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Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
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Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
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The Diagnostic and Statistical Manual of Mental Disorders (DSM) serves as the primary classification system for mental health disorders, providing standardized diagnostic criteria for clinicians and researchers. First published by the American Psychiatric Association (APA) in 1952, the DSM has undergone several revisions to reflect evolving psychiatric understanding. The fifth edition, DSM-5, released in 2013, introduced key updates that expanded diagnostic categories and modified diagnostic...
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Cognitive development continues throughout adulthood, undergoing significant shifts across early, middle, and late stages. Individual transition occurs from adolescent idealism to pragmatic and adaptable thinking in early adulthood. During this period, individuals learn to integrate personal beliefs with the recognition that other perspectives are equally valid. Exposure to the complexities of modern society, diverse experiences, and higher education contribute to this adaptive thought process,...
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Related Experiment Video

Updated: May 26, 2025

Symmetric Bihemispheric Postmortem Brain Cutting to Study Healthy and Pathological Brain Conditions in Humans
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Examining multimorbidity contributors to dementia over time.

Matthias Klee1, Sheila Markwardt2, Miriam R Elman2

  • 1Department of Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|February 23, 2025
PubMed
Summary

Multimorbidity significantly increases dementia risk, with eight chronic conditions accounting for over 70% of cases. Targeting cardiovascular health may be key to reducing dementia incidence.

Keywords:
ADRDAlzheimer's disease and related dementiaslongitudinal extension of the average attributable fraction ( LE‐AAF)multimorbiditypopulation attributable fraction ( PAF)population attributable risk

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Area of Science:

  • Gerontology
  • Epidemiology
  • Neurology

Background:

  • Multimorbidity is a known risk factor for dementia.
  • Previous studies did not fully capture the combined impact of conditions on dementia incidence, particularly regarding timing and additive effects.

Purpose of the Study:

  • To estimate the joint contribution of specific chronic conditions to dementia incidence.
  • To model additive contributions and temporal proximity in the sequential onset of conditions.

Main Methods:

  • Analysis of 9944 participants (ages 68-99) from the Health and Retirement Study and Medicare beneficiaries (1998-2016).
  • Utilized validated claims algorithms to encode Alzheimer's disease and related dementias (ADRD) and chronic conditions.
  • Employed the longitudinal extension of the average attributable fraction (LE-AAF) to estimate condition contributions.

Main Results:

  • Eight chronic conditions (hypertension, myocardial infarction, atrial fibrillation, diabetes, heart failure, ischemic heart disease, stroke, arthritis) accounted for 71.8% of incident ADRD cases.
  • Hypertension was identified as the largest single contributor to dementia risk.
  • Confidence intervals were narrowest for conditions within the cardiovascular pathway to dementia.

Conclusions:

  • Multimorbidity plays a critical role in the incidence of dementia.
  • Interventions targeting cardiovascular conditions may offer the most effective strategy for lowering dementia risk.
  • The LE-AAF method explicitly accounts for longitudinal comorbidity patterns.