A lifetime perspective on risk factors for cognitive decline with a special focus on early events

• Published in: Cerebral circulation - cognition and behavior 2024, Vol.6, p.100217, Article 100217
• Main Authors: Kuhn, H. Georg, Skau, Simon, Nyberg, Jenny
• Format: Article
• Language: English
• Subjects: Adolescence; Childhood; Cognition; Dementia risk factors; Longitudinal studies; Neurosciences; Neurovetenskaper
• ISSN: 2666-2450; 2666-2450
• DOI: 10.1016/j.cccb.2024.100217

•Alzheimer's disease and vascular dementia develop over several decades and altered risk for the development of dementia later in life can be linked to influences as far back as childhood and adolescence.•Childhood risk factors for dementia have been related to complications during pregnancy and the perinatal period, as well as psychosocial circumstances, including adverse childhood experiences with protracted exposure to high stress levels.•Adolescence includes sensitive periods for social, emotional, and cognitive development and exposure to unhealthy lifestyle choices (such as alcohol and drug abuse) influence brain plasticity and maturation processes.•Early habit formation, chronification of inflammation, metabolic diseases or affective disorders can be important early-life contributors to cognitive dysfunction later in life.•Mechanisms of long-term consolidation of negative influences during childhood and adolescence include structural changes in the brain as well as epigenetic modification of cellular responses. Both Alzheimer's disease and vascular dementia are the result of disease processes that typically develop over several decades. Population studies have estimated that more than half of the risk for dementia is preventable or at least modifiable through behavioral adaptations. The association between these lifestyle factors and the risk of dementia is most evident for exposure in midlife. However, habits formed in middle age often reflect a lifetime of behavior patterns and living conditions. Therefore, individuals who, for example, are able to maintain healthy diets and regular exercise during their middle years are likely to benefit from these cognition-protective habits they have practiced throughout their lives. For numerous adult diseases, significant risks can often be traced back to early childhood. Suboptimal conditions during the perinatal period, childhood and adolescence can increase the risk of adult diseases, including stroke, heart disease, insulin resistance, hypertension and dementia. This review aims at summarizing some of the evidence for dementia risks from a life-time perspective with the goal of raising awareness for early dementia prevention and successful aging.