When people under 65 start showing signs of dementia, we tend to point to family history first, but researchers say there are factors that can increase the risk of early-onset dementia. is not just genetic.
A new observational study published Tuesday in the peer-reviewed journal JAMA Neurology identifies 15 risk factors associated with the development of early-onset dementia, including depression, low socio-economic status, vitamin D deficiency and hearing loss. It was done.
The study, which reviewed data from more than 350,000 patients in the UK, did not prove a causal relationship between risk factors, but simply looked at which risk factors were more likely to be present in people who developed early dementia. I just did it.
“This ground-breaking research demonstrates the important role of international collaboration and big data in advancing our understanding of dementia,” said David Llewellyn, Professor at the University of Exeter in the UK and one of the study authors. He states: said in a press release.
“This is the largest and most robust study of its kind ever conducted. Interestingly, by targeting a variety of factors, we hope to reduce the risk of this debilitating disease. For the first time, it has become clear that we may be able to take action.”
Dementia is a collective term for several diseases, including Alzheimer’s disease, in which a person’s memory, cognitive processing, and ability to perform daily tasks rapidly decline.
Early-onset dementia is a term used to describe symptoms that start appearing before the age of 65. According to the Alzheimer’s Society of Canada, early-onset dementia accounts for approximately 2-8% of all dementia cases.
Experts say the issue of early onset dementia in younger people has not been adequately studied, as dementia primarily affects older people. And the effects of early-onset dementia can be even more volatile because we don’t expect patients to develop it so early.
“Early-onset dementia has a very serious impact because those affected usually still have jobs, have children and lead busy lives,” says Maastricht University in the Netherlands. said Stevie Hendricks, a researcher and one of the study authors. In the release.
“The cause is often thought to be genetic, but for many people we don’t know exactly what the cause is, so this study also wanted to look at other risk factors. I thought about it.”
The researchers looked at a cohort of 356,052 participants who were first assessed between 2006 and 2010, with information from the UK Biobank. Follow-up studies to track participants’ health over time were conducted by UK Biobank in 2018 or 2021. It depends on where the participants live.
A total of 485 confirmed cases of early-onset dementia were recorded during the follow-up period.
To investigate which potential risk factors are associated with early-onset dementia, researchers compared 485 participants to a control group.
Researchers investigated 39 potential risk factors and found that 15 were associated with a higher risk of early-onset dementia.
These include: lower education, lower socio-economic status, certain genetic markers, abstinence, alcohol use disorder, social isolation, vitamin D deficiency, high levels of certain proteins made in the liver, reduced grip strength, hearing loss, Orthostatic hypotension, stroke, diabetes, heart disease, depression.
Analyze risk factors
The researchers noted that the association was stronger for several risk factors: depression, low socioeconomic status, stroke, and the presence of two copies of a genetic marker called APOE ε4.
Some risk factors were influenced by gender. For example, men with diabetes have an increased risk of early-onset dementia, but no association was found between early-onset dementia and diabetes in women.
However, women with higher levels of C-reactive protein (CRP), which is produced in the liver, were more likely to develop early-onset dementia than women with lower levels. However, no correlation was found in men.
In terms of socio-economic factors, the researchers used the Townsend Index of Deprivation. The index scores regions and assigns them numerical values based on four variables. These variables are the percentage of unemployed, car owners, homeowners, and whether the household is overcrowded.
Researchers found that people in the most disadvantaged socio-economic groups were at higher risk of developing early-onset dementia.
Forty per cent of those who later developed early-onset dementia were from the most disadvantaged socio-economic group at the time of baseline assessment. Only 20% of people in this group did not develop early-onset dementia.
Grip strength may seem like an odd risk factor, but researchers included it to serve as a proxy for measuring general physical frailty. It is unlikely that a particularly firm handshake will completely eliminate dementia. This risk factor associated with lower incidence of early-onset dementia is rather due to observation of overall physical fitness.
Another complex risk factor is alcohol, with researchers finding that both abstinence and alcohol abuse disorders were associated with a higher risk of early-onset dementia, while moderate use was associated with a lower risk. .
Researchers suggest that moderate use may be associated with lower risk, as people who completely stop using alcohol may be doing so in response to worsening overall health. I theorized that there is a sex.
They found that although alcohol use disorder is more strongly associated with the risk of early-onset dementia, it is difficult to determine whether this is actually an alcohol use disorder or whether it may be a risk factor. He added that he could not. Addressing early-onset dementia is important because people with symptoms of impending dementia may be at higher risk of alcohol abuse before being diagnosed.
“Our findings regarding heavy alcohol use are complex and must be interpreted with caution,” the researchers noted in the study.
Some of the 15 risk factors were already observed as risk factors in older patients, such as educational level, depression, and social isolation.
In this study, people who reported visiting friends and family less than once a month were more likely to develop early-onset dementia than those who reported visiting friends and family more frequently. It was highly sexual.
Hearing loss, orthostatic hypotension, and CRP levels were not associated with common dementia in people over 65, the researchers said. Orthostatic hypotension is a condition in which a sudden drop in blood pressure causes you to feel dizzy or faint when you suddenly stand up or sit down.
Vitamin D deficiency is known to be associated with an increased risk of early-onset dementia, but it has not previously been studied or reported as a risk factor for early-onset dementia, the researchers said. There is.
The study is not without limitations. Because this is an observational study, it does not examine how these risk factors actually affect the body from a causal perspective. Although researchers are attempting to control for this possibility, it is possible that some of the risk factors identified may actually be early symptoms of pre-existing early-onset dementia. White people were also overrepresented in the UK Biobank sample, and researchers say more data on ethnic and racial minorities is needed.
Researchers believe that the 485 young-onset dementia patients identified in this study may represent a lower incidence than previously recorded and may reflect missing or undiagnosed cases. , pointed out that some of them may have been included in the control group.
The scale of this study is an important first step in identifying risk factors that may be included in future dementia prevention efforts, the researchers said.
In a statement, Leah Marsaleen, head of clinical research at Alzheimer’s Research UK, said: “We’re seeing a shift in understanding.” Alzheimer’s Research UK co-funded this research, along with several international research organizations and councils.
“This pioneering study sheds important and much-needed light on factors that can influence the risk of early-onset dementia. It fills an important gap in our knowledge. We are getting started, and it is important to build on these findings in broader research.”
