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Previous studies have identified a number of modifiable risk factors for dementia, but modifying them once the neurodegenerative process has begun does not help much.
Dementia is often associated with older people, but it doesn't just come out of nowhere. Some risk factors may start before we're born, while others emerge as we progress from childhood to adulthood. According to studies, this may also be the best time to start intervention.
Previous studies have identified a number of modifiable risk factors for dementia, but modifying them after the neurodegenerative process has begun does little to help. This has prompted researchers to look for interventions earlier in life that could one day make a difference.
A study conducted in 2023 by researchers in Sweden and the Czech Republic identified a number of birth factors associated with a slightly higher risk of dementia in later life.
While some, such as sharing a uterus with a twin, are beyond anyone's control, other factors - such as a shorter time span between 2 births and a woman becoming pregnant over the age of 35 - can be influenced by parental decision-making.
Another study, published in late 2024, looked at risk factors for younger adults aged 18-39. A team led by the Global Brain Health Institute (GBHI) in Ireland brought together a group of experts from 15 countries around the world to help develop a lifelong plan for improving brain health.
" Young age represents a key time frame for intervention, which can significantly reduce the risk of dementia later in life," says Franceska Farina, a neuroscientist at GBHI.
" To ensure healthier brain outcomes, young people must be included as key partners in research, education, and policy-making efforts," she believes.
Of the risk factors identified by researchers, some are related to lifestyle, including excessive alcohol consumption, smoking, lack of physical activity and social isolation.
Others are environmental, such as exposure to pollution, traumatic brain injuries, hearing or vision loss, or a low level of education.
And other factors, such as obesity, diabetes, hypertension, LDL cholesterol, and depression, are health problems that can arise from lifestyle choices. Ultimately, researchers suggest that many of the risk factors are steps we can take to help reduce our risk of developing dementia, which can start to increase much earlier in our lives than many people typically realize.
“ Can the roots of dementia lie in childhood or infancy? Increasing evidence suggests that they do, and exposures to risk factors in the first decade of life (or even while in the womb) may have a lifelong impact on dementia risk ,” the team explained in an article in The Conversation.
“ Most research on dementia focuses on changes associated with age-related cognitive decline in later life. But there is growing evidence that many of the changes in brain structure and function associated with dementia in older adults may have existed at least in part since childhood, ” they point out.
According to the team, there are many examples of this.
" In long-term studies, where people's cognitive ability is monitored throughout their lives, one of the most important factors explaining someone's cognitive ability at age 70 is their cognitive ability when they were 11 years old, " the study authors further explained.
So, older adults with weaker cognitive abilities have often had these lower abilities since childhood, rather than the changes being due solely to a more rapid decline in their abilities at an older age.
Another possible signal is evidence of brain damage or abnormalities in later life that may be linked to incidents or behaviours in youth. “Similar patterns are also seen when looking for evidence of dementia-related damage on brain scans, with some changes appearing to be more closely linked to exposures to risk factors in early life than to current unhealthy lifestyles.
" Taken together, we can conclude that perhaps the time has come for dementia prevention to be considered a lifelong goal, rather than a focus for the elderly, " the study authors concluded.
In their 2024 study, some of the risk factors identified may be more obvious. For example, drinking alcohol and smoking are known to be harmful to health in general, and suffering a brain injury is a direct risk for later dementia.
But others follow a more zigzag path. Hearing or vision loss, for example, is also linked to dementia, perhaps due to brain degeneration or social isolation. Recognizing the risks is one thing, but mitigating them is a tricky business.
The researchers believe this problem can best be addressed by identifying factors at the individual, community and national levels. Helping people at the individual level includes raising awareness about the importance of brain health and the risks, the team says.
This could be done through public health campaigns and education in schools, and financed through taxation of substances that negatively affect brain health, such as alcohol or cigarettes./ Adapted from "Pamphlet"
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