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  5. Examining the Lancet Commission risk factors for dementia using Mendelian randomisation.
 
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Examining the Lancet Commission risk factors for dementia using Mendelian randomisation.
File(s)
e300555.full.pdf (522.27 KB)
Published version
OA Location
https://mentalhealth.bmj.com/content/26/1/e300555
Author(s)
Desai, Roopal
John, Amber
Saunders, Rob
Marchant, Natalie L
Buckman, Joshua EJ
more
Type
Journal Article
Abstract
BACKGROUND: Dementia incidence is increasing across the globe and currently there are no disease-modifying pharmaceutical treatments. The Lancet Commission on dementia identified 12 modifiable risk factors which explain 40% of dementia incidence. However, whether these associations are causal in nature is unclear. OBJECTIVE: To examine the modifiable risk factors for dementia as identified in the Lancet Commission review using Mendelian randomisation (MR) to establish if, based on genetic evidence, these associations with different dementia subtypes are causal in nature. METHODS: Publicly available genome-wide association study data were used for 10 risk factors and Alzheimer's disease (AD), frontotemporal dementia and dementia with Lewy bodies. Two-sample MR using the inverse varianceweighted method was conducted to test for causal relationships. Weighted median MR and MR-Egger were used to test for pleiotropic effects. RESULTS: Genetic proxied risk for higher levels of smoking (OR: 0.80 (95% CI: 0.69; 0.92), p=0.002), obesity (OR: 0.87 (95% CI: 0.82; 0.92), p<0.001) and blood pressure (OR: 0.90 (95% CI: 0.82; 0.99), p=0.035) appeared to be protective against the risk of AD. Post hoc analyses indicated these associations had pleiotropic effects with the risk of coronary artery disease. Genetic proxied risk of educational attainment was found to be inconsistently associated with the risk of AD. CONCLUSIONS AND IMPLICATIONS: Post hoc analysis indicated that the apparent protective effects of smoking, obesity and blood pressure were a result of survivor bias. The findings from this study did not support those presented by the Lancet Commission. Evidence from causal inference studies should be considered alongside evidence from epidemiological studies and incorporated into reviews of the literature.
Date Issued
2023-02
Date Acceptance
2022-12-30
Citation
BMJ Mental Health, 2023, 26 (1), pp.1-8
URI
http://hdl.handle.net/10044/1/102661
URL
https://mentalhealth.bmj.com/content/26/1/e300555.info
DOI
https://www.dx.doi.org/10.1136/bmjment-2022-300555
ISSN
2755-9734
Publisher
BMJ Publishing Group
Start Page
1
End Page
8
Journal / Book Title
BMJ Mental Health
Volume
26
Issue
1
Copyright Statement
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
License URL
http://creativecommons.org/licenses/by-nc/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/36789917
PII: bmjment-2022-300555
Subjects
Adult psychiatry
PSYCHIATRY
Humans
Smoking
Genome-Wide Association Study
Risk Factors
Alzheimer Disease
Obesity
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2023-02-07
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