Prevalence of Alzheimer’s Disease and Cardiometabolic Multimorbidity in Older Adults Aged 60 and above in a Large-Scale Representative Sample in Türkiye: A Nationwide Population-Based Cross-Sectional Study

BACKGROUND: It is a well-established fact that Alzheimer's Disease (AD) is a growing public health challenge worldwide, with increasing prevalence among older adults. Cardiometabolic multimorbidity (CMM) and various sociodemographic and lifestyle factors are acknowledged to influence AD risk. This study aimed to estimate the prevalence of AD and investigate its association with CMM and related sociodemographic and behavioral factors in older adults aged 60 years and above in Türkiye. METHOD: This study was conducted using secondary data obtained from the Türkiye Health Survey, provided by the Turkish Statistical Institute (TÜİK). Data were derived from 4630 individuals (weighted sample of 11,331,239) aged 60 years and older. AD prevalence, CMM (hypertension, coronary heart disease, stroke, diabetes, hyperlipidemia), and relevant covariates were evaluated. Multivariable binary logistic regression models were used to identify independent predictors of AD. RESULTS: The overall prevalence of AD was 3.8% (95% CI: 3.6-4.9%), slightly higher in females (4.1%, 95% CI: 3.8-5.7%) than males (3.5%, 95% CI: 2.8-4.7%). AD was more common among individuals who were single/divorced (6.4%), had lower education (4.1%), presented with CMM (5.9%), or led sedentary lifestyles (4.9%). In the model adjusted for age, sex, educational status, and marital status, the presence of CMM was significantly associated with increased odds of AD (aOR = 2.081; 95% CI: 1.522-2.844). In the further adjusted model for BMI, tobacco use, alcohol use, and activity during the day, CMM remained a significant predictor of AD (aOR = 1.975, 95% CI: 1.446-2.698). CONCLUSIONS: This large-scale study highlights a substantial burden of AD among older adults in Türkiye, strongly linked to CMM and modifiable social and behavioral factors. The findings of this study highlight the importance of integrated prevention strategies targeting vascular health, education, social support, and physical activity to reduce AD risk.