Juvenile mental illness is associated with a significant increased risk of dementia in later years.
The results of a large longitudinal population-based study show that individuals hospitalized for mental illness have a four-fold higher relative risk (RR) of developing dementia than those who were not hospitalized for mental illness. It shows that.
In addition, people with dementia and mental illness developed dementia almost six years earlier than those without mental illness.
Findings are consistent across men and women, patients with early and late dementia, patients with Alzheimer’s and non-Alzheimer’s disease, and all psychiatric disorders, existing physical illnesses and socioeconomic factors. It was consistent even after considering.
“Dementia is usually not treated until later in life, but our research suggests that we need to think about dementia prevention very early in our life course,” said a researcher. Dr. Leah Richmond Raycard, Faculty of Psychology, College Michigan, said Medscape Medical News..
“Supporting the mental health of young people can be a window of opportunity to help reduce the burden of dementia in older people,” she said.
The survey results are Published online February 16th.
Underestimated risk factors
“Recognizing the significant effects of dementia on posterity function has facilitated research into correctable risk factors and preventive goals,” the researchers write.
Previous studies suggest that mental illness may “include an underestimated category of correctable risk factors.” However, they added that these studies focused primarily on middle-aged and older people, not on the capture of mental illness in young adulthood, a period of “peak prevalence.” increase. In addition, most studies do not investigate the full range of mental illness.
Richmond-Rakerd said it is well known that mental health disorders peak in adolescence and young adulthood and are treatable.
“If the same person with a mental illness at a young age tends to develop dementia as they get older, it may reduce or delay the burden of dementia in the elderly by preventing mental health problems in the young. It means there is a possibility, “she said.
Investigators evaluated records from the New Zealand Integrated Data Infrastructure, an anonymized register that includes the entire population of New Zealand. They also looked up information on hospitalization and diagnosis from records kept by the Ministry of Health of New Zealand.
Researchers followed 1,711,386 people born between 1928 and 1967 (50.6% male, 21-60 years old at baseline) for 30 years. The population was subdivided into age groups based on year of birth: 1928–1937 (14.8%), 1938–1947 (20.85%), 1948–1957 (29.35%), and 1958–1967 (35.1%).
Early onset
During the study period, 3.8% of individuals were identified as having a mental illness and 2% were identified as having dementia. A similar proportion of men and women had mental illness, and a similar proportion had dementia.
Dementia was “overestimated” between participants with and without mental illness (6.1% vs. 1.8%). This discovery was made across all age groups.
People diagnosed with mental illness are more likely to develop dementia than their non-mentally ill peers (RR, 3.51; 95% CI, 3.39 – 3.64), which is a physical illness and dementia. Greater than the association between (RR, 1.19; 95% CI, 1.16 – 1.21).
These associations were present in gender and all age groups, but were more relevant in recently born cohorts.
Even after adjusting for existing physical illness, the risk of dementia was 6-fold higher (HR, 6.49; 95% CI, 6.25 – 6.73). The increased risk was evident over various lengths of follow-up from index psychiatric disorders.
When researchers specifically focused on individuals diagnosed with dementia, they developed dementia on average 5.60 years earlier than those diagnosed with mental illness than those without. I found.
“Individuals diagnosed with psychosis, substance use, mood, neuropathy, and all other mental illnesses and engaged in self-harm are more cognitive than those without mental illness, even after considering their physical history. They were more likely to be diagnosed with the disease, “the researchers wrote.
There was an association between psychiatric disorders in both Alzheimer’s and non-Alzheimer’s dementia, but the association was greater in non-Alzheimer’s.
Researchers note that the study has some limitations, including the fact that it was conducted in New Zealand, and therefore the results may not be generalized to other regions. In addition, hospital records for inpatients do not record cases of less serious mental illness treated in an outpatient setting.
Richmond-Rakerd proposed several potential mechanisms that could explain the link between mental illness and dementia. This includes inadequate lifestyle choices and metabolic side effects associated with some psychiatric drugs.
“There may also be common risk factors for both mental illness and dementia, such as shared genetics, or individuals appear as mental health problems early in life and are cognitive later in life. You can experience lifelong brain fragility that manifests as dementia, “she said. ..
Important risk factors
comment Medscape Medical NewsDr. Kenduckworth, MD, Chief Medical Officer of the National Federation of Mental Illness Families, said the study’s main strengths are its long-term scope and large population size.
He described the study as allowing clinicians to “watch movies” rather than “snapshots” of the data.
“You can learn things from snapshots, but see 30 years of billing. A large, comprehensive public health system is not possible in the United States due to a more fragmented healthcare system, but more. It provides insight, “said Duckworth, who was not involved. research.
The investigator added, “I’m drawing a picture of the risk correlation. For me, that’s the beginning of further investigation.” “Will preventive efforts targeting dementia such as exercise and socialization help? A great study that raises these interesting questions.”
again, Medscape Medical NewsDr. Claire Sexton, director of science programs and outreach at the Alzheimer’s Association, said the study “adds a wealth of data to our understanding” of mental illness as a risk factor for dementia.
However, because this study was observational, “the findings cannot suggest a causal relationship. [and] Because someone has it depressionThat doesn’t mean they continue to develop Alzheimer’s disease, “said Sexton, who wasn’t involved in the study.
Still, “these data support the idea that mental health care is very important for overall well-being. For providers, making mental health assessments part of their patients’ routine health checks It’s important, “she added.
Richmond-Rakerd states that even if mental health status is not a risk factor for dementia, “the presence of mental health problems is still an important indicator of risk. Mental health providers are other than dementia. You may want to target the risk factors of. It is common in people with mental health conditions such as social discontinuity. “
This study is a center for promoting socio-population statistics and economic research at the National Institute of Aging, the British Medical Research Council, the National Institute of Pediatric Health Development through the Duke Population Research Center, and the National Institute of Aging. Funded by a grant from. Alzheimer’s disease And related dementia. Richmond-Rakerd reports that there is no relevant financial relationship. Disclosures of other researchers can be found in the original article. Sexton and Duckworth have not reported any relevant financial relationships.
JAMA Psychiatry. Published online on February 16, 2022. Full text
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