Improved heart health in midlife could reduce dementia risk, apathy may be an early warning sign

While some cognitive impairment and reduction in capacity for memory, thinking, concentration and other cognitive functions are likely to occur naturally with age, dementia isn’t. Dementia is a progressive and chronic neurological disease that occurs due to a variety of diseases or injuries that affect the brain, like a stroke or Alzheimer’s disease. The World Health Organization (WHO) says that globally, around 50 million people have dementia and around 10 million new cases emerge each year now. This disease is a leading cause of disability and low quality of life among the aged population of the entire world. Moreover, the WHO says that around 9 percent of dementia cases are young-onset, meaning that they can show up well before the age of 65 years. Preventing this disease is necessary but difficult, as it means reducing all risk factors associated with the onset of dementia. Equally important is recognising the symptoms of dementia early on so that proper rehabilitation and therapy can be provided to the patients. Two recently published studies, one in the journal PLOS Medicine and the other one in Alzheimer’s & Dementia, throw new light on these vital aspects of dementia. Here’s what you need to know about them. Cardiovascular risk factors and reducing them in midlife What’s bad for your heart can be equally bad for your brain and can eventually lead to dementia in later life. This idea forms the basis of the study in PLOS One, which suggests that maintaining good cardiovascular health scores in midlife and late-life can reduce the risk of dementia. This study included 1,449 participants from the Finnish Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study whose health status was followed from midlife (1972-1987) to late-life (1998). Of these, 744 dementia-free survivors were then followed until 2005-2008. Three behavioural factors — smoking, physical activity levels and body mass index (BMI) — and three biological factors — fasting plasma glucose, total cholesterol and blood pressure — were observed to give the participants a cardiovascular health score. The researchers found that participants who had moderate to ideal cardiovascular health scores, especially due to the behavioural factors, had lower risks of developing dementia in later life. However, lower blood pressure and cholesterol levels in later life were associated with a higher risk of dementia. Since the study did not take dietary patterns and some other factors into account, it has its limitations. And yet, these findings suggest that controlling behavioural factors associated with heart health throughout midlife can go a long way in reducing the risk of dementia. Could apathy be an early symptom? The second study, published in Alzheimer’s & Dementia, suggests that apathy (the lack of interest or motivation) could predict the onset of dementia symptoms long before they actually appear, providing a window of opportunity where more action to prevent or postpone the disease could be taken. The study conducted clinical assessments and MRIs on 304 participants who were presymptomatic carriers of a faulty gene associated with frontotemporal dementia and 296 of their relatives without the same faulty genes for a period of two years. The researchers measured longitudinal changes in apathy, cognition, gray matter volumes and their relationships during this period too. The researchers found that the severity of apathy increased over time in the presymptomatic carriers of the faulty gene but not in the non-carriers. The progression of apathy was associated with low gray matter volume in the frontal and cingulate regions of the brain. They also found that the apathy levels in presymptomatic carriers predicted that cognitive decline was likely to increase over the following two years instead of apathy being a product of cognitive decline as is often assumed. These findings indicate that apathy is an early marker of frontotemporal dementia-related changes in the brain and predicts a subsequent deterioration in cognitive function before the eventual onset of dementia. Apathy levels and progression can therefore be mapped in at-risk patients to determine dementia onset and the researchers even suggest that it’s a modifiable risk factor that can be regulated to prevent or postpone the onset of this debilitating disease. For more information, read our article on  Dementia. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.