About the feature picture: Exercise and healthy diet result in a healthy brain. Both of these activities reduce Population Attributable Fractions (PAFs). On the other hand, intake of unhealthy diet, sedentary lifestyle, and obesity predispose individuals to Alzheimer’s disease and increase PAFs. Footnote: Population Attributable Fractions (PAFs) refer to the quantum of health risk in a particular community or country. Source: Baranowski and others, 2020. [2]
1-Introduction — In this post, we elaborate on the population attributable fractions (PAFs) and their role in dementia
As defined in the Part 1 of this series of New Holy Grail in Dementia, PAFs are factors that contribute to the onset and progression of dementia. There are twelve of them.
2-What is the size of potentially reducible population attributable fractions in low and middle income countries of the world?
Based on the data from an analysis of cross-sectional surveys, low-income and middle income countries namely, India, China, and the six Latin American countries (Cuba, Dominican Republic, Mexico, Peru, Puerto Rico, and Venezuela) all of which used identical risk factor assessment methods in their surveys. It was noted that the reducible PAFs for dementia were 39.5% in China, 41.2% in India, and 55.8% in the 6 Latin American countries (Mukudam N and others, 2019). [1]
3-Which PAFs are potentially reducible in each stage of life in the countries studied?
- Early life (<45 years) — Low education
- Midlife (45 – 64 years) — There are 3 factors — Hearing loss, Hypertension, and Obesity.
- Later life (>65 years) — There are 5 factors — Smoking, Depression, Physical inactivity, Low social contact (loneliness), and Diabetes mellitus.
Footnote. Adding all the PAFs of a country together gives the aggregate of 39.5% in China, 41.2% in India, and 55.8% in the six Latin American countries. To keep this post easy to read, the component PAFs are not shown. The reader can obtain these figures from the published journal article by Mukudam N and others — see under the reference section. [1]
The remaining 3 PAFs not listed above are: Traumatic brain injury, Alcohol consumption, and Air pollution.
4-Healthy diet and exercise promote healthy brain, and healthy life. Simple carbohydrates, sedentary lifestyle, obesity, and Western diet predispose to Alzheimer’s disease.
The details are in the feature picture (Baranowski BJ and others, 2020). [2] See above.
5-Take home messages
- 1-PAFs are risk factors that contribute to the onset and progression of dementia. There are 12 that have been identified. To reduce dementia, we need to reduce each of these factors as much as possible in each individual.[1]
- 2-At each stage of life, there are some key risk factors to work on. [2]
- 3-Healthy diet and exercise promote healthy brain, and healthy life. [2]
6-Acknowledgements
Thanks are due to Baranowski BJ et al for the use of Figure 1 of the journal article [2] as a feature picture for this blog post.
7-References
- 1-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. 2019 May;7(5):e596-e603. PMID: 31000129. doi: 10.1016/S2214-109X(19)30074-9
- 2-Baranowski BJ, Marko DM, Fenech RK, Yang AJT, MacPherson REK. Healthy brain, healthy life: a review of diet and exercise interventions to promote brain health and reduce Alzheimer’s disease risk. Appl Physiol Nutr Metab. 2020 Oct;45(10):1055-1065. PMID: 32717151. https://pubmed.ncbi.nlm.nih.gov/32717151/