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Table 1 Modifiable risk factors obtained from BRFSS, 2015–2018

From: Overall and sex-specific risk factors for subjective cognitive decline: findings from the 2015–2018 Behavioral Risk Factor Surveillance System Survey

Risk factor Survey question Coding (yes/no) Years of available data
Subjective cognitive decline During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse? Used default All
Limited educational attainment What is the highest grade or year of school you have completed?
[Never attended school or only kindergarten/Grades 1–8/Grades 9–11/Grade 12 or GED/College 1–3 years (includes technical school or associate’s degree)/College ≥ 4 years (bachelor’s degree or higher)]
Limited educational attainment (YES) was defined as never having attended school or only kindergarten or Grades 1–8. All higher levels of education were classified as NO All
Deafness Are you deaf or do you have serious difficulty hearing? [Yes/No] Used default 2016–2018
Social isolation 1. How often do you get the social and emotional support you need? [Always/Usually/Sometimes/Rarely/Never]
2. Arthritis limited social activities by [A Lot/A Little/Not Limited/Don’t Have Arthritis]
Social isolation (YES) was defined as never or rarely receiving needed social and emotional support and/or having social activities limited a lot by arthritis. Social isolation (NO) was defined as always, usually, or sometimes receiving needed social and emotional support. Respondents who did not answer question 1 or 2 or who did not answer question 1 and answered “A Little”, “Not Limited” or “Don’t Have Arthritis” were excluded 1. 2015–2017
2. 2015, 2017
Depression Have you ever been told you have a depressive disorder including depression, major depression, dysthymia, or minor depression? [Yes/No] Used default All
Smoking Have you smoked at least 100 cigarettes in your lifetime and are you currently smoking every day or some days? [Yes/No] Used default All
Physical inactivity Have you engaged in physical activity or exercise during the past 30 days other than your regular job? [Yes/No] Used default All
Obesity What is your body weight status as determined by Body Mass Index (BMI)? [Underweight (≤ 18.49 kg/m2)/Healthy (18.50–24.99)/Overweight (25.00–29.99)/Obese (≥ 30.00)] Obesity (YES) was defined as a body weight of obese, while Obesity (NO) was defined as a body weight of underweight, healthy, or overweight All
Hypertension Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure? [Yes/No] Hypertension (NO) was defined as never having had high blood pressure, or only having had borderline-high blood pressure or pre-hypertension, or only having had high blood pressure during pregnancy. All other cases of high blood pressure were classified as YES All
Diabetes Have you ever been told that you have diabetes? [Yes/No] Diabetes (NO) was defined as never having had diabetes, or only having had pre-diabetes or borderline diabetes, or only having had diabetes during pregnancy. All other cases of diabetes were classified as YES All
Statistical analysis
Variable States with available data Sample sizea
Subjective cognitive decline Alabama, Alaska, Arizona, Arkansas, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Puerto Rico 216,838
Limited educational attainment Alabama, Alaska, Arizona, Arkansas, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Puerto Rico 216,231
Deafness Alaska, Delaware, Georgia, Hawaii, Idaho, Indiana, Kentucky, Massachusetts, Mississippi, Missouri, Montana, New Hampshire, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Tennessee, Vermont, Washington, Puerto Rico 100,825
Social isolation Alabama, Arizona, Arkansas, District of Columbia, Georgia, Hawaii, Illinois, Iowa, Louisiana, Minnesota, Mississippi, Nevada, New Jersey, North Dakota, Ohio, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Virginia, West Virginia, Wisconsin, Wyoming, Puerto Rico Total: 28,436
1. 18,168
2. 131,738 (11,102 for ‘arthritis limited social activities by a lot’)
Depression Alabama, Alaska, Arizona, Arkansas, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Puerto Rico 215,970
Smoking Alabama, Alaska, Arizona, Arkansas, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Puerto Rico 215,536
Physical inactivity Alabama, Alaska, Arizona, Arkansas, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Puerto Rico 216,395
Obesity Alabama, Alaska, Arizona, Arkansas, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Puerto Rico 204,233
Hypertension Alabama, Arizona, Arkansas, District of Columbia, Georgia, Hawaii, Illinois, Iowa, Louisiana, Minnesota, Mississippi, Nevada, New Jersey, North Dakota, Ohio, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Virginia, West Virginia, Wisconsin, Wyoming, Puerto Rico 132,662
Diabetes Alabama, Alaska, Arizona, Arkansas, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Puerto Rico 216,483
  1. aTotal n used in analysis of adults aged 45 and older from 2015 to 2018, excluding “Don’t Know” and “Refused” responses