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Contributions of Modifiable Risk Factors to Dementia Incidence: A Bayesian Network Analysis

  • Jing-hong Liang
    Affiliations
    Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China

    Department of Social medicine, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
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  • Lin Lu
    Affiliations
    School of Nursing, Medical College of Soochow University, Suzhou, P.R. China
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  • Jia-yu Li
    Affiliations
    Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China

    Departments of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
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  • Xin-yuan Qu
    Affiliations
    Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
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  • Jing Li
    Affiliations
    Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China

    Departments of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
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  • Sheng Qian
    Affiliations
    Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China

    Departments of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
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  • Ying-quan Wang
    Affiliations
    Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China

    Department of Social medicine, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
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  • Rui-xia Jia
    Affiliations
    Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China

    Department of Social medicine, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
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  • Chun-sheng Wang
    Affiliations
    School of medicine, Huzhou University, Huzhou, P.R. China

    Huzhou Central Hospital, Huzhou, P.R. China
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  • Yong Xu
    Correspondence
    Address correspondence to Yong Xu MD, School of Public Health, Medical College of, Soochow University, No.199 Ren Ai Rd, Suzhou, China 215123.
    Affiliations
    Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China

    Department of Social medicine, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China

    Departments of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
    Search for articles by this author

      Abstract

      Objective

      To determine and compare the contributions of modifiable risk factors (RFs) with the prevention of dementia in older adults.

      Design

      A systematic review and Bayesian network meta-analysis (NMA). The observational group was set as a reference to collect all existing RFs and compare them with each other.

      Setting and Participants

      An exhaustive and comprehensive literature search strategy was used to identify relevant prospective cohort studies from several online databases from their inception to May 1, 2019. Participants without dementia were adults aged greater than 50 years.

      Measures

      The required data were extracted from the eligible studies to facilitate the Bayesian NMA.

      Results

      Forty-three cohort studies with 277,294 participants were included in this NMA. Using the observation group as the reference, all defined RFs, except for antioxidants, were associated with lower risks of all-cause dementia [no sleep disturbances (odds ratio, OR 0.43, 95% credible interval, CrI 0.24–0.62), a high level of education (OR 0.50, 95% CrI 0.34–0.66), no history of diabetes (OR 0.57, 95% CrI 0.36–0.78), nonobese patients (OR 0.61, 95% CrI 0.39–0.83), no smoking history (OR 0.62, 95% CrI 0.45–0.79), living with family members (OR 0.67, 95% CrI 0.45–0.89), participation in physical exercise (OR 0.73, 95% CrI 0.46–0.94), abstinence from drinking (OR 0.78, 95% CrI 0.56–0.99), and no history of hypertension (OR 0.80, 95% CrI 0.65–0.96)].

      Conclusions/Relevance

      The findings provide reliable support for the hypothesis that modifiable somatic and lifestyle factors are strong predictors of all-cause dementia.
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