Modifiable Risk Factors for Early- and Late-Onset Dementia Using the Korean National Health Insurance Service Database - 05/12/24

Doi : 10.1016/j.tjpad.2024.100032 
Dougho Park 1, 2, Myeonghwan Bang 3, Hyoung Seop Kim 3, , Jong Hun Kim 4,
1 Medical Research Institute, Pohang Stroke and Spine Hospital, Pohang, South Korea 
2 School of Convergence Science and Technology, Pohang University of Science and Technology, Pohang, South Korea 
3 Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, South Korea 
4 Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea 

Correspondence: Hyoung Seop Kim, Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Goyang 10444, Republic of Korea, Tel: +82-31-900-0137, Fax: +82-31-900-0343Department of Physical Medicine and RehabilitationNational Health Insurance Service Ilsan Hospital100 Ilsan-roGoyang10444Republic of Korea⁎⁎Jong Hun Kim, Department of Neurology, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Goyang 10444, Republic of Korea, Tel: +82-31-900-0213, Fax: +82-31-900-0343Department of NeurologyNational Health Insurance Service Ilsan Hospital100 Ilsan-roGoyang10444Republic of Korea

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ABSTRACT

Background

Early-onset dementia (EOD) and late-onset dementia (LOD) may have distinct modifiable risk-factor profiles.

Objective

To identify and compare factors associated with EOD and LOD using a nationwide cohort database.

Design

Nationwide two nested case-control studies.

Setting

We used the National Health Insurance Service-National Sample Cohort database (2004–2019).

Participants

The initial sample size was 514,866; 5157 EOD and 39,326 LOD cases were matched 1:1 with controls based on age, sex, and the Charlson Comorbidity Index.

Measurements

Socioeconomic status, residential area, body mass index, alcohol consumption, smoking status, physical activity, blood pressure, and laboratory findings were analyzed. Multivariable logistic regression models were used to identify the risk factors.

Results

Higher socioeconomic status and increased frequency of physical activity were associated with a lower risk of both EOD and LOD. Rural residence, heavy alcohol consumption, and higher fasting blood sugar levels were associated with an increased risk of LOD, although there was no significant association with EOD. Overall, these factors impacted LOD more strongly than EOD. Demographic and lifestyle factors had a greater effect on LOD than blood pressure and relevant laboratory findings.

Conclusion

Modifiable risk factors were associated with LOD and EOD. The influence of some modifiable risk factors was more pronounced in the LOD group than in the EOD group. Identifying modifiable risk factors associated with dementia can aid in the development of preventive strategies, underscoring the clinical importance of our findings.

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Keywords : Early-onset dementia, Late-onset dementia, Modifiable risk factors, Socioeconomic status, Physical activity


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