Home › Research › Risk factors
Midlife and late‐life population attributable fractions of risk factors for dementia in the United States: The Dementia Risk Prediction Project
Joanne M. Li, Abigail Gauen, Rachel Zmora, John J. Stephen, Lucia C. Petito, Denise Scholtens, Elizabeth Peterson, Ciaran Navin Kohli-Lynch et al.. Alzheimer s & Dementia, 2026-01-01
Topic: Risk, prevention and care in population studies
Midlife and late-life risk factors contributed to 22.7% and 16.5% of total dementia cases, respectively. Midlife obesity (PAF: 7.7%; 95% confidence interval [CI]: 4.9%-10.5%), lower education (PAF: 8.1%; 95% CI: 5.2%-11.1%), and late-life physical inactivity (PAF: 10.4%; 95% CI: 6.2%-14.5%) were the greatest contributors. Midlife and late-life modifiable risk factors contribute to dementia risk, highlighting a need for interventions across the life course. HIGHLIGHTS: Our sample included 37,931 participants across six pooled, longitudinal US cohorts. We observed midlife and late-life risk factors contributed to 22.7% and 16.5% of dementia cases, respectively. Midlife obesity, late-life physical inactivity, and lower education appear to be the greatest contributors to dementia risk.
Key findings
- Midlife and late-life risk factors contributed to 22.7% and 16.5% of total dementia cases, respectively.
- Midlife obesity (PAF: 7.7%; 95% confidence interval [CI]: 4.9%-10.5%), lower education (PAF: 8.1%; 95% CI: 5.2%-11.1%), and late-life physical inactivity (PAF: 10.4%; 95% CI: 6.2%-14.5%) were the greatest contributors.
- Midlife and late-life modifiable risk factors contribute to dementia risk, highlighting a need for interventions across the life course.
- HIGHLIGHTS: Our sample included 37,931 participants across six pooled, longitudinal US cohorts.
- We observed midlife and late-life risk factors contributed to 22.7% and 16.5% of dementia cases, respectively.
Why it matters
This US analysis estimated that midlife risk factors contributed to 22.7% and late-life risk factors to 16.5% of dementia cases, with midlife obesity, lower education and late-life physical inactivity the largest contributors. It highlights the need for interventions across the life course, but does not test whether such interventions reduce dementia.
New to this subject? Start with our plain-English guide: Risk factors, ranked →
Study details
- Study designmeta-analysis
- Participants37,931
- Effect size22.7%; 16.5%; 7.7%
- Evidence strengthHigh
How this study scored 73/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. We have no data on senior author's track record, so that was left out: it earned 70 of the 96 points we could judge it on, which is 73 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 4 / 4 | 37,931 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 2 / 7 | Cited 5 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 5 / 6 | Cited 23.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Norrina B. Allen holds only 8 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 24 institution(s) in 5 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41559019) |
| Free to read | 2 / 2 | Free to read |
| Points | 70 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 70 of the 96 points we could judge it on is 73 out of 100. |
| Total | 73 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Li, J. M., Gauen, A., Zmora, R., Stephen, J. J., Petito, L. C., Scholtens, D., et al. (2026). Midlife and late‐life population attributable fractions of risk factors for dementia in the United States: The Dementia Risk Prediction Project. Alzheimer s & Dementia. https://doi.org/10.1002/alz.71065
Vancouver
Li JM, Gauen A, Zmora R, Stephen JJ, Petito LC, Scholtens D, et al. Midlife and late‐life population attributable fractions of risk factors for dementia in the United States: The Dementia Risk Prediction Project. Alzheimer s & Dementia. 2026. doi:10.1002/alz.71065. PMID: 41559019.
BibTeX
@article{li2026-41559019,
author = {Li, Joanne M. and Gauen, Abigail and Zmora, Rachel and Stephen, John J. and Petito, Lucia C. and Scholtens, Denise and Peterson, Elizabeth and Kohli-Lynch, Ciaran Navin and others},
title = {{Midlife and late‐life population attributable fractions of risk factors for dementia in the United States: The Dementia Risk Prediction Project}},
journal = {Alzheimer s \& Dementia},
year = {2026},
doi = {10.1002/alz.71065},
pmid = {41559019},
url = {https://doi.org/10.1002/alz.71065}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here. Showing 12 of 13.
Later studies that cite this one
1 study in the alzhub library lists this one in its references.