Traumatic life events may directly increase your risk for dementia
Khalid Butt
Traumatic life events may directly increase your risk for dementia. In a recent article
published in BMC Geriatrics, researchers
examined the association between traumatic life events (TLE) and the risk of
all-cause dementia in individuals aged ≥60.
Khalid Butt
Studies included in
the review encompassed outcomes of 276,570 participants with median age ranging
from 50.3 to 77 years and a follow-up time ranging between two to 37 years
(average = 9.5 years).
Study: Traumatic life events and risk for
dementia: a systematic review and meta-analysis. Image Credit: fizkes/Shutterstock.com
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Background
Studies have suggested
that experiencing TLEs, such as actual/threatened death, injury, and sexual
violence, might contribute to dementia risk.
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Globally, the care and
treatment cost of dementia is estimated to be around one trillion USD annually.
Given that >150 million people will be living with dementia by 2050, it has
become crucial to identify and target modifiable risk factors that could
prevent dementia.
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Systematic reviews
have reported an association between PTSD and dementia; however, none, so far, have
examined the same between dementia risk and TLE.
It is crucial to
understand whether TLE identified during PTSD diagnosis or diagnosed separately
is a risk factor for dementia to help find interventions to mitigate dementia
risk and prevent/delay its onset.
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About the study
In the current study,
researchers carried out a systematic review and generic inverse variance random
effects meta-analysis to estimate TLE's impact on dementia risk, which they
presented as risk, odds, and hazards ratios (HRs). The team utilized the Life
Events Checklist for DSM-5 (LEC-5) criterion to identify TLE.
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All included studies
were original research articles published in peer-reviewed journals with
case-control and cohort study designs that specified dementia diagnosis as an
outcome in a study population of a minimum of 60 people.
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All were related to
all-cause dementia, with varying severities, and across all recruitment
settings but excluded early onset dementia, having different etiology. They
collected information regarding various forms of TLE (e.g., childhood trauma)
from participants, their informants, or medical records.
The search strategy
involved searching PsychINFO, Embase, and MEDLINE databases from inception
until 20 April 2022 using keywords for "dementia,” "risk," and
"traumatic events."
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The team exported all
retrieved studies to Covidence systematic review software. Next, two reviewers
independently screened all articles at all stages, adhering to rigorous
inclusion and exclusion criteria.
They used the
Newcastle–Ottawa Scale for quality assessment of the studies and evaluated
non-randomized epidemiological studies (NOS) having three domains: selection,
comparability, and outcome. Further, they used a funnel plot to assess
publication bias in the included studies.
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The researchers
classified a study as good if it had ≥3 and ≥1 stars in the selection and
comparability domains and ≥ 3 stars in the outcome domain. Likewise, they also
classified studies as 'Fair' and 'Poor' quality.
Finally, the team
meta-analyzed all studies and then conducted sub-analyses, stratifying by type
of trauma, and used I2-statistic to measure heterogeneity. In
sensitivity analyses, they included studies reporting HRs and having high
quality.
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Results
The reviewers screened
3,523 studies and identified 29 research papers for full-text screening.
Finally, they included seven studies in the meta-analysis; one was a
cross-sectional study, three were prospective cohort studies, and three were
retrospective cohort studies.
Pooled results from
the meta-analysis of seven studies demonstrated that TLE increased the risk of
all-cause dementia (HR = 1.21). The results showed significant heterogeneity (I2 =
78%).
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Future studies should
investigate the impact of TLE-specific factors, such as chronicity and
severity, and individual factors, such as age effect and association of TLEs
with dementia subtypes.
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