New research explores pre-diagnostic indicators of dementia

A new study from Finland shows that low labor market participation for non-retirement related reasons may be an early indicator of dementia already years before the first evident symptoms occur. The study also identified other social markers that may be indicative of dementia up to ten years before a diagnosis of Alzheimer’s disease, frontotemporal dementia or vascular dementia.

Employing extensive nationwide registers, researchers at the University of Eastern Finland and the University of Oulu analyzed data on more than 2,200 patients as part the DEGE-RWD project coordinated by Neurocenter Finland. The patients were compared to controls of the same age, sex and area of residence.

We found that low labor market participation without the presence of a clear medical reason may be the first sign of dementia. Taking these social markers into consideration may enable an earlier diagnosis.”

Ave Kivisild, Doctoral Researcher, University of Eastern Finland

Key findings:

• Employment reduced significantly in all dementia groups already 10 years before the diagnosis.
• Patients with vascular dementia and patients diagnosed with both Alzheimer’s and vascular dementia had a lower level of education than controls. A similar difference was not found for pure early-onset Alzheimer’s disease or frontotemporal dementia, possibly suggesting that education does not protect against early-onset dementia, although it may protect against forms of dementia starting at the old age, as shown in previous literature.
• Patients with early-onset Alzheimer’s disease, and especially women, tended to live alone more frequently than controls.
• There were no significant differences in the marital status of those with frontotemporal dementia and controls.
•  

Social markers are worth considering in dementia prevention

The study highlights the role of social markers of dementia. For example, long-term unemployment or living alone may be early markers of onsetting dementia.

“We know that pathological processes in the brain start decades before the first symptoms. However, these new findings suggest that the early disease biology may cause changes in, e.g., employment, which may be indicative of dementia related brain changes long before any objectively discernible cognitive symptoms occur. Taking these markers into consideration may help to improve the timing of screening and prevention measures,” says Principal Investigator, Associate Professor Eino Solje of the University of Eastern Finland.

The strengths of the study include the scope and robustness of the data used. Patients were diagnosed by expert neurologists working in memory clinics at university hospitals, which renders the results highly reliable.

The findings were published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The study constitutes part of an extensive project combing extensive real-world evidence from patients with various register-based data. The project involves unique collaboration between the University of Oulu and the University of Eastern Finland, bringing together a variety of disciplines and, for example, medical scientists and scholars of law.