Young-onset dementia common in Southeast Asia

Young-onset dementia (YOD), particularly the Alzheimer’s type, occurs with high frequency among Southeast Asians, according to data from a memory clinic cohort in Singapore. Furthermore, YOD patients with higher education and those who have late-onset dementia (LOD) with moderate-to-severe cerebrovascular disease (CVD) burden exhibit a steeper and faster decline in global cognition.

Researchers characterized the clinico-demographic profiles of dementia in Southeast Asia and examined the association of onset-type, education, and CVD with dementia progression in a real-world setting.

The analysis included a consecutive series of 1,606 patients with dementia (mean age 71.2 years, 53.9 percent female, 85.4 percent Chinese). Their mean lifespan education was 7.4 years. Alzheimer’s disease was the most common diagnosis (59.8 percent), followed by vascular dementia (14.9 percent), frontotemporal dementia (11.1 percent), Parkinsonism spectrum (11.1 percent), autoimmune dementia (1.6 percent), and rapidly progressing dementia (1.4 percent).

YOD patients (<65 years age-at-onset) accounted for 28.5 percent of all dementia patients. Of note, there was an increasing trend in the annual incidence of YOD and LOD (≥65 years age-at-onset) over a 10-year period.

Patients with longer years of education had a steeper decline in global cognition (p<0.001), and this observation was evident in YOD (p=0.0006). Meanwhile, LOD patients with a moderate-to-severe burden of CVD experienced a faster decline in global cognition compared with their counterparts with a mild CVD burden.

The findings suggest that the protective role of education may not be able to sustain optimal cognitive function in YOD. As such, more resources may need to be devoted to the care, treatment, and research for YOD.