An Estimate of Attributable Cases of Alzheimer Disease and Vascular Dementia Due to Modifiable Risk Factors: The Impact of Primary Prevention

April 3, 2018

Dement Geriatr Cogn Dis Extra. 2018 Feb 21;8(1):60-71. doi: 10.1159/000487079. eCollection 2018 Jan-Apr.

An Estimate of Attributable Cases of Alzheimer Disease and Vascular Dementia due to Modifiable Risk Factors: The Impact of Primary Prevention in Europe and in Italy.

Mayer F¹, Di Pucchio A¹, Lacorte E¹, Bacigalupo I¹, Marzolini F¹, Ferrante G¹, Minardi V¹, Masocco M¹, Canevelli M², Di Fiandra T³, Vanacore N¹.

Abstract

Background

Up to 53.7% of all cases of dementia are assumed to be due to Alzheimer disease (AD), while 15.8% are considered to be due to vascular dementia (VaD). In Europe, about 3 million cases of AD could be due to 7 potentially modifiable risk factors: diabetes, midlife hypertension and/or obesity, physical inactivity, depression, smoking, and low educational level.

Aims

To estimate the number of VaD cases in Europe and the number of AD and VaD cases in Italy attributable to these 7 potentially modifiable risk factors.

Methods

Assuming the nonindependence of the 7 risk factors, the adjusted combined population attributable risk (PAR) was estimated for AD and VaD.

Results

In Europe, adjusted combined PAR was 31.4% for AD and 37.8% for VaD. The total number of attributable cases was 3,033,000 for AD and 873,000 for VaD. In Italy, assuming a 20% reduction of the prevalence of each risk factor, adjusted combined PAR decreased from 45.2 to 38.9% for AD and from 53.1 to 46.6% for VaD, implying a 6.4 and 6.5% reduction in the prevalence of AD and VaD, respectively.