Young-Onset Dementia Risk

Swedish researchers have found strong evidence that nine contributing factors for young-onset dementia can be traced back to early adulthood.

Young-onset dementia (YOD) is dementia diagnosed before 65 years of age. Dementia affects an estimated 35.6 million people worldwide, and YOD accounts for four to 10 percent of all dementia cases.

Experts have been able to trace early-onset dementia—such as Alzheimer’s disease beginning in a person’s early 30s—to gene mutations that affects how the body produces and processes a specific protein that causes plaques to build-up on the brain.

A new study published in the journal JAMA Internal Medicine suggests that nine risk factors account for the majority of YOD cases and can be traced to adolescence. The 37-year study followed 488,484 Swedish men enrolling in mandatory military service from 1969 to 1979 at the age of 19.

Nine Risk Factors for Early Dementia

The nine risk factors that accounted for 68 percent of YOD cases in the study population, in order of importance, are:

  • alcohol use
  • history of stroke
  • use of antipsychotic medication
  • depression
  • a father with dementia
  • illicit drug use
  • low cognitive function at the time of enlistment
  • low weight at enlistment
  • high blood pressure at enlistment 

Researchers say their results also showed that men in the lowest third of overall cognitive function with at least two of these risk factors had a 20-fold increased risk of young-onset dementia.

“In this nationwide cohort, nine independent risk factors were identified that accounted for most cases of YOD in men. These risk factors were multiplicative, most were potentially modifiable, and most could be traced to adolescence, suggesting excellent opportunities for early prevention,” the study, lead by Peter Nordstrӧm, Ph.D, of Umeå University in Sweden, concluded.

Address Your Risk Factors

Dr. Deborah A. Levine, an assistant professor of internal medicine at the University of Michigan Health System in Ann Arbor, said these findings could point to a new intervention strategy for men at a high risk of YOD.

“The finding that high systolic blood pressure in late adolescence is associated with an increased risk of YOD, if confirmed, provides a potential target for intervention studies to prevent YOD and possibly late-onset dementia,” she wrote in a commentary article in JAMA Internal Medicine.

Levine argues that because more men and women are developing YOD due to an increase in traumatic brain injuries among young veterans and stroke among young black and middle-aged adults, it’s important to intervene early to combat known risk factors.

“We must have effective and humane strategies to care for patients with YOD and their families,” she wrote. 

Testing For Early Dementia

Simply being able to identify the faces of celebrities could help doctors identify dementia earlier.

According to research published in the journal Neurology, how well a person can spot a celebrity and call out his or her name can help determine the patient's cognitive status.

"In addition to its practical value in helping us identify people with early dementia, this test also may help us understand how the brain works to remember and retrieve its knowledge of words and objects," lead study author Tamar Gefen, a doctoral candidate in neuropsychology at Northwestern University's Cognitive Neurology and Alzheimer's Disease Center, said in a press release.

Researchers found that 30 people with primary progressive aphasia—a form of early-onset dementia—were significantly worse at identifying and naming celebrities, scoring an average of 79 percent in recognition of famous faces and 46 percent in naming them. People without dementia scored 97 percent in recognition and 93 percent in naming.

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