Determining Risk Factors of High-risk Level for Developing Dementia in Adults Aged <65 Years Old with Hypertension


  • Anuchit Klangman School of Nursing, Walailak University
  • Jom Suwanno School of Nursing, Walailak University
  • Chidchanok Mayurapak School of Nursing, Walailak University
  • Oratai Nontaphet School of Nursing, Walailak University



Adults, Dementia, Hypertension, Prevention, Risk factors


This comparative analysis, and cross-sectional study aims at determining the risk factors of the high risk for developing dementia in adults with treated hypertension. Dementia risk was identified based on the CAIDE risk model. We analyzed secondary data from the complete project, which was performed from May 2017 to April 2019. The participants were recruited from four Health Promotion Hospitals. This study included 219 cases of adults aged <65 years old. The cut-off CADIE risk scores of ≥10 were considered high-risk. Approximately 2 in 3 of the participants were late adults (63.47%), and women (68.95%). Over half (57.53%) was in the high-risk group. All of the risk factors were statistically significant (p-value <0.001) associated with the high risk in a univariate test. Increased age (Wald = 35.95), inactivity exercise (Wald = 26.70, and primary education or never school (Wald = 24.82) were the most powerful attributors of the high risk. Increment Wald values (p-value <0.001) on high-risk were seen when added health behavior-exercise domain with sociodemographic (Wald = 40.79), and cardiometabolic risk factor (Wald = 15.53) domains. In conclusion, all of the CAIDE risk factors, and domains explained the high risk of future dementia in these hypertension participants.


Download data is not yet available.


GBD 2016 Dementia Collaborators. Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019; 18(1): 88-106.

Ninomiya T, Ohara T, Hirakawa Y, Yoshida D, Doi Y, Hata J, Kanba S, Iwaki T, Kiyohara Y. Midlife and late-life blood pressure and dementia in Japanese elderly: the Hisayama study. Hypertension. 2011; 58(1): 22-28.

Sierra C. Hypertension and the risk of dementia. Front Cardiovasc Med. 2020; 7: 5.

Hughes D, Judge C, Murphy R, Loughlin E, Costello M, Whiteley W, Bosch J, O'Donnell MJ, Canavan M. Association of blood pressure lowering with incident dementia or cognitive impairment: a systematic review and meta-analysis. JAMA. 2020; 323(19): 1934-1944.

Kivipelto M, Ngandu T, Laatikainen T, Winblad B, Soininen H, Tuomilehto J. Risk score for the prediction of dementia risk in 20 years among middle aged people: a longitudinal, population-based study. Lancet Neurol. 2006; 5(9): 735-741.

Freitag MH, Peila R, Masaki K, Petrovitch H, Ross GW, White LR, Launer LJ. Midlife pulse pressure and incidence of dementia: the Honolulu-Asia Aging Study. Stroke. 2006; 37(1): 33-37.

Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep. 2018; 20(2): 12.

Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, Liu S, Song Y. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2015; 4(7): e002014.

Fayosse A, Nguyen DP, Dugravot A, Dumurgier J, Tabak AG, Kivimäki M, Sabia S, Singh-Manoux A. Risk prediction models for dementia: role of age and cardiometabolic risk factors. BMC Med. 2020; 18(1): 107.

Exalto LG, Quesenberry CP, Barnes D, Kivipelto M, Biessels GJ, Whitmer RA. Midlife risk score for the prediction of dementia four decades later. Alzheimers Dement. 2014; 10(5): 562-570.

Senanarong V, Harnphadungkit K, Poungvarin N, Vannasaeng S, Chongwisal S, Chakorn T, Jamjumrus P, Raksthaput A, Chaichanettee S, Aoonkaew N, Udompunthurak S, Doody RS, Cummings JL. The Dementia and Disability Project in Thai Elderly: rational, design, methodology and early results.BMC Neurol. 2013; 13: 3.

Koson N, Suwanno J. Predictors of risk level for developing cardiovascular disease in patient with hypertension. Thai Journal of Cardio-Thoracic Nursing. 2019; 30(2): 66-81. (In Thai)

Bunsuk C, Suwanno J. Prevalence of metabolic syndrome (mets) and metabolic risk components in non-obese hypertension. Thai Journal of Cardio-Thoracic Nursing. 2019; 30(2): 94-110. (In Thai)

Arab W, Mayurapak C, Phonphet C, Chaimay P, Suwanno J. Association of metabolic syndrome, amount and components of metabolic risk with chronic kidney disease in persons with hypertension. Thai Journal of Cardio-Thoracic Nursing. 2020; 31(2): 29-45. (in Thai)

Vuorinen M, Spulber G, Damangir S, Niskanen E, Ngandu T, Soininen H, Kivipelto M, Solomon A. Midlife CAIDE dementia risk score and dementia-related brain changes up to 30 years later on magnetic resonance imaging. J Alzheimers Dis. 2015; 44(1): 93-101.

Sakboonyarat B, Rangsin R, Kantiwong A, Mungthin M. Prevalence and associated factors of uncontrolled hypertension among hypertensive patients: a nation-wide survey in Thailand. BMC Res Notes. 2019; 12(1): 380.

Qiu C, Fratiglioni L. A major role for cardiovascular burden in age-related cognitive decline. Nat Rev Cardiol. 2015; 12(5): 267-277.

Rundek T, Gardener H, Dias Saporta AS, et al. Global vascular risk score and CAIDE dementia risk score predict cognitive function in the Northern Manhattan Study. J Alzheimers Dis. 2020; 73(3): 1221-1231.

Fratiglioni L, Wang HX. Brain reserve hypothesis in dementia. J Alzheimers Dis. 2007; 12(1): 11-22.

Meng X, D'Arcy C. Education and dementia in the context of the cognitive reserve hypothesis: a systematic review with meta-analyses and qualitative analyses. PLoS One. 2012; 7(6): e38268.

Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev. 2011; 12(5): e426-e437.

Anstey KJ, Cherbuin N, Herath PM. Development of a new method for assessing global risk of Alzheimer's disease for use in population health approaches to prevention. Prev Sci. 2013; 14(4): 411-421.

Anstey KJ, Cherbuin N, Herath PM, Qiu C, Kuller LH, Lopez OL, Wilson RS, Fratiglioni L. A self-report risk index to predict occurrence of dementia in three independent cohorts of older adults: the ANU-ADRI. PLoS One. 2014; 9(1): e86141.

Chiang CJ, Yip PK, Wu SC, Lu CS, Liou CW, Liu HC, Liu CK, Chu CH, Hwang CS, Sung SF, Hsu YD, Chen CC, Liu SI, Yan SH, Fong CS, Chang SF, You SL, Chen CJ. Midlife risk factors for subtypes of dementia: a nested case-control study in Taiwan. Am J Geriatr Psychiatry. 2007; 15(9): 762-771.

Iwagami M, Qizilbash N, Gregson J, Douglas I, Johnson M, Pearce N, Evans S, Pocock S. Blood cholesterol and risk of dementia in more than 1·8 million people over two decades: a retrospective cohort study. The Lancet Healthy Longevity 2021; 2(8): E498-E506.

Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc. 2011; 86(9): 876-884.

Lautenschlager NT, Anstey KJ, Kurz AF. Non-pharmacological strategies to delay cognitive decline. Maturitas. 2014; 79(2): 170-173.

Zhao C, Noble JM, Marder K, Hartman JS, Gu Y, Scarmeas N. Dietary patterns, physical activity, sleep, and risk for dementia and cognitive decline. Curr Nutr Rep. 2018; 7(4): 335-345.

Pescatello LS, Buchner DM, Jakicic JM, Powell KE, Kraus WE, Bloodgood B, Campbell WW, Dietz S, Dipietro L, George SM, Macko RF, McTiernan A, Pate RR, Piercy KL. Physical activity to prevent and treat hypertension: a systematic review. Med Sci Sports Exerc. 2019; 51(6): 1314-1323.

Kivimäki M, Singh-Manoux A, Pentti J, Sabia S, Nyberg ST, Alfredsson L, Goldberg M, Knutsson A, Koskenvuo M, Koskinen A, Kouvonen A, Nordin M, Oksanen T, Strandberg T, Suominen SB, Theorell T, Vahtera J, Väänänen A, Virtanen M, Westerholm P, Westerlund H, Zins M, Seshadri S, Batty GD, Sipilä PN, Shipley MJ, Lindbohm JV, Ferrie JE, Jokela M; IPD-Work consortium. Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis. BMJ. 2019; 365: l1495.




How to Cite

Klangman A, Suwanno J, Mayurapak C, Nontaphet O. Determining Risk Factors of High-risk Level for Developing Dementia in Adults Aged <65 Years Old with Hypertension. Health Sci J Thai [Internet]. 2022 Jul. 29 [cited 2023 Dec. 10];4(3):1-12. Available from:



Review articles