Geospatial analysis of the association of cardiometabolic diseases and incident Lewy body dementia in the Medicare population

Geospatial analysis of the association of cardiometabolic diseases and incident Lewy body dementia in the Medicare population | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Geospatial analysis of the association of cardiometabolic diseases and incident Lewy body dementia in the Medicare population George K. Karway, Brittany Krzyzanowski, Jordan A. Killion, Irene M. Faust, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8491743/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 9 You are reading this latest preprint version Abstract INTRODUCTION: Research on the potential role of cardiometabolic diseases (CMDs) as risk factors for Lewy body dementia (LBD) is limited, and findings from existing studies remain inconclusive. We investigated the geospatial patterns of CMDs and the association with LBD across the United States (U.S.). METHODS We performed an observational case-control study using a nationwide, population-based Medicare dataset of 75,847 incident LBD and 379,235 controls from 2017 and 2018 and computed the odd ratios (ORs) and 95% confidence intervals (CIs) between eight CMDs and LBD, adjusted for age, sex, race, smoking, healthcare utilization, and area deprivation index. At the county-level, we computed and mapped the standardized incidence ratios (SIRs) of LBD. We then computed the standardized prevalence ratios (SPRs) for the CMDs that were positively associated with LBD to investigate the geospatial patterns of the association between these CMDs and LBD across the U.S. RESULTS Compared to controls, our LBD cases were older and male. Hispanic, non-Hispanic Black, and Asian/Pacific Islander beneficiaries had higher odds of LBD compared to the non-Hispanic White beneficiaries. Of the eight CMDs examined, stroke (OR = 1.99, 95% CI = 1.95–2.02) was positively associated with LBD risk, while the other CMDs were inversely associated with LBD risk. There was a substantial geographic variation of prevalent stroke and incident LBD across the U.S., with the highest spatial correlation in the South and Central Appalachia. DISCUSSION Stroke is associated with a higher LBD risk. We observed higher SIRs for LBD and SPRs for stroke among beneficiaries living in the Southern U.S. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Health sciences/Neurology Health sciences/Risk factors Lewy Body Dementia Cardiometabolic Diseases Geographic Information Systems Geospatial Analysis Full Text Additional Declarations No competing interests reported. Supplementary Files eTable1.doc eTable2.docx eTable3.docx Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 11 May, 2026 Reviews received at journal 06 May, 2026 Reviews received at journal 12 Apr, 2026 Reviewers agreed at journal 05 Apr, 2026 Reviewers agreed at journal 02 Apr, 2026 Reviewers invited by journal 05 Jan, 2026 Editor assigned by journal 03 Jan, 2026 Submission checks completed at journal 03 Jan, 2026 First submitted to journal 31 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8491743","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":570326571,"identity":"0fdc3e33-0490-4c90-8ddc-faef86ebd51a","order_by":0,"name":"George K. 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Disease","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"NPJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Lewy Body Dementia, Cardiometabolic Diseases, Geographic Information Systems, Geospatial Analysis","lastPublishedDoi":"10.21203/rs.3.rs-8491743/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8491743/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eINTRODUCTION:\u003c/h2\u003e \u003cp\u003eResearch on the potential role of cardiometabolic diseases (CMDs) as risk factors for Lewy body dementia (LBD) is limited, and findings from existing studies remain inconclusive. We investigated the geospatial patterns of CMDs and the association with LBD across the United States (U.S.).\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e \u003cp\u003eWe performed an observational case-control study using a nationwide, population-based Medicare dataset of 75,847 incident LBD and 379,235 controls from 2017 and 2018 and computed the odd ratios (ORs) and 95% confidence intervals (CIs) between eight CMDs and LBD, adjusted for age, sex, race, smoking, healthcare utilization, and area deprivation index. At the county-level, we computed and mapped the standardized incidence ratios (SIRs) of LBD. We then computed the standardized prevalence ratios (SPRs) for the CMDs that were positively associated with LBD to investigate the geospatial patterns of the association between these CMDs and LBD across the U.S.\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e \u003cp\u003eCompared to controls, our LBD cases were older and male. Hispanic, non-Hispanic Black, and Asian/Pacific Islander beneficiaries had higher odds of LBD compared to the non-Hispanic White beneficiaries. Of the eight CMDs examined, stroke (OR\u0026thinsp;=\u0026thinsp;1.99, 95% CI\u0026thinsp;=\u0026thinsp;1.95\u0026ndash;2.02) was positively associated with LBD risk, while the other CMDs were inversely associated with LBD risk. There was a substantial geographic variation of prevalent stroke and incident LBD across the U.S., with the highest spatial correlation in the South and Central Appalachia.\u003c/p\u003e\u003ch2\u003eDISCUSSION\u003c/h2\u003e \u003cp\u003eStroke is associated with a higher LBD risk. We observed higher SIRs for LBD and SPRs for stroke among beneficiaries living in the Southern U.S.\u003c/p\u003e","manuscriptTitle":"Geospatial analysis of the association of cardiometabolic diseases and incident Lewy body dementia in the Medicare population","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-07 16:57:09","doi":"10.21203/rs.3.rs-8491743/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-11T17:41:01+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-06T04:20:24+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-13T00:27:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"270948062916036869389026376905332501317","date":"2026-04-06T02:27:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"7847772183110652805809063826452766428","date":"2026-04-02T22:50:52+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-05T17:04:57+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-04T03:22:04+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-03T13:24:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"npj Parkinson's Disease","date":"2025-12-31T18:33:58+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"npj-parkinsons-disease","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"npjparkd","sideBox":"Learn more about [npj Parkinson's Disease](http://www.nature.com/npjparkd/)","snPcode":"41531","submissionUrl":"https://submission.springernature.com/new-submission/41531/3","title":"npj Parkinson's Disease","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"NPJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a4a527f7-2d28-482a-86ee-7ea13a03fcdf","owner":[],"postedDate":"January 7th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-11T17:41:01+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-06T04:20:24+00:00","index":34,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[{"id":60687352,"name":"Health sciences/Diseases"},{"id":60687353,"name":"Health sciences/Health care"},{"id":60687354,"name":"Health sciences/Medical research"},{"id":60687355,"name":"Health sciences/Neurology"},{"id":60687356,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-05-11T17:55:08+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-07 16:57:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8491743","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8491743","identity":"rs-8491743","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}