Last year I wrote a column entitled “Dementia Prevention – What Can be Done?” The column generated comments from “I had a comment and forgot what it was” to “Doctors don’t know the first thing about health…” to an active debate regarding dental hygiene. Other comments suggested that I don’t quit my day job. The frequent shares of that column and adjacent commentary do highlight one aspect of dementia; it stirs up emotions.
Most of us know somebody who has suffered from dementia. Dementia is a diagnosis made based upon the development of cognitive dysfunction to the degree that it impacts quality of life. Dementia is a progressive disease. The impact on quality of life often worsens not only for the patient, but also the associated family and loved ones.
Finding Dementia Risks in Our Early Years
Along these lines, I wanted to add to that prior column as a new study recently was published that looks at risk factors early in life that result in a higher risk of cognitive dysfunction in mid life. The definition of “early in life” for this study was 18-30 years of age. During those years most people are trying to get an education, trade, succeed in a career, and perhaps start a family. I suspect very few people consider choices made at that time may influence dementia risk. In this regard, this new study has particular relevance to young adults and those that are interested in their long-term health.
In this study, 3,381 young adults were recruited from populations in four United States cities (Birgmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota, and Oakland, California). These participants were then followed closely for 25 years. At the conclusion of the study the average age was 50 years. The study was a diverse and educated population: 46 percent were black, 44 percent were male, and 84 percent had greater than a high school education.
The Suspects: Blood Pressure, Sugar and Cholesterol
The authors studied four parameters of cardiovascular health. These included blood pressure (systolic and diastolic levels), fasting blood sugar, and total cholesterol. The study investigators used the current American Heart Association guidelines to set standards for comparison:
- Systolic blood pressure <120 mmHg
- Diastolic blood pressure <80 mmHg
- Fasting blood sugar (glucose) <100 mg/dL
- Total cholesterol <200 mg/dL
Participants completed three separate tests at intervals over the 25 year period to assess their cognitive function. These studies are designed to measure executive function, processing speed, and verbal memory.
The results of their study were remarkable despite the young age of the participants.
Lower Test Scores
Cognitive test scores were:
- 17-25 percent lower in young adults with elevated systolic blood pressures
- 25-29 percent lower in young adults with elevated diastolic blood pressures
- 9-15 percent lower in young adults with elevated fasting blood sugars
- 1-6 percent lower in young adults with elevated cholesterol levels
These profound changes in test scores were independent of the participants’ gender, race, and education level.
The authors also studied those people in whom the elevated blood pressure, fasting sugar, and cholesterol developed slightly late, at an age of >35 years. They found that even in people with less exposure (ie 10 year delay) there was still a significant reduction in all cognition test scores with each risk factor.
We have know for many years that heart disease such as coronary artery disease starts very early in life, sometimes in our 2nd and 3rd decade, particularly in active smokers and those with diabetes. This study teaches us that cognitive dysfunction may also start much earlier than we thought. Unfortunately, when the disease begins to impact quality of life it is often too late to reverse or treat adequately.
Heart Disease Risks are Dementia Risks
What does this study teach us? First, risk factors for heart disease are also risk factors for dementia. Second, the cumulative effect of these risk factors is important. If this is true, then hopefully by reducing the cumulative exposure we can also reduce dementia risk. Finally, it is never too late to take care of yourself. This is a group of very educated diverse people. There were likely tremendous professional demands on their time. These demands often take priority over healthy living choices. Like I have mentioned in my prior columns, even small changes can greatly impact your health including your blood pressure, fasting sugar and cholesterol. These choices include increasing your activity, walking more, setting aside 30-60 minutes to exercise, eating a more whole food, plant-based diet, and getting restorative sleep.
If not all are possible, work on a few. Hopefully your choices will pay off long-term in your heart and brain health.
A great resource for additional information regarding health guidelines is provided by the American Heart Association.