Early-onset dementia strongly correlated with alcohol intoxication in men

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1. Participants who had a history of alcohol intoxication were on average four times more likely to develop young-onset dementia. Those with daily consumption were six times more likely to develop young-onset dementia. 

2. Other significant risk factors for young-onset dementia include: height, dementia in father, overall cognitive function, use of antidepressants or neuroleptics, and stroke.

Evidence Rating Level: 2 (Good) 

Study Rundown: Young onset dementia (YOD) is defined as the onset of dementia before the age of 65. When patients are diagnosed with YOD they suffer severe consequences related to their careers, familial responsibilities, and planning for the significant morbidity associated with such a diagnosis. At follow-up, those diagnosed with YOD had significant differences in the following risk factors: height, dementia in father, overall cognitive function, alcohol intoxication, depression or antidepressant use, stroke, and use of neuroleptics. The authors looked further into alcohol consumption among the cohort and concluded a linear relationship between the frequency of consumption and the odds ratio of developing dementia.

One major limitation of this study is the homogeneous cohort of men. Women account for a significant proportion of those diagnosed with young onset dementia, however they were not included.  In addition, as a retrospective observational study, causation cannot be concluded, simply association. Nonetheless, the authors included a large cohort with long term follow up where information was available on baseline premorbid function in young adulthood compared to that at onset of YOD as well as provide information on those factors present at follow up.

Click to read the study, published today in JAMA Internal Medicine

Relevant Reading: The diagnosis of young-onset dementia

In-Depth [retrospective cohort study]: This study included 488,484 men from the Swedish Military Service Conscription Register from January 1969 through December 1979 and followed for a median of 37 years. The diagnosis of YOD was found in 487 of these men with mean age of 53.6 at diagnosis.  At conscription, the characteristics that were different between those that developed YOD and those with no dementia included dementia present in the father, diastolic blood pressure, cognitive function, alcohol intoxication, use of antidepressants and neuroleptics, with all values significant to p < 0.05.  At follow up, those with dementia compared to those without dementia differed significantly in height (HR 1.16), dementia in father (HR 1.65), overall cognitive function (1.26), alcohol intoxication (HR 4.83), depression or antidepressant use (HR 1.89), stroke (HR 2.96), and use of neuroleptics (HR 2.75). Of note, men with the lowest cognitive function and at least two additional risk factors were 20 times more likely to develop dementia.

By Camellia Banerjee and Brittany Hasty 

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