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- Risk Avoidance
- 24 and 665
- Risk Factors Defined
- Population Attributable Fraction (PAF)
- Modifying Dementia Risk
- Be Accountable
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Throughout life cycles, risk avoidance is typically learned behavior. While recreational dangers of sky diving, mountain climbing and “black diamond” skiing seem apparent, other personal hazards can be nuanced. In financial planning for comfortable retirement, risk and return factors are evaluated. Most will benefit from higher quality investments in profitable companies rather than penny stock speculation. Ideally, quality of life decisions should be guided by known risks.
Medically speaking, some conditions are acute, such as strokes or sudden hearing loss and others chronic, including diabetes, along with heart, lung and kidney diseases. As The Lancet journal article vividly describes, it is vital to proactively recognize and manage chronic risks associated with Dementia prevention, intervention and care.
Recognizing pride of authorship, what are 24 and 665?
The impressive number of authors and research references in 2017 The Lancet article. Motivated by those devoting careers to publish integral research, hearing care leaders feel compelled to gain and share dementia-related subject matter expertise.
For reference, the National Cancer Institute defines medical Risk Factors as: “Something that increases the chance of developing a disease.” *
*https://www.cancer.gov/publications/dictionaries/cancer-terms/def/risk-factor
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To reiterate, The Lancet’s landmark paper1 detailed nine risk factors that if completely eliminated, may reduce dementia’s negative impact by approximately 35% via decreasing risk, delaying onset and reducing severity. |
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While societal awareness of these nine risk factors is crucial, some are deemed more impactful. To deepen knowledge of Dementia risk factors and those associated with other comorbidities, we explore the concept of Population Attributable Fraction (PAF).
Another premier medical journal, The BMJ, noted “BMJ is a global healthcare knowledge provider with a vision for a healthier world. We share knowledge and expertise to improve healthcare outcomes.” 2
“Much statistical analysis seeks to identify associations between exposures and outcomes. The population attributable fraction (PAF) is an epidemiologic measure widely used to assess the public health impact of exposures in populations. PAF is defined as the fraction of all cases of a particular disease or other adverse condition in a population that is attributable to a specific exposure. The term “attributable” has a causal interpretation: PAF is the estimated fraction of all cases that would not have occurred if there had been no exposure.” 3
For illustration, a particular study indicated the smoking PAF for lung cancer deaths was 83%.4
Quantifiably, reducing or eliminating certain risk factors decreases negative health outcomes more than others. With a picture worth 1000 words, the paired Modifying Dementia Risk pie charts below convey:
9 Factors, 3 Goals, for Life, specifically:
- The proportion of projected dementia cases (35%) that may be prevented, delayed or severity reduced
- PAF’s of 9 risk factors, the most modifiable one being (9.1%) hearing loss
- Almost 70% of potential case and impact reduction includes, or relates to, hearing loss
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2 https://www.bmj.com/company/the-story-of-bmj-2/
3 https://www.bmj.com/content/360/bmj.k757
4 Doll R, Hill AB. A study of the aetiology of carcinoma of the lung. Br Med J1952;2:1271-86. doi:10.1136/bmj.2.4797.1271 pmid:12997741
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"It is not only what we do, but also what we do not do,
for which we are accountable."
—Moliere
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Hearing care professionals responsible for the most important modifiable risk factor recognize these research-based statistics are profound, especially since:
- 6.5 million Americans currently live with Alzheimer’s Disease
- 10s of millions of family members and caregivers are deeply affected
- By 2050, these numbers are expected to double 5
5 https://www.alz.org/
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The remarkable paradox is that while these educational imperatives should be urgent, at macro and micro levels, not enough people are enlightened with pertinent information. From fellow healthcare providers to senior living community decision makers and hearing-challenged individuals to family members, more must be alerted. To maximize public health impact, frontline efforts need to reputably spread knowledge in terms that, from health literacy perspectives, are more readily comprehended.
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As the Japanese Kaizen principle teaches, take small steps, every day. Commit to having one more caring conversation today on how to modify dementia risks, then each tomorrow. While others adopt scare tactics, the evident contrast of your compassionate expertise will speak volumes.
Amplify Your Impact, Accountability Matters.
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Bruce Essman
CEO
High Definition Impressions (HDI)
314.276.7392
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