Prevalence of behavioral risk factors and their association with dementia in the urban population of North India

Abstract

Background: Dementia has become a public health problems due to its association with behavioural risk factors; smoking, alcoholism, sedentary behaviour, western type diet, obesity, diabetes, and hypercholesterolemia. Most of these behavioural risk factors appear to be associated with dementia as well as with risk of cardiovascular diseases (CVDs) and diabetes. This study aims to find out the prevalence of behavioural risk factors and their association with cognitive deficit and dementia. Study design and setting: Cross-sectional survey in a hospital. Subjects and methods: After written informed consent and approval from hospital ethic committee, all subjects (n=2002) above 25 years of age (1016 males and 986 females) were randomly selected and recruited from urban population of Moradabad, North India. Clinical data and risk factors were recorded with the help of case record form and validated questionnaires. Assessment of cognitive decline and dementia was made by a new memory function rating scale and behavioural risk factors by validated questionnaires. The association of behavioral risk factors with dementia was calculated by multivariate logistic regression analysis after adjustment of age and sex, obesity, diabetes and CVDs. Results: Low cognitive activity, low education, sedentary behavior, sleep duration, tobacco intake, alcoholism and western diet, were highly prevalent independent risk factors of dementia. Low education was not associated with risk. Logistic regression analysis revealed that regardless of age and body mass index, sedentary behavior, odds ratio and confidence intervals: (men 0.74 (0.69 - 0.79), women, 0.71 (0.63 - 0.74) and tobacco intake (men 0.88 (0.79 - 0.94), women 0.90 (0.84 - 0.97) and sleep disruption (men 0.80 (0.71 - 0.89), women 0.85 (0.79 - 0.91) were strongly (p<001) and significantly (p<0.001) associated with dementia in both sexes, respectively. Alcoholism (men 0.71 (0.65 - 0.78) was also strongly and significantly (P<001) associated with dementia in men but not in women. Low cognitive activity, (men 0.83 (0.75 - 0.92), (women 0.89 (0.84 - 0.99), and western diet (men 0.88(0.80-0.95), (women 0.89 (0.81 - 0.99) were weakly but significantly (p=0.05) associated with dementia in both sexes. Meditation and prayer was inversely associated with dementia among (men 0.92 (0.85 - 0.99) and (women 0.90 (0.85 - 0.97). Conclusions: It is possible that increased physical activity, no tobacco and alcoholism, optimal sleep, intake of healthy foods, meditation and prayer, high cognitive activity, and good sleep for 6-8 hours, can protect against dementia.