Modifiable dementia risk factors in Chilean adults are distinctively associated with social determinants of health. Cross-sectional study

Abstract

Background
In Latin America, dementia cases will double by 2050. For effective prevention in this region, it is crucial to comprehend the distribution of dementia risk factors within the local population and to assess their association with social determinants of health (SDH). Our objective was to explore the association between different modifiable dementia risk factors within the Chilean population in a cross-sectional study.


Methods
3379 dementia-free subjects ≥ 45 years old from the 2016–2017 Chilean National Health Survey were analyzed and stratified into four groups by sex and age, searching for clusters using six continuous variables that had been related to dementia risk (years of education, systolic blood pressure, body mass index (BMI), units of alcohol consumption, physical activity, and depressive symptoms).


Results
Three clusters of individuals shared similar risk factors in each sex/age group. A cluster with high cardiometabolic risk was present in all sex/age groups, characterized by high systolic blood pressure (HSBP) in men midlife and by HSBP associated with high BMI (HSBP/HBMI) in women and in men later-life. A depressive cluster and a physically inactive cluster were present in 3⁄4 of the sex/age groups. Additionally, there was a cluster that was relatively healthy but had a risk of excessive alcohol consumption in men later-life and a low risk one in women midlife. The HSBP/HBMI and depressive clusters presented a high proportion of multiple dementia risk factors. Lower levels of education (and lower family income) were associated with the HSBP and HSBP/HBMI cluster; in contrast, higher levels of education were associated with clusters with lower risk.


Conclusion
In Chile, subpopulations with more disadvantages SDH have a high prevalence of cardiometabolic risk factors. Subpopulations with depression and those with high cardiometabolic risk have a higher accumulation of dementia risk factors. These results highlight that tailored programs improving healthcare accessibility for those with more disadvantages SDH and multidisciplinary interventions for high-risk populations are needed for effective dementia prevention.