Early onset dementia may be prevented by newly identified risk factors

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Researchers have identified 15 modifiable risk factors that contribute to developing early-onset dementia before age 65. Raffaello Ferrari/Getty Images

According to the Centers for Disease Control and Prevention (CDC), nearly 6 million adults age 65 and older have Alzheimer’s disease (AD), the most common form of dementia, which is about 1 out of every 10 adults in this age bracket.


Many scientists prioritize dementia research, which includes finding medications to slow disease progression and learning more about changes people can make to reduce symptoms.


Researchers from the University of Exeter in England and Maastricht University in the Netherlands worked together to study young-onset dementia.


They focused their research on identifying risk factors for young-onset dementia and whether targeting these risk factors could reduce the risk of developing early dementia.


The research was recently published in JAMA Neurology.


How common is early onset dementia?

Alzheimer’s Disease International projects dementia cases to increase from 55 million people worldwide in 2020 to 139 million people by 2050.


With such a staggering estimate, finding ways to identify factors that contribute to developing the disease is of utmost importance.


While young-onset dementia is rare, the CDC reports that young-onset Alzheimer’s disease still affects around 200,000 people in the United States.


The researchers say that since most of the research into young-onset dementia focuses on genetics, they wanted to look more into how modifiable risk factors affect this form of dementia. Some modifiable risk factors include smoking, mental health, and alcohol intake.


The researchers used data from the U.K. Biobank for the study; the U.K. Biobank has nearly a half million participants who provide their genetic and other medical data. The purpose of the U.K. Biobank is to study health issues and make improvements in public health.


The scientists in the current project used data from nearly 356,000 participants who met the inclusion guidelines of being under age 65 and not having any form of dementia. Women comprised just over half (55.3%) of the participant pool.


The participants for U.K. Biobank underwent their initial assessments between 2006 and 2010 and followed up over the years, with the last follow-up in March of 2021.


Some information collected from the participants includes:


After gathering information about the participants, the researchers analyzed the data to see whether there was an uptick in the incidence of young-onset dementia in people exposed to certain risk factors.


New risk factors linked to early-onset dementia

Throughout the follow-up period, 485 people developed young-onset dementia.


The researchers identified 39 risk factors, and after careful analysis, determined that 15 of these risk factors increased the risk of young-onset dementia.


Some of the newly-identified risk factors include:


  • lower level of education
  • alcohol use disorder
  • social isolation
  • vitamin D deficiency
  • high C-reactive protein level
  • depression
  • stroke
  • diabetes

“While further exploration of these risk factors is necessary to identify potential underlying mechanisms, addressing these modifiable factors may prove effective in mitigating the risk of developing [young onset dementia] and can be readily integrated in current dementia prevention initiatives,” the authors wrote.


The study findings show that staying on top of both mental and physical health is important, especially during mid-life.


Further, many risk factors are things people can take action on, such as expanding their social activities or asking their healthcare team to assess their vitamin D levels.


Early intervention key to preventing dementia, Alzheimer’s

Dr. David Merrill, a geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center in Santa Monica, CA, spoke about the study with Medical News Today. Dr. Merrill weighed in on some of the risk factors the researchers identified.


When asked why depression could contribute to an increased risk for developing young-onset dementia, Dr. Merrill explained that “depression has both direct and indirect effects on brain structure and function.”


“We know that chronic depression can lead to more rapid loss of brain volume over time with aging,” Dr. Merrill noted. “Depression also tends to decrease levels of social and cognitive activities, which are themselves risks for cognitive decline.”


“Untreated depression can lead to progressively worsening cognitive decline, decline that may lessen or even stop if the depression is addressed,” he added.


Dr. Merrill touched on education level as a risk factor as well.


“[Socioeconomic status] and education level are developmental factors related to ‘cognitive reserve.’ Cognitive reserve can be thought of as the buffer against developing symptomatic dementia,” he said.


Dr. Allison B. Reiss, associate professor of medicine at NYU Long Island School of Medicine and part of the Alzheimer’s Foundation of America, also commented on the study to MNT:


“There are many things that can contribute to dementia that are in our environment and they are now more and more recognized,” noted Dr. Reiss. “The brain needs a very stable environment to function well and that includes many factors that are within our control or can be treated very well if the person receives good healthcare. The finding that genetics are not destiny is a hopeful one and indicates that we can take action to keep our brains at peak function starting in the younger years,” commented Dr. Reiss.


Dr. Reiss said that it is helpful for people to know there are things they can do to improve their chances of avoiding young-onset dementia.


“Diet, lifestyle, stress reduction, heart-healthy behaviors and seeking help for depression can make a difference,” pointed out Dr. Reiss.


“Improving financial status and making sure that people have enough to eat, safe housing and social connections does matter. It is important to see your healthcare provider regularly, follow recommended screening guidelines and work with that person or team to maintain overall good health.”