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Identifying the optimal combinations of modifiable dementia risk factors to target in multidomain intervention – Three-year longitudinal findings from the Canadian longitudinal study on aging
Surim Son, Mark R. Speechley, Guangyong Zou, Manuel Montero‐Odasso. The Journal of Prevention of Alzheimer s Disease, 2025-08-15
Topic: Risk, prevention and care in population studies
The combinations that were both highly prevalent and had the most detrimental effect on global cognition were: hearing loss and physical inactivity for the dyad (mean difference in change score = -0.07 SD; 95 % CI: -0.09 to -0.06; p < 0.001; effect size = -0.28), hearing loss, physical inactivity, and hypertension for the triad (mean difference in change score = -0.07; 95 % CI: -0.09 to -0.06; p < 0.001; effect size = -0.28), and hearing loss, physical inactivity, hypertension, and sleep disturbance for the tetrad (mean difference in change score = -0.05; 95 % CI: -0.07 to -0.03; p < 0.001; effect size = -0.20). Similar patterns were observed for memory and executive function. A significant synergistic interaction was observed between hearing loss and physical inactivity for global cognition (p = 0.005). The combined effect of multiple risk factors varied by its combinations. The combination of hearing loss and physical inactivity offers a greater potential benefit than other dyad combinations. Hypertension and sleep disturbance can be further included for triad and tetrad combinations. Auditory health and exercise should be prioritized for multidomain interventions.
Key findings
- The combinations that were both highly prevalent and had the most detrimental effect on global cognition were: hearing loss and physical inactivity for the dyad (mean difference in change score = -0.07 SD; 95 % CI: -0.09 to -0.06; p < 0.001; effect size = -0.28), hearing loss, physical inactivity, and hypertension for the triad (mean difference in change score = -0.07; 95 % CI: -0.09 to -0.06; p < 0.001; effect size = -0.28), and hearing loss, physical inactivity, hypertension, and sleep disturbance for the tetrad (mean difference in change score = -0.05; 95 % CI: -0.07 to -0.03; p < 0.001; effect size = -0.20).
- Similar patterns were observed for memory and executive function.
- A significant synergistic interaction was observed between hearing loss and physical inactivity for global cognition (p = 0.005).
- The combined effect of multiple risk factors varied by its combinations.
- The combination of hearing loss and physical inactivity offers a greater potential benefit than other dyad combinations.
Why it matters
This observational study found that combinations of hearing loss, physical inactivity, hypertension, and sleep disturbance were linked to worse cognitive decline, with hearing loss and physical inactivity showing a synergistic effect. It suggests targets for future interventions but does not show that addressing these factors prevents or treats Alzheimer's disease.
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Study details
- Study designlongitudinal study
- Participants30,097
- Evidence strengthModerate
How this study scored 51/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Journal of Prevention of Alzheimer s Disease) |
| Journal's citation record | 0 / 4 | The Journal of Prevention of Alzheimer s Disease: journal h-index 63 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 30,097 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 1.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Manuel Montero‐Odasso: h-index 60 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Western University: institution h-index 899 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40817010) |
| Free to read | 2 / 2 | Free to read |
| Total | 51 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1016/j.tjpad.2025.100321
- PubMed: 40817010
- Original source →
- Free full text: The Journal of Prevention of Alzheimer s Disease →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Son, S., Speechley, M. R., Zou, G., & Montero‐Odasso, M. (2025). Identifying the optimal combinations of modifiable dementia risk factors to target in multidomain intervention – Three-year longitudinal findings from the Canadian longitudinal study on aging. The Journal of Prevention of Alzheimer s Disease. https://doi.org/10.1016/j.tjpad.2025.100321
Vancouver
Son S, Speechley MR, Zou G, Montero‐Odasso M. Identifying the optimal combinations of modifiable dementia risk factors to target in multidomain intervention – Three-year longitudinal findings from the Canadian longitudinal study on aging. The Journal of Prevention of Alzheimer s Disease. 2025. doi:10.1016/j.tjpad.2025.100321. PMID: 40817010.
BibTeX
@article{son2025-40817010,
author = {Son, Surim and Speechley, Mark R. and Zou, Guangyong and Montero‐Odasso, Manuel},
title = {{Identifying the optimal combinations of modifiable dementia risk factors to target in multidomain intervention – Three-year longitudinal findings from the Canadian longitudinal study on aging}},
journal = {The Journal of Prevention of Alzheimer s Disease},
year = {2025},
doi = {10.1016/j.tjpad.2025.100321},
pmid = {40817010},
url = {https://doi.org/10.1016/j.tjpad.2025.100321}
}
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