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 Previous research has linked what are known as vascular risk
factors, including obesity, diabetes, smoking, high cholesterol and
elevated blood pressure, to higher odds of both dementia and stroke.
For the current study, researchers examined data on 7,423 adults
living in Northern California, including 1,166 people born in high
stroke-mortality states - all but one in the South: Alabama, Alaska,
Arkansas, Louisiana, Mississippi, Oklahoma, Tennessee, South
Carolina and West Virginia.
At age 65, the risk of developing dementia in the next 20 years was
30 percent for people born in these states, compared to 21 percent
for those born elsewhere, the study found.
“We know that where someone was born can influence how likely they
are to have a stroke,” said lead study author Paola Gilsanz of the
University of California, San Francisco and the Kaiser Permanente
Northern California Division of Research in Oakland.
“But as far as we know this is the first paper to look at the
association between the place of birth and dementia,” Gilsanz said
by email.
All of the patients in the current study had insurance through
Kaiser Permanente in Northern California. Researchers examined
medical record data for these Kaiser members starting between 1964
and 1973, when they were middle aged, and continuing through 1996 to
2015, when they were elderly.
Overall, 2,254 people, or 30 percent, were diagnosed with dementia
during the study period, researchers report in JAMA Neurology.
Dementia was more common in people born in the high stroke-mortality
states, however, affecting 39 percent of people from those nine
states, compared to 29 percent of adults born elsewhere.
After accounting for age, sex and race, the study authors calculate
that having been born in one of the high stroke-mortality states is
associated with 29 percent higher odds of dementia later in life
compared to people born in other parts of the U.S.
Black people in the analysis were almost 10 times more likely to
have been born in one of the stroke belt states, though, and had the
highest dementia risk of all.
Black adults from the nine states with high stroke mortality rates
were 67 percent more likely to develop dementia than non-black
people born outside of the stroke belt. Black people born outside
the stroke belt were 48 percent more likely to develop dementia than
all others born outside the stroke belt.
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Non-black adults born in the states with high stroke mortality rates
were 46 percent more likely to develop dementia than non-black
people born elsewhere, the study also found.
The study wasn’t a controlled experiment designed to prove whether
or how birth in a state with high stroke mortality rates might
influence the odds of dementia.
Researchers also lacked data on how long people lived in their state
of birth or other places in the U.S., making it impossible to
determine how long people might have lived in the stroke belt or
whether their age when they moved away influenced their odds of
dementia, the authors note.
Even so, people should be aware of the similar risk factors for
stroke and dementia and focus early on prevention, especially if
they’re from a region where stroke mortality rates are unusually
high, said Daniel Lackland, author of an accompanying editorial and
a researcher at the Medical University of South Carolina in
Charleston
Among other things, people should check their blood pressure
regularly and adopt healthy lifestyle habits like eating a low-salt
diet and getting plenty of exercise, Lackland said by email.
Both the American Heart Association and the Alzheimer’s Association
have good prevention guides online, Gilsanz said (http://bit.ly/1Owhr6f
).
“If you were born in a high risk state and move to a low risk state,
you take the risk with you unless you modify your lifestyle and
control your risk factors,” Lackland said. “The good news is that
with a reduction in risk factors the risk of both stroke and
dementia can be reduced.”
SOURCE: http://bit.ly/2f1vOWw and http://bit.ly/2tSgePw JAMA
Neurology, online July 31, 2017.
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