(Press-News.org) A study of Swedish men suggests nine risk factors, most of which can be traced to adolescence, account for most cases of young-onset dementia (YOD) diagnosed before the age of 65 years, according to a report published by JAMA Internal Medicine, a JAMA Network publication.
Dementia is a major public health concern that affects an estimated 35.6 million people worldwide. The cost and disability associated with dementia are expected to increase in the next 40 years, affecting more than 115 million people by 2050, Peter Nordstrӧm, Ph.D, of Umeå University, Sweden, and colleagues write in the study background.
The study included 488,484 Swedish men conscripted for mandatory military service from September 1969 through December 1979 with an average age of 18 years.
"Young-onset dementia (YOD), that is, dementia diagnosed before 65 years of age, has been related to genetic mutations in affected families. The identification of other risk factors could improve the understanding of this heterogeneous group of syndromes," the study notes.
During a median follow-up of 37 years, 487 men were diagnosed as having YOD at a median age of 54 years. Significant risk factors for YOD included alcohol intoxication (hazard ratio [HR], 4.82); stroke (HR, 2.96); use of antipsychotics (HR, 2.75); depression (HR, 1.89); father's dementia (HR, 1.65); drug intoxication other than alcohol (HR, 1.54); low cognitive function at conscription (HR, 1.26); low height at conscription (HR, 1.16); and high systolic blood pressure at conscription (HR, 0.90), according to the results.
"Collectively, these factors accounted for 68 percent of the YOD cases identified," the authors comment.
The results also indicate that 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 YOD during follow-up.
"In this nationwide cohort, nine independent risk factors were identified that accounted for most cases of YOD in men. These risk factors were multiplicative, most were potentially modifiable, and most could be traced to adolescence, suggesting excellent opportunities for early prevention," the study concludes.
###
(JAMA Intern Med. Published online August 12, 2013. doi:10.1001/jamainternmed.2013.9079. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: This study was supported by grants from the Swedish Research Council and the Swedish Dementia Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Commentary: Unanswered Questions, Unmet Needs in Young-Onset Dementia
In a related commentary, Deborah A. Levine, M.D., M.P.H., of the University of Michigan Health System, Ann Arbor, writes: "The article by Nordstrӧm and colleagues provides new insights about potential risk factors for YOD."
"The finding that high systolic blood pressure in late adolescence is associated with an increased risk of YOD, if confirmed, provides a potential target for intervention studies to prevent YOD and possibly late-onset dementia," Levine continues.
"More Americans may develop YOD because of increases in traumatic brain injury among young veterans and stroke among young black and middle-aged adults. We must have effective and humane strategies to care for patients with YOD and their families. Improving care and access to long-term services for adults with YOD is a goal of a national action plan. This goal is critical because adults with YOD and their families need our help," Levine concludes.
(JAMA Intern Med. Published online August 12, 2013. doi:10.1001/jamainternmed.2013.8090. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: The author is supported by grants from the National Institutes of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Study suggests late adolescent risk factors for young-onset dementia
2013-08-13
ELSE PRESS RELEASES FROM THIS DATE:
Vitamin D supplementation does not appear to reduce blood pressure in patients with hypertension
2013-08-13
Vitamin D supplementation does not appear to improve blood pressure or markers of vascular health in older patients with isolated systolic hypertension (a common type of high blood pressure), according to a study by Miles D. Witham, Ph.D., of the University of Dundee, Scotland, United Kingdom, and colleagues.
A total of 159 patients (average age 77 years) with isolated systolic hypertension participated in the randomized clinical trial. Patients were randomly assigned to either the vitamin D group or the matching placebo group, and received supplementation every three ...
Earnings of physicians providing 'cognitive care' vs performing common specialty procedures
2013-08-13
Medicare reimburses physicians three to five times more for common procedural care than for cognitive care (the main professional activities of primary care physicians), and these financial pressures may be a contributing factor to the U.S. health care system's emphasis on procedural care, according to a study by Christine A. Sinsky, M.D., of the Medical Associates Clinic P.C., Dubuque, I.A., and David C. Dugdale, M.D., of the University of Washington, Seattle.
The study compared the hourly revenue generated by a physician performing cognitive services and billing by ...
Gauging ability of non-responsive patients to follow commands and communicate
2013-08-13
A case study using functional magnetic resonance imaging suggests that behaviorally nonresponsive patients can use selective auditory attention to convey their ability to follow commands and communicate, according to a small study by Lorina Naci, Ph.D., and Adrian M. Owen, Ph.D., of Western University, London, Ontario, Canada.
The study included three patients with severe brain injury, two diagnosed as being in a minimally conscious state and one as being in a vegetative state. Functional magnetic resonance imaging data were acquired as the patients were asked to selectively ...
Melting water's lubricating effect on glaciers has only 'minor' role in future sea-level rise
2013-08-13
Scientists had feared that melt-water which trickles down through the ice could dramatically speed up the movement of glaciers as it acts as a lubricant between the ice and the ground it moves over.
But in a paper published today in PNAS, a team led by scientists from the University of Bristol found it is likely to have a minor role in sea-level rise compared with other effects like iceberg production and surface melt.
The results of computer modelling, based on fieldwork observations in Greenland, revealed that by the year 2200 lubrication would only add a maximum ...
Stanford scientists develop 'molecular flashlight' that illuminates brain tumors in mice
2013-08-13
STANFORD, Calif. — In a breakthrough that could have wide-ranging applications in molecular medicine, Stanford University researchers have created a bioengineered peptide that enables imaging of medulloblastomas, among the most devastating of malignant childhood brain tumors, in lab mice.
The researchers altered the amino acid sequence of a cystine knot peptide — or knottin — derived from the seeds of the squirting cucumber, a plant native to Europe, North Africa and parts of Asia. Peptides are short chains of amino acids that are integral to cellular processes; knottin ...
Better scientific policy decisions start with knowing facts from values
2013-08-13
When gathering public input on policy questions, scientists can speak with authority about facts, but must remember that everyone is an expert when it comes to values.
"Using climate change as an example, a scientist could say, 'The climate is changing.' That's a fact that can be checked," said Thomas Dietz, a member of the MSU Center for Systems Integration and Sustainability (CSIS) and professor of sociology, environmental science and policy, and animal studies. "But if a scientist says, 'We need to take these actions to halt climate change because it's affecting what ...
Soil biodiversity crucial to future land management and response to climate change
2013-08-13
Research by scientists at The University of Manchester and Lancaster shows maintaining healthy soil biodiversity can play an important role in optimising land management programmes to reap benefits from the living soil.
The findings, published in the latest edition of the journal PNAS, extend the understanding about the factors that regulate soil biodiversity.
The team says more research on soil food webs – the community of organisms living all or part of their lives in the soil - and their response to land use and climate change could also improve predictions of climate ...
Planning by postcode -- new map reveals how prepared cities are for climate change
2013-08-13
The ability of cities to combat the cause of climate change and to adapt to future weather patterns depends on where we live, new research suggests.
Scientists at Newcastle University, UK, have revealed a "postcode lottery of preparedness" across the UK based on what each city is doing to not only reduce greenhouse emissions but also adapt to future climate change and extremes of weather such as flooding and drought.
Devising a new way of ranking cities - the 'Urban Climate Change Preparedness Scores' - the team scored 30 cities based on four levels of readiness: Assessment, ...
Tests passed
2013-08-13
Pile driving during construction of wind farms and the use of airguns when searching for oil and gas unavoidably result in noise pollution in the surrounding area. To ensure that marine mammals are not harmed when in the close vicinity of these activities, regulatory authorities request so-called mitigation measures for their protection. One of such measures requires airguns to be switched off or pile driving to be stopped when whales approach the respective sound source too closely. Yet how to monitor the surrounding seas for whales around the clock - and that for weeks ...
Irrigation in arid regions can increase malaria risk for a decade
2013-08-13
ANN ARBOR -- New irrigation systems in arid regions benefit farmers but can increase the local malaria risk for more than a decade -- which is longer than previously believed -- despite intensive and costly use of insecticides, new University of Michigan-led study in northwest India concludes.
The study's findings demonstrate the need to include a strong, binding commitment to finance and implement long-term public health and safety programs when building large-scale irrigation projects, according to the researchers.
"In these dry, fragile ecosystems, where increase ...