- The Washington Times - Saturday, August 5, 2006

LONDON — Researchers have for the first time developed a “risk score” to try to predict which people may develop dementia.

The leading factors virtually mirror those already known for cardiovascular disease: obesity, high blood pressure and high cholesterol, according to the study published yesterday in the journal Lancet Neurology.

Having any one of these risk factors doubles a person’s chance of developing dementia, and having all three increases their chances by six times, said Dr. Miia Kivipelto, an associate professor at the Aging Research Center in Stockholm and the study’s lead author.

Risk scores have been developed for other diseases such as diabetes and cardiovascular disease, “but we’ve never before had a tool like this for estimating the risk of dementia,” Dr. Kivipelto said.

The study looked at 1,409 middle-aged persons in Finland from 1972 to 1987, who were then re-examined 20 years later. Forty of them developed dementia.

While cautioning that the results still need to be validated in further studies in different populations, Dr. Kivipelto says their risk score predicted dementia occurrence with about a 70 percent accuracy rate.

“We have known for years that trying to control obesity, blood pressure and cholesterol can prevent heart disease,” Dr. Kivipelto said, “but now it’s not only the heart you can save, but also the brain.”

Unfortunately, there is no effective treatment for dementia, and mental health specialists admit that the disease may not be entirely preventable. “Even if you remove all of the risk factors and control your blood pressure and cholesterol and are not obese, there is no guarantee that you will not develop dementia,” said Dr. Jose Bertolote, coordinator of Mental and Brain Disorders at the World Health Organization.

Factors such as genetics and age, known to play a role in determining mental illness, simply cannot be modified. In addition, other risk factors such as drinking alcohol, diet and smoking, were not considered in the study.

Still, identifying at least some of the potential warning signs of dementia will be an important tool in attempting to prevent mental illness. “This is the first time that the synergistic effect of all of these risk factors has been demonstrated,” said Dr. Bertolote, who called the study a “landmark paper.”

The study also raises the possibility of identifying risk factors for dementia decades before it appears. “There is some evidence that if certain things are identified and treated in middle age, then the prospect of avoiding dementia increases,” said Dr. Alistair Burns, professor of Old Age psychiatry at the University of Manchester.

“Dementia affects predominantly older people, and if we are to have strategies to prevent dementia, there’s no point starting with people in their 70s and 80s,” he said.

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