When I was a child, I was afraid of report cards, when I was young, I was afraid of consumption bills, when I was middle-aged, I was afraid of physical examination reports, and I was afraid of loneliness in my old age.
As we age, not only the social responsibility on our shoulders is increasing, but also our own health burden will gradually increase, and the results on the physical examination report are more and more afraid to look directly. Like high blood pressure, diabetes, heart failure, these troublesome and intractable chronic diseases in addition to congenital inheritance, basically inseparable from long-term poor lifestyle. The chronic diseases saved up when I was young finally had to let myself, who was more than half a hundred years old, be on the stall.
A recent study published in the Journal of British Medical Sciences suggests that middle-aged people who suffer from two or more chronic diseases at the same time (hereinafter referred to as multiple diseases) should also be very vigilant against another age-related troublesome disease, dementia [1].
Céline Ben Hassen and her colleagues from the University of Paris in France, after a 30-year follow-up analysis of about 10,000 people, showed that middle-aged and elderly people (≥55 years old) with multiple diseases were associated with a 136% increased risk of dementia.
Moreover, the earlier the age of onset of multiple diseases, the closer the correlation with dementia risk, and the higher the risk of dementia. If you have more than 3 chronic diseases at the age of 55, the risk of dementia will even increase by nearly 4 times.
Screenshot of the first page of the paper
In addition to Alzheimer's disease as we know it, dementia also includes Dementia of Lewy Body, Vascular Dementia, and Frontotemporal Dementia. Dementia is a chronic syndrome characterized by a deterioration in cognitive function, often considered a "geriatric disease", associated with age growth, with 91 percent of patients under the age of 65 at the onset of the disease [2].
According to the latest data from the WHO, dementia is currently the 7th leading cause of death among all diseases in the world, and it is also one of the main causes of disability and dependence on others in the elderly worldwide, bringing a huge burden to the families and society of patients. Although treatment strategies and drug development are constantly being pioneered, dementia has not been completely cured so far [2].
However, we can still strive to be proactive, detect signs of dementia early, or identify people at high risk of dementia.
Several recent studies have found that middle-aged and elderly people with several chronic diseases at the same time have a higher risk of dementia, suggesting that age may be a key factor [3-5]. However, further confirmation of this conclusion will require larger, longer follow-up cohort studies.
So this time, C Ben Hassen and her colleagues used data from the large prospective cohort study Whitehall II[6] and included 10,095 people, 32.7% of whom were women. The baseline age of these people is 35-55 years old, half of them do not smoke (49.7%), 76.2% of them occasionally drink alcohol or do not stick, and none of them have dementia.
The chronic disease analysis included 13 diseases: coronary heart disease, stroke, heart failure, diabetes, hypertension, cancer, chronic kidney disease, chronic obstructive pulmonary disease, liver disease, depression, mental disorders, Parkinson's disease and arthritis/rheumatoid arthritis. Suffering from any two or more of these diseases is a combination of multiple diseases.
In the study, 6.6 percent had multiple illnesses at age 55 and 32 percent had multiple diseases at age 70. During the median follow-up period of 32 years, a total of 639 people developed dementia.
Multiple diseases at the age of 55, 60, 65 and 70 years
After adjusting for multivariate factors such as age, sex, education, diet and lifestyle, the analysis showed that middle-aged and older adults with multiple diseases were associated with an increased risk of dementia by 136% (HR 2.36; 95% CI 1.97-2.81).
However, when age was taken into account, the researchers found that things are much more than that, and that developing multiple diseases too early is associated with a higher risk of dementia.
For middle-aged adults aged 55 years, having multiple diseases was associated with a 144% increased risk of dementia in later life (HR 2.44; 95% CI 1.82 to 3.26).
For older people, it is also necessary to recall when they developed multiple diseases. For example, a 70-year-old who has multiple diseases at the same time at the age of 55 or before the age of 55 has a 160% increased risk of dementia (HR 2.60; 95% CI 1.84-3.67), but if the age of illness is between 55 and 60 years, the risk of dementia increases by only 36% (HR 1.36; 95% CI 0.94-1.96).
Not only that, but the researchers further divided the severity of multiple diseases by the number of diseases (0-1, 2, ≥3).
The results of the analysis showed that at the age of 55, with 3 or more chronic diseases, the risk of dementia increased by 396%. But if you only have 3 or more chronic diseases at age 70, the risk of dementia increases by 65%.
This once again shows that the earliest age of multiple diseases, the higher the risk of dementia. In addition, increased severity of multiple diseases is also associated with a sharp increase in the risk of dementia.
It is clear that multiple illnesses at an older age do not have much to do with the risk of dementia
It is worth mentioning that the researchers also intimately arranged the correlation between different combinations of multiple diseases and the risk of dementia, which you can compare and look at.
For middle-aged and elderly people (≥50 years old), if you have Parkinson's, there is a higher risk of dementia regardless of which chronic disease you have at the same time. In particular, the combination of multiple diseases of Parkinson 's + depression , Parkinson ' + cancer , Parkinson ' + coronary heart disease , parkinson ' + diabetes was significantly related to a 928%, 821%, 776% and 709% increase in the risk of dementia. In addition, the combination of stroke + depression is also more prominent, related to a 760% increase in the risk of dementia.
These pieces of dark red are very eye-catching
Overall, C Ben Hassen and her colleagues concluded based on a 32-year analysis of a 10,000-person cohort study that middle-aged and older adults with two or more chronic diseases were significantly associated with a 136 percent increased risk of dementia. Especially for middle-aged people or people who develop multiple diseases earlier (≤55 years), having two or more chronic conditions is associated with a higher risk of dementia.
Parkinson's patients are a high-risk group, and no matter which chronic disease they develop at the same time, they will have a higher risk of dementia.
In this regard, researchers said that it is still quite common for middle-aged and elderly people to suffer from one or two chronic diseases [7,8], and if people can realize the relationship between the "combination technique" of chronic diseases and the risk of dementia at an early stage, and find countermeasures, they may greatly reduce the burden of dementia in their later years.
bibliography:
[1]https://www.bmj.com/content/376/bmj-2021-068005
[2]https://www.who.int/news-room/fact-sheets/detail/dementia
[3] Grande G, Marengoni A, Vetrano DL, et al. Multimorbidity burden and dementia risk in older adults: The role of inflammation and genetics. Alzheimers Dement 2021;17:768-76. doi:10.1002/alz.12237
[4] Barbiellini Amidei C, Fayosse A, Dumurgier J, et al. Association Between Age at Diabetes Onset and Subsequent Risk of Dementia. JAMA 2021;325:1640-9. doi:10.1001/jama.2021.4001
[5] Abell JG, Kivimäki M, Dugravot A, et al. Association between systolic blood pressure and dementia in the Whitehall II cohort study: role of age, duration, and threshold used to define hypertension. Eur Heart J 2018;39:3119-25. doi:10.1093/eurheartj/ehy288
[6] Marmot MG, Smith GD, Stansfeld S, et al. Health inequalities among British civil servants: the Whitehall II study. Lancet 1991;337:1387-93. doi:10.1016/0140-6736(91)93068-K
[7] Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012;380:37-43. doi:10.1016/S0140-6736(12)60240-2
[8] Tinetti ME, Fried TR, Boyd CM. Designing health care for the most common chronic condition--multimorbidity. JAMA 2012;307:2493-4. doi:10.1001/jama.2012.5265
This article is written by | Eddie Zhang