According to a groundbreaking study published today on JAMA Network Open, early warning signs for dementia may appear in seemingly unrelated health measurements in the first decade of diagnosis. The study shows that subtle changes in weight and certain blood lipids may be early indicators of cognitive decline and may open up new avenues for early intervention.
A comprehensive analysis of more than 5,000 elderly people found that people with dementia later showed different body mass index (BMI) and waist measurements in the first few years of diagnosis. These people lose faster weight and have a constant smaller waist than those who do not develop dementia.
The team found that patients with dementia showed consistently lower BMI and waist circumference measurements compared to the control group, and these differences were evident in the decade before diagnosis. The study tracked participants for up to 11 years and provided one of the most detailed appearances for physical changes before dementia.
The research team, which includes scientists from multiple institutions in Australia and the United States, analyzed data from 1,078 patients and 4,312 people who did not. At the beginning of the study, the average age of participants was 76.9 years, and women (54.1%) were older than men.
Hidden signs in blood chemistry
Perhaps the most attractive thing is the abnormal patterns found in blood lipids, especially HDL cholesterol, commonly known as “good” cholesterol. People with dementia later showed high HDL levels about five years before diagnosis, followed by unexpected declines near diagnosis.
This discovery challenges some traditional ideas about HDL cholesterol, suggesting that its relationship with brain health may be more complicated than previously thought. The study found that although HDL levels in healthy older adults usually increase steadily with age, people with dementia showed different patterns.
Blood pressure pattern is not clear
Interestingly, the study found no significant differences in blood pressure patterns between patients with dementia and those who did not. This suggests that advanced blood pressure changes may not be as reliable as other measurements of dementia risk indicators.
The scale and methodology of the study are prominent. Unlike previous studies that often rely on hospital records or have smaller sample sizes, this survey was conducted regularly, precisely measured among community-based older adults, conducted by trained professionals. All cases of dementia were carefully verified through a rigorous process involving multiple cognitive tests and expert reviews.
Impact on early detection
These findings may have a significant impact on how healthcare providers monitor older adults. Regularly tracking weight, waist circumference and blood lipids may help identify people at higher risk for dementia, which may be years before cognitive symptoms are obvious.
The results show that regular monitoring of these cardiac metabolic changes can provide opportunities for early intervention in people with dementia. The study shows that traditionally considered a marker of cardiovascular health may also be an early warning sign of brain health.
Although the study included a wide variety of participants, it is worth noting that at the outset, all were relatively healthy without major cognitive deficits or cardiovascular disease. This means that these findings may be best for older people with similar health.
Looking to the future
The study opens up new questions about the relationship between body composition, metabolism, and brain health. Understanding why these physical changes occur in the years before cognitive symptoms may provide new insights into the development of dementia and potentially lead to new prevention strategies.
Currently, the study shows that healthcare providers may pay special attention to unexplained changes in weight loss and cholesterol patterns, even if cognitive function appears to be normal. These subtle changes may provide valuable early warnings of cognitive decline and potentially open a wider window for interventions.
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