New evidence on dementia risk factors in our region is needed

“The reason why we decided to conduct this review is that most of the evidence on dementia prevention comes from the Western world. But the region of Central and Eastern Europe (CEE) is culturally, politically, and economically different, and this specific context might influence population health, including cognitive health. For example, it has already been well established that, despite the recent improvements after the fall of the Berlin wall, there are still disparities between the East and the West in cardiovascular morbidity and mortality. We wanted to gather all available evidence to see whether we could create regionally-specific guidelines for dementia prevention based on what is already known.” says Katrin Wolfová, the lead author of the study.

We systematically searched major medical electronic databases such as PubMed or EMBASE using defined key term and selecting only studies based on samples from the CEE countries as defined by The Organisation for Economic Co-operation and Development (OECD). We identified 2,400 records, which were independently reviewed and assessed for a risk of bias. Of those, only 25 studies were included in the narrative synthesis describing associations of neurocognitive disorders with mainly cardiovascular risk factors, social factors, oxidative stress, vitamins and genetic factors. Most of the studies originated in Poland, followed by multinational studies. Four countries of the CEE region were not represented in the final selection at all.

The 2020 Lancet Commission on dementia prevention, intervention and care listed 12 known risk factors for dementia as potentially modifiable: less education, hypertension, obesity, alcohol, traumatic brain injury, hearing loss, smoking, depression, physical inactivity, social isolation, diabetes, and air pollution. Four of these have not been studied in the context cognitive ageing in the CEE region and two of the identified studies showed contra-intuitive findings suggesting that alcohol and higher body-mass index might have protective effect on later-life cognition. The largest body of evidence was focused on the link cognitive health and the history of cardiovascular diseases as well as factors that are known to increase cardiovascular risk. However, we concluded that the area of risk and protective factors for neurocognitive disorders is still generally largely unexplored in the CEE region.

“This study is important due to many reasons, of which the main one is the lack of epidemiological data about dementia in countries situated in CEE. This is a major obstacle for proposing national dementia strategies and implementing activities for the prevention of cognitive decline and dementia in this region. We hope that our review will stimulate future efforts to establish population-based longitudinal studies in our region, ideally as a part of international consortiums.” says Pavla Čermáková, the senior author of the study.

Link to the publication: Risk and protective factors of neurocognitive disorders in older adults in Central and Eastern Europe: A systematic review of population-based studies. Katrin Wolfova, Matej Kucera, Pavla Cermakova. PlosOne 2021.

Created: 7. 12. 2021 / Modified: 7. 12. 2021 / Responsible person: MUDr. Pavla Čermáková, Ph.D.