Adults with subjective cognitive decline were more likely to report 4 modifiable risk factors for Alzheimer's disease

Adults ages 45 years and older with subjective cognitive decline, an early indicator of potential future Alzheimer's disease and related dementias, were more likely to report four or more modifiable risk factors versus those without, recent data show.

Researchers analyzed information from 161,941 respondents to the 2019 Behavioral Risk Factor Surveillance System survey. They assessed eight modifiable risk factors for Alzheimer's disease: hypertension, not meeting guidelines for aerobic physical activity, obesity, diabetes, depression, current cigarette smoking, hearing loss, and binge drinking. They classified respondents as having no, one, two, three, or four or more risk factors and as experiencing subjective cognitive decline if they responded “yes” when asked if they had experienced worsening or more frequent confusion or memory loss in the previous 12 months. Results were published appeared May 20 by MMWR.

The 2019 combined median response rate was 49.4% for those who responded to the survey via landline and mobile phone. The cognitive decline module was administered to adults ages 45 years and older in 31 states and Washington, D.C. Overall prevalence of subjective cognitive decline was 11.3%. Those with subjective cognitive decline were more likely to report four or more risk factors compared to those with without (34.3% vs. 13.1%). Overall prevalence increased from 3.9% among adults with no risk factors to 25.0% among those with four or more risk factors, the study found. The most common modifiable risk factor for Alzheimer's disease and related dementias was hypertension (49.9%), followed by not meeting guidelines for aerobic physical activity (49.7%), obesity (35.3%), diabetes (18.6%), depression (18.0%), current cigarette smoking (14.9%), hearing loss (10.5%), and binge drinking (10.3%). Adults with each modifiable risk factor, except for binge drinking, were more likely to report subjective cognitive decline than those without the risk factor.

Among other limitations, the researchers noted that causality cannot be inferred from a cross-sectional study and that use of self-reported data and the low response rates could have resulted in bias.

“[I]n addition to helping patients discuss concerns about memory loss, health care professionals should also screen patients for modifiable risk factors, counsel patients with risk factors, and refer them to effective programs and interventions where recommended,” the authors concluded. “Public health professionals can implement policy, systems, and environmental strategies to address modifiable risk factors at the population level.”