For health policy makers, knowing the number of dementia cases that could be prevented by decreasing exposure to known risk factors is key to formulating an evidence-based dementia response strategy. The proposed pilot project will calculate this for South Africa. South Africa is a middle-income country with a rapidly aging population and increasing number of people living with dementia. Little is known about which risk factors are important for population-based prevention strategies and how they differ by important population characteristics. We propose calculating the potentially preventable burden of dementia due to established dementia risk factors, mid-life hypertension and obesity, type 2 diabetes, low education, physical inactivity, smoking, depression, social isolation, and hearing loss. We will also explore how these vary by sex, population group, and other characteristics.
We will obtain relative risk estimates and calculate prevalence for established dementia risk factors (diabetes mellitus, midlife hypertension, midlife obesity, physical inactivity, depression, smoking, low educational attainment, social isolation, and hearing loss) in South Africa by comprehensive literature review and analysis of recent population-based survey data. We will replicate previously published methods to estimate the population attributable risk (PAR) using Levin’s formula and account for risk factor overlap. We will determine overall PAR and then PAR by strata of sex, population group and other characteristics. This study will provide the first estimates of the potentially preventable burden of dementia due to established dementia risk factors in South Africa. Findings from this study will be used to galvanize action around dementia prevention strategies that are locally appropriate. Methods used in this study have broad implications for other understudied regions of the world, and could be replicated in other countries where data are available.