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Dementia risk in a diverse population: A single-region nested case-control study in the East End of London

Bothongo, PLK; Jitlal, M; Parry, E; Waters, S; Foote, IF; Watson, CJ; Cuzick, J; ... Marshall, CR; + view all (2022) Dementia risk in a diverse population: A single-region nested case-control study in the East End of London. The Lancet Regional Health - Europe , 15 , Article 100321. 10.1016/j.lanepe.2022.100321. Green open access

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Abstract

Background: Most evidence about dementia risk comes from relatively affluent people of White European ancestry. We aimed to determine the association between ethnicity, area level socioeconomic deprivation and dementia risk, and the extent to which variation in risk might be attributable to known modifiable clinical risk factors and health behaviours. Methods: In this nested case-control study, we analysed data from primary care medical records of a population of 1,016,277 from four inner East London boroughs, United Kingdom, collected between 2009 and 2018. The outcome measures were odds ratios for dementia according to ethnicity and deprivation, before and after the addition of major modifiable risk factors for dementia; and weighted population attributable risk for comparison between individual risk factors. Findings: We identified 4137 dementia cases and 15,754 matched controls (mean age for cases and controls were 80·7 years, (SD 8·7); 81·3 years, (SD 8·9) respectively, range 27–103). Black and South Asian ethnicity were both associated with increased risk of dementia relative to White (odds ratios [95% CI]: Black 1·43 [1·31–1·56]; South Asian 1.17 [1·06–1·29]). Area-level deprivation was independently associated with an increased risk of dementia in a dose-dependent manner. Black and South Asian ethnicity were both associated with a younger age at dementia diagnosis (odds ratios [95%CI]: 0·70 [0·61–0·80] and 0·55 [0·47–0·65], respectively). Population attributable risk was higher for ethnicity (9·7%) and deprivation (11·7%) than for any established modifiable risk factor in this population. Interpretation: Ethnicity and area-level deprivation are independently associated with dementia risk in East London. This effect may not be attributable to the effect of known risk factors.

Type: Article
Title: Dementia risk in a diverse population: A single-region nested case-control study in the East End of London
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.lanepe.2022.100321
Publisher version: https://doi.org/10.1016/j.lanepe.2022.100321
Language: English
Additional information: © 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Keywords: Alzheimer's; Dementia; Deprivation; Ethnicity; Socioeconomic status
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health of Older People
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10147049
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