Older people who feel lonely and have few close relationships may have an increased chance of developing dementia. Perhaps surprisingly, being socially isolated with few or infrequent social contacts does not seem to predict dementia risk, researchers found.
This study was carried out before the coronavirus pandemic but the findings are relevant now, when the over-70s are socially isolated. It suggests that those who have supportive social relationships with relatives and carers may be protected from cognitive decline. The quality of their relationships seems to be more important than how often they meet up in person.
People who have social contact may still feel lonely. The study stresses the importance of supportive relationships for people with early stage dementia.
The less healthy your lifestyle, the more you are at risk of developing dementia in later life, a new systematic review has shown. Researchers analysed the results of 18 studies with over 44,000 participants | BMJ Open | via National Institute for Health research
Having two or more ‘modifiable risk factors’, including smoking, high blood pressure, poor diet, inactivity, obesity and excessive alcohol consumption, puts adults at greater risk of developing dementia.
The included studies followed up people without signs of cognitive decline to see who developed dementia of any cause.
A third of the studies could be combined in a meta analysis and these showed a 20% increase in the risk of dementia for one risk factor, which rose to 65% for two risk factors. The presence of three risk factors doubled the risk of dementia.
There was also a reduction in risk conveyed by having fewer risk factors and this, despite any direct evidence from intervention trials, holds out hope that interventions which either reduce or remove risk will lead to a reduction in the incidence of dementia diagnoses.
These results are consistent with our growing knowledge of the links between unhealthy lifestyles and dementia and are highly relevant to the promotion of healthy ageing behaviours in mid-life and beyond, providing a compelling call to action in terms of public health and ageing.
This study investigated whether midlife forgetfulness was an indicator of an increased risk of dementia in old age | Dementia & Geriatric Cognitive Disorders
Background: Despite the current evidence of a high prevalence of forgetfulness in middle-aged individuals, and the evidence of a link between midlife memory complaints and biological changes in the brain, no previous study has yet investigated midlife forgetfulness in relation to risk of dementia in old age.
Methods: We used data from 3,136 employed men and women who participated in the Danish Work Environment Cohort Study in 1990. These data were linked to Danish national registers. Participants were asked whether their closest relative had ever told them that they were forgetful. Incidence rate ratios (IRR) were estimated using Poisson regression analysis.
Results: At baseline, 749 (24%) study participants were categorized as forgetful, and 86 (2.7%) participants were diagnosed with dementia during a total of 31,724 person-years at risk. After adjusting for sociodemographic factors, comorbidities, and work-related factors, midlife forgetfulness was associated with a higher risk of dementia (IRR = 1.82; 95% CI: 1.12–2.97).
Conclusions: This study is the first to investigate midlife forgetfulness and dementia, and the results suggest that midlife forgetfulness is an early indicator of an increased risk of dementia in old age.
In this blog, Honor Pollard explores if sleep problems could have a long-term effect on the brain| Alzheimers Research UK
Growing evidence points to a link between poor quality of sleep and an increased risk of Alzheimer’s disease. We know that disturbed sleep can be one of the earliest signs of Alzheimer’s and it often occurs years before changes to memory and thinking skills start to show. But this is not the full story when it comes to sleep and dementia.
A number of studies have shown that interrupted sleep may speed up the progression of Alzheimer’s in the brain. But it’s difficult for researchers to tease apart cause and effect. They need to work out whether poor quality sleep might contribute to the development of the disease or vice-versa.
A large study analising the medical data of thousands of people suggests that dementia incidence is lower among those who take blood pressure medication | via Medical News Today
A large new study has found a link between taking various kinds of blood pressure-lowering drugs and a lower risk of dementia among older adults, adding to the discussion around the link between cognitive decline and high blood pressure.
In their study the researchers analised data from 12,405 people, aged 60 or over, with dementia who attended one of 739 general practices in Germany as patients in 2013–2017. The team had access to all of these participants’ blood pressure values, as well as their medication records. This data was compared with those of 12,405 participants without dementia who had visited a general practice in the same time period.
The team found that those who took certain antihypertensive drugs — including beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers — seemed to have a lower risk of dementia.
Moreover, among those who took calcium channel blockers — which are another type of blood pressure drug — for a longer period of time, the incidence of dementia also decreased.
Risk reduction of cognitive decline and dementia | The World Health Organisation
These WHO guidelines provide evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia. Worldwide, around 50 million people have dementia and, with one new case every three seconds, the number of people with dementia is set to triple by 2050. The increasing numbers of people with dementia, its significant social and economic impact and lack of curative treatment, make it imperative for countries to focus on reducing modifiable risk factors for dementia.
These guidelines are intended as a tool for health care providers, governments, policy-makers and other
stakeholders to strengthen their response to the dementia challenge.
Objective: Depression afflicts 14% of individuals with type 1 diabetes (T1D). Depression is a robust risk factor for dementia but it is unknown if this holds true for individuals with T1D, who recently started living to an age conferring dementia risk. We examined if depression is a dementia risk factor among elderly individuals with T1D.
Methods: 3,742 individuals with T1D aged over 50 were followed for dementia from 1/1/96-9/30/2015. Depression, dementia, and comorbidities were abstracted from electronic medical records. Cox proportional hazard models estimated the association between depression and dementia adjusting for demographics, glycosylated hemoglobin, severe dysglycemic epidsodes, stroke, heart disease, nephropathy, and end stage renal disease. The cumulative incidence of dementia by depression was estimated conditional on survival dementia-free to age 55.
Results: Five percent (N = 182) were diagnosed with dementia and 20% had baseline depression. Depression was associated with a 72% increase in dementia (fully adjusted HR = 1.72; 95% CI:1.12-2.65). The 25-year cumulative incidence of dementia was more than double for those with versus without depression (27% vs. 12%).
Conclusions: For people with T1D, depression significantly increases dementia risk. Given the pervasiveness of depression in T1D, this has major implications for successful aging in this population recently living to old age.
New study predicts that sleep disturbance, depression, and anxiety increase the hazard of Alzheimer’s disease | Aging & Mental Health
Objectives: Alzheimer’s disease (AD) dementia is a neurodegenerative condition, which leads to impairments in memory. This study predicted that sleep disturbance, depression, and anxiety increase the hazard of AD, independently and as comorbid conditions.
Methods: Data from the National Alzheimer’s Coordinating Center was used to analyze evaluations of 12,083 cognitively asymptomatic participants. Survival analysis was used to explore the longitudinal effect of depression, sleep disturbance, and anxiety as predictors of AD. The comorbid risk posed by depression in the last two years coupled with sleep disturbance, lifetime depression and sleep disturbance, clinician-verified depression and sleep disturbance, sleep disturbance and anxiety, depression in the last two years and anxiety, lifetime depression and anxiety, and clinician-verified depression and anxiety were also analyzed as predictors of AD through main effects and additive models.
Results: Main effects models demonstrated a strong hazard of AD development for those reporting depression, sleep disturbance, and anxiety as independent symptoms. The additive effect remained significant among comorbid presentations.
Conclusion: Findings suggest that sleep disturbance, depression, and anxiety are associated with AD development among cognitively asymptomatic participants. Decreasing the threat posed by psychological symptoms may be one avenue for possibly delaying onset of AD.
Full reference: Burke, S. L. et al. | Psychosocial risk factors and Alzheimer’s disease: the associative effect of depression, sleep disturbance, and anxiety |Aging & Mental Health | 2018 Vol. 22, issue 12 | p1577-1584 | DOI: 10.1080/13607863.2017.1387760
Alzheimer’s Research UK | February 2019 | Half of UK adults can’t identify single key risk factor for dementia
Alzheimer’s Research UK, the the UK’s leading dementia research charity, has published its findings from one of the most comprehensive surveys of UK-wide public perceptions of dementia. They have been published today (6 February) by Alzheimer’s Research UK. The Dementia Attitudes Monitor, which will be repeated biennially, includes data from 2,361 interviews conducted by Ipsos MORI between 15 June and 5 July 2018.
The charity’s findings highlight enduring misconceptions around the physical nature of the diseases that cause dementia as well as low understanding of the risk factors for dementia, which is now the leading cause of death in the UK.
The Monitor reveals that just 1% of UK adults are able to name seven known risk or protective factors for the dementia (risk factors: heavy drinking, genetics, smoking, high blood pressure, depression and diabetes, protective factor: physical exercise) and 48% fail to identify any. With a third of cases of dementia thought to be influenced by factors in our control to change, the findings highlight a clear need for education around dementia prevention.
Key findings include:
More than half of UK adults (52%) now say they know someone with dementia.
Only half (51%) recognise that dementia is a cause of death* and more than 1 in 5 (22%) incorrectly believes it’s an inevitable part of getting older.
Only 34% of people believe it’s possible to reduce the risk of dementia, compared with 77% for heart disease and 81% for diabetes.
Three-quarters (73%) of adults would want to be given information in midlife about their personal risk of developing dementia later in life, if doctors could do so.
Sleep requirements change throughout life. As part of normal aging, sleep generally becomes briefer and fragmented, with older people often having multiple naps throughout the day. In this article, Osman Shabir explains that this may not be the pattern of sleep seen in patients with Alzheimer’s disease and other neurodegenerative conditions, however. | via News Medical
Most patients with Alzheimer’s develop sleep problems which worsen as the disease progresses. Some common sleep disturbances seen in patients with Alzheimer’s are:
Loss of the ability to stay asleep, despite being able to get to sleep
Increased sleep latency (duration required to get to sleep is longer)
Increased agitation before bedtime and throughout the night
Disorientation upon waking up (in the night, or in the morning)
Sleepy during the day, whilst being alert during the night (circadian abnormalities)
Periodic limb movement (PLM) is worsened in around 50% of Alzheimer’s patients
Shorter duration of both slow-wave-sleep (SWS) and rapid-eye movement sleep (REM) despite the total number of sleep cycles remaining unchanged
The article notes however that not all studies have shown a significant correlation between sleep disruption and Alzheimer’s disease, either in the pre-clinical stage or after symptoms develop. Therefore, not all Alzheimer’s patients suffer from sleep problems, and likewise, not all people suffering from sleep issues in older age necessarily have Alzheimer’s. However, it is now increasingly accepted that sleep loss may indeed be an important risk factor and symptom of Alzheimer’s disease. Whether sleep loss contributes to Alzheimer’s progression, or whether Alzheimer’s causes sleep problems, is yet to be determined.