Risk factors revealed for young onset dementia

A “breakthrough study” has identified lifestyle and health factors among the risks for young onset dementia, laying the groundwork for new prevention strategies, researchers say.

The findings of the largest research of its kind by the University of Exeter, UK, and Maastricht University, the Netherlands, challenge the suggestion that it is only genetics that cause the condition.

Writing in JAMA Neurology, the team outline 15 risk factors after following more than 350,000 under-65s involved in the UK Biobank study. The factors are similar to those for late-onset dementia, the researchers say.

The team evaluated a range of risk factors, from genetic predispositions to lifestyle and environmental influences, and found lower formal education, lower socioeconomic status, genetic variation, lifestyle factors such as alcohol use disorder and social isolation, and health issues including vitamin D deficiency, depression, stroke, hearing impairment and heart disease significantly elevate risk of young-onset dementia

Professor David Llewellyn, of the University of Exeter, said: “This breakthrough study illustrates the crucial role of international collaboration and big data in advancing our understanding of dementia. There’s still much to learn in our ongoing mission to prevent, identify, and treat dementia in all its forms in a more targeted way.

“This is the largest and most robust study of its kind ever conducted. 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.”

Dr Stevie Hendriks, researcher at Maastricht University, said: “Young-onset dementia has a very serious impact, because the people affected usually still have a job, children, and a busy life. The cause is often assumed to be genetic, but for many people we don’t actually know exactly what the cause is. This is why we also wanted to investigate other risk factors in this study.”

Professor Sebastian Köhler, professor of neuroepidemiology at Maastricht University, said it is already known there are modifiable risk factors in older people who develop dementia, such as mental health – avoiding chronic stress, loneliness and depression.

“The fact that this is also evident in young-onset dementia came as a surprise to me, and it may offer opportunities to reduce risk in this group too,” he added.

Dr Leah Mursaleen, head of clinical research at Alzheimer’s Research UK, which co-funded the study, said the study was filling in “important gaps” in scientists’ knowledge.

“We’re witnessing a transformation in understanding of dementia risk and, potentially, how to reduce it on both an individual and societal level,” she said.

“In recent years, there’s been a growing consensus that dementia is linked to 12 specific modifiable risk factors such as smoking, blood pressure and hearing loss. It’s now accepted that up to four in 10 dementia cases worldwide are linked to these factors.

“This pioneering study shines important and much-needed light on factors that can influence the risk of young-onset dementia. This starts to fill in an important gap in our knowledge. It will be important to build on these findings in broader studies.’

Hendriks S, Ranson JM, Peetoom K. Risk factors for young-onset dementia in the UK Biobank: A prospective population-based study. JAMA Neurology 26 December 2023; doi:10.1001/jamaneurol.2023.4929


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