Risks of young-onset dementia revisited

Risks of young-onset dementia revisited

Side view of human head with dark blue gears on light blue background, some of them flying away at the back of the brain; concept of dementia praecox

Dementia usually occurs in people aged 65 and older. So-called dementia praecox occurs less commonly in people under 65.Now, a new study published in December 2023 JAMA Neurology Fifteen factors have been identified that are associated with a higher risk of dementia praecox.

Let’s take a look at what they found and, most importantly, what you can do to reduce your own risk.

Are early stage dementia and dementia praecox the same?

Won’t. Experts consider early stage dementia to be the first stage of dementia. Mild cognitive impairment and mild dementia are early forms of dementia. Therefore, someone who is 50, 65 or 88 years old may have early stage dementia.

Dementia praecox refers to the age at which dementia is diagnosed. If symptoms and diagnosis appear before age 65, you have dementia praecox.

What does previous research show?

A previous study of Swedish men found a number of risk factors for dementia praecox, including high blood pressure, stroke, depression, alcohol use disorder, vitamin D deficiency, drug use disorders and overall cognitive function.

What to know about this new study

In the new study, a team of researchers from the Netherlands and the United Kingdom looked at data from the UK Biobank. The biobank tracked around 500,000 people in the UK between 2006 and 2010, aged between 37 and 73 when they first joined the project. The majority of participants identified as white (89%), with the remaining 11% described only as “other.” Slightly more than half of the participants (54%) were female.

The researchers excluded people 65 or older and those who already had dementia at the start of the study, leaving 356,052 participants for analysis. Over approximately ten years, 485 participants developed dementia praecox. Researchers compared participants with and without dementia praecox to identify possible risk factors.

What do researchers know about the risk of young-onset dementia?

When reviewing the results, I think it is helpful to break the risk factors into categories and then examine them one by one. These risks may act directly or indirectly on the brain.

Eight factors are known or strongly suspected to cause dementia:

  • Gene: Carries two apolipoprotein E (APOE) ε4 alleles It is the main genetic risk factor for Alzheimer’s disease. This risk is thought to be caused by the inability of the APOE ε4 protein to effectively clear amyloid from the brain. This allows amyloid to accumulate and form plaques, triggering the cascade of cell death and Alzheimer’s disease.
  • Diagnosed with alcohol use disorder (AUD) is associated with damage to multiple parts of the brain, including the frontal lobes, which can lead to problems with executive function and working memory. When combined with malnutrition, AUD also damages small areas connected to the hippocampus that are critical for forming new memories.
  • socially isolated Is a major risk factor for dementia. Although the exact mechanism is unknown, it may be because our brains evolved in large part for social interaction. People who have less social contact also have less social interaction and simply cannot use their brains to their full potential to stay healthy.
  • Not getting enough vitamin D May lead to more viral infections. Many studies have shown that certain viral infections increase the risk of dementia.
  • poor hearing As I discussed in my previous article, there is an increased risk of dementia. This may be due to reduced brain stimulation and reduced social interaction. Using hearing aids can reduce this risk.
  • had a stroke before is a risk factor because stroke can directly damage the brain, leading to vascular dementia.
  • have heart disease It is a major risk factor for stroke, which can lead to vascular dementia.
  • If you are male, you have diabetes Dementia can be caused in many different ways. Why are you the only one who is a man? Researchers believe this is because middle-aged men are more likely than middle-aged women to suffer from diabetes-related mini-strokes, which in turn can lead to vascular dementia.

Two factors that reduce cognitive reserve

Cognitive reserve can be described as our ability to think, improvise, and solve problems even as our brains change as we age. These two risk factors make it more likely that dementia symptoms will appear at a younger age.

  • Have less formal education May affect your familiarity with paper-and-pencil cognitive testing items used to diagnose dementia.
  • lower socioeconomic status It may be related to the lower quality of education.

Is each factor identified in the study a clear risk?

No, and here’s why: Sometimes studies find apparent risk factors that may be caused by reverse causation. For example, symptoms of impending dementia may be risk factors because they become apparent before overt dementia is diagnosed.

  • lower grip strength is a sign of weakness, often associated with dementia.
  • No drinking is a risk factor because people may stop drinking when they experience memory loss (also known as the “healthy drinker effect” in dementia).
  • frustrated This is a risk factor because many people experience grief when they have trouble remembering or worry about dementia.

Finally, there are risk factors that may be a cause or consequence of impending dementia.

  • High C-reactive protein is a sign of inflammation.
  • orthostatic hypotension It is an abnormal drop in blood pressure when a person stands up after lying down or sitting. While this condition can lead to brain damage and dementia, it can also be the result of certain types of dementia, such as Parkinson’s disease dementia and Lewy body dementia.

What can you do to prevent dementia praecox?

Taking these five steps can reduce your risk of developing dementia before age 65:

  • Don’t drink too much alcohol.
  • Look for opportunities to interact with others on a regular basis.
  • Make sure you get enough vitamin D. If your skin is exposed to the sun (without sunscreen), you can synthesize vitamin D on your own. But in northern climates, you may need to take supplements, especially in the winter. Because vitamin D can interact with other medications, ask your doctor about this option.
  • Make sure you have good hearing, if not, use a hearing aid.
  • Reduce your risk of stroke, heart disease, and diabetes by exercising regularly, eating a healthy diet, maintaining a healthy weight, and working with your doctor.

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