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Revolutionary Screening Tool : Accurate Dementia Prediction Unveiled

Dementia is a progressive neurodegenerative condition that impacts memory and cognitive abilities. The condition affects millions of people all over the world and that too, without a cure. When it comes to dementia, preventative strategies are vital, as new research indicates that addressing 12 key risk factors, such as low education, smoking, and hypertension, could prevent up to 40 percent of dementia cases.(1,2)

It is important to know that existing dementia risk prediction models have limitations; only a few out of 61 have been externally validated, with inconsistent performance. Additionally, most data originates from North American cohorts, raising uncertainties about their applicability to other populations.(3)

There is a pressing need for new, externally validated risk scores inclusive of diverse populations. Recently, researchers developed the UK Biobank Dementia Risk Score (UKBDRS), utilizing 11 risk factors to predict 80 percent of dementia cases nearly 14 years before onset. This groundbreaking study was published in BMJ Mental Health.(4)

Read on to find out about these cutting-edge screening tools and how they predict dementia risk with high accuracy.

Looking at the 11 Dementia Risk Factors found in the Study

In their study utilizing healthcare data from the UK Biobank, researchers examined 28 factors associated with dementia among 220,762 individuals averaging 60 years old. Through a 14-year follow-up, they identified 11 key predictors of dementia risk:(5

Testing these factors with 80 percent of the UK Biobank data accurately predicted dementia incidence in 80 percent of individuals. External validation with the Whitehall II study (2,934 participants, average age 57) revealed a 77 percent accuracy rate in predicting dementia cases.(6)

Sensitivity tests indicated the UKBDRS’s strong ability to predict dementia development within 14 years. Remarkably, the UKBDRS’s predictive performance was comparable to APOE testing, a genetic biomarker for dementia.(7)

APOE testing predicted 83 percent of dementia cases in the UK Biobank sample and 79 percent in the UK Whitehall II study. Additionally, the UKBDRS outperformed three other widely used externally validated dementia risk scores.

Exploring the Potential Link between Gender and Dementia Risk

In discussions with medical experts not involved in the study, insights were shared regarding the surprising association between gender and dementia risk, particularly in males. While historical data often suggested a higher risk for Alzheimer’s disease in women due to their longer life expectancy, recent perspectives shed light on potential factors contributing to increased dementia risk in men.

Dr. Anita Szerszen, the director of inpatient geriatrics at Staten Island University Hospital, highlighted that although dementia prevalence is higher among women due to their longer lifespan, certain lifestyle factors more common in men, such as smoking, excessive alcohol consumption, and occupational exposure to toxins, might elevate their risk.(8,9)

Meanwhile, Dr. Joyce Gomes-Osman, vice-president of interventional therapy at Linus Health, emphasized the higher cardiovascular risk in men compared to women and their tendency to seek medical assistance less frequently, which might contribute to their increased susceptibility to dementia.(10,11,12)

These perspectives offer valuable insights into the multifaceted nature of dementia risk, indicating the significance of gender-specific considerations in understanding and addressing this complex health concern.

Looking at the Impact of Psychosocial Factors on Dementia Risk

Further insights from Dr. Stella Panos, a neuropsychologist and director of neuropsychology at the Pacific Neuroscience Institute, provided a comprehensive understanding of how psychosocial variables contribute to an increased risk of dementia. It is important to understand the multifaceted impact of factors like material deprivation and living alone on brain health.(13)

It is necessary to highlight the indirect influence of these variables on brain health by limiting access to healthcare and activities that support cardiovascular and brain health, such as safe spaces for physical engagement, quality education, and cognitive stimulation through social interactions. Moreover, the manner in which these factors, particularly material deprivation, can induce chronic stress, directly affecting the brain via neurotoxic pathways, notably cortisol is important to be considered.(14,15)

Additionally, Dr. Panos also clarified how these psychosocial aspects might trigger changes in gene expression, potentially elevating the activity of pro-inflammatory genes, which, over time, could detrimentally impact brain function.

This insightful perspective underscores the complex relationship between psychosocial factors and brain health, emphasizing their significance in understanding dementia risk and advocating for interventions that address these complex influences. 

Unveiling Restrictions in Dementia Risk Prediction Studies

While the study showed some impressive results, insights from other healthcare professionals also shed light on crucial limitations within the study, despite its meticulous methodology and robust cohort selection. 

Some experts acknowledged the study’s strengths in using a unique cohort and careful methodology. However, there were limitations, notably the absence of gold-standard clinical processes or assessments for diagnosing dementia within the cohort. Additionally, discrepancies in available hospital records and self-reported outcome measures between the study samples affected sensitivity, impacting the reliability of comparisons. 

Acknowledging these limitations is important for refining future research methodologies.

Using Dementia Risk Prediction for Diagnosis and Prevention

Experts have emphasized that there is a lot of potential in using the UKBDRC as an initial screening tool. Individuals identified as high-risk could benefit from additional screening, such as cognitive or genetic assessments.(16)

Moreover, the importance of using this tool to empower individuals and healthcare providers in targeting and modifying health behaviors before the onset of dementia cannot be ruled out. Acknowledging the absence of a cure for dementia, there is a critical need to prioritize prevention efforts.

The researchers have urged healthcare providers to first clearly explain the implications of dementia prediction tools to their patients. There is also a necessity of proper follow-up care to help individuals adapt behaviors and mitigate their risk.(17)

Tips to Reduce Dementia Risk

Reducing a person’s dementia risk involves adopting a healthy lifestyle and making choices that support brain health. Here are several tips to help reduce the risk of developing dementia: 

  1. Stay mentally active: Engage in activities that stimulate your mind, such as reading, puzzles, learning new skills, or pursuing hobbies. Mental stimulation can help build cognitive reserve and potentially reduce the risk of dementia.(18
  2. Remain socially engaged: It is a good idea to maintain strong social connections and stay engaged with family, friends, or community groups. Social interaction can help prevent feelings of isolation and stimulate brain function.(19)
  3. Follow a balanced diet: Adopting a healthy diet that is rich in fruits, vegetables, whole grains, lean proteins, and omega-3 fatty acids is a good idea. A Mediterranean-style diet, known for its brain-protective qualities, may lower the risk of cognitive decline.(20)
  4. Exercise regularly: Regular physical activity is crucial for your brain health. Aim for getting at least 150 minutes of moderate-intensity exercise every week. Activities like brisk walking, swimming, or dancing can improve blood flow to the brain and promote overall well-being.(21)
  5. Control your cardiovascular risk factors: Manage conditions like high blood pressure, diabetes, high cholesterol, and obesity. These conditions can increase your risk of dementia, so maintaining a healthy lifestyle and seeking medical treatment when necessary is essential.(22)
  6. Do not skip on getting a good night’s sleep: Prioritize getting adequate sleep, aiming for at least seven to nine hours per night. Quality sleep is vital for brain health and helps consolidate memory and cognitive function.(23)
  7. Limit your alcohol intake: Excessive alcohol consumption can impair cognitive function and increase the risk of dementia. Moderation or avoidance of alcohol is advisable for brain health.(24)
  8. Avoid smoking: Smoking is linked to an increased risk of cognitive decline and dementia. Quitting smoking can have significant benefits for overall health, including brain health.(25)
  9. Protect your head: Prevent head injuries by wearing helmets during activities like biking or participating in contact sports to reduce the risk of traumatic brain injury, which has been associated with a higher dementia risk.

Conclusion 

The development of cutting-edge screening tools, such as the UK Biobank Dementia Risk Score (UKBDRS), marks a significant stride in predicting dementia risk with remarkable accuracy. This innovative tool, incorporating 11 key risk factors, demonstrates promising potential by forecasting up to 80 percent of dementia cases as much as 14 years before onset. Despite certain study limitations, the UKBDRS offers a valuable opportunity for early identification, enabling targeted interventions and lifestyle modifications to mitigate dementia risk. Its high accuracy emphasizes a crucial step forward in proactive dementia management. 

References:

  1. Mendez, M.F. and Cummings, J.L., 2003. Dementia: a clinical approach. Butterworth-Heinemann. 
  2. Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C. and Costafreda, S.G., 2020. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), pp.413-446.
  3. Hou, X.H., Feng, L., Zhang, C., Cao, X.P., Tan, L. and Yu, J.T., 2019. Models for predicting risk of dementia: a systematic review. Journal of Neurology, Neurosurgery & Psychiatry, 90(4), pp.373-379.
  4. Anatürk, M., Patel, R., Ebmeier, K.P., Georgiopoulos, G., Newby, D., Topiwala, A., de Lange, A.M.G., Cole, J.H., Jansen, M.G., Singh-Manoux, A. and Kivimäki, M., 2023. Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohorts. BMJ Ment Health, 26(1).
  5. UK Biobank (2019). UK Biobank. [online] Ukbiobank.ac.uk. Available at: https://www.ukbiobank.ac.uk/.
  6. UCL (2019). Whitehall II. [online] Institute of Epidemiology & Health Care. Available at: https://www.ucl.ac.uk/epidemiology-health-care/research/epidemiology-and-public-health/research/whitehall-ii.
  7. National Institute on Aging. (2023). Alzheimer’s Disease Genetics Fact Sheet. [online] Available at: https://www.nia.nih.gov/health/genetics-and-family-history/alzheimers-disease-genetics-fact-sheet.
  8. www.northwell.edu. (n.d.). Anita B. Szerszen, DO | Northwell Health. [online] Available at: https://www.northwell.edu/find-care/find-a-doctor/internal-medicine/dr-anita-b-szerszen-do-11366162 [Accessed 16 Dec. 2023].
  9. CDC (2019). The Truth About Aging and Dementia | CDC. [online] www.cdc.gov. Available at: https://www.cdc.gov/aging/publications/features/Alz-Greater-Risk.html.
  10. linushealth.com. (n.d.). Take Action Against Dementia: Lifestyle & Health-Based Interventions. [online] Available at: https://linushealth.com/blog/take-action-against-dementia-cognitive-testing-reduce-risk-factors [Accessed 16 Dec. 2023].
  11. Bots, S.H., Peters, S.A. and Woodward, M., 2017. Sex differences in coronary heart disease and stroke mortality: a global assessment of the effect of ageing between 1980 and 2010. BMJ global health, 2(2), p.e000298.
  12. Wang, Y., Hunt, K., Nazareth, I., Freemantle, N. and Petersen, I., 2013. Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ open, 3(8), p.e003320.
  13. Pacific Neuroscience Institute. (n.d.). Stella Panos, PhD. [online] Available at: https://www.pacificneuroscienceinstitute.org/people/stella-panos/ [Accessed 16 Dec. 2023].‌
  14. Rawtaer, I., Gao, Q., Nyunt, M.S.Z., Feng, L., Chong, M.S., Lim, W.S., Lee, T.S., Yap, P., Yap, K.B. and Ng, T.P., 2017. Psychosocial risk and protective factors and incident mild cognitive impairment and dementia in community dwelling elderly: Findings from the Singapore Longitudinal Ageing Study. Journal of Alzheimer’s Disease, 57(2), pp.603-611.
  15. Bernhardt, T., Seidler, A. and Frölich, L., 2002. The effect of psychosocial factors on risk of dementia. Fortschritte der Neurologie-psychiatrie, 70(6), pp.283-288.
  16. Tang, E.Y., Harrison, S.L., Errington, L., Gordon, M.F., Visser, P.J., Novak, G., Dufouil, C., Brayne, C., Robinson, L., Launer, L.J. and Stephan, B.C., 2015. Current developments in dementia risk prediction modelling: an updated systematic review. PloS one, 10(9), p.e0136181.
  17. Stephan, B.C., Kurth, T., Matthews, F.E., Brayne, C. and Dufouil, C., 2010. Dementia risk prediction in the population: are screening models accurate?. Nature Reviews Neurology, 6(6), p.318.
  18. Marioni, R.E., Proust-Lima, C., Amieva, H., Brayne, C., Matthews, F.E., Dartigues, J.F. and Jacqmin-Gadda, H., 2015. Social activity, cognitive decline and dementia risk: a 20-year prospective cohort study. BMC public health, 15(1), pp.1-8.
  19. Solfrizzi, V., Panza, F., Frisardi, V., Seripa, D., Logroscino, G., Imbimbo, B.P. and Pilotto, A., 2011. Diet and Alzheimer’s disease risk factors or prevention: the current evidence. Expert review of neurotherapeutics, 11(5), pp.677-708.
  20. Larson, E.B., Wang, L.I., Bowen, J.D., McCormick, W.C., Teri, L., Crane, P. and Kukull, W., 2006. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of internal medicine, 144(2), pp.73-81.
  21. Fillit, H., Nash, D.T., Rundek, T. and Zuckerman, A., 2008. Cardiovascular risk factors and dementia. The American journal of geriatric pharmacotherapy, 6(2), pp.100-118.
  22. Benito‐Leon, J., Bermejo‐Pareja, F., Vega, S. and Louis, E.D., 2009. Total daily sleep duration and the risk of dementia: a prospective population‐based study. European journal of neurology, 16(9), pp.990-997.
  23. Wiegmann, C., Mick, I., Brandl, E.J., Heinz, A. and Gutwinski, S., 2020. Alcohol and dementia–what is the link? A systematic review. Neuropsychiatric Disease and Treatment, pp.87-99.
  24. Anstey, K.J., von Sanden, C., Salim, A. and O’Kearney, R., 2007. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. American journal of epidemiology, 166(4), pp.367-378.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 3, 2024

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