An increasing public health concern is multimorbidity, or having two or more chronic health concerns.
Even if none of these health problems is neurological, their presence in mid-life can dramatically increase your risk of dementia in the years ahead. Here’s what you need to know…
Multimorbidity affects a quarter of adult Americans. It usually starts in early adulthood, increases steeply after the age of 40 and spirals out of control over the age of 65. In fact, after age 65 one in three Medicare beneficiaries report having four health problems or more.
Given that dementia is most common among that age group it’s no surprise that studies show those with dementia often have multimorbidity. What’s more, some studies have even linked multimorbidity with cognitive decline.
Previous research strongly suggests mid-life cardiovascular disease or diabetes increases the risk of dementia. But whether people suffering a range of chronic conditions in middle age are at greater risk of dementia in later life is unknown. Researchers from the Université de Paris and University College London thought this knowledge gap needed to be filled.
Thirteen Conditions Considered
The researchers took data from the Whitehall II study of 10,095 British civil servants who were aged 35 to 55 when they were first enrolled in the study between 1985 and 1988. All were free of dementia at the time.
The chronic conditions researchers looked for included 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.
The researchers accounted for age, gender, ethnicity, education, marital status, time spent in moderate and vigorous physical activity, alcohol consumption, smoking, and frequency of fruit and vegetable intake.
Over a follow-up period of 32 years, the team identified 639 cases of dementia. The findings make for grim reading.
Dementia Risk Soars Up to Five-fold
Multimorbidity – two or more chronic conditions – at age 55 increased the risk of dementia by 2.4-fold compared to those with no chronic conditions.
By age 65, those who had multimorbidity before they reached the age of 55 had a 2.5-fold higher risk compared to a 1.5-fold higher risk for 65-year-olds whose onset of multimorbidity occurred later, between the ages of 60 and 65.
The scientific analysis showed that for every five-year younger age at onset of multimorbidity, ranging from 70 down to 55, the risk of dementia was 18 percent higher.
These findings are disturbing, but it gets worse for those with severe multimorbidity – three or more chronic conditions.
Compared to participants with none or one condition at age 55, those with three or more at age 55 had almost a five-fold higher risk of dementia, whereas the risk was 1.7-fold higher when the onset of multimorbidity was at age 70.
The researchers repeated the analysis excluding Parkinson’s from the list of diseases, but this did not affect the findings.
Possible Causes – Inflammation and Drugs
This research is the first to show that multimorbidity in mid-life is associated with a higher risk of dementia at older ages.
The authors of the study, published in the online medical journal thebmj in February, wrote, “Although chronic conditions considered individually affect the risk of dementia, the research on multimorbidity shows specific cumulative effects of clustering of chronic diseases, accelerating cognitive decline and increasing the risk of dementia.”
Since the study was observational it cannot explain why this occurs, but the authors did suggest inflammatory processes could play a role, as inflammation is a risk factor for many chronic diseases as well as dementia.
They also considered that interactions between the various medications people were taking and/or their cumulative effects could affect cognitive processes and lead to dementia.
This is no surprise to me. We’ve long known that inflammation is a trigger for memory loss. We’ve also known that memory loss is a common side effect of many drugs frequently taken in middle age.
My advice? Do everything you can to prevent or manage any chronic conditions through diet and lifestyle. For example, follow an anti-inflammatory diet and nutritional supplement regimen and get regular exercise and sufficient sleep. These steps can move you a long way toward reducing inflammation, balancing blood sugar and cholesterol, improving blood flow, preventing cancer and obesity as well as improving your energy level and mood—and so much more. In other words, you’ll help protect your memory and protect against multimorbidity, too.