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Low formal education and socioeconomic status, social isolation, and diabetes were among the factors linked to a higher risk of dementia
By: Naveen Athrappully
A major study from the United Kingdom has identified 15 factors linked to the development of dementia before the age of 65, opening a pathway of new preventive strategies.
The peer-reviewed study, published in JAMA Neurology, examined factors associated with incidences of young-onset dementia (YOD), a condition that usually affects individuals between the ages of 45 to 65 years. In some cases, people in their late 30s or early 40s can also be affected.
YOD tends to be more aggressive than dementia during old age. Researchers recruited 356,052 people who were younger than 65 and without dementia to be in the study.
After follow up, 485 incidences of YOD were identified.
Researchers found that 15 factors were “significantly associated” with a higher risk of YOD: lower formal education, lower socioeconomic status, no alcohol use, alcohol use disorder, social isolation, vitamin D deficiency, high C-reactive protein levels, lower handgrip strength, hearing impairment, orthostatic hypotension, stroke, diabetes, heart disease, depression, and carrying two copies of the apolipoprotein E4 allele, which is a major genetic risk factor for Alzheimer’s.
The discovery of these influential factors challenges the idea that genetics are the only cause of the condition and opens up the possibility that the risk of YOD could be reduced by targeting lifestyle and health factors.
Such factors are “mostly modifiable,” the study stated. “These modifiable risk factors should be incorporated in future dementia prevention initiatives and raise new therapeutic possibilities for YOD.”
The research was led by University of Exeter in the United Kingdom and Maastricht University in the Netherlands. Data for the study came from the UK Biobank, a repository of biological samples for research purposes.
“Young-onset dementia has a very serious impact because the people affected usually still have a job, children, and a busy life,” Stevie Hendriks, one of the authors of the study, said in a statement published by the University of Exeter.
“The cause is often assumed to be genetic, but for many people we don’t actually know exactly what the cause is. This is why we also wanted to investigate other risk factors in this study.”
Co-author Janice Ranson pointed out that their research “breaks new ground” by identifying that the risk of YOD can be reduced. “We think this could herald a new era in interventions to reduce new cases of this condition.”
The study was supported by Alzheimer’s Research UK, The Alan Turing Institute/Engineering and Physical Sciences Research Council, Alzheimer Nederland, Gieskes Strijbis Fonds, the Medical Research Council, the National Institute for Health and Care Research (NIHR) Applied Research Collaboration South West Peninsula (PenARC), the National Health and Medical Research Council, the National Institute on Aging, and Alzheimer Netherlands.
Young-Onset Dementia Risk
YOD, also called early onset dementia, has symptoms similar to dementia in old age. This includes memory loss, repetitive behavior, confusion, difficulty performing regular tasks, changes to behavior, language issues, and losing the ability to think or make clear judgments.
Some causes of YOD include Alzheimer’s, problems with blood flow in the brain, deterioration in the front part of the brain, chronic alcohol overuse spanning several years, and illnesses like HIV infection, Parkinson’s disease, Huntington’s disease, and multiple sclerosis, according to HealthDirect.
A 2021 study estimated that young-onset dementia was prevalent in individuals between the ages of 30 and 64 at a rate of 119 per 100,000 people. This comes to roughly 3.9 million people suffering from the condition worldwide in this age group.
While YOD prevalence among men was at 216.5 per 100,000 individuals, women had higher rates at 293.1 per 100,000 individuals.
Higher income nations had the lowest rate of YOD at 663.9 per 100,000 people, which rose to 764.2 in lower-middle-income nations, and then to 1,873.6 in upper-middle-income countries.
Recent studies have shown multiple ways to reduce dementia risk. A study from December 2022 found that levels of vitamin D were associated with the risk of age-related cognitive decline. High levels of vitamin D were associated with up to 33 percent lower chances of developing mild cognitive impairment or dementia.
There are numerous vitamin D receptors in the brain tissue. Vitamin D has been shown to clear amyloid plaques, which are “abnormal clusters of protein fragments” that build up between nerve cells, according to the Alzheimer’s Association.
Another recent study proposed that owning pets can reduce the risk of cognitive decline. Individuals who lived alone and did not have pets were found to have faster decline rates in verbal cognition and verbal fluency.
Pet owners who lived alone had better attention, reasoning, accuracy, and processing speed compared to those who lived alone and did not own pets.
Sleep disruptions experienced by a person in their 30s and 40s can also result in cognitive decline once they grow older, according to a study published this month.
Out of 175 individuals who experienced the most disrupted sleep, 44 had poor cognitive performance 10 years later. In contrast, just 10 of the 176 individuals with the least disrupted sleep suffered cognitive decline.
This means that while over 25 percent of those with the most disrupted sleep saw cognitive abilities fall over time, only 5.68 percent of those with the least disrupted sleep suffered the same.
“Our findings indicate that the quality rather than the quantity of sleep matters most for cognitive health in middle age,” said study author Yue Leng.
