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Title : Middle age spread raises risk of dementia by up to a THIRD
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Middle age spread raises risk of dementia by up to a THIRD

• People with a high BMI in their 50s were much more likely to develop the disease two decades later
• Suggests maintaining a healthy weight could prevent or delay the disease
• A previous, large study found the opposite – that being overweight may have a protective effect
• But the latest research followed participants for a longer period – 38 years
• It found weight loss can occur up to 10 years before a dementia diagnosis
• This can mask the harm that carrying too many pounds does to the brain

By Claudia Tanner For Mailonline

Published: 07:44 EST, 1 December 2017 | Updated: 08:06 EST, 1 December 2017

Middle-age spread raises the risk of dementia by up to a third – because being overweight reduces blood flow to the brain, experts say. 

A worldwide study of more than 1.3 million people found those with a high body mass index (BMI) in their 50s were much more likely to develop the condition two decades later. 

Being overweight is known to be harmful to the cerebrovascular system – the vessels that carry blood to and from the brain. 

Researchers suggest the arteries in fatter people do not work as well in supplying oxygenated blood to the brain, harming mental function.

The study found that for each five unit increase on your BMI raises the risk by between 16 and 33 per cent. For instance, for a 5ft 7in tall person, five BMI units is 32lbs (14.5kg) – about the difference between overweight and normal weight people, or the obese and overweight.

A large study found those with a high body mass index (BMI) in their 50s were much more likely to develop the condition two decades later (stock image)

The latest findings, published in Alzheimer's & Dementia, suggest that maintaining a healthy weight could prevent, or at least delay the devastating disease.  

Study author Professor Mika Kivimaki, from the University College London, said: 'Obesity is harmful for the cerebrovascular and metabolic systems, increasing the risk of cardiovascular disease and type 2 diabetes. 

'These two conditions, in turn, are related to an increased dementia risk and this is one possible pathway linking obesity to increased dementia risk.'

It contradicts a previous, similarly large-scale study in 2015 that found middle age spread may actually protect against dementia. 

But the latest research followed participants for a longer period and found weight loss can occur up to 10 years before the diagnosis – which may have skewed the previous findings.

This week Britain was named as the 'obesity capital' of western Europe with almost 30 per cent of women and just under 27 per cent of men falling into this category. 

Someone in the world is diagnosed with dementia every three seconds, according to Alzheimer's Disease International.

DEMENTIA BREAKTHROUGH

New drugs for one of the most common types of dementia could be on the horizon after scientists discovered how it spreads.

The drugs could stop it 'in its tracks' by targeting a key chemical called alpha-synuclein, according to researchers.

The rogue protein is one of four types believed to be behind the devastating neurological disorder.

It disrupts brain cells in dementia with Lewy bodies – also known as DLB that is progressive and gets worse over time.

Brain tissue from people who died from it showed the protein builds up in vital parts of neurons that connect cells.

These may jump from one cell to another through these connections, say the international team led by Edinburgh University.

The findings, fromthe Edinburgh University, shed light on the causes of DLB and will help to speed up the search for a treatment, they say.

Key findings   

The 2015 study – carried out by the highly respected London School of Hygiene and Tropical Medicine, London, and a London/Madrid-based clinical research company OXON Epidemiology – examined nearly 2 million UK adults aged over 40.

It found that overweight and obese people were about 30 per cent less likely to develop dementia 15 years later than people of a healthy weight.

Conversely, underweight people were 34 per cent more likely to develop dementia than those whose weight was normal.   

The authors of the latest study, carried out by University College London (UCL), believes he can explain why that research appeared to show being overweight is protective – but the opposite is true.

People with dementia are at a very high risk for weight loss as eating, and drinking, becomes more difficult as the disease progresses.

The team followed participants for so long they found dramatic weight reduction can actually occur up to 10 years before the diagnosis.

This can mask the harm that carrying too many pounds does to the brain.

This research found participants had a higher-than-average body mass index some 20 years before dementia onset – at middle age. 

Professor Mika Kivimaki explained: 'Higher midlife body mass index (BMI) is suggested to increase the risk of dementia, but weight loss during the preclinical dementia phase may mask such effects.'

The UCL-led research pooled data from 39 population studies that had followed individuals from across Europe – including the UK – as well as the US and Asia over 38 years. 

The previous study used data from 1992 up until 2013 – 21 years – suggesting looking at trends over a longer period gives a more accurate picture.

Professor Kivimaki added: 'The association between BMI and dementia is likely to be attributable to two different processes: a harmful effect of higher BMI, which is observable in long follow-up, and a reverse-causation effect that makes a higher BMI to appear protective when the follow-up is short. 

When he 2015 study came out, NHS Choices shared its response on the unexpected findings and stated: 'Many dietary, environmental and genetic factors are likely to influence both BMI and dementia, so the relationship is complex.'

DEMENTIA'S OUR BIGGEST KILLER BUT IS STARVED OF FUNDING? PAT HAGAN INVESTIGATES WHY

The UK spends more than £30 million every day treating and caring for patients who have dementia.

This enormous pot of money is what’s needed to cover everything from the drugs that ease symptoms to the personal care needed by the country’s 850,000 dementia patients.

To put this in perspective, the daily bill for other major diseases is around £14 million for cancer, £8 million for stroke and £6.8 million for heart disease. Dementia costs more than all three combined.

It would be reasonable, therefore, to expect a similar breakdown in the way research funding is carved up.

But according to a study by Oxford University, dementia receives a fraction of the sum allocated to cancer research and less than that awarded to heart disease — even though, in 2016, dementia became the leading cause of death in the UK, claiming more than 70,000 lives.

According to a study by Oxford University, dementia receives a fraction of the sum allocated to cancer research (stock photo)

The researchers looked at how an annual amount of £856 million of funding — cash provided by the Government and charities — was split. Nearly two-thirds (£544 million) was handed to scientists working on potential cancer treatments and around 20 per cent (£166 million) was allocated to heart disease research.

Dementia was awarded a mere 11 per cent of the pot (£90 million).

Scientific expertise follows money, so since dementia has been starved of research cash, it has also been denied the skilled workforce it requires.

For every four scientists in the UK working on potential cancer cures, there is only one doing the same in dementia.

This shortage of resources, some say, partly explains why the search for new treatments is littered with failures.

A succession of promising new therapies designed to tackle brain deposits called amyloid plaques — thought to be a major factor in Alzheimer’s disease — flopped.

‘This is what happens when you don’t have enough investment,’ says Dr David Reynolds, chief scientific officer of Alzheimer’s Research UK.

‘You have to decide what is the best option available on which to spend your limited resources.

‘In dementia, that was amyloid-lowering drugs. But there have been no effective drugs produced from all that research.’

So why is dementia so badly neglected? Partly to blame, say experts, is the misplaced perception that it is an inevitable part of ageing, so not worthy of cash.

Ageing is the major risk factor for the disease, but there is nothing inevitable about it, says Dr Reynolds. ‘Dementia is at the stage where heart disease was in the Seventies, or cancer was in the Nineties,’ he explains.

‘It was then they saw major investments in research funding that led to breakthrough medicines many years later.’

Things are improving. As Prime Minister, David Cameron set scientists the challenge of coming up with a cure by 2025. Since then, Government funding for research has doubled to more than £60 million a year.

A further £250 million — from charities and the Medical Research Council — has been invested in a new UK Dementia Research Institute, based at University College London.

But some fear science is trying to come up with a cure for a disease it still doesn’t understand.

Dr James Pickett, head of research at the Alzheimer’s Society, says: ‘Most of the money went into amyloid-lowering molecules because they were judged the best candidates.

‘But perhaps we’ve not spent enough time or money understanding the natural progression of the disease.

‘We now know that when you start to show symptoms, dementia has been developing for 20 years. That’s when we should go in with a drug.’

Dr Pickett say around one in three cases of dementia is potentially preventable — mainly through lifestyle modifications such as a healthy diet.

‘Yet the amount of research into prevention of dementia is pitiful — it’s a travesty.’

There are around 80 dementia drugs in phase two or three trials (being tested on patients). ‘But the pipeline for new cancer treatments has over 1,000 new drugs,’ says Dr Reynolds.

Even if a new treatment is discovered, Hilda Hayo, chief executive of the charity Dementia UK, warns: ‘There are 200 different types of dementia. A “magic pill” won’t help everyone. ‘In the meantime, 850,000 people living with the disease need more help and support now.’ 

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