Cohort studies suggested that some dementia-related health conditions were present early and consistently, long before diagnosis, while others became severe much later.
For those subsequently diagnosed with Alzheimer’s disease, the earliest and most consistent associations at all time points over 15 years included depression, erectile dysfunction, gait abnormalities, hearing loss, neurological and musculoskeletal symptoms. reports Lori Beason-Held. She is a PhD and co-author from the Baltimore National Institute on Aging.
For patients ultimately diagnosed with vascular dementia, the earliest and most consistent associations over 13 years were abnormal electrocardiogram (EKG), arrhythmia, cerebrovascular disease, non-epithelial skin cancer, and depression. , and had hearing loss, the researchers reported. Neurological Annals.
“Although hypertension, cerebrovascular disease, and depression are most commonly associated with dementia in the literature, there is some variability in the health conditions associated with dementia,” wrote Beason-Held and colleagues. increase. “The timing of onset of these conditions may also be particularly important, but less is known about the years immediately preceding dementia diagnosis.”
“As the population continues to age, understanding the relationship between physical and cognitive health is critical,” the researchers added. “Our results reinforce the need for medical interventions and treatments to reduce the effects of age-related health conditions and may potentially reduce the future risk of dementia in older patients.” I have.”
Beason-Held and co-authors reviewed the medical records of participants in the ongoing Baltimore Longitudinal Study of Aging (BLSA). They evaluated data from 347 with Alzheimer’s disease, 76 with vascular dementia, and 811 control participants without dementia. The average age at diagnosis of the participants he was 80 years. Patients with Alzheimer’s disease and vascular dementia were matched to controls based on age, sex and follow-up period.
The investigators performed ICD- We examined the relationship between 9 codes and dementia status. , control age, sex, and duration of follow-up.
The most common health conditions associated with subsequent Alzheimer’s dementia were hearing loss (39% of participants), urinary incontinence (23%) and depression (11%). Cardiac hypertrophy, urinary incontinence, non-epithelial skin cancer, and pneumonia were not significant until 1 year before diagnosis of Alzheimer’s disease.
Those subsequently diagnosed with vascular dementia most commonly had hearing loss (49% of participants), ECG abnormalities (41%), arrhythmias (37%), and atrial fibrillation (30%). . Atrial fibrillation, cerebral artery occlusion, essential tremor, and reflex dysreflexia were not significant until his year before diagnosis of vascular dementia.
These time-dependent findings “could help explain the variability in results not only from a clinical perspective, but also in studies examining different intervals before dementia diagnosis,” Beason-Held and colleagues said. observed.
“Unlike Alzheimer’s disease, which included numerous significant codes in the cardiovascular, cutaneous, genitourinary, psychiatric, and sensory categories, the majority of associations in vascular dementia are cardiovascular and cerebrovascular. It is related to circulatory categories, including both code and neurological health,” the researchers said.
“These findings highlight differences between the two types of dementia and add to our knowledge of the timing of health comorbidities associated with the progression of vascular-associated dementia,” they added.
A limitation of this study was the inclusion of a relatively small number of participants with dementia, which may be due to the characteristics of BLSA. “Our participants are generally highly educated, undergo regular physical examinations, are aware of comorbidities, and seek treatment when necessary. can reduce the risk of dementia,” said Beason-Held and co-authors.
“People who develop cognitive problems are likely to seek more medical care than those who do not, resulting in less common dementia-related conditions such as the skin disorders observed in the Alzheimer’s disease group.” Increased reporting of health conditions. Additionally, disease severity may play an important role, although that information was not available.
This work was supported by the Intramural Research Program of the National Institute on Aging.
The authors report no conflicts of interest.
Source reference: Beason-Held LL, et al. “Health conditions associated with Alzheimer’s disease and vascular dementia,” Ann Neurol 2022; DOI: 10.1002/ana.26584.