By Lisa Rapaport Published on January 12, 2024
There are a lot of concrete things people can do to help reduce their risk of getting dementia in their forties or fifties, a new study suggests.
For the study, researchers examined detailed genetic and medical information for roughly 356,000 adults who were 55 years old on average and had no history of dementia. During an average follow-up period of eight years, 485 people were diagnosed with what’s known as “young-onset” dementia, or cases caught in people under 65.
Social isolation, alcohol use disorder, and preventable or poorly managed chronic health conditions were all among the risk factors associated with an increased risk of young-onset dementia, according to study results published in JAMA Neurology.
This is actually good news, because these are what’s known as modifiable risk factors, which means people have some control over their odds of developing young-onset dementia, says Andrew Budson, MD, a neurology professor at Boston University and chief of cognitive behavioral neurology at the VA Boston.
“You can boil all these factors down to one sentence: It is important to stay healthy,” says Dr. Budson, who wasn’t involved in the new study. “Staying healthy is most important to the brain, and unhealthy choices often show up first in the brain.”
15 Risk Factors for Early-Onset Dementia
The study found the following traits or conditions increased the risk of developing dementia before 65:
- 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 (when blood pressure drops after standing up after sitting or lying down)
- Stroke
Drinking, Depression, and Social Isolation Are All Treatable Risk Factors for Early-Onset Dementia
Alcohol use disorder was associated with a more than doubled risk of dementia in the study. Stroke — which can be caused by modifiable risk factors like excessive drinking, poorly controlled blood sugar, or untreated hypertension — was likewise associated with twice the odds of young-onset dementia.
Social isolation, which researchers defined as visiting family or friends no more than once a month, was associated with a 53 percent higher risk of young-onset dementia. Heart disease was tied to a 61 percent higher risk, and type 2 diabetes was linked to a 65 percent greater risk. In addition, vitamin D deficiency was associated with a 59 percent increased risk, and hearing impairment was tied to a 56 percent greater risk.
Depression was associated with a more than tripled risk of young-onset dementia, the study also found.
“I believe based on our results that mental health is very important,” says lead study author Stevie Hendriks, PhD, of Maastricht University in the Netherlands. That’s because depression can be treated, and it’s also possible to increase social interactions to reduce isolation.
Genetic Risk Factors Can’t Be Changed
The study wasn’t designed to prove whether or how any one risk factor might directly cause young-onset dementia. It also confirmed that a genetic predisposition to dementia can increase the risk of this condition developing before age 65 — a risk factor that’s impossible to change. Genetic risk factors were associated with a 27 percent to 87 percent greater risk.
However, the results still offer fresh evidence of steps people can take to make young-onset dementia less likely, says Nada El Husseini, MD, an associate professor of neurology at Duke University in Durham, North Carolina, who wasn’t involved in the new study.
“Avoiding stroke and heart disease by managing risk factors such as hypertension and diabetes, staying physically and socially active, and avoiding excessive alcohol and recreational drug use are all important things people can do to prevent early onset dementia,” Dr. El Husseini says. “In addition, although more studies are needed to confirm this, managing and treating depression, hearing impairment and vitamin D deficiency are also likely to be beneficial.”
