Lost your keys – again? Can you prevent mid-life dementia?

Young-onset dementia is on the rise, according to a new study. Here’s how people in their 40s and 50s can reduce the risk

‘Young-onset’ dementia is defined as the development of symptoms, including behaviour and memory problems, usually between the age of 30 and 65

Dementia is a condition most often associated with growing old, the consequence of progressive decline in cognitive ability that gradually causes problems with memory, thinking and problem-solving. But new research conducted at University College London and published in the Journal of Dementia Care shows it can strike much earlier, in midlife. The findings show a rising number of people in their 40s, 50s and 60s are being diagnosed with the condition.

Figures released by Dementia UK show that in 2014 there were 42,000 people in the UK living with “young-onset” dementia, defined as the development of symptoms, including behaviour and memory problems, usually between 30 and 65. But by 2022 the figure had increased to 70,800, a rise of 69 per cent.

“In the study we have exposed a hidden population living with young-onset dementia that has not previously been recognised,” says Dr Janet Carter, an associate professor of mental health neuroscience at UCL and lead author of the new paper. “This number is likely to be the tip of the iceberg.”

For many cases of young-onset dementia the cause is unclear, and individual risk is likely to be the result of a complex interaction of genes, lifestyle, environment and age. But there’s much that can be done to reduce your risk.

 

What are the warning signs?

Dr Hilda Hayo, chief executive of the charity Dementia UK, says onset of dementia in the under-65s is “poorly recognised and misdiagnosed”, and a general lack of awareness surrounds the condition.

Unlike with dementia in later life, it is less common for memory loss to be an early symptom in younger people, and most younger adults who report memory problems do not have the condition.

“Usually, younger people first present with non-memory problems, such as language or visual symptoms, and impaired thinking and planning skills,” Carter says. “Behavioural changes with impairment or loss of speech, and sometimes inappropriate social behaviour, are other signs.”

Too often, these symptoms are dismissed as “stress” or depression and anxiety, or wrongly attributed to other causes – including menopause, physical health problems and relationship issues – in early consultations. On average, Hayo says, there is a four-year delay in getting an accurate diagnosis and access to appropriate support, which negatively impacts the long-term outcome, so if you notice signs in yourself or someone else, seek help as early as possible.

 

Get a consistent seven hours of sleep a night

If midlife stresses are causing you to miss out on valuable sleep, it could take its toll in the long term. Last year a study in Nature Communications of almost 8000 people in Britain, the youngest aged 50 and the oldest in their 70s, assessed how many hours they slept each night. Some of the participants wore accelerometers to measure sleep time.

“Results showed that people in their 50s and 60s getting six hours of sleep or less were at greater risk of developing dementia later in life,” Carter says. “Compared with those getting normal sleep, defined as seven hours, those getting less rest each night were 30 per cent more likely to be diagnosed with dementia.” It suggests that short sleep duration during midlife could increase the risk of developing dementia later in life, Carter says, “although more research is needed to confirm and understand the reasons”.

 

Keep your waistline in check

Weight gain and obesity are known risk factors for some types of dementia, and people who carry excess weight at middle age have an increased risk of developing the condition, according to research from the long-running English Longitudinal Study of Ageing, which followed more than 6000 people aged over 50 for an average of 11 years.

Men and women who were obese and had a high waist circumference showed a 28 per cent increased risk of dementia. Being overweight also raises the risk of type 2 diabetes, another known risk factor for brain disease. “There was a recent longitudinal study of 10,000 participants showing that those with younger-onset type 2 diabetes were younger at onset of dementia if they developed it,” Carter says.

 

Your social life could be vital

Keeping connected with family and friends is an important aspect of brain health and helps to lower the risk of dementia. The findings of one study, of 2192 middle-aged and older adults, presented at this year’s Alzheimer’s Research UK conference suggested that spending face-to-face time with other people, at church services, in workouts or at classes, may return brain function to normal in people with early signs of dementia.

“Staying socially active has been shown to have a protective effect on the brain, so keep in contact with family and friends, or look around for local clubs or online groups of people who have similar interests to you,” Carter says. “Trying something new can also be beneficial.”

 

Power walk for 2½ hours a week

Exercising regularly is important for dementia prevention, Carter says, and poor cardiovascular health has been shown to damage blood flow to the brain, increasing the risk of the condition. A nine-year study involving 649,605 people, presented to the American Academy of Neurology conference by researchers at Washington VA Medical Centre, showed that people with the highest levels of cardiorespiratory fitness were 33 per cent less likely to develop Alzheimer’s disease than those who were less fit.

The researchers recommended a brisk walk most days, “for a total of 2½ hours or more per week”, as being enough to attain protective fitness effects for people who are middle-aged and older. “The idea that you can reduce your risk for Alzheimer’s disease by simply increasing your activity is very promising, especially since there are no adequate treatments to prevent or stop the progression of the disease,” said Edward Zamrini, the adjunct professor of clinical research at George Washington University and lead author on the paper.

 

Eat healthily and consider a supplement

“A diet rich in fruit, vegetables and cereals, and low in red meat and sugar – while keeping alcohol within recommended limits of no more than 14 units a week – could help to reduce dementia risk,” Carter says. And while no supplement provides protection against dementia, researchers from the Wake Forest University School of Medicine, and Brigham and Women’s Hospital, reported this week that three years of multivitamin supplementation roughly translated to a 60 per cent – or about 1.8 years – slowing of cognitive decline in a group of more than 2000 people over 65. For their study they compared the effects of taking a 500mg daily cocoa-extract supplement, rich in beneficial compounds called flavanols, or a daily multivitamin-mineral supplement.

“Our study showed that although cocoa extract did not affect cognition, daily multivitamin-mineral supplementation resulted in statistically significant cognitive improvement,” says Laura D Baker, a professor of gerontology and geriatric medicine at Wake Forest. “It’s too early to recommend daily multivitamin supplementation to prevent cognitive decline,” she says, but if you want to leave nothing to chance, you may consider taking one. Look for any supplement with a long list of vitamins and minerals, and including lutein, which is important for healthy vision and brain function.

The Times