Effective interventions for potentially modifiable risk factors for late-onset dementia: a costs and cost-effectiveness modelling study

Eating disorders (ED) are among the top three most common debilitating illnesses in adolescent females, while high Body Mass Index (BMI) is one of the five leading modifiable risk factors for preventable disease burden. The high prevalence of eating and weight-related problems in adolescence is of great concern, particularly since this is a period of rapid growth and development. Here, we comment on the current evidence for the prevention of EDs and high BMI and the importance of assessing the cost-effectiveness of interventions that integrate the prevention of EDs and high BMI in this population. There is evidence that there are effective interventions targeted at children, adolescents and young adults that can reduce the prevalence of risk factors associated with the development of EDs and high BMI concurrently. However, optimal decision-making for the health of younger generations involves considering the value for money of these effective interventions. Further research investigating the cost-effectiveness of potent and sustainable integrated preventive interventions for EDs and high BMI will provide decision makers with the necessary information to inform investment choices.

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Nanotargeting of Drug(s) for Delaying Dementia: Relevance of Covid-19 Impact on Dementia

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317520976761 ◽

2020 ◽

Vol 35 ◽

pp. 153331752097676

Author(s):

Joseph S. D’Arrigo

Keyword(s):

Risk Factors ◽

Memory Impairment ◽

Late Onset ◽

Scavenger Receptors ◽

Type I ◽

Human Coronavirus ◽

Memory Decline ◽

Class B ◽

Lipid Nanocarriers ◽

Late Onset Dementia

By incorporating appropriate drug(s) into lipid (biobased) nanocarriers, one obtains a combination therapeutic for dementia treatment that targets certain cell-surface scavenger receptors (mainly class B type I, or “SR-BI”) and thereby crosses the blood-brain barrier. The cardiovascular risk factors for dementia trigger widespread inflammation -- which lead to neurodegeneration, gradual cognitive/memory decline, and eventually (late-onset) dementia. Accordingly, one useful strategy to delay dementia could be based upon nanotargeting drug(s), using lipid nanocarriers, toward a major receptor class responsible for inflammation-associated (cytokine-mediated) cell signaling events. At the same time, the immune response and excessive inflammation, commonly observed in the very recent human coronavirus (COVID-19) pandemic, may accelerate the progression of brain inflammatory neurodegeneration—which increases the probability of post-infection memory impairment and accelerating progression of Alzheimer’s disease. Hence, the proposed multitasking combination therapeutic, using a (biobased) lipid nanocarrier, may also display greater effectiveness at different stages of dementia.

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Effective interventions for potentially modifiable dementia risk factors: Their costs and cost‐effectiveness

Alzheimer s & Dementia ◽

10.1002/alz.040251 ◽

2020 ◽

Vol 16 (S10) ◽

Author(s):

Naaheed Mukadam ◽

Robert Anderson ◽

Martin Richard John Knapp ◽

Raphael Wittenberg ◽

Maria Karagiannidou ◽

...

Keyword(s):

Risk Factors ◽

Cost Effectiveness ◽

Effective Interventions ◽

Dementia Risk

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Suicidal Ideations and Behavior in Patients With Young and Late Onset Dementia

Frontiers in Neurology ◽

10.3389/fneur.2021.647396 ◽

2021 ◽

Vol 12 ◽

Author(s):

Marion Ortner ◽

Lina Riedl ◽

Ralf J. Jox ◽

Julia Hartmann ◽

Carola Roßmeier ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Suicidal Ideation ◽

Suicidal Behavior ◽

Late Onset ◽

Physical Symptoms ◽

Advanced Dementia ◽

Death Wishes ◽

And Behavior ◽

Late Onset Dementia

Background and Objectives: Data on suicidal ideation, behavior and the risk factors in patients with dementia is scarce. To evaluate the prevalence of death wishes, suicidal ideation, and suicidal behavior of young (YOD) and late onset dementia (LOD) and to identify risk factors for suicidal ideation and behavior.Methods: We interviewed 157 family caregivers of patients with advanced dementia using questions from the Columbia-Suicide Severity Rating Scale to gather information about suicidal ideation and behavior before the onset of symptoms of dementia, after the onset of dementia and within 30 days prior to the interview. At the time of the interview, we also assessed disease severity, cognitive function, and other psychological, behavioral and physical symptoms of the patients as well as the caregivers' psychological well-being.Results: Forty four (28%) of the patients expressed suicidal ideation or behavior at some time after the onset of symptoms, and 14 (9%) of these within the month prior to the assessment. Two patients had attempted suicide after the onset of dementia. There were no statistically significant differences between patients with and without suicidal ideations or behavior with regards to demographics or age at onset of dementia. In patients with advanced dementia, Alzheimer's disease (rather than frontotemporal lobar degeneration), better cognitive function, more severe psychological, behavioral, and physical symptoms, and a reduced quality of life were associated with the expression of suicidal ideation.Conclusions: According to caregivers' reports, majority of patients with dementia did not express suicidal ideation or show suicidal behavior. Patients who expressed suicidal ideation during early stages of dementia often stopped expressing them in advanced stages. It remains unclear if this was due to reduced communication abilities, a reduction of disease awareness, and/ or an adjustment to their situation.

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Lifestyle risk Factors for early versus late onset dementia: A systematic review and meta-analysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.114 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

N Berselli ◽

G Adani ◽

T Filippini ◽

M Vinceti

Keyword(s):

Risk Factors ◽

Brain Injuries ◽

Age Of Onset ◽

Late Onset ◽

Meta Analysis ◽

Lifestyle Risk Factors ◽

Modifiable Factors ◽

Lifestyle Risk ◽

The Impact ◽

Late Onset Dementia

Abstract Background Dementia is a widely prevalent and growing condition, affecting nearly 10% of people aged 60 years and older. It is a leading cause of disability entailing important economic and social costs for the population, so much so that it has been defined as a “global public health priority' from WHO in 2016. Dementia can be divided into two forms according to age of onset of the first symptoms: Early Onset Dementia (EOD - < 65 years) and Late Onset Dementia (LOD, ≥ 65 years). The differences between the two forms, and if they could be considered as separate diseases, are still not well understood. The aim of this meta-analysis was to determine if environmental-lifestyle risk factors of dementia may differ between EOD and LOD. Methods Literature databases were searched to June 2020, to retrieve studies assessing the impact of modifiable factors in patients who had developed the first symptoms of dementia before (for EOD) or after (for LOD) 65 years. Data were then meta-analysed in order to understand the overall impact of the single factors on EOD and LOD separately. Results The results show different effects for some risk factors as alcohol consumption (OR 2.8, 95%CI: 2.2-3.4 for EOD and OR 1.2, 95%CI: 0.9-1.5 for LOD) and brain injuries (OR 1.4, 95%CI: 1.2-1.6 for EOD, and OR 1, 95%CI: 0.6-1.4 for LOD), which appear to have more impact on EOD compared with LOD. No association with smoking for both forms of dementia emerged. The other factors considered, such as low educational attainment, socio-economic status, closeness of magnetic field, appear to have similar impact on the two forms of dementia. Conclusions These results suggest that there may be a difference, in terms of modifiable risk factors, between the two forms of dementia, even if more research is needed on this issue. Key messages There may be different risk factors determining EOD versus LOD onset. By modifying some environmental and lifestyle factors we could delay or prevent the onset of dementia.

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