Are You At Risk For What Comes Before Dementia?

About two in 10 people over the age of 65 have mild cognitive impairment – a noticeable change in their memory, problem-solving ability or attention. This is partly due to the brain changes that occur in dementia. While mild cognitive impairment usually has little effect on a person’s way of life, 5 to 10 percent of people with it will develop dementia.

Why some people with mild cognitive impairment develop dementia while others have not been a long-standing mystery. But one recent research from Columbia University have identified several factors that determine whether a person is more likely to have mild cognitive impairment. These findings may give us clues about who is more likely to develop dementia.

Researchers looked at 2,903 people aged 65 and older and tracked their brain function for nine years. Cognitive impairment was diagnosed by seeing if participants struggled with a memory task, if they reported difficulty performing certain daily tasks (such as using a phone), and have not been diagnosed with dementia.

At the start of the study, all participants had normal brain function. At the 6-year follow-up, 1,805 participants had normal cognitive function, 752 had mild cognitive impairment, and 301 had dementia. The researchers then followed the cognitive decline group for another three years.

Because some of the participants were “unfollowable,” the researchers were only able to look at 480 people from the initial mild cognitive impairment group. While 142 people still had mild cognitive impairment, they found that 62 people in this group now had dementia. The researchers also found that 276 people no longer met the criteria for mild cognitive impairment – ​​showing us that mild cognitive impairment does not always lead to dementia and it does not necessarily lead to dementia. necessarily forever.

Mohamed717 / Wikimedia Commons

Let’s first look at the factors associated with a reduced risk of developing mild cognitive impairment.

Education

The amount of time a person spends in education is a factor in reducing a person’s risk of mild cognitive impairment. People with an average of 11.5 years of schooling were 5% less likely to develop mild cognitive impairment than those with only 10 years of schooling. The study did not distinguish between types of education (such as general education or higher education).

One theory for this link is that longer schooling is associated with higher socioeconomic status – which could mean a person has better access to a healthy lifestyle and better health care.

Another theory is that education helps the brain form more neurons and connections, which helps the brain maintain good function. This can help the brain compensate for any changes that may result from mild cognitive impairment, such as memory loss.

Leisure activities

People who are more physically or socially active have a slightly lower risk of developing cognitive impairment.

To measure how social or active the participants were, they filled out questionnaires about the activities they did and how often they did it, such as walking or going to the movies. The researchers then gave the participants a score out of 13. The higher the score, the more active the participants were. Those without mild cognitive impairment scored an average of 7.5, while those with mild cognitive impairment scored a slightly lower score of 7.4. Those with dementia scored 5.8.

Previous studies have also shown that moderate-intensity activity (such as swimming) during mid- or late-life may reduce the risk of mild cognitive impairment. The protective effects of exercise may be explained by the beneficial structural changes that occur in our brains as a result of exercise. Growing evidence also shows us that socializing can help maintain brain health and reduce the risk of early death.

Earnings = earnings

People earning more than $36,000 a year had a 20% lower risk of mild cognitive impairment than those earning less than $9,000 a year.

Income is probably associated with a reduced risk of cognitive decline for the same reasons as education, as people with higher incomes are more likely to be able to afford better health care and better access to health care. Eat better and live better. They can also live in places where environmental factors – such as pollution – have less of an effect on them. This is important, as there is growing evidence that pollution may also be linked to diseases like Alzheimer’s and Parkinson’s.

Greater risk

Columbia University researchers also identified several factors that are associated with a lower risk of developing mild cognitive impairment. These include:

Genetics

The presence of the AP0E E4 allele (one of two or more versions of the gene) was found to increase the risk of developing mild cognitive impairment by 18%. This finding chimes with earlier evidence that also suggests that this allele may increase the risk of dementia.

People with AP0E E4 are about three times more likely to develop Alzheimer’s disease than those with another variant of the AP0E gene. It is thought this is because this variant makes people more likely to build up toxic proteins in the brain – a hallmark of Alzheimer’s disease. The researchers also suggest that this gene only causes harm as we age.

Basic health condition

Columbia University researchers found that people with one or more chronic health conditions, such as heart disease, depression or diabetes, had a 9 percent higher risk of mild cognitive impairment.

The increased burden of having certain health conditions can mean that a person is less likely to participate in their usual daily activities or social life. Both of these can accelerate the decline in brain health. Other conditions, such as heart disease, are also known to increase the risk of cognitive decline.

This study reminds us that mild cognitive impairment is not necessarily a prelude to dementia. In fact, some study participants with mild cognitive impairment eventually returned to normal brain function. Not entirely sure why, but it’s possible that lifestyle changes after diagnosis (such as exercising more) may improve outcomes. While it was also possible that some participants were misdiagnosed at the start of the study, this was unlikely given the many tools they used to confirm their diagnosis.

Our brains are very active and keeping them active throughout life is important for maintaining good brain function. While there are some risk factors – such as our genes – that we can’t change, staying active and following a healthy lifestyle can be one way to reduce your risk of heart failure. mild cognitive impairment and dementia.

Mark Dallas is an Associate Professor of Cellular Neuroscience at the University of Reading