And how you can take steps to prevent it.
While dementia is much more common in older adults, new research is shedding light on why some develop symptoms earlier in life.
According to a groundbreaking study published late December in JAMA Neurology, scientists from Maastricht University in the Netherlands and the University of Exeter in the U.K. pinpointed 15 health and lifestyle factors, including diabetes and social isolation, that could increase your risk of developing the brain condition.
While the results don’t prove dementia is necessarily caused by these factors, they do help build a more detailed picture of early cognitive decline, and knowing more about the causes can help develop better treatments as well as preventative measures.
“This is the largest and most robust study of its kind ever conducted,” said epidemiologist David Llewellyn from the University of Exeter. “Excitingly, for the first time, it reveals that we may be able to take action to reduce risk of this debilitating condition, through targeting a range of different factors.”
Amid these promising new findings, here’s a look at the mysterious condition, including some of the early warning signs and risk factors.
Early-onset dementia age
Early-onset dementia occurs in cases where those diagnosed are under the age of 65.
An estimated 3.9 million people experience young-onset dementia symptoms, with 370,000 people newly diagnosed each year and these numbers could soon rise. According to the staggering estimates from the study, dementia cases are expected to increase from 50 million in 2020 to 115 million by 2025.
“Although the prevalence of YOD [younger-onset dementia] is low compared with LOD [late-onset dementia], the personal, societal, and economic impact of YOD is particularly high, with consequences related to employment, social life, and familial responsibilities,” the study stated.
What are the early-onset dementia symptoms?
Dementia isn’t a disease itself but rather a collection of symptoms that result from damage to the brain caused by different diseases, such as Alzheimer’s. (Alzheimer’s can be younger-onset, too.) While everyone’s experience might vary, common early signs include memory loss, difficulty concentrating, and finishing familiar everyday tasks, such as getting confused when driving home. It could also mean struggling to follow a conversation or find the right word — a common one is saying “hand-clock” instead of “watch,” according to the Alzheimer’s Association.
Some get confused about time and place, causing them to ask the same question over and over again. Others exhibit strong mood and personality changes that make them seem like strangers even to their own families. This might mean becoming more irritable, suspicious, fearful, or depressed.
What are the risk factors for younger-onset dementia?
Our risk of developing dementia is influenced by age, genes, and a host of lifestyle factors.
Since most of the previous research has mostly been based on genetics, researchers in the latest study focused on how modifiable risks like smoking and alcohol intake affect this condition. They did this by surveying more than 350,000 people younger than 65 in the biomedical database, UK Biobank, to gain insight. Since women are more predisposed to this brain condition, it’s worth noting that they made up 55 percent of participants. The research team also acknowledged some limitations — namely that this cohort was largely healthy and white, so “the results of this study not generalizable to other racial and ethnic groups.”
Still, out of the 39 risk factors analyzed, the team found 15 factors that substantially increase the risk of young-onset dementia. Low socioeconomic status and formal education were associated with a higher risk for younger-onset dementia. A vitamin D deficiency and high C-reactive protein levels also meant an increased risk, as did having two copies of the APOE4 gene (a genetic combo that has already been linked to Alzheimer’s disease).
The effects of alcohol use are a little more “complex,” researchers said. While alcohol abuse led to an increased risk, moderate to heavy drinking correlated with a reduced risk. This might be because people in the latter group are usually healthier in general.
In addition to physical factors, health also played a key role. Avoiding chronic stress, loneliness, and depression can make a surprising difference.
The full list of the newly discovered early-onset dementia risks is below:
- Lower formal education
- Lower socioeconomic status
- Two copies of the APOE4 gene
- Alcohol use disorder
- Social isolation
- Vitamin D deficiency
- High C-reactive protein levels
- Lower handgrip strength
- No alcohol use
- Hearing impairment
- Diabetes
- Heart disease
- Depression
- Orthostatic hypotension
- Stroke
How is early dementia diagnosed?
Symptoms play a key role in diagnosing early dementia. Doctors might also use cognitive and neurological tests to evaluate thinking and physical functioning. These include assessing memory, problem-solving, language skills, and math skills, as well as balance, sensory response, and reflexes. There are also cerebrospinal fluid tests that measure proteins or other substances found in the clear fluid that surrounds the brain and these levels can be used to diagnose early dementia.
Brain scans can identify strokes and tumors that can lead to dementia, while also identifying any changes in the brain’s function. If early symptoms are primarily mood-related, a psychiatric evaluation may be recommended to help determine if symptoms are causing or contributing to symptoms.
While they’re not necessarily used as a diagnostic tool, genetic tests might be helpful as well for some forms of dementia to see if the cause of the condition has to do with their DNA. Though these kinds of cases tend to be rare, a genetic test can detect whether a patient has altered genes.
Is there a way to prevent early dementia?
The good news is that researchers said in their study that those with young-onset dementia can benefit from early diagnosis and treatment. Nearly 40 percent of all dementias, including Alzheimer’s disease, can potentially be prevented or at least delayed by modifying the lifestyle factors mentioned above and preventing chronic diseases like diabetes and high blood pressure.
This includes working in more exercise throughout your day, so you’re sitting less and moving more. What you eat plays a role too — the Mediterranean diet has long been thought to be beneficial for brain health because it is high in antioxidants from fruits and vegetables. While research has been mixed, a study published last March in the journal BMC Medicine found that this simple meal change could reduce dementia overall by 23 percent.
Cognitive and mood stimulation are also thought to be an effective preventative measure for dementia. This could mean challenging yourself by learning new languages or taking dancing classes and finding ways to reduce stress whether through meditation or yoga.
Leah Mursaleen, the head of clinical research at Alzheimer’s Research UK, which co-funded the study, told The Guardian, “We’re witnessing a transformation in understanding of dementia risk and, potentially, how to reduce it on an individual and societal level.”
