Background and aims: This study investigates the global impact of ambient ultraviolet radiation (UVR) on dementia incidence, addressing its controversial association with dementia risk. UVR, through both vitamin D-dependent and independent mechanisms, influences physiological processes essential for brain health, such as reducing neuroinflammation, improving sleep regulation, and enhancing neuroplasticity. This study aims to clarify the relationship between UVR and dementia incidence and evaluate its role in public health strategies for dementia prevention.
Methods: An ecological analysis across 204 countries was conducted using country-specific data on UVR levels and dementia incidence rates. Bivariate analysis, partial correlation, and multiple linear regression models were employed to assess the relationship between UVR and dementia incidence. Confounding factors, including aging, economic affluence, genetic predisposition, and urbanization, were controlled to ensure robust results. Subgroup analyses were performed to explore differences across income classifications, regional groupings, and developmental statuses, based on World Bank and United Nations criteria.
Results: A significant inverse correlation between UVR and dementia incidence was identified (r = -0.764, p < 0.001), which persisted after adjusting for confounding factors. UVR emerged as the strongest predictor of dementia incidence, explaining a substantial portion of the variance, followed by aging as the second strongest predictor. Subgroup analyses revealed that the protective effects of UVR were particularly pronounced in developing countries, where limited access to vitamin D supplementation, combined with greater exposure to natural sunlight may enhance its influence.
Conclusion: Lower ambient UVR levels are associated with higher dementia incidence rates worldwide, suggesting a critical role for UVR in mitigating dementia risk. Public health strategies should consider environmental factors like UVR, particularly in regions with limited sunlight. Incorporating interventions to optimize UVR exposure could offer a cost-effective approach to reducing the global dementia burden and improving brain health outcomes.
Keywords: ambient ultraviolet radiation; dementia prevention; ecological analysis; neuroinflammation; public health strategies; vitamin D synthesis.
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