- Millions of Americans are at risk of developing dementia, but early detection and proactive measures could help delay its onset and lessen its effects, according to a new report.
- The report states that cognitive abilities, lifestyle factors and physical health can predict dementia risk up to two decades before symptoms appear.
- These factors include diabetes, not exercising, and not having worked or having worked for very few years.
- Addressing barriers such as cost and accessibility could expand routine cognitive testing and connect more people to treatments and resources in the critical early stages of dementia.
According to a new report According to the nonprofit research organization RAND, cognitive abilities, functional limitations and physical health can strongly predict the risk of developing dementia up to 20 years before its appearance.
Although current uptake of cognitive testing among older adults remains low, research suggests that participation would increase if tests were free, easily accessible, and supported by better treatment options.
Early detection of Alzheimer’s disease and associated dementias is particularly crucial for the 58 million Americans over 65 years old, because existing disease-modifying treatments are only effective at an early stage.
However, only approximately 16% of individuals in this age group undergo cognitive assessments during routine visits with their primary care providers.
RAND researchers conducted three studies to identify people at highest risk for cognitive impairment, explore ways to increase cognitive testing in older adults, and encourage at-risk people to maintain brain health care.
The first study analyzed data on cognition and dementia in Health and retirement studya nationally representative survey of approximately 20,000 older Americans and their households, ongoing since 1992.
This analysis identified lifestyle factors such as lack of exercise, obesity and not engaging in hobbies at age 60 as leading predictors of dementia risk, based on a review of 181 potential risk factors.
In addition to lifestyle influences, the study found regional variations in dementia risk, with individuals born in the South facing a significantly higher likelihood of developing dementia, even after accounting for other factors. variables.
Although black, Hispanic, and low-income people were at higher risk, race and ethnicity were not independent risk factors once education and income were taken into account.
Parental health, family size, and marital history were not significant predictors of dementia.
Research highlights the importance of adopting a lifestyle that promotes brain health throughout life.
Understanding what increases dementia risk can help doctors and policymakers identify those most at risk and provide the appropriate support to slow or lessen the impact of cognitive decline.
The study found that the following factors are strong predictors of developing dementia:
- Have poor physical health,
- Experiencing a stroke,
- Possessing specific genes that strongly predict a future risk of developing cognitive impairment and dementia,
- Not having private health insurance at age 60,
- Having never worked or having only worked for a few years,
- Be diabetic or have a body mass index (BMI) of 35 or more at age 60,
- Never drink alcohol or drink excessively,
- Never exercise,
- A low score on various physical tests (such as grip strength, walking speed and balance, etc.),
- Being less conscientious,
- Have low engagement in hobbies and activities that involve learning new things.
Another study explored how people respond to cognitive problems.
Using data from a long-term US survey, the study found that newly diagnosed dementia patients are much more likely to take action, noting that 25% of respondents sought financial help from their children, compared to only 2% of those without a diagnosis.
Even without a formal diagnosis, 29% of people with signs of dementia sought financial help, suggesting many are recognizing the changes and starting to plan early.
A diagnosis often leads to practical steps like creating a living will, granting power of attorney, or moving in with family for support.
A third study found that out-of-pocket costs pose the greatest barrier to accessing cognitive assessments and dementia care.
While 80% of Americans said they would benefit from a free cognitive test, that figure was cut in half when a $300 fee was introduced.
Most people surveyed said they would seek care if better treatments were available. About 60% of them would use therapy that could help them remain independent for three more years.
Expanding access to affordable cognitive testing could help more people plan for their future and benefit from current and future treatments.
Two experts, not involved in these studies or in the writing of the report, spoke with Medical news today.
Clifford Segil, D.O.neurologist at Providence Saint John’s Health Center in Santa Monica, California, said it was “refreshing to read an article about dementia in 2024 that does not support the use of amyloid drugs to treat it.”
“This report noted, in common-sense language, the risk factors that I believe increase people with dementia, including stroke, poor health and diabetes. I was surprised to see data supporting that working for only a few years or not having private health insurance at age 60 is an increased risk factor for developing dementia. Refreshing to read an article on dementia that does not support early diagnosis with a blood test, which clinicians like me strongly disagree with the need to do.
— Clifford Segil
Ryan GlattCPT, NBC-HWC, senior brain health coach and director of the FitBrain program at the Pacific Neuroscience Institute in Santa Monica, Calif., said the study on early predictors of cognitive impairment and dementia “provides valuable insight into early risk factors for dementia using a large, nationally representative sample.
“It highlights modifiable and non-modifiable risk factors, including lifestyle behaviors, socioeconomic status and health markers,” Glatt said.
Glatt also discussed some of the study’s limitations.
“While the report is robust in its methodology, its reliance on observational data limits the ability to establish causation,” he said.
“For example, factors such as physical activity and social engagement are associated with a lower risk of dementia, but the study cannot definitively determine whether these behaviors prevent cognitive decline or are simply markers of dementia. ‘better basic cognitive health,’ he explained.
Segil noted that “the implications of this Rand study are that there are clear things people can do for ‘brain health’ to prevent dementia.”
“This article stated that exercising, working additional years, taking up hobbies and new information activities after retirement, and maintaining good physical health are likely to prevent a person from develop dementia. I think these lifestyle changes should be shared with anyone trying to avoid suffering from memory loss or dementia as they age.
— Clifford Segil