Middle-aged Americans and dementia risk: Lots of worry, not enough proven prevention

November 15, 2019

Nearly half of Americans in their 50s and early 60s think they're likely to develop dementia as they grow older, but only 5% of them have actually talked with a doctor about what they could do to reduce their risk, a new study finds.

Meanwhile, a third or more say they're trying to stave off dementia by taking supplements or doing crossword puzzles - despite the lack of proof that such tactics work.

The new findings suggest a need for better counseling for middle-aged Americans about the steps they can take to keep their brains healthy as they age.

Meanwhile, pharmaceutical companies continue to work on potential dementia-preventing medications. But an over-estimation of future dementia risk by individuals may lead to costly over-use of such products, the researchers warn.

The new results appear in a research letter in the new edition of JAMA Neurology, and a presentation at the Gerontological Society of America's annual meeting.

Both are by members of a team from the University of Michigan's Institute for Healthcare Policy and Innovation who analyzed data from a nationally representative poll of 1,019 adults between the ages of 50 and 64.

Donovan Maust, M.D., M.S., a geriatric psychiatrist specializing in dementia-related care and lead author of the JAMA Neurology letter, notes that even among the oldest Americans, the risk of dementia is lower than one in three people over age 85.

Risk starts rising around age 65, and is higher among people of Latino or African-American heritage.

When people are in their 50s and early 60s, he says, they still have time to bring down their future dementia risk.

"There is growing evidence that adults in mid-life can take steps to lower their risk of dementia, including increasing physical activity and controlling health conditions like hypertension and diabetes," says Maust. "Unfortunately, our findings suggest that people may not be aware of this and are not asking their doctor."

Meanwhile, the new study shows, 32% of those polled said they were taking fish oil or omega-3 fatty acid supplements, and 39% said they took other supplements for brain health. More than half said they were doing crossword puzzles or other brain games in hopes of keeping their minds "sharp."

Other findings

The new data come from the National Poll on Healthy Aging, carried out by IHPI with support from AARP and Michigan Medicine, U-M's academic medical center. The new paper, and GSA presentation by poll co-director Erica Solway, Ph.D., M.S.W., delve deeper into the poll data than the report issued earlier this year.

The level of worry about dementia among some groups of middle-aged adults may not be in line with their risk compared to others, the study suggests. For example, studies suggest that people of Latino heritage are about 50% more likely to develop dementia than non-Latino whites, and African-Americans are about twice as likely as non-Latino whites.

However, in the poll, those of African-American or Latino backgrounds did not consider themselves more likely to develop dementia than white respondents.In fact, African-American respondents felt they were significantly less likely to develop dementia than other groups.

Similarly, middle-aged people with worse physical health because of conditions such as diabetes, high blood pressure and heart disease are more likely to develop dementia than those in good health. However, poll respondents who reported their physical health as just fair or poor did not judge their risk of dementia to be higher than their healthier peers.

Turning worry into prevention

Reducing the risk of developing dementia can be done in mid-life through things like increasing physical activity, smoking cessation, and managing chronic medical conditions such as diabetes or hypertension, says Maust.

Physicians and public health authorities should communicate to middle-aged adults that taking these steps are the most evidence-based strategies to help preserve brain function into old age, Maust says, as well as reducing the risk of everything from heart attacks and strokes to lung disease, cancer and loss of vision and mobility.

Even if drug developers succeed where past attempts have failed, and come up with medications that act specifically to prevent dementia, those drugs are likely to be costly. And the failure of several would-be preventive drugs mean it could be years before one hits the market.

But people in their 50s and 60s can take specific actions to improve their health now at much lower cost to themselves and society, plus saving the dollars they've been spending on supplements and brain games.
In addition to Maust and Solway, the authors of the paper and presentation are IHPI members and U-M faculty Kenneth M. Langa, M.D., Ph.D., Jeffrey Kullgren, M.D., M.S., M.P.H. and NPHA director Preeti Malani, MD, MSJ, and poll team members Matthias Kirch, M.S. and Dianne C. Singer, M.P.H. The National Poll on Healthy Aging results behind the paper and presentation are based on responses from a nationally representative sample of 1,019 adults aged 50 to 64 who answered a wide range of questions online. Questions were written, and data interpreted and compiled, by the IHPI team. Laptops and Internet access were provided to poll respondents who did not already have them. A previous report of the initial findings and poll methodology is available at http://www.healthyagingpoll.org, along with past National Poll on Healthy Aging reports.

Reference: JAMA Neurology, doi:10.1001/jamaneurol.2019.3946

Michigan Medicine - University of Michigan

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.