Behaviors in Adolescence May Affect Early Dementia Risk
Nine risk factors account for most cases of young-onset dementia (YOD) diagnosed before age 65 years, suggest results of a study of Swedish men.
These risk factors were multiplied, most were potentially modifiable, and most could be traced to adolescence, suggesting excellent opportunities for early prevention.
The strongest risk factor for YOD was alcohol intoxication, suggesting that “the effect of alcohol abuse on the overall risk of YOD in men is at present severely underestimated,” they conclude.
The study was published online August 12 in JAMA Internal Medicine.
For this analysis, researchers included 488,484 Swedish men who started mandatory military service from September 1969 through December 1979 at an average age of 18 years.
During a median follow-up of 37 years, 487 men were diagnosed with YOD at a median age of 54 years.
Significant independent risk factors for YOD included alcohol intoxication, stroke, use of antipsychotics, depression, father’s dementia, drug intoxication (other than alcohol), low cognitive function, lower height, and high systolic blood pressure at conscription (all P < .05).
Collectively, these factors accounted for 68% of the YOD cases identified, the investigators say.
Men with at least 2 of the 9 risk factors and in the lowest third of overall cognitive function had a 20-fold increased risk for YOD during follow-up (hazard ratio [HR], 20.38; 95% confidence interval [CI], 13.64 – 30.44).
YOD was also associated with a high risk for premature death (HR, 3.54; 95% CI, 2.77 – 4.53).
Potential Target for Intervention
Young-onset dementia causes major health, social, and financial problems for patients and their families. Adults with young-onset dementia often become unable to parent young children or hold a job. They frequently lose health insurance. Although adults with young-onset dementia have high Caregiving needs, many lack access to health care and adult caregivers.
JAMA Intern Med. Published online August 12, 2013. Abstract Editorial
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