Advancing age, limited education, high cholesterol levels, high blood pressure, and obesity at midlife are significantly associated with the later development of dementia, according to findings from a 20-year follow-up study.
A new, simple dementia-risk prediction tool may allow for the earlier detection of the disease based on these midlife factors, Miia Kivipelto of the Karolinska Institute in Stockholm and colleagues reported in the Lancet Neurology (Epub ahead of print: doi 10.1016/S1474–4422(06)70537–3).
The detection technique highlights the role of vascular factors in the development of dementia “and could help to identify individuals who might benefit from intensive lifestyle consultations and pharmacological interventions,” they said.
Data were derived from the population-based Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study, in which 1,409 patients were studied in midlife and reexamined 20 years later; 4% were diagnosed with dementia.
Future dementia was associated with age 47 or older, less than 10 years of education, systolic blood pressure over 140 mm Hg, high cholesterol levels greater than 6.5 mmol/L, and obesity (body mass index over 30). In a second model that factored in apolipoprotein ϵ4 status (carriers vs. noncarriers), age and education became more predictive and cholesterol less so.
Potential risk factors not examined in this study include a family history of dementia, serum triglyceride levels, concentrations of high- and low-density lipoproteins, waist-to-hip ratio, and diabetes (insulin resistance). “There is much evidence that diabetes is associated with an increased risk of dementia, and thus its inclusion in future risk scores is important,” the investigators explained, adding that further research is needed to validate the dementia risk score.