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Cited by 82Dementia and Cognitive Impairment ResearchCardiovascular Health and Risk FactorsHealth disparities and outcomes

Differences in the potential for dementia prevention between major ethnic groups within one country: A cross sectional analysis of population attributable fraction of potentially modifiable risk factors in New Zealand

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Ma'u, Etuini, Cullum, Sarah, Cheung, Gary, Livingston, Gill, Mukadam, Naaheed·2021·The Lancet Regional Health - Western Pacific
DOI 10.1016/j.lanwpc.2021.100191PMC PMC8358157
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Abstract

BACKGROUND: Twelve potentially modifiable risk factors (less education, hypertension, obesity, alcohol, traumatic brain injury (TBI), hearing loss, smoking, depression, physical inactivity, social isolation, diabetes, air pollution) account for an estimated 40% of worldwide dementia cases. We aimed to calculate population attributable fractions (PAFs) for dementia for the four largest New Zealand ethnic groups (European, Māori, Asian, and Pacific peoples) to identify whether optimal dementia prevention targets differed by ethnicity. METHODS: We calculated risk factor prevalence for 10 risk factors using the New Zealand Health Survey 2018/19 and published reports for hearing loss and TBI prevalences. We calculated the PAF for each risk factor using calculated prevalence and relative risk estimates from previous meta-analyses. To account for risk factor overlap, we calculated communality of risk factors and a weighted PAF. FINDINGS: The weighted PAF for dementia was 47.7% overall in New Zealand, 47.6% for Europeans, 51.4% for Māori, 50.8% for Pacific peoples, and 40.8% for Asians. Highest PAFs for Europeans were hearing loss (8%) and social isolation (5.7%), and for Asians hearing loss (7.3%) and physical inactivity (5.5%). For Māori and Pacific peoples, highest PAFs were for obesity (7.3% and 8.9% respectively) and hearing loss (6.5% and 6.6%). INTERPRETATION: New Zealand has higher dementia prevention potential than worldwide estimates with high prevalences of untreated hearing loss and obesity. The relative contribution of individual risk factors PAFs varies by ethnic group. Public health strategies for dementia prevention need to be tailored to these differences. FUNDING: Health Research Council of New Zealand (HRC:20/021).

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  • Underserved ethnic groups, such as the Māori group in New Zealand, First Nation groups in Australia, Black individuals in the US and UK, and Hispanic individuals in the US, have higher prevalence of potentially modifiable risk factors.

    “Underserved ethnic groups, such as the Māori group in New Zealand, First Nation groups in Australia, Black individuals in the US and UK, and Hispanic individuals in the US, have higher prevalence of potentially modifiable risk factors.(38-45)”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [39]

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References 32 · Cited by 82

Research works printed but not linked: 24

  1. [1]World Health Organisation ICD-10: international statistical classification of diseases and related health problems: tenth revision 2004 World Health Organization 2nd ed 3376487
  2. [5]Livingston G Sommerlad A Orgeta V Costafreda SG Huntley J Ames D Dementia prevention, intervention, and care Lancet 390 10113 2017 2673 2734 28735855
  3. [6]Barnes DE Yaffe K. The projected effect of risk factor reduction on Alzheimer's disease prevalence Lancet Neurol 10 9 2011 819 828 21775213 PMC3647614
  4. [8]Milne RJ Lennon DR Stewart JM Vander Hoorn S Scuffham PA. Incidence of acute rheumatic fever in New Zealand children and youth J Paediatr Child Health 48 8 2012 685 691 22494483
  5. [10]Adelman S Blanchard M Rait G Leavey G Livingston G. Prevalence of dementia in African-Caribbean compared with UK-born White older people: two-stage cross-sectional study Br J Psychiatry 199 2 2011 119 125 21653946
  6. [11]Lee HB Richardson AK Black BS Shore AD Kasper JD Rabins PV. Race and cognitive decline among community-dwelling elders with mild cognitive impairment: findings from the Memory and Medical Care Study Aging Ment Health 16 3 2012 372 377 21999809 PMC3302954
  7. [12]Yaffe K Falvey C Harris TB Newman A Satterfield S Koster A Effect of socioeconomic disparities on incidence of dementia among biracial older adults: prospective study BMJ 347 2013 f7051 24355614 PMC3898154
  8. [13]Harris RB Stanley J Cormack DM. Racism and health in New Zealand: Prevalence over time and associations between recent experience of racism and health and wellbeing measures using national survey data PLoS One 13 5 2018 e0196476 PMC5933753 29723240
  9. [14]Mukadam N Sommerlad A Huntley J Livingston G. Population attributable fractions for risk factors for dementia in low-income and middle-income countries: an analysis using cross-sectional survey data Lancet Glob Health 7 5 2019 e596 e603 31000129 PMC7617123
  10. [19]Richardson EA Pearce J Kingham S. Is particulate air pollution associated with health and health inequalities in New Zealand? Health Place 17 5 2011 1137 1143 21621448
  11. [25]Stevens G Flaxman S Brunskill E Mascarenhas M Mathers CD Finucane M Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries Eur J Public Health 23 1 2013 146 152 22197756
  12. [26]Exeter DJ Wu B Lee AC Searchfield GD. The projected burden of hearing loss in New Zealand (2011-2061) and the implications for the hearing health workforce N Z Med J 128 1419 12 21 2015 26365841
  13. [28]Wilson DH Walsh PG Sanchez L Davis AC Taylor AW Tucker G The epidemiology of hearing impairment in an Australian adult population Int J Epidemiol 28 2 1999 247 252 10342686
  14. [29]Te Ao B Tobias M Ameratunga S McPherson K Theadom A Dowell A Burden of Traumatic Brain Injury in New Zealand: Incidence, Prevalence and Disability-Adjusted Life Years Neuroepidemiology 44 4 2015 255 261 26088707
  15. [31]Oakley Browne MA Wells JE Scott KM McGee MA New Zealand Mental Health Survey Research T. Lifetime prevalence and projected lifetime risk of DSM-IV disorders in Te Rau Hinengaro: the New Zealand Mental Health Survey Aust N Z J Psychiatry 40 10 2006 865 874 16959012
  16. [33]Livingston M Callinan S. Underreporting in alcohol surveys: whose drinking is underestimated? J Stud Alcohol Drugs 76 1 2015 158 164 25486405
  17. [36]Gosling AL Buckley HR Matisoo-Smith E Merriman TR. Pacific Populations, Metabolic Disease and 'Just-So Stories': A Critique of the 'Thrifty Genotype' Hypothesis in Oceania Ann Hum Genet 79 6 2015 470 480 26420513
  18. [38]Lee CH Duck IM Sibley CG. Ethnic inequality in diagnosis with depression and anxiety disorders N Z Med J 130 1454 2017 10 20 28449012
  19. [40]Chen H Kwong JC Copes R Hystad P van Donkelaar A Tu K Exposure to ambient air pollution and the incidence of dementia: A population-based cohort study Environ Int 108 2017 271 277 28917207
  20. [41]Desai R John A Stott J Charlesworth G. Living alone and risk of dementia: A systematic review and meta-analysis Ageing Res Rev 62 2020 101122 32659336
  21. [42]Prince M Ali G-C Guerchet M Prina AM Albanese E Wu Y-T. Recent global trends in the prevalence and incidence of dementia, and survival with dementia Alzheimer's Research & Therapy 8 1 2016 23 PMC4967299 27473681
  22. [43]Matthews FE Stephan BC Robinson L Jagger C Barnes LE Arthur A A two decade dementia incidence comparison from the Cognitive Function and Ageing Studies I and II Nat Commun 7 2016 11398 27092707 PMC4838896
  23. [45]Cullum S Dudley M Kerse N. The case for a bicultural dementia prevalence study in Aotearoa New Zealand N Z Med J 133 1524 2020 119 125 33119575
  24. [48]Dudley M Menzies O Elder H Nathan L Garrett N Wilson D. Mate wareware: Understanding 'dementia' from a Maori perspective N Z Med J 132 1503 2019 66 74 31581183

Authors
Ma'u, E., Cullum, S., Cheung, G., Livingston, G., & Mukadam, N.
Affiliations
  • University of Auckland (NZ)
  • St Pancras Hospital (GB)
ORCID
Venue
The Lancet Regional Health - Western Pacific
Publisher
Elsevier BV
Published
2021-08
Volume
13
Pages
100191
ISSN
2666-6065 (ISSN-L)
DOI
10.1016/j.lanwpc.2021.100191
PMC
PMC8358157
OpenAlex
W3177707402
Cited by
82
References
32
Citations by year
2026: 7 · 2025: 16 · 2024: 26 · 2023: 22 · 2022: 10 · 2021: 1
FWCI
10.58
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Regional Health - Western Pacific (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
  • ResearchSpace (University of Auckland) (submittedVersion, cc-by-nc-nd)
Funders
  • NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
  • Ministerio de Sanidad, Consumo y Bienestar Social
  • National Institute for Health Research
  • Alzheimer's Society
  • Health Research Council of New Zealand
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Social Sciences › Health › Health disparities and outcomes
Keywords
dementia prevention, population attributable fraction, modifiable risk factors, ethnic differences, Māori, Pacific Islanders, Asian populations, European populations, hearing loss, obesity, social isolation, physical inactivity, New Zealand

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