Population attributable fraction for dementia in American Indians

These findings collectively demonstrate important differences across populations in PAF for dementia. In the Lancet report, 45% of PAF for dementia was attributable to 14 factors; in this study of older American Indians, education, diabetes, hypertension, depression, and isolation alone accounted for 60% of PAF, with other factors not associated. However, more research is needed to understand these unique patterns: especially timing of risk exposure, risk factor burden and interactions, and likelihood to survive to older-age. Meanwhile, public health programs to address these institutional or structural early-life exposures, vascular risks at mid-life, and psychological health in later-life may provide appropriate targets for reducing risk in American Indian communities.