Modifiable Risk Factors for Dementia in the Indian Context – Where Vascular and Metabolic Ends Meet

The TLSA and SANSCOG studies have reported 39.84% and 22.77% prevalence of hypertension and diabetes respectively, with the rural population having a greater burden of undiagnosed and untreated conditions placing them at greater risk. Metabolic syndrome affects 46.2% of rural and 54.8% of the urban population. Insulin resistance is particularly high in the urban population (56.5%). The SANSCOG study showed that higher cardiovascular risk was associated with impairment in several cognitive domains. In addition to factors reported by the Lancet Commission, the cohorts were examined for other potentially modifiable risk factors. High homocysteine levels were found to be associated with impairment in language domain and lesser white matter volume. Poorer sleep duration and efficiency CONCLUSION: The results show that the burden of vascular and metabolic risk factors is high in the Indian context and highlight the relationship of these risk factors with cognition in individuals without dementia, suggesting their potential utility as early targets to prevent or delay incidence of dementia. The findings also underscore the need for low-and middle-income countries like India, with a high cardiovascular burden, to focus on correcting modifiable risk factors in mid-life to reduce dementia burden.