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Multimorbidity Linked to Increased Dementia Risk in Older Adults, Study Finds

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A recent study has revealed a significant connection between multimorbidity – the presence of multiple chronic conditions – and an increased risk of dementia, including Alzheimer’s disease, among older adults. This research, conducted on a large scale, offers new insights into the complex relationship between chronic illnesses and cognitive decline.

The study, published in the journal Alzheimer’s & Dementia in 2023, involved 5,432 participants, all aged 60 years or older. Researchers focused on the association of multimorbidity with mild cognitive impairment (MCI), dementia, and Alzheimer’s disease-related plasma biomarkers. A subgroup of 1,412 participants underwent detailed measurements of plasma biomarkers, including amyloid beta, total tau, and neurofilament light chain, key indicators of Alzheimer’s disease.

The average age of participants was 70.71 years, with women constituting 57.46% of the study group. A significant portion, 39.73%, had no formal schooling, and a majority, 83.32%, were farmers. Multimorbidity was observed in 60.03% of participants, indicating the presence of two or more chronic health conditions.

The study’s results were telling: the number of chronic diseases a participant had was directly associated with an increased likelihood of developing dementia. Specifically, a 22% increased likelihood for dementia, 13% for Alzheimer’s disease, and a striking 44% for vascular dementia were noted. Individuals with multimorbidity were 1.45 times more likely to develop dementia and 2.75 times more likely to develop vascular dementia compared to those without multimorbidity.

Researchers identified five distinct clusters of multimorbidity based on 23 chronic health conditions:

  1. Metabolic cluster. Included are diabetes, hyperlipidemia, hypertension, stroke, chronic kidney disease, and lower extremity varicose veins. This cluster was particularly associated with an increased likelihood of vascular dementia, but not Alzheimer’s disease.
  2. Cardiac-musculoskeletal cluster. Comprised ischemic heart disease, heart failure, atrial fibrillation, thyroid disease, degenerative disc disease, and arthritis. It was associated with vascular dementia.
  3. Degenerative ocular cluster. Included cataracts and glaucoma and was significantly associated with dementia, especially Alzheimer’s disease.
  4. Respiratory cluster. Included chronic obstructive pulmonary disease and asthma.
  5. Mixed cluster. Comprised of epilepsy, tuberculosis, hepatitis, Parkinson’s disease, gall bladder disease, and peptic ulcer.

Interestingly, the respiratory and mixed clusters were not significantly associated with any cognitive phenotypes.

This study underscores the complex interplay between chronic physical health conditions and cognitive health in older adults. It highlights the need for integrated care approaches that address multiple chronic conditions to potentially mitigate the risk of dementia, including Alzheimer’s disease. The findings also pave the way for further research into the mechanisms underlying these associations and how targeted interventions could slow or prevent cognitive decline in this vulnerable population.

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