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These 15 lifestyle and health factors may increase your risk of early dementia, new study finds
Loneliness, vitamin D deficiency, low socioeconomic status, and alcohol abuse disorder are just a few of the health and lifestyle factors associated with an increased risk of early- or young-onset dementia, according to a groundbreaking new study.
Dementia affects a growing number of people globally. For the first time, researchers have identified 15 key risk factors, from gene variations to social conditions and environmental influences, that significantly raise a person's chance of developing young-onset dementia.
The findings, published in JAMA Neurology, challenge previous notions about the causes of the condition and lay the groundwork for new prevention strategies, the study authors wrote.
Researchers at University of Exeter and Maastricht University followed more than 350,000 participants under the age of 65 from across the United Kingdom in the UK Biobank (a large biomedical database) to understand the risks of early dementia.
“This is the biggest, most robust and wide-ranging study of its kind,” David Llewellyn, Ph.D., study co-author and professor of clinical epidemiology and digital health at the University of Exeter, tells TODAY.com.
“The most important finding was that a wide range of modifiable risk factors appear to be important, not just genetics,” says Llewellyn.
What is young-onset dementia?
Dementia is a term used to describe impairments in memory, thinking, problem-solving and decision-making that interfere with daily life, according to the United States Centers for Disease Control and Prevention.
Alzheimer’s disease is the most common type of dementia, with more than 6 million people living with the condition in the U.S., according to the Alzheimer's Association. While Alzheimer's is most prevalent in people over 65, about 5% of patients develop symptoms before 65, aka young-onset dementia, according to the Mayo Clinic.
Certain risk factors for dementia and Alzheimer’s after age 65 are well-established. Some are qualities a person can't change, referred to as "non-modifiable," like their age and genes. Other risk factors are more related to lifestyle (and modifiable), such as smoking, physical inactivity and excessive alcohol use, per the CDC.
As a result, researchers have known that a healthy diet and being physically and socially active can reduce dementia risk after age 65. But it wasn't clear if this also applies to young-onset dementia, until now.
Risk factors for young-onset dementia
In the new study, researchers investigated the association between 39 potential risk factors and the incidence of young-onset dementia among 356,052 participants to understand how health, social and environmental influences play a role.
Of these risk factors, researchers identified 15 that were significantly associated with a higher risk of young-onset dementia:
Social isolation
Lower formal education
Lower socioeconomic status
Carrying two copies of the APOE gene
Vitamin D deficiency
Hearing impairment
Alcohol use disorder
No alcohol use (abstinence)
Depression
High C-reactive protein levels
Lower handgrip strength (physical frailty)
Orthostatic hypotension (a form of low blood pressure)
Stroke
Diabetes
Heart disease
Most of these overlap with the known risk factors for and behaviors that reduce risk of late-onset dementia, the study authors wrote.
“We were surprised by just how many risk factors for dementia in elderly people were also important in people who were middle-aged,” says Llewellyn.
The study also identified several risk factors for young-onset dementia that had not been reported or studied before, the researchers wrote, including social isolation, vitamin D deficiency, orthostatic hypotension, and high C-reactive protein (CRP) levels.
Researchers found that participants who saw friends or family once a month or less had a higher association with young-onset dementia, suggesting a link between isolation and cognitive reserve.
Vitamin D is important for building bones, immune function and brain health — and getting enough of it may reduce the risk of young-onset dementia. "It has been suggested that vitamin D acts as a neurosteroid that protects against neurodegenerative processes," the study authors wrote.
High CRP levels in the bloodstream are a sign of inflammation, according to the Mayo Clinic. This was a new risk factor identified in the study, and CRP levels are significantly higher in women.
Orthostatic hypotension is a sudden drop in low blood pressure that happens when a person stands up after sitting or lying down, per the Mayo Clinic. The findings suggest it may increase the risk of young-onset dementia, possibly by reducing blood flow and depriving the brain of oxygen, the authors noted.
The 15 risk factors varied in importance, Llewellyn notes, but more research is needed to confirm how they rank. “There may be additional risk factors that we still need to identify,” he adds.
Additionally, the relationship between dementia and certain risk factors, such as alcohol use, is complex. For example, both "no alcohol" and "alcohol use disorder" made the list of 15 key factors.
Researchers found people with a diagnosis of alcohol use disorder had a higher risk of young-onset dementia. However, moderate to heavy alcohol consumption was associated with a lower incidence compared to abstinence. "This may be due to the 'healthy drinker effect,' in which people who drink are healthier, while abstainers are more likely to not consume alcohol because of poor health or use of medication," the study authors wrote.
Ultimately, the findings suggest that many risk factors for young-onset dementia are controllable and addressing these through lifestyle changes may lower a person's risk.
"There’s good evidence that staying physically, mentally and socially active may help to protect the brain as we age," says Llewellyn. "In addition, try to avoid or at least carefully manage any health conditions that you have," he adds, especially high blood pressure, diabetes and depression.
"We can be hopeful that a wide range of modifiable risk factors appear important, thus we can be hopeful that dementia can be delayed or even prevented," says Llewellyn.
This article was originally published on TODAY.com
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