Low socioeconomic level triples risk of developing dementia before age 65 | Health and wellness

People from lower socioeconomic backgrounds are three times more likely to develop early-onset dementia. And if those same people lead an unhealthy lifestyle, the risk is 440% higher compared to people of a higher socioeconomic level who lead a healthy lifestyle. The data comes from a study conducted by researchers at Huazhong University of Science and Technology (China), which was recently published in the journal. Lancet of Healthy Longevity.

“Our study was one of the first to examine the complex relationships between lifestyle, socioeconomic status and the risk of early dementia in people aged 37 to 60 years. Both lifestyle and socioeconomic level were significantly associated with early onset of dementia, but the latter to a much greater extent,” explains Gan Liu, professor at Huazhong University School of Public Health and author, via email to EL PAÍS. The expert notes that after adjusting for various risk factors, people with a low socioeconomic level had a 238% higher risk of developing early dementia than people with a high socioeconomic level. Meanwhile, people with three or four healthy lifestyle patterns had a 40% lower risk of early onset dementia than people with one or no healthy lifestyle patterns.

For the study, the authors used UK Biobank data on more than 440,000 participants aged 37 to 73 years who were followed for 12 years, taking into account measures such as lifestyle and status variables. level of education, level of family income and level of employment. One of the most surprising aspects for researchers is that only 12% of cases of early-onset dementia associated with socioeconomic status can be explained by lifestyle factors, Gang Liu said. This suggests that people from lower socioeconomic backgrounds may not necessarily reduce their risk of developing early-onset dementia by adopting a healthier lifestyle.

“The mechanisms underlying the relationship between socioeconomic inequality and early dementia remain to be discovered in future research, but it seems clear that socioeconomic status itself can influence people’s cognitive performance,” he reflects. “For example, higher education may lead to improved cognitive reserve, which may offset neurodegeneration; Poverty can also directly impact cognitive performance, as poor financial status can cause excessive mental workload, stress, anxiety or depression, which some research suggests may be linked to dementia,” he adds.

“This is a very powerful study that changes what we already knew about the influence of lifestyle, because it appears that socioeconomic status itself is already an important factor in increasing the risk of developing dementia,” said David Perez, who led the study. Neurological Service of the University Hospital of 12 October in Madrid and member of the Spanish Society of Neurology (SEN). The neurologist notes that instability can affect brain health in many aspects, including at the lifestyle level: “On the one hand, there is the stress caused by this situation, or a higher prevalence of depressive disorders, but, in addition, the person has more difficult. For example, by following a Mediterranean diet, you are more likely to do more routine, less motivating, less intellectual work, and do it for longer periods of time, which means you have less time to exercise or check your health. . cholesterol or hypertension.”

Fighting inequality

Early dementia refers to cases of dementia diagnosed in patients under 65 years of age. According to a 2021 study, the prevalence of these dementias is about 119 cases per 100,000 inhabitants, or 3.9 million people worldwide. In Spain, although there is no national registry, it is estimated that between 600,000 and one million people will suffer from dementia, of which between 10% and 15% (about 70,000 cases) will be early-onset dementia. The preamble to the Department of Health’s Comprehensive Plan for Alzheimer’s Disease and Other Dementias 2019-2023 recognizes that the fight against dementia is “a public health priority and a major social and health problem that has become a great silent epidemic.” 21st century and in the enormous task of ensuring the sustainability of any social and health care system.” The definition of “epidemic” is not trivial. More than 50 million people worldwide have dementia, a figure expected to increase to 75 million in 2030 and 132 million in 2050, according to WHO.

“We must remember that in Western countries, especially European countries, there has been a decline in the incidence of dementia over the last two to three decades, which has gone somewhat unnoticed as the number of cases rises as the population ages. “, reflects David Perez. The expert explains that this decline is largely due to the welfare state, “which has allowed many people to have access to quality public education, quality public health care and a higher standard of living. Now we have other outstanding challenges, such as trying to implement public policies that will force us to move towards reducing social inequality, because we already see that this, directly or indirectly, will prevent dementia,” he adds.

For Unai Martin, professor of sociology at the University of the Basque Country and member of the working group on social determinants of health of the Spanish Society of Epidemiology (SEE), this study is of great importance because, thanks to its reliability, it highlights what experts have condemned for decades: social inequality breeds disease and that it is a risk factor as important or even more important than others to which science and medicine usually place greater emphasis.

“Often, even when we understand that inequalities are important, we tend to think that the way to tackle health inequalities is through lifestyle interventions. And this research shows that this strategy is a mistake, that if we don’t address the fundamental factor – social inequality, nothing else will do much good. This is a question that we find difficult to understand when it comes to action; in fact, most efforts to improve public health today still focus on habits,” says the expert, who believes that focusing on lifestyle is the right thing to do. also a way of blaming the victims, holding them responsible: “They just smoke more, they exercise less, they eat worse, we say, and we try to implement strategies to convince them to quit smoking.” .”, exercise, eat better. But often people don’t even have the opportunity to eat better or exercise!” – he says.

While the importance of promoting healthy lifestyles at the individual level cannot be ignored, research supports the need for governments to take public health measures to alleviate the burden of dementia to reduce the burden of dementia, Gang Liu said. capital.

The view is echoed by Unai Martin, who believes that tackling social and economic inequalities is one of the best possible strategies to tackle the serious problem of dementia. “This is, first of all, about social justice. And this is also because improving health has very little to do with what we do in the health care system. The health care system is very good at treating disease, at saving people when they get sick, but if we want to improve population health, we must move beyond the health care system to address other types of policies (urban, income, education). , social, etc.) that reduce inequality, because it will also reduce the burden on the health system,” argues the representative of the Spanish Society of Epidemiology, who regrets that traditionally at the political level it is so difficult to think in the medium. and in the long term, which is exactly what this policy requires. “It is very easy to understand that we must treat a person who has had a heart attack or suffers from dementia, but it is more difficult for us to understand that in order for these people not to have a heart attack or suffer from dementia, we must address the factors that could to delay or avoid these illnesses. This is the key to better health today,” he concludes.

You can follow EL PAIS Health and Wellness V Facebook, X And instagram.