Early-onset dementia: 9 risk factors identified

Nine risk factors account for most cases of dementia that are diagnosed before the age of 65 years, and most of those risk factors can be traced to adolescence, according to results of a Swedish study published by JAMA Internal Medicine. Armed with this knowledge and further research, scientists could create treatments to prevent development of the disease, they maintain.

Peter Nordstrӧm, PhD, of Umeå University, Sweden, and colleagues studied 488,484 Swedish men conscripted for mandatory military service from September 1969 to December 1979. The men were aged an average of 18 years.

During a median follow-up of 37 years, early-onset dementia was diagnosed in 487 men at a median age of 54 years. Significant risk factors for the disease, according to results:

  • Alcohol intoxication
  • Stroke
  • Use of antipsychotics
  • Depression
  • Father’s dementia
  • Drug intoxication other than alcohol
  • Low cognitive function at conscription
  • Low height at conscription and
  • High systolic blood pressure at conscription.

“Collectively, these factors accounted for 68 percent of the…cases identified,” according to the authors.

Men with at least two of the nine risk factors and in the lowest third of overall cognitive function had a 20-fold increased risk of early-onset dementia during follow-up, researchers found.

The nine independent risk factors “were multiplicative, most were potentially modifiable, and most could be traced to adolescence, suggesting excellent opportunities for early prevention,” the authors concluded.

The study was supported by grants from the Swedish Research Council and the Swedish Dementia Foundation.

The research offers new insights into potential risk factors for early-onset dementia, Deborah A. Levine, MD, MPH, of the University of Michigan Health System, Ann Arbor, wrote in a related commentary.

“The finding that high systolic blood pressure in late adolescence is associated with an increased risk of [early-onset dementia], if confirmed, provides a potential target for intervention studies to prevent [early-onset dementia] and possibly late-onset dementia,” she said.

One goal of a national action plan is improving care and access to long-term services for adults with early-onset dementia, Levine added.

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