Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.
Risk Factors Beyond Longevity
Until now, the gap had been largely attributed to the longevity of women, since age is the number one risk factor for Alzheimers.;Roberta Diaz Brinton,;a University of Southern California professor who studies gender differences said, It is true that age is the greatest risk factor for developing Alzheimers disease. But she went on to say, on average, women live four or five years longer than men and we know that Alzheimers is a disease that starts 20 years before the diagnosis.
Thus far, genetic studies have;offered a;startling account for the difference. Researchers from Stanford University studied over 8,000 people looking for a form of the gene ApoE-4, a gene that increases the risk of Alzheimers. They found that women who carry a copy of that particular gene variant were twice as likely to eventually develop Alzheimers as women without the gene. Men who had the gene were only at a slightly increased risk than men who did not have the gene. While it is not clear why the gene poses such a drastic increase in risk, Brinton believes it may be how the gene interacts with estrogen.;
Another study suggests that it may be related to heart health. A study from;Framingham, Massachusetts suggests that because men are more likely to die from heart disease in middle age, those men who live past 65 may have healthier hearts which may protect the brain from Alzheimers.;These two diseases share many risk factors including high cholesterol, diabetes, and obesity.
Does Alzheimers Disease Affect Men And Women Differently Updated
Alzheimers disease is the fifth leading cause of death of Americans aged 65 or older. It was identified more than 100 years ago, but most of the research into the symptoms, causes and treatments of the disease has only come about within the last 30 years. While this research has shed a lot of light, theres still much more to be done to find out the biological changes that cause Alzheimers, as well as why it progresses at certain rates among those affected. Currently, there is no cure or effective prevention for Alzheimers disease.
The Impact of Alzheimers Disease on Men vs. Women
One thing that is known at this point is that Alzheimers affects more women than men. According to theAlzheimers Associations 2020;Facts and Figures report,;almost two-thirds of Americans with Alzheimers disease are women.
While there is no evidence showing that women are more likely to develop Alzheimers disease at any given age over men, one of the reasons Alzheimers is more prevalent in women is that females on average live longer than their male counterparts. According to the U.S. Census Bureau, womens life expectancy is around 81 years old, while mens is 76 years old. This means that by age 65, women have a higher risk of developing Alzheimers due to their longer lifespan. In fact, 1 in 6 women in their 60s has a chance of getting Alzheimers over the remainder of her life, while for men that figure is 1 in 11.
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Who Is More Likely To Get A Pacemaker Someone With Or Without Dementia
- 4 per 1000 person-years for participants without cognitive impairment;
- 4.7 per 1000 person-years for participants with MCI
- 6.5 per 1000 person-years for participants with dementia
- Patients were 1.6 times more likely to receive a pacemaker if they had dementia than if they didn’t have any cognitive impairment
- Patients were 2.9 more likely to receive a pacemaker if they had severe dementia;than if they didn’t have any cognitive impairment.
Time Until Dementia Symptoms Appear Can Be Estimated Via Brain Scan
Researchers at Washington University School of Medicine in St. Louis have developed an approach to estimating when a person who is likely to develop Alzheimers disease, but has no cognitive symptoms, will start showing signs of Alzheimers dementia.
The algorithm, available online in the journal Neurology, uses data from a kind of brain scan known as amyloid positron emission tomography to gauge brain levels of the key Alzheimers protein amyloid beta.
In those who eventually develop Alzheimers dementia, amyloid silently builds up in the brain for up to two decades before the first signs of confusion and forgetfulness appear. Amyloid PET scans already are used widely in Alzheimers research, and this algorithm represents a new way of analyzing such scans to approximate when symptoms will arise. Using a persons age and data from a single amyloid PET scan, the algorithm yields an estimate of how far a person has progressed toward dementia and how much time is left before cognitive impairment sets in.
The researchers also accessed over 1,300 clinical assessments on 180 of the participants. The assessments typically were performed every one to three years. Most participants were cognitively normal at the start of data collection, so the repeated assessments allowed the researchers to pinpoint when each participants cognitive skills began to slip.
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More Useful Links And Resources
Risk factors.Alzheimer Society of Canada, 2021. Read about risk factors for dementia in our downloadable, print-friendly infosheet. This sheet also contains strategies and lifestyle changes that can help you reduce your risk of developing dementia.
Understanding genetics and Alzheimer’s disease.Alzheimer Society of Canada, 2018.In our downloadable, print-friendly infosheet, learn more about the role that genetics plays as a risk factor for dementia, and find out whether you should pursue genetic testing.
Risk factors and prevention. Alzheimer’s Society UK. This comprehensive webpage from the Alzheimer’s Society UK has some helpful nuggets of research and advice related to reducing your risk of dementia.
Tobacco use and dementia. World Health Organization , 2014. This report from the WHO details the evidence behind smoking tobacco as a risk factor for dementia.
Women and Dementia: Understanding sex/gender differences in the brain. brainXchange, 2018. This webinar discusses understandings of sex and gender, sex differences in Alzheimerâs disease, how the higher number of women with Alzheimer’s may be due to both, and a discussion of the role of estrogen in the health of brain regions associated with Alzheimerâs disease. In partnership with the Alzheimer Society of Canada and the Canadian Consortium of Neurodegeneration in Aging .
Women Have A Higher Caregiver Burden Than Men
Speaking of caregiving, 60 percent of family caregivers, including caregivers for family members with dementia, are women. Studies show that full-time caregivers of a loved one may actually be at a higher risk of developing dementia compared to non-caregivers. Plus, female caregivers are more likely to change their lifestyles compared to male caregivers, often giving up their job, moving or changing their living arrangements in order to provide care.
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Cultural Beliefs About Dementia And Cognitive Decline
Social and cultural differences in the meaning of dementia and beliefs about cognitive decline among elders may play a part in the different rates of AD by ethnicity, and may also explain the lack of consensus on rates of AD across studies. Cultural values may include beliefs that dementia-related changes are part of the normal aging process rather than an abnormal process, such that in some groups and communities, cognitive decline may not elicit concern until symptoms are well beyond the early or mild stages . Differences in the meaning of cognitive decline highlight the need for community-based random samples and recruitment strategies that improve the rates of participation of ethnically diverse elders .
Individuals within some cultures may be more likely to view cognitive decline as disgraceful and something that should be kept within the family. A dementing illness may be difficult to accept when the ethnic elder may be the historian, mediator, and provider of emotional and financial support for many generations of family members living in the same home . found that although African-Caribbean elders living in London reported a larger number of family members living nearby and were more likely to live with at least one other family member, they received no more help from their families with activities of daily living, yet were more likely to have difficulties in this area.
Which Is More Likely To Get Heart Disease: Dementia Or Coronary Artery Disease
A study of more than 1,000 people has found that people with dementia are at increased risk of heart disease.
Thats according to a study published today in The Lancet.
The researchers found that older people who were at least 70 years old were more likely than their younger counterparts to have heart disease and that they had the same risk as people with coronary artery diseases.
The findings come at a time when many people are concerned about the rise in dementia, and the lack of treatment options.;
The study, conducted by researchers at the University of Copenhagen and the Copenhagen Health Center for Epidemiology and Biostatistics, looked at data from the Danish National Registry of Disease Control and Prevention, a national database of hospital and health records.
The study, which was funded by the Danish Health Foundation, looked for differences between people with different types of heart diseases.
The team looked at two groups of people: those with coronary arterial disease and those without.
The researchers found a significant increase in the number of heart attacks among people with cardiovascular disease, but not among people without the condition.
The difference was even greater for those with dementia, which increases the risk by 2.4 times.
The study is a reminder that people living with heart disease are not necessarily more likely or healthier than those without, says Dr Daniela Fahlmark-Pieters, one of the researchers.
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People With Dementia Are Twice As Likely To Get Covid
Patients with dementia who contracted Covid-19 had significantly worse outcomes in terms of … hospitalizations and deaths than those who had Covid-19 but not dementia.
Patients with dementia are at higher risk for Covid-19 and are more likely to have worse outcomes, according to a new study published today.
The study, led by Case Western Reserve University researchers, reviewed electronic health records of 61.9 million adults in the United States and found that the risk for contracting Covid-19 was twice as high for people with dementia compared to the general population.
The risk was even greater still for African Americans with dementia, who were found to be close to three times as likely to be infected with Covid-19.
The results also found that those with dementia who contracted the virus had far worse outcomes in terms of hospitalisations and deaths than those who caught Covid-19 but didnt have dementia.
These preliminary findings suggest a frightening reality of the vulnerabilities associated with dementia,” said Maria Carrillo, PhD, Alzheimer’s Association chief science officer.
The overall hospitalisation risk for adults with Covid-19 is about 25% for the general public but almost two-thirds of patients who had dementia and Covid-19 were hospitalised and that figure jumped to over 70% for African Americans with Covid-19 and dementia.
Dementia Linked To Loneliness Study Finds
People who feel lonely are much more likely than those who do not to develop dementia in old age, according to new research suggesting that loneliness is a risk factor for the condition.
Those who suffer from loneliness have a 64% greater risk of dementia, according to a Dutch study that appears in the Journal of Neurology, Neurosurgery and Psychiatry. But the authors stress that the risk depends on having those feelings and not simply the fact that someone lives alone or is socially isolated.
“Individuals with feelings of loneliness remained 1.64 times more likely to develop clinical dementia than persons who did not feel lonely. In contrast, objective aspects of social isolation no longer showed such an association,” concluded the authors of the Amsterdam Study of the Elderly , led by Dr Tjalling Jan Holwerda from VU University Medical Centre in Amsterdam.
“These results suggest that feelings of loneliness independently contribute to the risk of dementia in later life. Interestingly, the fact that ‘feeling lonely’ rather than ‘being alone’ was associated with dementia onset suggests that it is not the objective situation but, rather, the perceived absence of social attachments that increases the risk of cognitive decline,” the authors say.
They studied risk factors for depression, dementia and high death rates among 2,173 Dutch people aged 65 or over who did not have dementia, then examined their health again three years later.
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Over The Past 20 Years New Dementia Cases In The Uk Have Dropped By 20% Driven Mostly By A Fall In Incidence Among Men Over 65
Experts say this may be because of public health campaigns targeting heart disease and smoking. Both are risk factors for Alzheimers. But because men tend to get heart disease younger and smoke more than women, these campaigns also may have helped stave off these risk factors more for men than women.
Meanwhile, other risk factors for the disease affect women more than men. For example, more women develop depression and depressed mood has been linked to the onset of Alzheimers. Other risk factors affect only women, such as surgical menopause and pregnancy complications like pre-eclampsia, both of which have been linked to cognitive decline in later life.
Depression is one risk factor for developing dementia; it also affects more women than men
This idea is gaining momentum. Advocacy group the Womens Brain Project , co-founded by Santuccione-Chadha, Ferretti and Schumacher as well as chemist Gautam Maitra, has just published a major review analysing a decades worth of scientific literature on Alzheimers, revising existing data and asking scientists to stratify it by sex for the first time.
The most obvious differences that come out of the literature are in the display and progression of cognitive and psychiatric symptoms between men and women with Alzheimers disease. Based on these new studies we can design new hypotheses and figure out new ways to improve treatment of patients, says Ferretti.
Why Are Women More Likely To Develop Dementia Than Men
We dont fully understand why women are more likely to develop Alzheimers disease than men, but one of the main theories is to do with the hormone oestrogen.
Whilst both men and women produce oestrogen, its the main female sex hormone and so women usually have more of it. When women go through menopause, their bodies stop producing as much oestrogen.
On the other hand, men continue to produce testosterone, the male sex hormone, throughout their lives. Testosterone;is actually converted into oestrogen inside brain cells. This means that women who have been through menopause have lower levels of oestrogen in their brain than men of the same age.;
As Alzheimers disease is more common in women after the menopause, it is possible that;oestrogen plays a role in protecting the brain;from the damage caused by Alzheimers, and that this protective effect is lost when oestrogen levels are decreased.
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Look After Your Heart
Research shows that people who have high blood pressure, high cholesterol, diabetes, or are obese, particularly around middle age, have a greater risk of developing dementia later in life. Leaving these conditions untreated can lead to damaged blood vessels in the brain, which in turn damages brain cells and leads to impaired thinking functions.
Although there are no guarantees that keeping your heart healthy will prevent dementia, you will give yourself the best chance of avoiding or delaying dementia.
Promisingly, studies have shown that the treatment of high blood pressure reduces that risk. Other studies indicate that treating high cholesterol and diabetes may also reduce the risk of developing dementia, although more research is needed in this area.
It is recommended you have regular check-ups to assess your:
Social And Economic Impact
Dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. In 2015, the total global societal cost of dementia was estimated to be US$ 818 billion, equivalent to 1.1% of global gross domestic product . The total cost as a proportion of GDP varied from 0.2% in low- and middle-income countries to 1.4% in high-income countries.
Ethnic Comparisons Within The United States
A number of studies have compared the rates of dementia and AD between ethnic groups residing in the United States. Despite differences in sampling methods and definitions of dementia as well as in definitions of race/ethnicity, the most frequent findings in reviewing this literature are that African Americans and Hispanics have higher prevalence and incidence of dementia and AD than whites. Native Americans appeared to have lower rates of AD in comparison to whites. Asian Americans had rates of dementia comparable to whites; however, whether there is the same proportion of AD compared to vascular dementia among Asian Americans and Asian immigrants remains uncertain. Opinion differs on whether correction for education accounted for the different rates of dementia and AD found among these cultural groups.
The rate of dementia on admission to nursing homes is higher among black residents than among white residents ; however, findings from studies of long-term outcomes for African-American elders with dementia are not consistent. Mortality associated with dementia was found to be higher among blacks than non-Hispanic whites, especially among black males . However, there were no statistically significant differences in survival from time of entry into the CERAD study of whites and African Americans after accounting for the effects of age, gender, and severity of dementia . However, for each of these studies, the exact way in which racial groups were defined was not stated.