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Impact of interventions scenarios targeting three main vascular risk factors on the future burden of dementia in France

  • NEURO-EPIDEMIOLOGY
  • Published:
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Abstract

The epidemiological and societal burden of dementia is expected to increase in the coming decades due to the world population aging. In this context, the evaluation of the potential impact of intervention scenarios aiming at reducing the prevalence of dementia risk factors is an active area of research. However, such studies must account for the associated changes in mortality and the dependence between the risk factors. Using micro-simulations, this study aims to estimate the changes in dementia burden in France in 2040 according to intervention scenarios targeting the prevention or treatment of hypertension, diabetes and physical inactivity. Accounting for their communality and their effects on mortality, the results show that the disappearance of hypertension, diabetes and physical inactivity in France in 2020 could decrease dementia prevalence by 33% among men and 26% among women in 2040 and increase the life expectancy without dementia at age 65 by 3.4 years (men) and 2.6 years (women). Among the three factors, the prevention of hypertension would be the most efficient. These projections rely on current estimates of the risk of dementia and death associated with risk factors. Thanks to the R package developed they could be refined for different countries or different interventions and updated with new estimates.

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Funding

Methodological developments for this work were partly performed in the framework of the Drugs Systematized Assessment in real-liFe Environment (DRUGS-SAFE) research program funded by the French Medicines Agency (Agence Nationale de Sécurité du Medicament et des Produits de Santé, ANSM). This publication represents the views of the authors and does not necessarily represent the opinion of the French Medicines Agency. The Paquid study was funded by ARMA (Bordeaux); Caisse Nationale d’Assurance Maladie des Travailleurs Salariés (CNAMTS); Conseil Général de la Dordogne; Conseil Général de la Gironde; Conseil Régional d’Aquitaine; Fondation de France; France Alzheimer (Paris); GIS Longévité; Institut National de la Santé et de la Recherche Médicale (INSERM); Mutuelle Générale de l’Education Nationale (MGEN); Mutualité Sociale Agricole (MSA); NOVARTIS Pharma (France); SCOR Insurance (France). The 3 C Study was conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux II University and Sanofi-Synthélabo Company. The Fondation pour la Recherche Médicale supported the preparation and initiation of the study. The 3 C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Conseils Régionaux of Aquitaine, Languedoc-Roussillon and Bourgogne, Fondation de France, Ministry of Research-INSERM Programme ‘Cohortes et collections de données biologiques’, Mutuelle Générale de l’Education Nationale, Institut de la longévité, Conseil Général de la Côte d’Or, Agence Nationale de la Recherche ANR PNRA 2006 (ANR/DEDD/PNRA/PROJ/200206–01–01) and Longvie 2007 (LVIE-003-01), Fondation plan Alzheimer (FCS 2009–2012) and Fonds de coopération scientifique Alzheimer and F. Hoffmann-La Roche Ltd.

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Authors and Affiliations

  1. Bordeaux Population Health Research Center U1219, Inserm, Univ. Bordeaux, 146 rue Léo Saignat CS61292, 33076, Bordeaux CEDEX, France

    Hélène Jacqmin-Gadda, Viviane Philipps, Florian Guillet, Christophe Tzourio, Catherine Helmer & Pierre Joly

Authors
  1. Hélène Jacqmin-Gadda
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  2. Viviane Philipps
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  3. Florian Guillet
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  4. Christophe Tzourio
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  5. Catherine Helmer
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  6. Pierre Joly
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Contributions

H.J.-G. and P.J. conceived, designed and supervised the research. H.J.-G wrote the original draft. F.G. and V.P. implemented the R code and performed the simulations. C.H. provided the Paquid data and contributed to the analysis of Paquid data. C.T. and C.H. provided the 3 C data and contributed to their analysis. All authors contributed to the interpretation of the results, revised the paper and approved the final manuscript.

Corresponding author

Correspondence to Hélène Jacqmin-Gadda.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The Paquid protocol was approved by the Ethics Committee of the Bordeaux University Hospital The 3 C protocol was approved by the Ethical Committee of the University Hospital of Kremlin-Bicêtre and Sud-Mediterranée III.

Each participant provided signed informed consent.

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Jacqmin-Gadda, H., Philipps, V., Guillet, F. et al. Impact of interventions scenarios targeting three main vascular risk factors on the future burden of dementia in France. Eur J Epidemiol 38, 435–443 (2023). https://doi.org/10.1007/s10654-023-00974-w

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  • DOI: https://doi.org/10.1007/s10654-023-00974-w

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