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Research published on April 23, 2025, in Neurology®, the journal of the American Academy of Neurology, indicates a link between metabolic syndrome and an increased risk of young-onset dementia, which is diagnosed in individuals under the age of 65. While the study establishes this association, it does not confirm that metabolic syndrome directly causes young-onset dementia.
Metabolic syndrome is characterized by the presence of excess abdominal fat along with at least two of the following conditions: high blood pressure, elevated blood sugar levels, increased triglycerides (a type of fat in the bloodstream), and low levels of high-density lipoprotein (HDL) cholesterol, often referred to as “good” cholesterol.
According to Minwoo Lee, MD, PhD, from Hallym University Sacred Heart Hospital in Anyang, South Korea, “Most dementia cases are diagnosed in older adults, but young-onset dementia affects individuals who may still be working and raising families. Our research suggests that having metabolic syndrome during middle age poses a risk for developing young-onset dementia.”
In this study, the research team analyzed national health insurance records from South Korea, focusing on nearly two million individuals aged 40 to 60 who underwent health check-ups. These health evaluations measured waist circumference, blood pressure, blood sugar, triglyceride, and cholesterol levels. Out of the participants, 25% were found to have metabolic syndrome.
Over an average follow-up period of eight years, 8,921 individuals (0.45% of the total sample) were diagnosed with dementia. The incidence of dementia among those with metabolic syndrome was 0.86 cases per 1,000 person-years, whereas it was only 0.49 cases per 1,000 person-years for participants without metabolic syndrome. The term “person-years” combines the number of participants with the duration of their participation in the study.
After controlling for factors such as age, education, physical activity levels, depression, and prior strokes, the study found that metabolic syndrome was correlated with a 24% higher risk of developing dementia. This increased risk was more pronounced when examining specific dementia types, revealing a 12% higher risk for Alzheimer’s disease and a 21% higher risk for vascular dementia.
Notably, female participants with metabolic syndrome exhibited a 34% higher risk of dementia, compared to a 15% increased risk observed in males. Additionally, participants in their 40s had a higher risk than those in their 50s.
Each component of metabolic syndrome was found to contribute cumulatively to the risk of dementia. Individuals exhibiting all five risk factors faced a staggering 70% increase in their risk of developing dementia.
Lee emphasized the potential for lifestyle interventions to mitigate this risk, noting, “Adopting healthier habits to counter metabolic syndrome, such as maintaining a balanced diet, exercising regularly, achieving a healthy weight, quitting smoking, and managing stress could help lower the risk of young-onset dementia.” He also called for further research that investigates these associations over extended periods and employs brain imaging techniques to uncover potential dementia biomarkers.
However, the study does have limitations, most notably the lack of exploration into genetic factors that could influence the risk of Alzheimer’s disease.
This research was supported by the Korean National Research Foundation.
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