Abstract Details

Title Public Health Impact of Cardiometabolic Diseases on Incident Lewy Body Dementia in the U.S. Medicare Population

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P6 - Poster Session 6 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-005

Objective Understanding the impact of cardiometabolic diseases (CMDs) on incident Lewy body dementia (LBD) can inform primary preventative measures.

Background Studies suggest that LBD risk factors are similar to those for Alzheimer’s disease, including CMDs. Regional variations in CMDs across the US may contribute differentially to LBD disease risk.

Design/Methods We utilized nationwide, population-based Medicare data to identify all incident LBD cases (N=93,005) in 2017-2018 and frequency matched controls 5:1 (N=465,025) by month and year of LBD diagnosis. LBD was defined as either having an ICD-10 code for dementia with Lewy bodies or having incident PD with dementia two-year prior or one-year following. Exposure variables were the prevalence of eight CMDs: acute myocardial infarction (AMI), ischemic heart disease (IHD), atrial fibrillation, chronic heart failure, diabetes, hypertension, hyperlipidemia, and stroke. We computed the odd ratios (ORs) and 95% confidence intervals (CIs) of LBD for each demographic and CMD variable along with their individual and combined population attributable fractions (PAFs). ORs and PAF were adjusted for age, sex, and race/ethnicity. We mapped county-level PAFs using geospatial smoothing.

Results

LBD cases were older (OR=1.091, 95% CI: 1.090-1.092) and more commonly male (OR=1.624, 95% CI: 1.601-1.648) than controls. All CMDs were positively associated with LBD, with ORs ranging from 1.257 (95% CI: 1.221-1.294) for AMI to 2.343 (95% CI: 2.303-2.383) for stroke. The nationwide combined weighted PAF for the CMDs was 43.0%, with hypertension (36.1%), hyperlipidemia (23.4%), and IHD (22.2%) having the greatest individual PAFs. The highest county-level PAFs of CMDs on LBD were in the South and part of the Midwest and Northeast.

Conclusions Incident LBD cases among Medicare beneficiaries could be reduced substantially by mitigating CMD risk factors. CMDs disproportionally affect LBD burden in the South, part of Michigan, and Northeast.

Authors/Disclosures
George K. Karway, PhD (Barrow Neurological Institute) PRESENTER	Dr. Karway has nothing to disclose.
Brittany Krzyzanowski, PhD	Dr. Krzyzanowski has nothing to disclose.
Jordan A. Killion, PhD (Barrow Neurological Institute)	Dr. Killion has received personal compensation for serving as an employee of CommonSpirit Health. The institution of Dr. Killion has received research support from The Michael J. Fox Foundation for Parkinson's Research (MJFF-000939). The institution of Dr. Killion has received research support from Department of Defense Grant (PD190057). The institution of Dr. Killion has received research support from Barrow Neurological Foundation. The institution of Dr. Killion has received research support from Kemper and Ethel Marley Foundation. The institution of Dr. Killion has received research support from Moreno Family.
Irene Faust, MPH (Barrow Neurological Institute)	Ms. Faust has nothing to disclose.
Osvaldo J. Laurido-Soto, MD (Washington University)	The institution of Dr. Laurido-Soto has received research support from Washington University in St. Louis.
Brad A. Racette, MD, FAAN (Barrow Neurological Institute)	Dr. Racette has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for American Regent. Dr. Racette has received personal compensation in the range of $500-$4,999 for serving as a advisory council with NIEHS.

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