Environmental and lifestyle risk factors for early-onset dementia: a systematic review: Environmental factors and EOD risk

Environmental and lifestyle risk factors for early-onset dementia: a systematic review

Environmental factors and EOD risk

Authors

  • Matteo Bosi Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
  • Marcella Malavolti Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy https://orcid.org/0000-0002-1719-7204
  • Caterina Garuti Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy and Department of Neuroscience and Rehabilitation, Division of Neurology, University Hospital of Ferrara, Ferrara, Italy https://orcid.org/0000-0001-6242-531X
  • Manuela Tondelli Neurology Unit, Modena University Hospital, Baggiovara, Modena, Italy and Primary Care Department, Local Health Unit of Modena, Modena, Italy https://orcid.org/0000-0001-6698-5437
  • Cristina Marchesi Head Office, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
  • Marco Vinceti Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy and Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA https://orcid.org/0000-0002-0551-2473
  • Tommaso Filippini Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy and School of Public Health, University of California Berkeley, Berkeley, CA, USA https://orcid.org/0000-0003-2100-0344

Keywords:

early-onset dementia, risk factor, environment, lifestyle, prevention

Abstract

Background and aim: The term early-onset dementia (EOD) encompasses several forms of neurodegenerative diseases characterized by symptom onset before 65 years and leading to severe impact on subjects already in working activities, as well as on their family and caregivers. Despite the increasing incidence, the etiology is still unknown, with possible association of environmental factors, although the evidence is still scarce. In this review, we aimed to assess how several environmental and lifestyle factors may be associated with the onset of this disease. Methods: We conducted a literature search in PubMed and EMBASE databases up to May 6, 2022, to retrieve epidemiological studies evaluating the effect of environmental and lifestyle factors on EOD risk. Results: We eventually included 22 studies, ten with cohort and twelve with case-control design. Traumatic injury, especially on the head/brain, some cardiovascular diseases such as atrial fibrillation and stroke, metabolic diseases including diabetes and hypercholesterolemia, and alcohol consumption have been identified as potential risk factors for EOD. Conversely, playing leisure activities including sports (without trauma), higher educational attainment and higher adherence to Mediterranean DASH-Intervention for Neurodegenerative Delay (MIND) diet appeared to be protective for EOD. Conclusions: The literature on environmental risk factors for EOD has been considerably growing in recent years. Overall, it supports an association between some environmental and lifestyle factors with disease risk. However, additional high-quality research is required to confirm these relations and its causal nature (www.actabiomedica.it).

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. 4th Edition. Washington, DC: American Psychiatric Association; 2000

Rossor MN, Fox NC, Mummery CJ, et al. The diagnosis of young-onset dementia. Lancet Neurol 2010; 9 (8): 793-806. https://doi.org/10.1016/S1474-4422(10)70159-9.

Kuruppu DK, Matthews BR. Young-onset dementia. Semin Neurol 2013; 33 (4): 365-85. https://doi.org/10.1055/s-0033-1359320.

Chiari A, Vinceti G, Adani G, et al. Epidemiology of early onset dementia and its clinical presentations in the province of Modena, Italy. Alzheimers Dement 2021; 17 (1): 81-88. https://doi.org/10.1002/alz.12177.

Harvey RJ, Skelton-Robinson M, Rossor MN. The prevalence and causes of dementia in people under the age of 65 years. J Neurol Neurosurg Psychiatry 2003; 74 (9): 1206-9. https://doi.org/10.1136/jnnp.74.9.1206.

Kvello-Alme M, Brathen G, White LR, et al. The prevalence and dubtypes of young onset dementia in Central Norway: a population-based study. J Alzheimers Dis 2019; 69 (2): 479-87. https://doi.org/10.3233/JAD-181223.

Chiari A, Pistoresi B, Galli C, et al. Determinants of caregiver burden in early-onset dementia. Dement Geriatr Cogn Dis Extra 2021; 11 (2): 189-97. https://doi.org/10.1159/000516585.

Flynn R, Mulcahy H. Early-onset dementia: the impact on family care-givers. Br J Community Nurs 2013; 18 (12): 598-606. https://doi.org/10.12968/bjcn.2013.18.12.598.

Withall A, Draper B, Seeher K, et al. The prevalence and causes of younger onset dementia in Eastern Sydney, Australia. Int Psychogeriatr 2014; 26 (12): 1955-65. https://doi.org/10.1017/S1041610214001835.

Mendez MF. Early-onset Alzheimer disease and its variants. Continuum (Minneap Minn) 2019; 25 (1): 34-51. https://doi.org/10.1212/CON.0000000000000687.

Fenoglio C, Scarpini E, Serpente M, et al. Role of genetics and epigenetics in the pathogenesis of Alzheimer's disease and frontotemporal dementia. J Alzheimers Dis 2018; 62 (3): 913-32. https://doi.org/10.3233/JAD-170702.

Cations M, Withall A, Low LF, et al. What is the role of modifiable environmental and lifestyle risk factors in young onset dementia? Eur J Epidemiol 2016; 31 (2): 107-24. https://doi.org/10.1007/s10654-015-0103-9.

Dautaj A, Mandara L, Tassi V, et al. Genetic analysis of genes associated with Mendelian dementia. Acta Biomed 2020; 91 (13-S): e2020004. https://doi.org/10.23750/abm.v91i13-S.10602.

Balboni E, Filippini T, Crous-Bou M, et al. The association between air pollutants and hippocampal volume from magnetic resonance imaging: a systematic review and meta-analysis. Environ Res 2021; 204 (Pt A): 111976. https://doi.org/10.1016/j.envres.2021.111976.

Killin LO, Starr JM, Shiue IJ, et al. Environmental risk factors for dementia: a systematic review. BMC Geriatr 2016; 16 (1): 175. https://doi.org/10.1186/s12877-016-0342-y.

Weuve J, Bennett EE, Ranker L, et al. Exposure to air pollution in relation to risk of dementia and related outcomes: an updated systematic review of the epidemiological literature. Environ Health Perspect 2021; 129 (9): 96001. https://doi.org/10.1289/EHP8716.

Zagnoli F, Filippini T, Jimenez MP, et al. Is greenness associated with dementia? A systematic review and dose-response meta-analysis. Curr Environ Health Rep 2022; in press. https/doi.org/10.1007/s40572-022-00365-5.

Bagge CN, Henderson VW, Laursen HB, et al. Risk of dementia in adults with congenital heart disease: population-based cohort study. Circulation 2018; 137 (18): 1912-20. https://doi.org/10.1161/CIRCULATIONAHA.117.029686.

Basit S, Wohlfahrt J, Boyd HA. Pre-eclampsia and risk of dementia later in life: nationwide cohort study. BMJ 2018; 363: k4109. https://doi.org/10.1136/bmj.k4109.

Han E, Lee JY, Han KD, et al. Gamma glutamyltransferase and risk of dementia in prediabetes and diabetes. Sci Rep 2020; 10 (1): 6800. https://doi.org/10.1038/s41598-020-63803-0.

Kim D, Yang PS, Lip GYH, et al. Atrial fibrillation Increases the risk of early-onset dementia in the general population: data from a population-based cohort. J Clin Med 2020; 9 (11): 3665. https://doi.org/10.3390/jcm9113665.

Liao JN, Chao TF, Liu CJ, et al. Risk and prediction of dementia in patients with atrial fibrillation--a nationwide population-based cohort study. Int J Cardiol 2015; 199: 25-30. https://doi.org/10.1016/j.ijcard.2015.06.170.

Mahmoudi E, Lin P, Peterson MD, et al. Traumatic spinal cord Injury and risk of early and late onset Alzheimer's disease and related dementia: large longitudinal study. Arch Phys Med Rehabil 2021; 102 (6): 1147-54. https://doi.org/10.1016/j.apmr.2020.12.019.

Nordstrom P, Nordstrom A, Eriksson M, et al. Risk factors in late adolescence for young-onset dementia in men: a nationwide cohort study. JAMA Intern Med 2013; 173 (17): 1612-8. https://doi.org/10.1001/jamainternmed.2013.9079.

Nyberg J, Aberg MA, Schioler L, et al. Cardiovascular and cognitive fitness at age 18 and risk of early-onset dementia. Brain 2014; 137 (Pt 5): 1514-23. https://doi.org/10.1093/brain/awu041.

Osler M, Rozing MP, Eliasen MH, et al. Traumatic brain injury and risk of dementia at different levels of cognitive ability and education. Eur J Neurol 2020; 27 (2): 399-405. https://doi.org/10.1111/ene.14095.

Phung TK, Waltoft BL, Laursen TM, et al. Hysterectomy, oophorectomy and risk of dementia: a nationwide historical cohort study. Dement Geriatr Cogn Disord 2010; 30 (1): 43-50. https://doi.org/10.1159/000314681.

Adani G, Filippini T, Garuti C, et al. Environmental risk factors for early-onset Alzheimer's dementia and frontotemporal dementia: a case-control study in Northern Italy. Int J Environ Res Public Health 2020; 17 (21): 7941. https://doi.org/10.3390/ijerph17217941.

Cations M, Draper B, Low LF, et al. Non-genetic risk factors for degenerative and vascular young onset dementia: results from the INSPIRED and KGOW studies. J Alzheimers Dis 2018; 62 (4): 1747-58. https://doi.org/10.3233/JAD-171027.

Chen Y, Sillaire AR, Dallongeville J, et al. Low prevalence and clinical effect of vascular risk factors in early-onset Alzheimer's disease. J Alzheimers Dis 2017; 60 (3): 1045-54. https://doi.org/10.3233/JAD-170367.

Cheng YF, Xirasagar S, Yang TH, et al. Risk of early-onset dementia among persons with tinnitus: a retrospective case-control study. Sci Rep 2021; 11 (1): 13399. https://doi.org/10.1038/s41598-021-92802-y.

Filippini T, Adani G, Malavolti M, et al. Dietary habits and risk of early-onset dementia in an Italian case-control study. Nutrients 2020; 12 (12): 3682. https://doi.org/10.3390/nu12123682.

Kadohara K, Sato I, Kawakami K. Diabetes mellitus and risk of early-onset Alzheimer's disease: a population-based case-control study. Eur J Neurol 2017; 24 (7): 944-9. https://doi.org/10.1111/ene.13312.

Kennedy E, Panahi S, Stewart IJ, et al. Traumatic brain injury and early onset dementia in post 9-11 veterans. Brain Inj 2022: 1-8. https://doi.org/10.1080/02699052.2022.2033846.

Mendez MF, Paholpak P, Lin A, et al. Prevalence of traumatic brain injury in early versus late-onset Alzheimer's disease. J Alzheimers Dis 2015; 47 (4): 985-93. https://doi.org/10.3233/JAD-143207.

Slooter AJ, Bronzova J, Witteman JC, et al. Estrogen use and early onset Alzheimer's disease: a population-based study. J Neurol Neurosurg Psychiatry 1999; 67 (6): 779-81. https://doi.org/10.1136/jnnp.67.6.779.

van Duijn CM, Hofman A. Relation between nicotine intake and Alzheimer's disease. BMJ 1991; 302 (6791): 1491-4. https://doi.org/10.1136/bmj.302.6791.1491.

Vivanti G, Tao S, Lyall K, et al. The prevalence and incidence of early-onset dementia among adults with autism spectrum disorder. Autism Res 2021; 14 (10): 2189-99. https://doi.org/10.1002/aur.2590.

Willer BS, Zivadinov R, Haider MN, et al. A preliminary study of early-onset dementia of former professional football and hockey players. J Head Trauma Rehabil 2018; 33 (5): E1-E8. https://doi.org/10.1097/HTR.0000000000000421.

Pearce N, Gallo V, McElvenny D. Head trauma in sport and neurodegenerative disease: an issue whose time has come? Neurobiol Aging 2015; 36 (3): 1383-9. https://doi.org/10.1016/j.neurobiolaging.2014.12.024.

Washington PM, Villapol S, Burns MP. Polypathology and dementia after brain trauma: does brain injury trigger distinct neurodegenerative diseases, or should they be classified together as traumatic encephalopathy? Exp Neurol 2016; 275 Pt 3: 381-8. https://doi.org/10.1016/j.expneurol.2015.06.015.

Loane DJ, Kumar A, Stoica BA, et al. Progressive neurodegeneration after experimental brain trauma: association with chronic microglial activation. J Neuropathol Exp Neurol 2014; 73 (1): 14-29. https://doi.org/10.1097/nen.0000000000000021.

Li Y, Li Y, Li X, et al. Head Injury as a risk factor for dementia and Alzheimer's disease: a systematic review and meta-analysis of 32 observational studies. PLoS One 2017; 12 (1): e0169650. https://doi.org/10.1371/journal.pone.0169650.

Fann JR, Ribe AR, Pedersen HS, et al. Long-term risk of dementia among people with traumatic brain injury in Denmark: a population-based observational cohort study. Lancet Psychiatry 2018; 5 (5): 424-31. https://doi.org/10.1016/s2215-0366(18)30065-8.

McKee AC, Daneshvar DH, Alvarez VE, et al. The neuropathology of sport. Acta Neuropathol 2014; 127 (1): 29-51. https://doi.org/10.1007/s00401-013-1230-6.

Russell ER, Mackay DF, Stewart K, et al. Association of field position and career length with risk of neurodegenerative disease in male former professional soccer players. JAMA Neurol 2021; 78 (9): 1057-63. https://doi.org/10.1001/jamaneurol.2021.2403.

Omalu BI, DeKosky ST, Minster RL, et al. Chronic traumatic encephalopathy in a National Football League player. Neurosurgery 2005; 57 (1): 128-34. https://doi.org/10.1227/01.neu.0000163407.92769.ed.

McKee AC, Cairns NJ, Dickson DW, et al. The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Acta Neuropathol 2016; 131 (1): 75-86. https://doi.org/10.1007/s00401-015-1515-z.

Asken BM, Rabinovici GD. Professional soccer and dementia risk-The ugly side of the beautiful game. JAMA Neurol 2021; 78 (9): 1049-51. https://doi.org/10.1001/jamaneurol.2021.2246.

Nordstrom A, Nordstrom P. Traumatic brain injury and the risk of dementia diagnosis: a nationwide cohort study. PLoS Med 2018; 15 (1): e1002496. https://doi.org/10.1371/journal.pmed.1002496.

Changa AR, Vietrogoski RA, Carmel PW. Dr Harrison Martland and the history of punch drunk syndrome. Brain 2018; 141 (1): 318-21. https://doi.org/10.1093/brain/awx349.

Winblad B, Ankarcrona M, Johansson G, et al. Head trauma in sports and risk for dementia. J Intern Med 2019; 285 (6): 591-3. https://doi.org/10.1111/joim.12918.

Bowen ME. A prospective examination of the relationship between physical activity and dementia risk in later life. Am J Health Promot 2012; 26 (6): 333-40. https://doi.org/10.4278/ajhp.110311-QUAN-115.

Brini S, Sohrabi HR, Peiffer JJ, et al. Physical activity in preventing Alzheimer's disease and cognitive decline: a narrative review. Sports Med 2018; 48 (1): 29-44. https://doi.org/10.1007/s40279-017-0787-y.

Silva MVF, Loures CMG, Alves LCV, et al. Alzheimer's disease: risk factors and potentially protective measures. J Biomed Sci 2019; 26 (1): 33. https://doi.org/10.1186/s12929-019-0524-y.

Rege SD, Geetha T, Broderick TL, et al. Can diet and physical activity limit Alzheimer’s disease risk? Curr Alzheimer Res 2017; 14 (1): 76-93. https://doi.org/10.2174/1567205013666160314145700.

Lee J. The relationship between physical activity and dementia: a systematic review and meta-analysis of prospective cohort studies. J Gerontol Nurs 2018; 44 (10): 22-9. https://doi.org/10.3928/00989134-20180814-01.

Du Z, Li Y, Li J, et al. Physical activity can improve cognition in patients with Alzheimer's disease: a systematic review and meta-analysis of randomized controlled trials. Clin Interv Aging 2018; 13: 1593-603. https://doi.org/10.2147/CIA.S169565.

Carroll S, Dudfield M. What is the relationship between exercise and metabolic abnormalities? A review of the metabolic syndrome. Sports Med 2004; 34 (6): 371-418. https://doi.org/10.2165/00007256-200434060-00004.

Giannone ME, Filippini T, Whelton PK, et al. Atrial fibrillation and the risk of early-onset dementia: a systematic review and meta-analysis. J Am Heart Assoc 2022; 11 (14): e025653. https://doi.org/10.1161/jaha.122.025653.

Chinta V, Askandar S, Nanda A, et al. Atrial fibrillation and deterioration in cognitive function. Curr Probl Cardiol 2019; 44 (11): 100386. https://doi.org/10.1016/j.cpcardiol.2018.07.001.

Ihara M, Washida K. Linking atrial fibrillation with Alzheimer's disease: epidemiological, pathological, and mechanistic evidence. J Alzheimers Dis 2018; 62 (1): 61-72. https://doi.org/10.3233/JAD-170970.

Kim JY, Park SJ, Kim SK, et al. Pesticide exposure and cognitive decline in a rural South Korean population. PLoS One 2019; 14 (3): e0213738. https://doi.org/10.1371/journal.pone.0213738.

Hayden KM, Norton MC, Darcey D, et al. Occupational exposure to pesticides increases the risk of incident AD: the Cache County study. Neurology 2010; 74 (19): 1524-30. https://doi.org/10.1212/WNL.0b013e3181dd4423.

Gunnarsson LG, Bodin L. Occupational exposures and neurodegenerative diseases-A systematic literature review and meta-analyses. Int J Environ Res Public Health 2019; 16 (3): 337. https://doi.org/10.3390/ijerph16030337.

Armstrong RA. Risk factors for Alzheimer's disease. Folia Neuropathol 2019; 57 (2): 87-105. https://doi.org/10.5114/fn.2019.85929.

Cicero CE, Mostile G, Vasta R, et al. Metals and neurodegenerative diseases. a systematic review. Environ Res 2017; 159: 82-94. https://doi.org/10.1016/j.envres.2017.07.048.

Tomljenovic L. Aluminum and Alzheimer's disease: after a century of controversy, is there a plausible link? J Alzheimers Dis 2011; 23 (4): 567-98. https://doi.org/10.3233/jad-2010-101494.

Loef M, Schrauzer GN, Walach H. Selenium and Alzheimer's disease: a systematic review. J Alzheimers Dis 2011; 26 (1): 81-104. https://doi.org/10.3233/jad-2011-110414.

Vinceti M, Chiari A, Eichmuller M, et al. A selenium species in cerebrospinal fluid predicts conversion to Alzheimer's dementia in persons with mild cognitive impairment. Alzheimers Res Ther 2017; 9 (1): 100. https://doi.org/10.1186/s13195-017-0323-1.

Muller-Thomsen T, Arlt S, Mann U, et al. Detecting depression in Alzheimer's disease: evaluation of four different scales. Arch Clin Neuropsychol 2005; 20 (2): 271-6. https://doi.org/10.1016/j.acn.2004.03.010.

Rosness TA, Barca ML, Engedal K. Occurrence of depression and its correlates in early onset dementia patients. Int J Geriatr Psychiatry 2010; 25 (7): 704-11. https://doi.org/10.1002/gps.2411.

Verkaik R, Nuyen J, Schellevis F, et al. The relationship between severity of Alzheimer's disease and prevalence of comorbid depressive symptoms and depression: a systematic review. Int J Geriatr Psychiatry 2007; 22 (11): 1063-86. https://doi.org/10.1002/gps.1809.

Draper B, Withall A. Young onset dementia. Intern Med J 2016; 46 (7): 779-86. https://doi.org/10.1111/imj.13099.

Dhana K, Evans DA, Rajan KB, et al. Healthy lifestyle and the risk of Alzheimer dementia: findings from 2 longitudinal studies. Neurology 2020; 95 (4): e374-e83. https://doi.org/10.1212/WNL.0000000000009816.

Morris MC, Tangney CC, Wang Y, et al. MIND diet associated with reduced incidence of Alzheimer's disease. Alzheimers Dement 2015; 11 (9): 1007-14. https://doi.org/10.1016/j.jalz.2014.11.009.

Scarmeas N, Stern Y, Tang MX, et al. Mediterranean diet and risk for Alzheimer's disease. Ann Neurol 2006; 59 (6): 912-21. https://doi.org/10.1002/ana.20854.

Berendsen AM, Kang JH, Feskens EJM, et al. Association of long-term adherence to the MIND diet with cognitive function and cognitive decline in American women. J Nutr Health Aging 2018; 22 (2): 222-9. https://doi.org/10.1007/s12603-017-0909-0.

Morris MC, Tangney CC, Wang Y, et al. MIND diet slows cognitive decline with aging. Alzheimers Dement 2015; 11 (9): 1015-22. https://doi.org/10.1016/j.jalz.2015.04.011.

Tangney CC, Li H, Wang Y, et al. Relation of DASH- and Mediterranean-like dietary patterns to cognitive decline in older persons. Neurology 2014; 83 (16): 1410-6. https://doi.org/10.1212/WNL.0000000000000884.

Morris MC. Nutrition and risk of dementia: overview and methodological issues. Ann N Y Acad Sci 2016; 1367 (1): 31-7. https://doi.org/10.1111/nyas.13047.

Kosti RI, Kasdagli MI, Kyrozis A, et al. Fish intake, n-3 fatty acid body status, and risk of cognitive decline: a systematic review and a dose-response meta-analysis of observational and experimental studies. Nutr Rev 2022; 80 (6): 1445-58. https://doi.org/10.1093/nutrit/nuab078.

Samadi M, Moradi S, Moradinazar M, et al. Dietary pattern in relation to the risk of Alzheimer's disease: a systematic review. Neurol Sci 2019; 40 (10): 2031-43. https://doi.org/10.1007/s10072-019-03976-3.

Malavolti M, Naska A, Fairweather-Tait SJ, et al. Sodium and potassium content of foods consumed in an Italian population and the impact of adherence to a Mediterranean diet on their intake. Nutrients 2021; 13 (8): 2681. https://doi.org/10.3390/nu13082681.

Sacks FM, Appel LJ, Moore TJ, et al. A dietary approach to prevent hypertension: a review of the Dietary Approaches to Stop Hypertension (DASH) Study. Clin Cardiol 1999; 22 (7 Suppl): III6-10. https://doi.org/10.1002/clc.4960221503.

Filippini T, Naska A, Kasdagli MI, et al. Potassium intake and blood pressure: a dose-response meta-analysis of randomized controlled trials. J Am Heart Assoc 2020; 9 (12): e015719. https://doi.org/10.1161/JAHA.119.015719.

Filippini T, Violi F, D'Amico R, et al. The effect of potassium supplementation on blood pressure in hypertensive subjects: A systematic review and meta-analysis. Int J Cardiol 2017; 230: 127-35. https://doi.org/10.1016/j.ijcard.2016.12.048.

Filippini T, Malavolti M, Whelton PK, et al. Blood pressure effects of sodium reduction: dose-response meta-analysis of experimental studies. Circulation 2021; 143 (16): 1542-67. https://doi.org/10.1161/CIRCULATIONAHA.120.050371.

Vinceti M, Filippini T, Crippa A, et al. Meta-analysis of potassium intake and the risk of stroke. J Am Heart Assoc 2016; 5 (10): e004210. https://doi.org/10.1161/JAHA.116.004210.

Filippini T, Malavolti M, Whelton PK, et al. Sodium intake and risk of hypertension: a systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022; 24 (5): 133–44 https://doi.org/10.1007/s11906-022-01182-9.

Mogi M. Hypertension management to prevent dementia. Hypertens Res 2022; 45 (4): 573-5. https://doi.org/10.1038/s41440-022-00869-5.

Littlejohns TJ, Collister JA, Liu X, et al. Hypertension, a dementia polygenic risk score, APOE genotype, and incident dementia. Alzheimers Dement 2022: 1–10 https://doi.org/10.1002/alz.12680.

Chiari A, Tondelli M, Galli C, et al. How long does it take to diagnose young-onset dementia? A comparison with late-onset dementia. Neurol Sci 2022; 43: 4729–34 https://doi.org/10.1007/s10072-022-06056-1.

Downloads

Published

16-12-2022

Issue

Section

REVIEWS

How to Cite

1.
Environmental and lifestyle risk factors for early-onset dementia: a systematic review: Environmental factors and EOD risk. Acta Biomed [Internet]. 2022 Dec. 16 [cited 2024 Jun. 19];93(6):e2022336. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/13279

Most read articles by the same author(s)