: 0.11–0.22, HR = 0.22, 95% CI: 0.18–0.25). Compared to the group with no coexistence of risk factors, the clusters of excessive alcohol, diabetes, vision loss, and hearing loss (HR = 4.11; 95% CI = 3.42–4.95; p < 0.001); excessive alcohol, vision loss, smoking, and hearing loss (HR = 5.18; 95% CI = 4.30–6.23; p < 0.001); and excessive alcohol, obesity, diabetes, and smoking (HR = 5.96; 95% CI = 5.11–6.95; p < 0.001) were most strongly associated with dementia risk.ConclusionAmong the 11 risk factors, educational attainment has the greatest impact on dementia risk and cognitive decline. A dose–response relationship exists between the number of modifiable risk factor events and dementia risk. The coexistence of multiple risk factors is associated with dementia risk, and these associations vary by risk factor cluster.
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spelling doaj-art-65df4f6b1d4f4a4fa86ef27ce46e26ca2025-01-15T05:11:09ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011310.3389/fpubh.2025.15299691529969Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohortsMengzhao Wang0Changming Fan1Yanbai Han2Yifei Wang3Hejia Cai4Wanying Zhong5Xin Yang6Zhenshan Wang7Hongli Wang8Yiming Han9College of Physical Education and Health, Guangxi Normal University, Guilin, ChinaDepartment of Physical Education, Hebei University of Environmental Engineering, Qinhuangdao, ChinaCollege of Physical Education and Health, Guangxi Normal University, Guilin, ChinaCollege of Physical Education and Health, Guangxi Normal University, Guilin, ChinaOutdoor Sports Academy, Guilin Tourism University, Guilin, ChinaCollege of Physical Education and Health, Guangxi Normal University, Guilin, ChinaCollege of Physical Education and Health, Guangxi Normal University, Guilin, ChinaCollege of Physical Education and Health, Guangxi Normal University, Guilin, ChinaCollege of Physical Education and Health, Guangxi Normal University, Guilin, ChinaCollege of Physical Education and Health, Guangxi Normal University, Guilin, ChinaObjectiveThis study aims to assess the relationship between modifiable dementia risk factors and both dementia and cognitive decline.MethodsData were obtained from the Health and Retirement Study (HRS) [2008–2020], the China Health and Retirement Longitudinal Study (CHARLS) [2011–2020], and the English Longitudinal Study of Ageing (ELSA) [2010–2020]. After adjusting for confounding factors, multivariable logistic regression was utilized to analyze the relationship between modifiable dementia risk factors and dementia, while multivariable linear regression was employed to examine the relationship between these risk factors and cognitive decline. Additionally, the Cox proportional hazards model was used to assess the relationship between the number of risk factor events, clusters, and dementia risk.ResultsA total of 30,113 participants from HRS, CHARLS, and ELSA were included (44.6% male, mean age 66.04 years), with an average follow-up period of 7.29 years. A low education level was significantly associated with an increased risk of dementia and accelerated cognitive decline (Overall, OR = 2.93, 95% CI: 2.70–3.18; Overall, β = −0.25, 95% CI: −0.60 to-0.55). The presence of multiple dementia risk factors correlated with a higher dementia risk; Specifically, compared with more than 5 risk factor events, both having no dementia risk factors and having only one dementia risk factor were associated with a significantly lower risk of dementia (Overall, HR = 0.15, 95% CI: 0.11–0.22, HR = 0.22, 95% CI: 0.18–0.25). Compared to the group with no coexistence of risk factors, the clusters of excessive alcohol, diabetes, vision loss, and hearing loss (HR = 4.11; 95% CI = 3.42–4.95; p < 0.001); excessive alcohol, vision loss, smoking, and hearing loss (HR = 5.18; 95% CI = 4.30–6.23; p < 0.001); and excessive alcohol, obesity, diabetes, and smoking (HR = 5.96; 95% CI = 5.11–6.95; p < 0.001) were most strongly associated with dementia risk.ConclusionAmong the 11 risk factors, educational attainment has the greatest impact on dementia risk and cognitive decline. A dose–response relationship exists between the number of modifiable risk factor events and dementia risk. The coexistence of multiple risk factors is associated with dementia risk, and these associations vary by risk factor cluster.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1529969/fullmodifiable risk factorscoexistencedementiacognitive declinecohort study
spellingShingle Mengzhao Wang
Changming Fan
Yanbai Han
Yifei Wang
Hejia Cai
Wanying Zhong
Xin Yang
Zhenshan Wang
Hongli Wang
Yiming Han
Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts
Frontiers in Public Health
modifiable risk factors
coexistence
dementia
cognitive decline
cohort study
title Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts
title_full Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts
title_fullStr Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts
title_full_unstemmed Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts
title_short Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts
title_sort associations of modifiable dementia risk factors with dementia and cognitive decline evidence from three prospective cohorts
topic modifiable risk factors
coexistence
dementia
cognitive decline
cohort study
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1529969/full
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