Tag: stroke

Modifiable risk factors for stroke, dementia and late-life depression: a systematic review and DALY-weighted risk factors for a composite outcome

Mary Pat Campbell

Link: https://jnnp.bmj.com/content/early/2025/03/21/jnnp-2024-334925.long

Excerpt:

Abstract

Background At least 60% of stroke, 40% of dementia and 35% of late-life depression (LLD) are attributable to modifiable risk factors, with great overlap due to shared pathophysiology. This study aims to systematically identify overlapping risk factors for these diseases and calculate their relative impact on a composite outcome.

Methods A systematic literature review was performed in PubMed, Embase and PsycInfo, between January 2000 and September 2023. We included meta-analyses reporting effect sizes of modifiable risk factors on the incidence of stroke, dementia and/or LLD. The most relevant meta-analyses were selected, and disability-adjusted life year (DALY) weighted beta (β)-coefficients were calculated for a composite outcome. The β-coefficients were normalised to assess relative impact.

Results Our search yielded 182 meta-analyses meeting the inclusion criteria, of which 59 were selected to calculate DALY-weighted risk factors for a composite outcome. Identified risk factors included alcohol (normalised β-coefficient highest category: −34), blood pressure (130), body mass index (70), fasting plasma glucose (94), total cholesterol (22), leisure time cognitive activity (−91), depressive symptoms (57), diet (51), hearing loss (60), kidney function (101), pain (42), physical activity (−56), purpose in life (−50), sleep (76), smoking (91), social engagement (53) and stress (55).

Conclusions This study identified overlapping modifiable risk factors and calculated the relative impact of these factors on the risk of a composite outcome of stroke, dementia and LLD. These findings could guide preventative strategies and serve as an empirical foundation for future development of tools that can empower people to reduce their risk of these diseases.

Author(s): http://orcid.org/0009-0002-6540-480XJasper Senff1,2,3,4,5, http://orcid.org/0000-0003-3204-0309Reinier Willem Pieter Tack1,2,3,4,5, Akashleena Mallick1,2,3,4, Leidys Gutierrez-Martinez1,2,3,4, Jonathan Duskin1,2,3,4, Tamara N Kimball1,2,3,4,6, Benjamin Y Q Tan1,2,3,4,7, Zeina N Chemali1,2,8, Amy Newhouse1,9, Christina Kourkoulis1,2,3,4, Cyprien Rivier10,11, Guido J Falcone10,11, Kevin N Sheth10,11, Ronald M Lazar12, Sarah Ibrahim13,14,15,16,17, Aleksandra Pikula14,15,16,17, Rudolph E Tanzi1, Gregory L Fricchione8, Hens Bart Brouwers5, Gabriel J E Rinkel5, Nirupama Yechoor1,2,3,4, Jonathan Rosand1,2,3,4, Christopher D Anderson1,2,3,4,6, Sanjula D Singh1,2,3,4

https://doi.org/10.1136/jnnp-2024-334925

Publication Date: April 2025

Publication Site: Journal of Neurology, Neurosurgery, & Psychiatry

17 Ways to Cut Your Risk of Stroke, Dementia and Depression All at Once

Mary Pat Campbell

Link: https://www.nytimes.com/2025/04/23/well/dementia-stroke-depression-prevention.html?smid=url-share

Graphic:

Excerpt:

New research has identified 17 overlapping factors that affect your risk of stroke, dementia and late-life depression, suggesting that a number of lifestyle changes could simultaneously lower the risk of all three.

Though they may appear unrelated, people who have dementia or depression or who experience a stroke also often end up having one or both of the other conditions, said Dr. Sanjula Singh, a principal investigator at the Brain Care Labs at Massachusetts General Hospital and the lead author of the study. That’s because they may share underlying damage to small blood vessels in the brain, experts said.

….

The study, which looked at data from 59 meta-analyses, identified six factors that lower your risk of brain diseases:

  • Low to moderate alcohol intake (Consuming one to three drinks a day had a smaller benefit than consuming less than one drink a day.)
  • Cognitive activity, meaning regular engagement in mentally stimulating tasks like reading or doing puzzles
  • A diet high in vegetables, fruit, dairy, fish and nuts
  • Moderate or high levels of physical activity
  • A sense of purpose in life
  • A large social network

The study also identified 13 health characteristics and habits that make you more likely to develop dementia, a stroke or late-life depression. (Altogether, the protective and harmful factors add up to 19 factors because two of them, diet and social connections, can increase or decrease risk, depending on their type and quality.)

  • High blood pressure
  • High body mass index
  • High blood sugar
  • High total cholesterol
  • Depressive symptoms
  • A diet high in red meat, sugar-sweetened beverages, sweets and sodium
  • Hearing loss
  • Kidney disease
  • Pain, particularly forms that interfere with activity
  • Sleep disturbances (for example, insomnia or poor sleep quality) or sleep periods longer than eight hours
  • Smoking history
  • Loneliness or isolation
  • General stress or stressful life events (as reported by study subjects)

Author(s): Nina Agrawal

Publication Date: 23 Apr 2025

Publication Site: NYT

Mortality Stays Slightly Elevated: Globe Life Exec

Mary Pat Campbell

Link:https://www.thinkadvisor.com/2024/07/30/mortality-stays-slightly-elevated-globe-life-exec/

Excerpt:

Since the COVID-19 pandemic began, in early 2020, Globe Life has been one of the life insurers that’s been quickest to give analysts candid assessments of U.S. mortality.

Mortality is much lower than it was when pandemic-related mortality was peaking, and mortality trends are now helping, not, hurting, Globe Life’s earnings, Kalmbach said.

“Mortality has been fairly consistent over the last few quarters, which has been good,” he said.

He sees the mortality rate from accidents and other nonmedical causes improving.

….

“Heart disease and cancer, although improved, are still a little bit higher,” he said. “Another one that remains elevated as a cause of death is neurological disorders, which would be stroke and Alzheimer’s. We’re keeping an eye on that.”

Author(s): Allison Bell

Publication Date: 30 July 2024

Publication Site: think Advisor