Dementia: Doctor outlines changes to help prevent disease

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Dementia – a general term for clusters of symptoms associated with brain decline – is set to rise inexorably as populations age. It is a cruel paradox of improving living standards. Although there is currently no cure for dementia, researchers continue to shed light on the associated risk factors. This buys time to slow down its development and potentially mitigate its worst effects.

New research has drawn an association that could have implications for millions of people across the world.

A large study at Karolinska Institutet in Sweden has found a link between ADHD and dementia across generations.

The study, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, shows that parents and grandparents of individuals with ADHD were at higher risk of dementia than those with children and grandchildren without ADHD.

ADHD (attention-deficit/hyperactivity disorder) is a neurodevelopmental disorder characterized by inattention, impulsiveness and hyperactivity. It affects an estimated three percent of adults worldwide.

Prior to this study, there has only been a limited number of small studies on the development of dementia in people with ADHD, often with conflicting results.

In the current study, the researchers wanted to overcome this by examining to what extent older generations to individuals with ADHD were diagnosed with dementia.

The study looked at more than two million people born in Sweden between 1980 and 2001, of whom around 3.2 percent were diagnosed with ADHD.

Using national registries, the researchers linked these persons to over five million biological relatives, including parents, grandparents and uncles and aunts, and investigated to what extent these relatives developed dementia.

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The researchers found that parents of individuals with ADHD had 34 percent higher risk of dementia than parents of individuals without ADHD.

The risk of Alzheimer’s disease, the most common type of dementia, was 55 percent higher in parents of individuals with ADHD.

Individuals with ADHD were more likely to have parents with early-onset dementia than late-onset.

The researchers note that the absolute risk of dementia was low for the parent cohort; only 0.17 percent of the parents were diagnosed with dementia during the follow-up period.

The association was lower for second-degree relatives of individuals with ADHD, i.e. grandparents and uncles and aunts.

For example, grandparents of individuals with ADHD had 10 percent increased risk of dementia compared to grandparents of individuals without ADHD.

While the study is unable to determine a cause-and-effect relationship, the researchers present several potential explanations that can be explored in future research.

“One could imagine that there are undiscovered genetic variants that contribute to both traits, or family-wide environmental risk factors, such as socioeconomic status, that may have an impact on the association,” said Zheng Chang, researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet, and the study’s last author.

“Another possible explanation is that ADHD increases the risk of physical health conditions, which in turn leads to increased risk of dementia.”

The study’s first author, Le Zhang, PhD student at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet, said: “The findings suggest that there are common genetic and/or environmental contributions to the association between ADHD and dementia. Now we need further studies to understand the underlying mechanisms.”

Dementia – common symptoms

Different types of dementia can affect people differently, and everyone will experience symptoms in their own way.

However, there are some common early symptoms that may appear some time before a diagnosis of dementia.

According to the NHS, these include:

• Memory loss
• Difficulty concentrating
• Finding it hard to carry out familiar daily tasks, such as getting confused over the correct change when shopping
• Struggling to follow a conversation or find the right word
• Being confused about time and place
• Mood changes.

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