Background: As there are currently no curative treatments for Alzheimer's disease (AD) and other forms of dementia, focusing on risk factor reduction and primary prevention is essential. Objectives: This study aimed to explore the factors that influence the occurrence of AD in comparison to other dementias. Methods: We conducted a case-control study involving caregivers of Alzheimer's patients (n=60) and a control group of caregivers for individuals with other dementias (n=60). Participants were recruited from a hospital in Yogyakarta between January 2018 and December 31, 2023. An online questionnaire containing 62 questions was administered via Zoho Forms and analyzed using IBM SPSS Statistics 25.0. We employed chi-square tests, and logistic regression to identify factors associated with the incidence of AD relative to other dementias. Results: Our findings indicated that an adequate dietary pattern (P=0.02; AOR=3.665; 95% CI=1.219-11.11) and age of 60 years or older (P=0.06; AOR=2.34; 95% CI=0.95-5.73) are significant risk factors for AD. Conversely, adequate sleep quality (P=0.03; AOR=0.24; 95% CI=0.07-0.87) and a history of stroke (P=0.00; AOR=0.07; 95% CI=0.02-0.26) were identified as protective factors against developing AD compared to other dementias. A poor diet can lead to systemic inflammation and oxidative stress, which may trigger neuroinflammation, including stroke. Additionally, increased tau load associated with being 60 years or older, along with poor sleep quality, can contribute to neuronal dysfunction and ultimately result in brain atrophy. Conclusion: This study identifies moderate dietary habits and age over 60 as risk factors for AD, while adequate sleep quality and a history of stroke serve as protective factors. The insights gained from this research may serve as foundational data for further studies and provide guidelines for preventing the onset of AD.
United Nation, World Population Ageing 2019. New York: United Nations, 2019. [Access date: 30 September 2022]
World Health Organization, Global status report on the public health response to dementia. Geneva: World Health Organization, 2021. [Access date: 10 December 2022]
Central Statistics Agency, Statistics of the elderly population. Jakarta: 3. Central statistics agency, 2022. Language: Indonesia; 6 April 2023
Chang AY, Skirbekk VF, Tyrovolas S, Kassebaum NJ, Dieleman JL. Measuring population ageing: an analysis of the Global Burden of Disease Study 2017. Lancet Public Health. 2019;4(3): e159-e67. doi:10.1016/S2468-2667(19)30019-2. PMID:30851869; PMCID: PMC6472541.
World Health Organization, “International statistical classification of diseases and related health problems 10th revision,” 2019. https://icd.who.int/browse10/2019/en [Access date: 14 May 2023]
World Health Organization, “International statistical classification of diseases and related health problems, 10th Revision ICD-10 : Tabular List,” World Heal. Organ., vol. 1, pp. 2, 33–95, 2016, [Online]. Available: http://www.who.int/classifications/icd/icdonlineversions/en/. [Access date: 18 May 2023]
GBD 2019 Dementia Forecasting Collaborators. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022;7(2):e105-e25. doi: 10.1016/S2468-2667(21)00249-8. PMID: 34998485; PMCID: PMC8810394.
Suriastini NW, Turana Y, Witoelar F, Supraptilah B, Wicaksono TY, Dwi E. Dementia prevalence rate: Needs the attention of all of us” Yogyakarta, 2016. [Online]. Available: http://www.surveymeter.org/. [Access date: 19 September 2022]
Dhari IF, Zaidah L. Identification of dementia risk factor in the pre-elderly and elderly in public health center (puskesmas) of Sleman District. Intisari Sains Medis. 2022;13(3):805-10. doi: 10.15562/ism.v13i3.921.
Suriastini NW, Turana Y, Supraptilah B, Wicaksono TY, Mulyanto ED. Prevalence and risk factors of dementia and caregiver’s knowledge of the early symptoms of alzheimer’s disease. Aging Med Health. 2020;11(2):60-6. doi: 10.33879/AMH.2020.065-1811.032.
GBD 2019 Indonesia Subnational Collaborators. The state of health in Indonesia's provinces, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Glob Health. 2022;10(11):e1632-e45. doi: 10.1016/S2214-109X(22)00371-0. Erratum in: Lancet Glob Health. 2023;11(6):e832. doi: 10.1016/S2214-109X(23)00174-2. PMID: 36240829; PMCID: PMC9579357.
Liang CS, Li DJ, Yang FC, Tseng PT, Carvalho AF, Stubbs B, et al. Mortality rates in Alzheimer's disease and non-Alzheimer's dementias: a systematic review and meta-analysis. Lancet Healthy Longev. 2021;2(8):e479-e88. doi: 10.1016/S2666-7568(21)00140-9. PMID: 36097997.
Uleman JF, Melis RJF, Quax R, van der Zee EA, Thijssen D, Dresler M, et al. Mapping the multicausality of Alzheimer's disease through group model building. Geroscience. 2021;43(2): 829-43. doi: 10.1007/s11357-020-00228-7. PMID: 32780293; PMCID: PMC8110634.
Turana Y, Tengkawan J, Suswanti I, Suharya DY, Riyadina W, Pradono J. Primary prevention of Alzheimer’s disease in Indonesia. Int J Aging Res. 2019;2(3):40.
Ong PA, Annisafitrie FR, Purnamasari N, Calista C, Sagita N, Sofiatin Y. et al. Dementia prevalence, comorbidities, and lifestyle among Jatinangor elders. Front Neurol. 2021;12:643480. doi: 10.3389/fneur.2021.643480
Dolatshahi M, Mahmoudi S, Torabi nia M, Kheirandish V. Alzheimer’s disease and its risk factors: A case-control study. Trends Med Sci. 2021;1(1). doi: 10.5812/tms.113857.
Azwar MK, Setiati S. Modifiable risk factors for dementia in Indonesia's urban population. Acta Med Indones. 2021;53(1):31-41. PMID: 33818405.
Morton RE, St. John PD, Tyas SL. Migraine and the risk of all‐cause dementia, Alzheimer's disease, and vascular dementia: A prospective cohort study in community‐dwelling older adults. Int J Geriatr Psychiatry. 2019;34(11):1667-76. doi: 10.1002/gps.5180.
Sindi S, Kåreholt I, Johansson L, Skoog J, Sjöberg L, Wang HX, et al. Sleep disturbances and dementia risk: A multicenter study. Alzheimers Dement. 2018;14(10):1235-42. doi: 10.1016/j.jalz.2018.05.012. PMID: 30030112.
Hack EE, Dubin JA, Fernandes MA, Costa SM, Tyas SL. Multilingualism and dementia risk: Longitudinal analysis of the nun study. J Alzheimers Dis. 2019;71(1):201-12. doi: 10.3233/JAD-181302. PMID: 31322560.
Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248): 413-46. doi: 10.1016/S0140-6736(20)30367-6. Erratum in: Lancet. 2023;402(10408):1132. doi: 10.1016/S0140-6736(23)02043-3. PMID: 32738937; PMCID: PMC7392084.
Dahlan MS. Sample size in medical and health research, 5th ed. Jakarta: MSD books, (Language: Indonesia); 2019. https://lib.ui.ac.id/detail?id=20511223 [Access date: 6 April 2023]
Sastroasmoro S. Ismael S. Fundamentals of clinical research methodology. 5th ed. Jakarta: Sudigdo Sastroasmoro, (Language: English); 2014. https://onesearch.id/Record/IOS3774.JAKPU000000000124322 Language: Indonsia, [Access Date: 18 March 2023]
Karota E, Development of sleep quality and sleep disorder instruments in research pdf method. Res Gate no. 2018;1-10. Language: Indonesia. [Access Date: 20 June 2023] doi:10.7454/jki.v9i2.159
Zhang XX, Tian Y, Wang ZT, Ma YH, Tan L, Yu JT. The epidemiology of Alzheimer's disease modifiable risk factors and prevention. J Prev Alzheimers Dis. 2021;8(3):313-21. doi: 10.14283/jpad.2021.15. PMID: 34101789.
Xu Lou I, Ali K, Chen Q. Effect of nutrition in Alzheimer’s disease: A systematic review,” Front Neurosci. 2023;17:1-12. doi: 10.3389/fnins.2023.1147177.
Arora S, Santiago JA, Bernstein M, Potashkin JA. Diet and lifestyle impact the development and progression of Alzheimer's dementia. Front Nutr. 2023;29;10:1213223. doi: 10.3389/fnut.2023.1213223. PMID: 37457976; PMCID: PMC10344607.
Yarns BC, Holiday KA, Carlson DM, Cosgrove CK, Melrose RJ. Pathophysiology of Alzheimer’s disease. Psychiatr Clin North Am. 2022;45(4):663–76. doi: 10.1016/j.psc.2022.07.003.
Sheppard O. Coleman M. Alzheimer’s disease: Etiology, neuropathology and pathogenesis. In Alzheimer’s disease: Drug discovery, Huang X, Ed. Brisbane: Exon Publications, Brisbane, Australia, 2020. doi:10.36255/exonpublications.alzheimersdisease.2020.ch1
Wang JH, Wu YJ, Tee BL, Lo RY. Medical comorbidity in Alzheimer’s disease: A nested case-control study. J Alzheimer’s Dis. 2018;63(2):773-81. doi: 10.3233/JAD-170786.
Trevisan K, Cristina-Pereira R, Silva-Amaral D, Aversi-Ferreira TA. Theories of aging and the prevalence of Alzheimer's disease. Biomed Res Int. 2019;2019:9171424. doi: 10.1155/2019/9171424. PMID: 31317043; PMCID: PMC6601487.
Lucey BP. It's complicated: The relationship between sleep and Alzheimer's disease in humans. Neurobiol Dis. 2020;144:105031. doi: 10.1016/j.nbd.2020.105031. PMID: 32738506; PMCID: PMC7484285.
Minakawa EN, Wada K, Nagai Y. Sleep disturbance as a potential modifiable risk factor for alzheimer’s disease. Int J Mol Sci. 2019;20(4):803. doi: 10.3390/ijms20040803.
Xu W, Tan CC, Zou JJ, Cao XP, Tan L. Sleep problems and risk of all-cause cognitive decline or dementia: an updated systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2020; 91(3):236-44. doi: 10.1136/jnnp-2019-321896. PMID: 31879285; PMCID: PMC7035682.
Sabia S, Fayosse A, Dumurgier J, van Hees VT, Paquet C, Sommerlad A, et al. Association of sleep duration in middle and old age with incidence of dementia. Nat Commun. 2021; 12 (1):2289. doi: 10.1038/s41467-021-22354-2. PMID: 33879784; PMCID: PMC8058039.
Kuang H, Zhu YG, Zhou ZF, Yang MW, Hong FF, Yang SL. Sleep disorders in Alzheimer's disease: the predictive roles and potential mechanisms. Neural Regen Res. 2021;16(10):1965-72. doi: 10.4103/1673-5374.308071. PMID: 33642368; PMCID: PMC8343328.
Gottesman RF, Schneider AL, Zhou Y, Coresh J, Green E, Gupta N, et al. Association between midlife vascular risk factors and estimated brain amyloid deposition. JAMA. 2017;317(14):1443-50. doi: 10.1001/jama.2017.3090. PMID: 28399252; PMCID: PMC5921896.
Rusjini,R. , Kariasa,I. M. and Faradita Aryani,D. (2024). Factors influencing alzheimer's disease: A case-control study. Nursing and Midwifery Studies, 13(4), 213-221. doi: 10.48307/nms.2024.449666.1386
MLA
Rusjini,R. , , Kariasa,I. M. , and Faradita Aryani,D. . "Factors influencing alzheimer's disease: A case-control study", Nursing and Midwifery Studies, 13, 4, 2024, 213-221. doi: 10.48307/nms.2024.449666.1386
HARVARD
Rusjini R., Kariasa I. M., Faradita Aryani D. (2024). 'Factors influencing alzheimer's disease: A case-control study', Nursing and Midwifery Studies, 13(4), pp. 213-221. doi: 10.48307/nms.2024.449666.1386
CHICAGO
R. Rusjini, I. M. Kariasa and D. Faradita Aryani, "Factors influencing alzheimer's disease: A case-control study," Nursing and Midwifery Studies, 13 4 (2024): 213-221, doi: 10.48307/nms.2024.449666.1386
VANCOUVER
Rusjini R., Kariasa I. M., Faradita Aryani D. Factors influencing alzheimer's disease: A case-control study. Nurs Midwifery Stud, 2024; 13(4): 213-221. doi: 10.48307/nms.2024.449666.1386