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One in two women and one in three men will develop neurological disease

Prioritise population-level preventive interventions to greatly cut burden of dementia, parkinsonism & stroke

Louise Prime

Tuesday, 02 October 2018

About a half of women and a third of men will probably be diagnosed with dementia, parkinsonism and/or stroke during their lifetime, predict the researchers behind a large observational study* published today in the Journal of Neurology Neurosurgery & Psychiatry. But, they said, preventive strategies that delay disease onset could theoretically reduce lifetime risk for developing any of these diseases by 20%-50%, and they have called for a focus on preventive interventions to reduce the burden of common neurological disease in the ageing population.

A research team led from University Medical Center Rotterdam, in the Netherlands, within the prospective population-based Rotterdam study, studied lifetime risk of dementia, stroke and parkinsonism between 1990 and 2016. They followed up 12,102 people (just over half of them women) who at baseline were aged at least 45 years (median 62.2 years), and free from these diseases, for 26 years.

During this time, 1,489 individuals were diagnosed with dementia, 1,285 with stroke and 263 with parkinsonism; and of these 438 people (14.6%) were diagnosed with multiple diseases. Women were almost twice as likely as men to be diagnosed with both stroke and dementia during their lifetime.

The researchers calculated that women’s overall remaining lifetime risk for any of these diseases at the age of 45 was 48.2% and men’s was 36.2%. The combined cumulative risk of developing any of these diseases increased steeply with age, ranging from 2.6% for women and 3.2% for men aged 45 years until age 65, to up to 45.8% for women and 35.3% for men until the age of 95.

The study authors noted that women aged 45 years had a significantly higher lifetime risk of developing dementia and stroke than men (31.4% compared with 18.6% in men; and 21.6% compared with 19.3% in men, respectively); whereas lifetime risk of parkinsonism (4.3% in women and 4.9% in men) was not significantly different. They also saw similar patterns in sex-specific occurrence for Alzheimer’s disease and vascular dementia, ischaemic, haemorrhagic and unspecified stroke and Parkinson’s disease.

They also calculated that if the onset of dementia, stroke, and parkinsonism were delayed by one to three years, the remaining lifetime risk could, in theory, be reduced by 20% in 45 year-olds, and by more than 50% in those aged 85+.

They concluded: “One in two women develops dementia, stroke or parkinsonism in their lifetime, whereas this risk approximates one in three for men. Women are almost twice as likely as men to be diagnosed with both stroke and dementia during their lifetime. Risks are theoretically highly amendable by preventive interventions at the population level. These findings strengthen the call for focus on preventive interventions to reduce the burden of common neurological disease in the ageing population.”


*Licher S, Darweesh SKL, Wolters FJ, et al. Lifetime risk of common neurological diseases in the elderly population. J Neurol Neurosurg Psychiatry epub ahead of print 2 October 2018; doi:10.1136/jnnp-2018-318650

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