Dementia risk factors and cognitive decline: Results from the 2023 Behavioral Risk Factor Surveillance System (BRFSS)

BackgroundThe potentially modifiable risk factors of obesity, diabetes, hypertension, smoking, physical inactivity, depression, hearing impairment, and excessive alcohol consumption, have been found to be associated with cognitive decline and dementia. ObjectiveTo study the association between subjective cognitive decline (SCD) among survey respondents and the 8 risk factors compared with other potential risks. MethodsUsing 2023 Behavioral Risk Factor Surveillance data from 155,112 respondents ages 45+ in 35 states with data on SCD the associations between the 8 dementia risk factors, separately and in a composite measure, plus other demographic and health measures were studied using Stata. ResultsSCD rates were 17.2% overall ranging from 11.0% to 23.9% across states while 81.9% of adults 45+ reported any of the 8 dementia risk factors. Adults with each of the risk factors had higher SCD rates compared with those without the risk factor, with SCD rates ranging from 8.4% for adults with 0 risks, 19.2% for any of the 8 risks, and 45.3% for those with 5 or more. Logistic regression confirmed most results with adjusted odds ratios (AORs) up to 6.0 for 5 or more risk factors, >3.1 for current long COVID and >1.2 for low education. Obesity was not confirmed as a separate risk and highest AOR for age was 1.2 for ages 75+ with 8 risk factors entered separately. ConclusionsResults suggest that prevention efforts for SCD, which can be a step toward dementia, should focus on 8 common potentially modifiable risk factors plus long COVID.