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ORIGINAL RESEARCH article

Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1529969

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

Provisionally accepted
Mengzhao Wang Mengzhao Wang 1Changming Fan Changming Fan 2*Yanbai Han Yanbai Han 1*Yifei Wang Yifei Wang 1Hejia Cai Hejia Cai 3Wanying Zhong Wanying Zhong 1*Xin Yang Xin Yang 1Zhenshan Wang Zhenshan Wang 1*Hongli Wang Hongli Wang 1Yiming Han Yiming Han 1*
  • 1 College of Physical Education and Health, Guangxi Normal University., Guilin, China
  • 2 Department of physical education, Hebei university of environmental engineering, Qinhuangdao, China
  • 3 College of Outdoor Sports, Guilin Tourism University, Guilin, Guangxi Zhuang Region, China

The final, formatted version of the article will be published soon.

    Objective: This study aims to assess the relationship between modifiable dementia risk factors and both dementia and cognitive decline. Methods: Data 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. Results: A 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. Conclusion: Among 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.

    Keywords: modifiable risk factors, coexistence, Dementia, cognitive decline, cohort study

    Received: 04 Dec 2024; Accepted: 03 Jan 2025.

    Copyright: © 2025 Wang, Fan, Han, Wang, Cai, Zhong, Yang, Wang, Wang and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Changming Fan, Department of physical education, Hebei university of environmental engineering, Qinhuangdao, China
    Yanbai Han, College of Physical Education and Health, Guangxi Normal University., Guilin, China
    Wanying Zhong, College of Physical Education and Health, Guangxi Normal University., Guilin, China
    Zhenshan Wang, College of Physical Education and Health, Guangxi Normal University., Guilin, China
    Yiming Han, College of Physical Education and Health, Guangxi Normal University., Guilin, China

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