Modifiable risk factors
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Modifiable Risk Factors: Insights from Recent Research
Modifiable Risk Factors and Dementia
Cognitive Decline and Dementia
Research consistently shows that multiple co-occurring modifiable risk factors significantly increase the risk of cognitive decline and dementia. A systematic review and meta-analysis found that the presence of one risk factor increased the relative risk of dementia by 1.20, two risk factors by 1.65, and three or more risk factors by 2.21, compared to individuals with no risk factors 1. Key modifiable risk factors include smoking, physical inactivity, poor diet, and lack of social engagement 13.
Alzheimer's Disease and Related Dementias (ADRDs)
Longitudinal studies indicate a downtrend in the incidence and prevalence of ADRDs, likely due to improved management of modifiable risk factors. These factors include maintaining a high level of education, avoiding smoking, managing diabetes and hypertension, and engaging in physical exercise 78. Early-life, middle-life, and late-life interventions targeting these factors can significantly reduce the risk of ADRDs 8.
Cardiovascular Disease and Mortality
Global Impact
A large-scale prospective cohort study involving 155,722 participants from 21 countries found that approximately 70% of cardiovascular disease cases and deaths were attributable to modifiable risk factors. Metabolic factors, particularly hypertension, were the predominant risk factors, contributing to 41.2% of the population-attributable fraction (PAF) for cardiovascular disease 2. Behavioral factors such as tobacco use, poor diet, and physical inactivity were also significant contributors 2.
Stroke
The Global Burden of Disease Study 2013 highlighted that over 90% of the global stroke burden is attributable to modifiable risk factors. Behavioral factors like smoking, poor diet, and low physical activity accounted for 74.2% of stroke-related disability-adjusted life-years (DALYs). Metabolic factors, including high blood pressure and high body mass index (BMI), were also major contributors 4.
Cancer
Bladder Cancer
A systematic review of meta-analyses identified several modifiable risk factors for bladder cancer. Smoking, both current and former, significantly increased the risk, as did occupational exposures such as working in the tobacco and dye industries. Conversely, higher intakes of fruits, vegetables, and certain vitamins were associated with a reduced risk 5.
General Cancer Risk
In the UK, nearly 38% of cancer cases in 2015 were attributable to known modifiable risk factors. Tobacco smoking was the largest contributor, followed by overweight/obesity. Public health policies targeting these risk factors could significantly reduce cancer incidence 9.
Nonalcoholic Fatty Liver Disease (NAFLD)
Key Risk Factors
A comprehensive Mendelian randomization study identified several modifiable risk factors for NAFLD. These include alcohol consumption, obesity, type 2 diabetes, and hypertension. Higher education and high-density lipoprotein cholesterol (HDL-cholesterol) were associated with a decreased risk of NAFLD 10.
Anxiety Disorders
Lifestyle Factors
A systematic review identified several modifiable risk factors for anxiety disorders, including cigarette smoking, alcohol use, and negative appraisals of life events. Protective factors included social support, coping mechanisms, and physical activity. Smoking was particularly associated with an increased risk of agoraphobia and panic disorder 7.
Rheumatoid Arthritis (RA)
Inflammatory Polyarthritis
Smoking is a significant modifiable risk factor for RA, contributing up to 25% of the population burden. Other potential risk factors include high coffee consumption and obesity, while dietary antioxidants and breastfeeding may offer protective benefits 6.
Conclusion
The evidence underscores the critical role of modifiable risk factors in the prevention of various diseases, including dementia, cardiovascular disease, cancer, NAFLD, anxiety disorders, and RA. Public health strategies focusing on reducing exposure to these risk factors can significantly mitigate disease burden and improve population health outcomes.
Sources and full results
Most relevant research papers on this topic
Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis
Multiple co-occurring modifiable risk factors increase the risk of cognitive decline and dementia, emphasizing the need to minimize exposure and avoid additional risks.
Meta-Analysis
Rigorous Journal
Highly CitedModifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study
Most cardiovascular disease cases and deaths can be attributed to a small number of common, modifiable risk factors, with metabolic factors being the predominant cause and behavioral risk factors contributing to deaths.
Observational StudyRigorous JournalHighly CitedContributions of Modifiable Risk Factors to Dementia Incidence: A Bayesian Network Analysis.
Modifiable somatic and lifestyle factors, except for antioxidants, are strong predictors of all-cause dementia in older adults.
Meta-AnalysisGlobal burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
Modifiable risk factors contribute to 90% of the global stroke burden, with behavioral factors, metabolic factors, and environmental factors being the largest contributors.
Meta-AnalysisHighly CitedModifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses
Modifying lifestyle and occupational exposures, particularly smoking, can significantly reduce the bladder cancer burden.
Meta-AnalysisRigorous JournalHighly CitedModifiable risk factors for RA: prevention, better than cure?
Smoking contributes to RA, while dietary antioxidants, breastfeeding, and reducing alcohol intake may protect against the disease.
Meta-AnalysisHighly CitedModifiable risk and protective factors for anxiety disorders among adults: A systematic review
Cigarette smoking is a significant risk factor for anxiety disorders, while social support, coping, and physical activity can help reduce anxiety.
Systematic ReviewRigorous JournalHighly CitedModifiable Risk Factors in Alzheimer Disease and Related Dementias: A Review.
Modifiable risk factors for Alzheimer's disease and related dementias can be identified and managed, offering opportunities for therapeutic and preventive actions.
Systematic ReviewThe fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015
Tobacco smoking and overweight/obesity remain the top contributors to attributable cancer cases in the UK, with 37.7% of cancer cases in 2015 attributable to known risk factors.
Meta-AnalysisRigorous JournalHighly CitedThe associations between modifiable risk factors and nonalcoholic fatty liver disease: A comprehensive Mendelian randomization study
Genetically predicted alcohol frequency, elevated liver enzymes, poor physical condition, obesity traits, type 2 diabetes, and hypertension increase the risk of nonalcoholic fatty liver disease, while higher education and HDL-cholesterol decrease the risk.
Rigorous JournalHighly Cited