We are living longer but lifestyles threaten health gains
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One in two women and one in three men will likely be diagnosed with stroke, dementia or Parkinson’s disease in their lifetime, however, preventative strategies, which delay the onset of these common diseases by even a few years, could, significantly reduce this risk, according to a new study.
The global costs of dementia, stroke, and parkinsonism are thought to amount to more than 2 per cent of the world’s annual economic productivity (GDP), a figure that is set to rise steeply as life expectancy continues to increase.
However, while the lifetime risks of other serious illnesses, such as breast cancer and heart disease are well known and used to raise public awareness, the same cannot be said of dementia, stroke and parkinsonism.
In an effort to redress this, a team of Dutch researchers tracked the neurological health of more than 12,000 people taking part in the Rotterdam Study between 1990 and 2016. This study has been looking at the incidence of, and influential factors behind, diseases of ageing in the general population.
All the participants were aged at least 45 when they were recruited, and more than half were women.
A higher prevalence of high blood pressure, abnormal heart rhythm (atrial fibrillation), high cholesterol and type 2 diabetes was evident at the start of the monitoring period among those diagnosed
When they joined, participants were given a thorough health check, which was repeated every four years. Family doctor health records were also scrutinised for signs of disease or diagnoses arising between the four yearly check-ups.
Monitoring for dementia, parkinsonism, and stroke continued until death, or January 01, 2016, whichever came first.
Between 1990 and 2016, 5,291 people died, 3,260 of whom had not been diagnosed with any neurological disease.
However, 1,489 people were diagnosed with dementia, mostly Alzheimer’s disease (just under 80%); 1, 285 had a stroke, nearly two thirds of which (65%) was caused by a blood clot (ischaemic); and 263 were diagnosed with parkinsonism.
A higher prevalence of high blood pressure, abnormal heart rhythm (atrial fibrillation), high cholesterol and type 2 diabetes was evident at the start of the monitoring period among those subsequently diagnosed with any of the three conditions.
Unsurprisingly, the risk of developing any of these three conditions rose steeply with age, but based on the data, the overall lifetime risk of a 45-year-old developing dementia, parkinsonism, or having a stroke was one in two for a woman (48%) and one in three for a man (36%).
This gender difference was largely driven by women being at heightened risk of developing dementia before men but there were other gender differences in risk.
While 45-year-olds of both sexes had a similar lifetime risk of stroke, men were at substantially higher risk of having a stroke at younger ages than women.
Women were twice as likely as men to be diagnosed with both dementia and stroke during their lifetime.
"This study further strengthens the need to prioritise the focus on preventive interventions at population level which could substantially reduce the burden of common neurological diseases in the ageing population,"
The researchers calculated that if the onset of dementia, stroke, and Parkinson’s disease was delayed by one to three years, the remaining lifetime risk could, in theory, be reduced by 20 per cent in 45-year-olds, and by more than 50 per cent in those aged over 85.
A delay of only a few years for one disease could also have a significant impact on combined lifetime risk, suggested the researchers.
“For instance, delaying dementia onset by three years has the potential to reduce lifetime risk of any disease by 15 per cent for men and women aged 45, and by up to 30 per cent for those aged 85 and older,” they wrote.
This research is observational, so no definitive conclusions can be drawn. However, the researchers concluded: “These findings strengthen the call for prioritising the focus on preventive interventions at population level which could substantially reduce the burden of common neurological diseases in the ageing population.”
Commenting on the research Dr Angie Brown, Medical Director of the Irish Heart Foundation said the findings strengthened the need to prioritise the focus on prevention.
Dr Brown said, “This observational study shows that 1 in 2 women and 1 in 3 men will possibly develop, dementia stroke or parkinsonism in their life time. Since the prevalence of these diseases can be reduced by treating risk factors such as hypertension, atrial fibrillation and smoking etc. this study further strengthens the need to prioritise the focus on preventive interventions at population level which could substantially reduce the burden of common neurological diseases in the ageing population.”
This study was published online recently in the Journal of Neurology Neurosurgery & Psychiatry.
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