People with dementia forget and get confused more and more over time. This can’t be stopped or slowed down by medicine.

Prevention is therefore essential, and there is evidence to suggest that finding risk factors early could help prevent or delay dementia.

In this new study, researchers from UCL looked at the evidence and found that people with psychotic disorders like schizophrenia are 2.5 times more likely to develop dementia than people without psychotic disorders.

A recent meta-analysis and systematic review published in Psychological Medicine suggests that psychotic disorders may have a larger association with dementia than other mental health problems including depression and anxiety.

“We found that having a diagnosis of a psychotic disorder is linked to a much higher risk of developing dementia later in life,” says senior author Dr. Jean Stafford.

“Our findings add to evidence that protecting people’s mental health throughout life could help to prevent dementia.”

It is the first high-quality systematic review to examine the relationship between a variety of psychotic conditions and the risk of dementia. Schizophrenia and other psychotic disorders that are similar to it are serious illnesses that include social withdrawal, hallucinations, and other psychotic symptoms. Many people also have trouble with their thinking and doing things.

The researchers looked at the results of 11 studies that were done in nine countries and on four continents. In total, close to 13 million people took part in these studies.

Multiple psychotic disorders, regardless of the age at which a person initially experienced their mental illness, were associated with an increased risk of dementia later in life.

In several studies, patients with psychotic disorders who were diagnosed as young adults were followed up on for several decades.

Additionally, they discovered that individuals with a history of psychotic diseases are significantly more likely to receive a dementia diagnosis while they are still in their 60s than the general population.

The findings expand the list of modifiable dementia risk factors. According to prior research from UCL, addressing risk factors over the lifespan could prevent or delay the onset of dementia in four out of every ten cases.

Dr Vasiliki Orgeta (UCL Psychiatry), the current study’s joint senior author, previously discovered that PTSD increases the risk of dementia, and while depression and anxiety also increase the risk, these new results imply that psychotic disorders have the strongest association with dementia risk.

The cause of the relationship, whether it be the mental illness itself or perhaps because psychotic disorders raise the chance of conditions that raise the risk of dementia, could not be determined by the researchers.

Some of the links may be because psychotic symptoms could be early signs of dementia for some people. However, the fact that some of the studies had very long follow-up periods and included people with psychosis at young ages suggests that this is not the only explanation.

“People with psychotic disorders are more likely to have other health conditions such as cardiovascular disease, or obesity, which can increase the risk of dementia, while they are also more likely to have a poor diet, smoke or use drugs, which may harm their health in ways that could increase their likelihood of developing dementia,” adds the author.

“Cognitive impairment and hallucinations can be symptoms of both dementia and psychotic disorders,” says lead author Sara EI Miniawi, “so it is possible there could be a link between the two illnesses. This impairment could also limit people’s cognitive reserve, and increase their vulnerability to dementia symptoms.”

Due to a lack of data and possible confounding factors, the study authors could not conclude that successful treatment for psychotic disorders would reduce the risk of dementia.

“As people with psychotic disorders face a higher risk of numerous other health conditions, managing their overall physical and mental health is very important, and here we found that health professionals working with them should also be watchful for any signs of cognitive decline,” adds the lead author.

The NIHR UCLH Biomedical Research Centre funded the research.

Source: 10.1017/S0033291722002781

Image Credit: Getty

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