Loneliness, depression and all kinds of controllable lifestyle factors increase the risk of dementia at a young age. This form of dementia, which usually affects people between the ages of 40 and 65, is therefore not only genetically determined.
Dutch and British scientists found fifteen risk factors for early dementia. They discovered, among other things, a clear link with vitamin D deficiency, cardiovascular disease, low blood pressure when standing and hearing problems. This offers starting points for the prevention of this disease, the authors write in their study that was published at the end of December in the medical scientific journal JAMA Neurology.
In the Netherlands, around 15,000 people live with early dementia, and up to 1,500 new patients are added every year. Early dementia is relatively rare, roughly fifteen times less common than dementia at a later age. The risk of the disease is therefore small. But the influence on daily life, on relationships and on work and income is great. The diagnosis is often delayed, and those around us often first think of relationship problems, stress or depression.
Followed closely
The researchers, from Maastricht and Exeter (United Kingdom), studied the data of more than 350,000 people who were closely followed for the UK Biobank between 2006 and 2021. The participants were all younger than 65 years and had no dementia diagnosis at baseline. Of this group, 485 people developed early dementia.
Fifteen of the 39 factors the scientists looked at were linked to an increased risk of early dementia. These included a known genetic risk factor for dementia (APOE-(epsilon)4) and issues such as lower education level or socio-economic status. Nothing can be done about this once a diagnosis is made. But many other factors can be influenced – sometimes after the diagnosis, but certainly also before. For example, physical fragility (measured by measuring the grip strength of the hand) turned out to be a risk factor, as did hearing problems and alcohol addiction.
Remarkably, not drinking alcohol was also a risk factor. Moderate alcohol consumption actually lowered the risk. An explanation for this could be that people who have an illness or are taking medication do not drink alcohol. Previous stroke, heart disease, diabetes and depression were also more common in people who developed early dementia.
Four risk factors have never before been associated with early dementia: vitamin D deficiency, high inflammation, low blood pressure when standing, and loneliness. People who only saw family or friends once a month were at a higher risk of early dementia than people who saw friends or family more often.
Eating unhealthy
The association with other known risk factors, such as smoking, little exercise and unhealthy eating, disappeared when adjustment was made for socio-economic status or other lifestyle factors.
Modifiable risk factors also play a role in dementia at a later age, as was already known from previous studies: lifestyle factors that promote cardiovascular disease, but also mental factors such as chronic stress, loneliness and depression. Scientists estimate that about 30 percent of dementia cases can be prevented by living a healthier lifestyle.
The new study does not show that the risk factors are the cause of early dementia. But the authors urge that modifiable risk factors be included in dementia prevention plans, and find out whether improving these aspects could play a role in future treatments.
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