Dementia before the age of 65, 15 risk factors identified

Dementia before the age of 65, 15 risk factors identified

The results of a large survey of over 350 thousand people in the United Kingdom have surprised scientists: the onset of dementia before the age of 65 appears to be driven not only by genetic predispositions, but also by lifestyle factors , general health conditions and the surrounding environment. This opens the way to new prevention strategies.

Not just genetics

While research on Alzheimer’s disease and other forms of senile dementia is very active, studies on young-onset forms of dementia (of which there are 370 thousand new cases per year globally) are relatively few and so far seemed to indicate that the main responsible for a genetic predisposition to the development of the disease – an agent on which it is not possible to intervene. Now, however, the results of a large investigation, recently published in the magazine Jama Neurologyhave allowed us to better understand the complex origin of young-onset dementia and promise to change our approach, focusing on risk reduction.

The study – the largest and most complete so far carried out on these disorders – used the clinical data of over 350 thousand people under 65 years old contained in the British database UK Biobank, highlighting for the first time how there are various other factors risk involved in the onset of young-onset dementia.

Modifiable risk factors

The researchers from the universities of Exeter and Maastricht who conducted the investigation identified in particular 15 risk factors closely associated – from genetic predispositions to lifestyle, to environmental influences: the presence of variants of the ApoE4 gene, the deficiency of some vitamins (especially vitamin D), high levels of C-reactive protein (a molecule produced by the liver and an indicator of inflammation), hearing disorders, diabetes, stroke, cardiovascular disease, depression, orthostatic hypotension (i.e. excessive drop in blood pressure arterial by moving to the upright position), physical frailty (measured as hand grip strength), but also low levels of education, social isolation and low socioeconomic status.

Both alcohol abuse and completely abstaining from its consumption were associated with an increased risk of developing dementia before the age of 65, but – the authors themselves warn – these results are complex to interpret and require caution . The fact that habitual alcohol consumption (moderate or high consumption) is linked to a lower risk of early-onset dementia compared to complete abstinence could be due to the fact that teetotal people often do not drink for health reasons or because they use alcohol. of drugs. Furthermore, it is unclear whether alcohol use disorder predisposes to young-onset dementia or is a sort of prodrome of the disease.

Focus on prevention

Second David Llewellyn from the University of Exeter, this is a revolutionary study in the sector, the largest and most consistent ever carried out so far on young-onset dementia, which demonstrates the crucial role of collaboration between research groups and the use of big data to improve knowledge and understanding of certain conditions. “The interesting thing – he concluded – is that for the first time it is revealed that we may be able to act to reduce the risk of this debilitating condition by targeting a number of different factors”.

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