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Potentially Modifiable Risk Factors in Adolescence for Young-Onset Dementia

Summary and Comment |
September 13, 2013

Potentially Modifiable Risk Factors in Adolescence for Young-Onset Dementia

  1. Jaime Toro, MD

An analysis of men conscripted into the Swedish military suggests many factors are modifiable, but genetics remain important as well.

  1. Jaime Toro, MD

Young-onset dementia (YOD) is dementia diagnosed before age 65. It is often related to causative genes, but much research has been done to identify other risk factors. In one study, the prevalence of dementia was 54 per 100,000 with onset between ages 30 and 65and 98 per 100,000 between 45 and 65 (J Neurol Neurosurg Psychiatr 2003; 74:1206). In that study, the epidemiology of YOD was classified as follows: Alzheimer disease 34%, vascular dementia 18%, frontotemporal lobe degeneration 12%, dementia with Lewy bodies 7%, alcoholic dementia 10%, and other 19%. Other studies have had similar findings.

In this cohort study, researchers examined risk factors for YOD among 488,484 men conscripted at a mean age of 18 into the Swedish military service from January 1, 1969, through December 31, 1979. During an average follow- up of 37 years, 487 men had a diagnosis of YOD at a median age of 54 years. Significant risk factors for YOD identified at conscription were alcohol intoxication, stroke, use of antipsychotics, depression, father's dementia, drug intoxication other than alcohol, low cognitive function, low stature, and high blood pressure. The attributable risk for YOD in this population with all nine risk factors was 68%.

Comment

Although many of the risk factors for young-onset dementia identified in this study are important and, in many cases, preventable, genetic abnormalities are very common and appear to increase risk substantially for YOD. Unfortunately, in this cohort study, other potentially important risk factors such as head trauma and HIV were not examined. Future research must also look at the role of physical activity in preventing both young-onset and late-onset dementia.

  • Disclosures for Jaime Toro, MD at time of publication Editorial boards Multiple Sclerosis and Related Disorders

Citation(s):

Reader Comments (2)

Peter Mativo Other, Neurology, Aga Khan University hopsital- Nairobi

Good insight on YOD. Great study on environmental YOD.
In 3rd world countries HIV and head trauma is common and it's associated with dementia. More knowledge in genetics it's important.
congrats

Dawn Peterson, current ba student

I was curious as to the drug aspect of the study. So would a man be at higher risk for dementia if they were on a pain management? And if so, what steps could they take to lower the risk, and be able to stay on pain management?
The other question I had was, is this study limited to men, or were women involved, and if so what were the findings?

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