Risk Of Subsequent Dementia Research Articles

Adiposity and dementia among Chinese adults: longitudinal study in the China Health and Retirement Longitudinal Study (CHARLS).

Evidence on the age-dependent association between adiposity and risk of dementia in the Chinese population is unclear. We aim to disentangle the association of mid- and late- life adiposity with subsequent dementia risk in Chinese adults and compare ageing trajectories of adiposity between those with/out dementia. Dementia was ascertained based on cognitive batteries and the Activity of Daily Living Scale in the China Health and Retirement Longitudinal Study (CHARLS). Adiposity was measured by body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WtHR). We estimated hazard ratio (HR) of adiposity for incident dementia by age groups (i.e. 50-64, and ≥65). Age trajectories of adiposity measures were fitted using a mixed-effect model in a case-control design. The interaction terms of age and dementia were included to examine the difference between cases and controls. Hazard ratios (HRs) for incident dementia in two age groups (50-64 and ≥65) were estimated in 13,355 participants. Raised mid-life BMI was associated with incident dementia (HR (95% CI): overweight 1.33 (1.03 to 1.73), obesity 1.63 (1.17 to 2.28)). Mid-life abdominal obesity was associated with incident dementia (WC 1.45 (1.15 to 1.84), WtHR 1.44 (1.08 to 1.94)), accounting for ≤24.2% of dementia cases. Among participants developing dementia, adiposity measures were higher in mid-life and declined faster with age, compared to those remaining dementia-free. Late-life adiposity was not associated with dementia risk. Mid-life but not late-life adiposity was associated with dementia incidence in China. Accelerated weight loss in prodromal dementia is likely to explain the mixed evidence on adiposity and dementia risk in the Chinese population. Rapid decline in adiposity in later life may be an early sign. Reducing mid-life adiposity in the population may mitigate the future dementia burden.

Age at diagnosis of diabetes, obesity, and the risk of dementia among adult patients with type 2 diabetes.

While Type 2 Diabetes Mellitus (T2DM) prevalence is increasing among younger individuals, few studies have examined how age at T2DM diagnosis relates to dementia risk in diabetic populations. We aimed to investigate the association between age at T2DM diagnosis and subsequent dementia risk, and to determine whether obesity moderates this relationship. We conducted a prospective cohort study using data from the Health and Retirement Study (2002-2016) matched with its 2003 Diabetes Mail-Out Survey. The study included 1,213 dementia-free adults aged ≥50 with diagnosed T2DM. Primary exposures were age at T2DM diagnosis (categorized as <50, 50-59, 60-69, and ≥70 years) and obesity status (BMI ≥30 kg/m2). The outcome was incident dementia, assessed using the Telephone Interview for Cognitive Status. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for sociodemographic factors, health behaviors, health status, and diabetes medication use. Over a median follow-up of 10 (interquartile range, 6-14) years, 216 (17.8%) participants developed dementia. Compared to participants diagnosed with T2DM at age ≥70 years, those diagnosed at younger ages had increased dementia risk: HR 1.70 (95% CI, 1.03-2.80) for 60-69 years, 1.72 (95% CI, 1.06-2.79) for 50-59 years, and 1.90 (95% CI, 1.14-3.18) for <50 years. Obesity significantly moderated this relationship, with obese individuals diagnosed with T2DM before age 50 showing the highest dementia risk (HR 3.05; 95% CI 1.23-7.56) compared to non-obese individuals diagnosed at ≥50 years. Younger age at diagnosis of T2DM was significantly associated with a higher risk of dementia, particularly among individuals with obesity. Interventions specifically targeting obesity may be more effective in preventing dementia for adults with a younger onset of T2DM.

Diagnosis, prevention and management of delirium: spot it, stop it, treat it

SUMMARY Delirium frequently occurs among hospital in-patients, with significant attributable healthcare costs. It is associated with long-term adverse outcomes, including an eightfold increased risk of subsequent dementia. The purpose of this article is to inform clinicians of the best practices for spotting, stopping and treating delirium and provide guidance on common challenging clinical dilemmas. For spotting delirium, suggested screening tools are the 4 ‘A's Test (in general medical settings) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Prevention is best achieved with multicomponent interventions and targeted strategies focusing on: (a) avoiding iatrogenic causes; (b) brain optimisation by ensuring smooth bodily functioning; (c) maintaining social interactions and normality. Non-pharmacological approaches are the first line for treatment; they largely mirror prevention strategies, but the focus of empirical evidence is on prevention. Although sufficient evidence is lacking for most pharmacological approaches, an antipsychotic at low doses for short durations may be of utility for highly distressing or high-risk situations, particularly in hyperactive delirium, but only as a last resort.

Association of psychosocial state with subsequent risk of dementia: a prospective cohort study based on the UK Biobank

BackgroundMultiple psychosocial factors have been associated with dementia, while the individual or joint effects of various psychosocial states on dementia remain unrevealed due to the complex interplay between those factors. Here, the authors examined the associations of psychosocial factors and patterns with subsequent risk of dementia, and if the associations could be modified by genetic susceptibility to dementia.MethodsUK Biobank dementia-free participants were followed from one year after recruitment (median date: 24 January, 2010) until 31 October, 2022. Psychosocial states were measured by 22 items related to five dimensions, including psychiatric history, recent stressful life events, current psychiatric symptoms, social contact, and individual socioeconomic state. We identified clusters of individuals with distinct psychosocial patterns using latent class analysis. Cox proportional hazards models were used to evaluate the association between psychosocial items, as well as psychosocial patterns, and risk of dementia. We further performed stratification analyses by apolipoprotein E (APOE) genotype, polygenic risk score (PRS) of dementia, and family history of dementia.ResultsOf 497,787 included participants, 54.54% were female. During a median follow-up of 12.70 years, we identified 9,858 (1.98%) patients with newly diagnosed dementia. We identified seven clusters with distinct psychosocial patterns. Compared to individuals with a pattern of ‘good state’, individuals with other unfavorable patterns, featured by varying degrees of poor psychological state (‘fair state’ and ‘mildly, moderately, and extremely poor psychological state’), low social contact or socioeconomic state (‘living alone’ and ‘short education years’), were all at an increased risk of dementia (hazard ratios [HR] between 1.29 and 2.63). The observed associations showed no significant differences across individuals with varying APOE genotypes, levels of PRS, and family histories of dementia.ConclusionUnfavorable psychosocial patterns are associated with an increased risk of dementia, independent of genetic susceptibility. The findings highlight the importance of surveillance and prevention of cognitive decline among individuals with suboptimal psychosocial state.

Unraveling the role of the renin-angiotensin system in severe mental illnesses: An insight into psychopathology and cognitive deficits

Severe mental illnesses (SMI), especially schizophrenia and bipolar disorder (BD), are associated with significant distress to patients, reduced life expectancy and a higher cost of care. There is growing evidence that SMI may increase the risk of dementia in later life, posing an additional challenge in the management of these patients. SMI present a complex and highly heterogeneous pathophysiology, which has hampered the understanding of its underlying pathological mechanisms and limited the success of the available therapies. Despite the advances in therapeutic approaches in psychiatry over the past decades, treatment resistance is still a common problem in clinical practice, highlighting the urgent need for novel therapeutic targets for SMI. The discovery that renin-angiotensin system (RAS) components are expressed in the central nervous system opened new possibilities for investigating a potential role for this system in the neurobiology of SMI. The safety and efficacy of AT1 receptor blockers and angiotensin-converting enzyme inhibitors in cardiovascular and metabolic diseases, common medical comorbidities among SMI patients and well-known risk factors for dementia, suggest the potential scalability of these strategies for the management of SMI outcomes including the risk of subsequent dementia. This review aimed to discuss the available evidence from animal models and human studies of the potential involvement of RAS in the pathophysiology of SMI. We also provided a reflection on drawbacks and perspectives that can foster the development of new related therapeutic strategies.

Association between Age at Diagnosis of Type 2 Diabetes and Subsequent Risk of Dementia and Its Major Subtypes.

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a major contributor to cognitive decline and dementia in older adults; however, the role of the age of onset of T2DM in younger patients remains uncertain. We explored the association between the risk of dementia and its subtypes in relation to the age at T2DM diagnosis. Methods: This population cohort study included a total of 612,201 newly diagnosed T2DM patients. The controls were randomly selected from the general population and matched at a 1:2 ratio based on the propensity score. The outcomes of interest were all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD). The association of T2DM with dementia was stratified by the age at diagnosis of T2DM. Results: The mean ages of the subjects in the T2DM and control groups were 55.7 ± 13.0 and 55.7 ± 13.0. The patients with T2DM diagnosed at <50 years had the highest excess risk for most outcomes relative to the controls, with a hazard ratio (HR) (95% CI) of 3.29 (3.11-3.49) for all-cause dementia, 4.08 (3.18-5.24) for AD, and 5.82 (3.84-8.81) for VD. All risks were attenuated progressively with each increasing decade at the diagnostic age, but remained significant; for T2DM diagnosed at ≥80 years, the HR (95% CI) was 1.38 (1.34-1.41) for all-cause dementia, 1.35 (1.31-1.40) for AD, and 1.98 (1.70-2.30) for VD. Conclusions: We need to stratify T2DM management according to the age of diagnosis. Physicians should closely monitor cognitive function in patients with T2DM, especially in younger individuals.

Association of changes in predicted body composition with subsequent risk of dementia.

The effect of body composition change on the risk of dementia is not clear. This study analyzed the associations of changes in predicted lean body mass index (pLBMI), predicted appendicular skeletal muscle mass index (pASMI), and predicted body fat mass index (pBFMI) with the risk of dementia. In this nationwide cohort study, data were obtained from the Korean National Health Insurance Service database. The exposure was defined as changes in pLBMI, pASMI, and pBFMI derived from validated prediction equations. The outcome was dementia, defined based on the dementia diagnosis with prescription of anti-dementia medication. Cox proportional hazards regression analyses were performed to obtain the hazard ratio with a 95% confidence interval for risk of dementia according to changes in predicted body composition. A total of 13,215,208 individuals with no prior record of dementia who underwent health screenings twice between 2009-2010 and 2011-2012 were included. A 1-kg/m2 increase in pLBMI and pASMI had an association with reduced risk of dementia (aHR: 0.85, 95% CI 0.84-0.87; aHR: 0.70, 95% CI 0.69-0.72, respectively for men, and aHR: 0.69, 95% CI 0.67-0.71; aHR: 0.59, 95% CI 0.57-0.61, respectively for women). A 1-kg/m2 increase in pBFMI had an association with a raised risk of dementia (aHR: 1.19, 95% CI 1.17-1.21 for men and aHR: 1.53, 95% CI 1.48-1.57 for women). These results remained consistent regardless of sex or weight change. Increase in pLBMI or pASMI, or reduction in pBFMI was linked to lower risk of dementia.

ZOom Delivered Intervention Against Cognitive decline (ZODIAC) COVID-19 pandemic adaptations to the Post-Ischaemic Stroke Cardiovascular Exercise Study (PISCES): protocol for a randomised controlled trial of remotely delivered fitness training for brain health

BackgroundStroke increases subsequent dementia risk yet there are no specific post-stroke therapies to protect cognition. Cardiorespiratory exercise is recommended for secondary prevention of stroke and may be neuroprotective. The Post Ischaemic Stroke Cardiovascular Exercise Study (PISCES) aims to reduce post-stroke secondary neurodegeneration and cognitive decline. During the pandemic, we pivoted to a ZOom Delivered Intervention Against Cognitive decline (ZODIAC) protocol, reducing pandemic-amplified barriers to exercise.MethodsWe present pandemic adaptions for a multicentre phase IIb assessor-blinded randomised controlled trial of ischaemic stroke survivors testing the efficacy and feasibility of an 8-week home-based exercise intervention delivered at 2 months post-stroke. We compare cardiorespiratory exercise (intervention arm) versus balance and stretching (active control arm). Participants are assessed with magnetic resonance imaging (MRI), fitness, blood, microbiome, and neuropsychological tests at three study visits: before and after the exercise intervention and at 12 months. Modifications to the original protocol include pre-exercise safety home visits, commercial delivery of exercise equipment to facilitate assessor blinding, and reconsideration of statistical plan to allow pooling of the studies. We have reduced in-person study visits from 27 to 3. Primary outcome remains between-group (intervention versus control) difference in brain volume change; secondary outcome is between-group difference in global cognitive ability to allow remote administration of a validated cognitive scale.DiscussionRemotely delivered exercise interventions reduce participant burden and may reduce barriers to recruitment. A decrease in the number of in-person study visits can be supported by greater information capture via self-reported questionnaires and phone surveys.Trial registrationProspectively ACTRN12616000942459. Registered on July 2016.

Age at Diagnosis of Obstructive Sleep Apnea and Subsequent Risk of Dementia

Age at Diagnosis of Obstructive Sleep Apnea and Subsequent Risk of Dementia

Association between colchicine use and the risk of dementia among patients with gout: A nationwide retrospective cohort study.

Recent findings suggest a link between gout and the development of dementia. Early treatment with colchicine is recommended as a first-line therapy for gout flares. Animal studies demonstrate that colchicine could induce cognitive impairment. This cohort study aimed to investigate the association between colchicine use and the risk of developing dementia. In this nationwide cohort study, we performed comparative analysis on 6147 patients ≥40 years, with gout and colchicine new users against 6147 controls to assess subsequent dementia risk. The colchicine group and the control group (urate lowering therapy group) were matched on the bases of age, sex, index year, and comorbidities. All participants were followed for up to 14 years for a diagnosis of dementia considering medical records were retrospectively checked over this period. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Sensitivity analyses were performed to validate our findings. The adjusted hazard ratio (aHR) of dementia for colchicine users was 1.45 (95% CI = 1.05, 1.99) relative to comparison group after adjusting for sex, age, and comorbidities. Sensitivity analysis aiming to minimize underdiagnosed occult dementia at the time of index year yielded consistent positive association. In higher accumulative dose colchicine group (cumulative defined daily dose [cDDD] >30), the aHR of dementia risk for colchicine users was 1.42 (95% CI = 1.03, 1.97) compared with nonusers. For those duration of colchicine use >30 days, the aHR was 1.53 (95% CI = 1.01-2.32) compared to the nonuser group. A significant risk of dementia was observed in this study in patients with gout using colchicine at higher cDDD and for a longer period. Further research is needed to elucidate the relationship between colchicine, gout, and dementia.

Association of Cancer History with Lifetime Risk of Dementia and Alzheimer's Disease.

The literature presents conflicting results regarding the potential protective effect of prevalent cancer on the development of dementia and Alzheimer's disease (AD). Association between cancer and subsequent risk of dementia and/or AD was reported previously, but survival bias has been of concern. Here, we aimed to calculate the lifetime risk of dementia and AD and evaluate the association of cancer history with these two conditions. In this retrospective analysis, we included 292,654 participants aged 60+ y during the follow-up and free of dementia at baseline, within the UK Biobank cohort. Lifetime risks of dementia and AD were estimated in individuals with and without cancer history, and different durations of cancer exposure and cancer types. During a median of 12.5 follow-up years, 5,044 new dementia and 2,141 AD cases were reported. Lifetime risks of dementia and AD were lower in cancer survivors compared to those without cancer, and this effect was more pronounced in participants with cancer history exposure≥5 years. Similar relationship was observed in individual cancer types, except for breast cancer. Results suggested an inverse association between cancer history and lifetime risk of dementia and AD, which may be modified by different cancer types and cancer exposure time.

Association of Combined Healthy Lifestyle Factors With Incident Dementia in Participants With and Without Multimorbidity: A Large Population-Based Prospective Cohort Study.

The effect of a healthy lifestyle on dementia associated with multimorbidity is not well understood. Our objective is to examine whether the adoption of a healthy lifestyle could potentially reduce the elevated risk of dementia in individuals with and without multimorbidity. We utilized data from the UK Biobank cohort. A comprehensive healthy lifestyle score, ranging from 0 to 6, was generated. Cox proportional hazards models were used to examine the associations between multimorbidity, the healthy lifestyle score, and the incidence risk of dementia. Over a median follow-up period of 12.5 years, 5852 all-cause dementia were recorded. Multimorbidity including cardiovascular, metabolic, neuropsychiatric, and inflammation-related diseases was associated with a higher risk of subsequent dementia. Each additional chronic disease was associated with a hazard ratio (HR) of 1.38 (95% CI: 1.33, 1.44). Compared to individuals without multimorbidity and a healthy lifestyle score of 5-6, patients with multimorbidity and a lifestyle score of 0-1 had a significantly higher risk of dementia (HR: 3.13; 95% CI: 2.64, 3.72), but the risk was markedly attenuated among those with multimorbidity and a lifestyle score of 5-6. Among patients with 3 or more diseases, the HR for dementia was 0.53 (95%CI: 0.42, 0.68) when comparing a lifestyle score of 5-6 to 0-1. And we observed more pronounced association between them among people younger than 60 years old. Adherence to a combination of healthy lifestyle factors, especially at a young age, was associated with a significantly lower risk of dementia among participants with multimorbidity.

Towards a Clearer Causal Question Underlying the Association Between Cancer and Dementia.

Several observational studies have described an inverse association between cancer diagnosis and subsequent dementia risk. Multiple biologic mechanisms and potential biases have been proposed in attempts to explain this association. One proposed explanation is the opposite expression of Pin1 in cancer and dementia, and we use this explanation and potential drug target to illustrate the required assumptions and potential sources of bias for inferring an effect of Pin1 on dementia risk from analyses measuring cancer diagnosis as a proxy for Pin1 expression. We used data from the Rotterdam Study, a population-based cohort. We estimate the association between cancer diagnosis (as a proxy for Pin1) and subsequent dementia diagnosis using two different proxy methods and with confounding and censoring for death addressed with inverse probability weights. We estimate and compare the complements of a weighted Kaplan-Meier survival estimator at 20 years of follow-up. Out of 3634 participants, 899 (25%) were diagnosed with cancer, of whom 53 (6%) had dementia, and 567 (63%) died. Among those without cancer, 15% (411) were diagnosed with dementia, and 667 (24%) died over follow-up. Depending on the confounding and selection bias control, and the way in which cancer was used as a time-varying proxy exposure, the risk ratio for dementia diagnosis ranged from 0.71 (95% confidence interval [CI] = 0.49, 0.95) to 1.1 (95% CI = 0.79, 1.3). Being explicit about the underlying mechanism of interest is key to maximizing what we can learn from this cancer-dementia association given available or readily collected data, and to defining, detecting, and preventing potential biases.

Association between Age at Diagnosis of Hyperlipidemia and Subsequent Risk of Dementia

ObjectivesThe relationship between age at diagnosis of hyperlipidemia and dementia remains unclear. We examined whether younger age at diagnosis of hyperlipidemia is associated with higher risk of subsequent dementia. DesignA longitudinal population-based study with a median follow-up of 12.8 years. Setting and ParticipantsWe analyzed data on a sample of 489,642 participants in the United Kingdom. MethodsThis study was based on the UK Biobank. Information on hyperlipidemia and dementia diagnoses was collected at baseline (2006–2010) and follow-up [median = 12.8 years, interquartile range (IQR): 12.1–13.6 years]. Propensity score matching method and Cox proportional hazards models were used to assess the association between age at diagnosis of hyperlipidemia and dementia. ResultsAmong 489,642 participants (mean age: 56.9 ± 8.1 years; female: 54.7%), 114,112 (23.3%) were diagnosed with hyperlipidemia. Younger age at diagnosis of hyperlipidemia (per 10-year decrease) was significantly associated with higher risks of all-cause dementia [hazard ratio (HR), 1.12; 95% CI, 1.07–1.18; P < .001], Alzheimer’s disease (AD) (HR, 1.22; 95% CI, 1.14–1.31; P < .001), and vascular dementia (VD) (HR, 1.16; 95% CI, 1.05–1.27; P < .001). After propensity score matching, patients with hyperlipidemia diagnosed before 50 years had the highest HR for all-cause dementia (HR, 1.46; 95% CI, 1.15–1.86; P = .002), followed by patients diagnosed between 50 and 69 years (HR, 1.21; 95% CI, 1.12–1.31; P < .001) and then patients diagnosed aged 70 years and older (HR, 0.94; 95% CI, 0.84–1.06; P = .302). Similar results were observed for AD and VD. Conclusions and ImplicationsA dose-response relationship between age at hyperlipidemia diagnosis and risk of dementia was found in the longitudinal cohort study, with younger age at diagnosis of hyperlipidemia being associated with higher subsequent risk.

The impact of postoperative agitated delirium on dementia in surgical patients.

This study investigates the association between postoperative agitated delirium and the risk of dementia in patients who were cognitively intact before undergoing major inpatient surgery. The study included inpatients aged 20 years or older who underwent major surgery requiring general, epidural, or spinal anaesthesia and hospitalization for over one day in Taiwan between 2008 and 2018. Patients were categorized into two groups based on the presence or absence of postoperative agitated delirium. Propensity score matching was conducted to balance various covariates known to influence dementia risk. The final analysis included 10 932 patients (5466 in each group). Multivariate Cox regression analysis was performed to assess the risk of dementia, and incidence rates and incidence rate ratios were calculated. After Propensity score matching, the study cohort comprised 5467 patients without postoperative agitated delirium and 5467 patients with postoperative agitated delirium. In the multivariate Cox regression analysis, the adjusted hazard ratio for dementia were 1.26 (95% confidence intervals, 1.08-1.46; P = 0.003) in the postoperative agitated delirium group compared to the no postoperative agitated delirium group. The incidence rates of dementia was significantly higher in patients with postoperative agitated delirium (97.65 versus 70.85 per 10 000 person-years), with an incidence rate ratio of 1.21 (95% CI: 1.04-1.40). Our study demonstrates a substantial rise in dementia incidence linked to postoperative agitated delirium. These findings stress the need for effective prevention and management strategies. Addressing this issue emerges as a vital clinical approach to reduce subsequent dementia risk, with broad implications for enhancing overall perioperative patient outcomes.

Herpes zoster diagnosis and treatment in relation to incident dementia: A population-based retrospective matched cohort study.

Evidence suggests that some infectious diseases, such as herpes zoster (HZ), are associated with elevated risk of subsequent dementia, while certain anti-viral medications are associated with lower risk. We sought to evaluate associations between HZ diagnosis and treatment with incident dementia in a large, retrospective matched cohort. Using ICD-9 and ICD-10 diagnosis codes in electronic medical records, we identified members of Kaiser Permanente Northwest age 50 and older from 2000-2019 with a HZ diagnosis during this period. A comparison group without HZ diagnosis was individually matched 3:1 on age at HZ diagnosis date (index date), sex, and membership length prior to index date. We excluded subjects with dementia diagnosed before the index date. Antiherpetic medication was identified using pharmacy fills 1 month before to 12 months after the index date. We employed survival analysis to examine the associations between dementia and HZ diagnosis and antiherpetic medication, adjusting multivariable models for demographic and clinical factors. We stratified on age and sex and conducted a sensitivity analysis with a 5-year lag period. The study included 101,328 persons, 25,332 with HZ. Over a median follow-up of 4.8 years, 6,000 developed dementia. HZ diagnosis was not associated with higher hazard of dementia (hazard ratio (HR) = 0.99, 95% CI 0.93-1.05) in the primary analysis. Among persons with HZ diagnoses, the HR for receipt of any antiherpetic medication was 0.79 (95% CI 0.70-0.90) in univariate analysis and 0.88 (95% CI 0.77-1.00) after adjustment for demographic and clinical factors. Dementia was not associated with trends in duration of medication use or cumulative dose. We found little evidence for an association between HZ diagnosis and dementia overall. Antiherpetic medication prescribed around the time of HZ diagnosis was statistically associated with lower risk of subsequent dementia in some but not all analyses and subgroups.

Weight change in people with depression and the risk of dementia: a nationwide cohort study.

Depression is a risk factor for dementia and weight change can appear as a symptom of depression. However, the association between weight change after the diagnosis of depression and the risk of dementia is poorly established. This study aimed to investigate the association between weight change before and after a diagnosis of depression with the subsequent risk of dementia. The National Health Insurance Sharing Service database was used. 1 308 730 patients aged ⩾40 years diagnosed with depression were identified to be eligible. Weight changes after their depression diagnosis were categorized and subsequent incidence of dementia was followed up. During an average follow-up period of 5.2 years (s.d., 2.0 years), 69 373 subjects were newly diagnosed with all-cause dementia (56 351 were Alzheimer's disease and 6877 were vascular dementia). Regarding all outcomes, compared to those with a minimal weight change (-5 to 5%), all groups with weight gain or loss showed increased risks of dementia after adjusting potential risk factors for dementia, in all analysis models with a dose-response relationship, showing a U-shaped association. Weight change as a symptom of depression could be a predictor for the future development of dementia.

Sex Difference in the Association between Prior Fracture and Subsequent Risk of Incident Dementia: A Longitudinal Cohort Study.

A history of fracture has been associated with increased risk of dementia; however, it is uncertain whether sex difference exists in the association between prior fracture and subsequent risk of incident dementia. To investigate whether sex modified the relationship between prior fracture and subsequent risk of dementia. Prospective cohort study. UK Biobank. 496,331 participants (54.6% women) free of dementia at baseline. History of fracture was self-reported via touchscreen questionnaires at baseline. The primary outcome was all-cause dementia. Both any fracture and fragility fracture were significantly associated with an increased risk of subsequent all-cause dementia in men (adjusted hazard ratio (HR): 1.28; 95% confidence interval (CI): 1.14-1.43; adjusted HR: 1.48; 95% CI: 1.18-1.87, respectively), but not in women (adjusted HR: 1.04; 95% CI 0.95-1.15; adjusted HR: 1.01; 95% CI: 0.87-1.18, respectively); and these sex-differences were significant (P interaction = 0.006; P interaction = 0.007, respectively). The sex differences in the impacts of different fracture sites (including upper limb, lower limb, spine, and multiple sites) were consistent on all-cause dementia. This study demonstrated that prior fracture was associated with an increased risk of dementia in men but not in women, and the sex difference was significant. Previous fracture may be an important marker for identifying subsequent dementia in middle-aged and older men.

Severe psychiatric disorders are associated with increased risk of dementia

BackgroundIndividuals with psychiatric disorders have an increased risk of developing dementia. Most cross-sectional studies suffer from selection bias, underdiagnosis and poor population representation, while there is only limited evidence from...

The trajectory of depressive symptoms over time and the presence of depressive symptoms at a single time point with the risk of dementia among US older adults: A national prospective cohort study.

This study aims to assess the association between trajectories of depressive symptoms and the risk of dementia, and to compare the predictive ability of trajectories using multiple data points with depressive symptoms at a single data point. We included 5306 older adults from the Health and Retirement Study. We assessed depressive symptoms using the Center for Epidemiology Depression Scale (CES-D), and identified its 8- year trajectories (2002-2010) using latent class trajectory modeling. We calculated hazard ratios (HR) using Cox proportional hazards models. The concordance index (C-index) was used to compare the discriminative power of the models. We identified two trajectories of depressive symptoms, characterized by maintaining low CES-D scores, and moderate starting scores that steadily increased throughout the follow-up period. During 40,199 person-years, compared to the low trajectory, the increasing trajectory of depressive symptoms was associated with a higher risk of dementia (HR = 1.35; 95% CI: 1.09-1.67) (C-index = 0.759). For every point increase in the degree of depressive symptoms (CES-D scores) in 2010, the risk of dementia increased by 7% (95% CI: 1.03-1.12) (C-index = 0.760). The presence of depressive symptoms (CES-D scores ≥3) in 2010 was not associated with an increased risk of dementia (HR = 1.18; 95% CI: 0.98-1.43) (C-index = 0.759). The C-index values of cox models showed similar discriminative power. The increasing trajectory of depressive symptoms at multiple data points and the degree of depressive symptoms at a single data point were associated with an increased risk of subsequent dementia among older adults.