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Dementia Risk More than Doubled in Patients With Schizophrenia
The risk of dementia in people with schizophrenia or other psychotic disorders is 2.52 times higher than the risk of those without a psychotic disorder, according to results from a new systematic review and meta-analysis published in Psychological Medicine.
“This is an important finding indicating that the risk of future dementia attributed to non-affective psychotic disorders is higher than the relative risk associated with other psychiatric disorders and future dementia, such as depression, anxiety, and posttraumatic stress disorder,” researchers wrote. “Importantly, our results remained robust after excluding lower-quality studies and studies that did not adjust for confounders.”
The investigation included data from 11 studies across nine countries on four continents that involved nearly 13 million people.
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The risk of dementia was increased across multiple different psychotic disorders, according to the findings, and regardless of age of psychotic disorder onset. Some studies included people diagnosed with psychotic disorders in young adulthood and spanned decades of follow-up.
People with psychotic disorders tended to be younger than average at dementia diagnosis, researchers reported. Two studies indicated the patient population was significantly more likely to be diagnosed with dementia in their 60s.
The cause of the association, however, is not clear.
“People with psychotic disorders are more likely to have other health conditions, such as cardiovascular disease or obesity, which can increase the risk of dementia,” said joint senior author Vasiliki Orgeta, PhD, University College London Division of Psychiatry, “while they are also more likely to have a poor diet, smoke, or use drugs, which may harm their health in ways that could increase their likelihood of developing dementia.”
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“Cognitive impairment and hallucinations can be symptoms of both dementia and psychotic disorders, so it is possible there could be a link between the two illnesses,” added lead author Sara El Miniawi, who completed the research for her MSc dissertation at University College London. “This impairment could also limit people’s cognitive reserve, and increase their vulnerability to dementia symptoms.”
Regardless of the underlying mechanisms, researchers advised careful monitoring for cognitive and functional decline in patients with diagnosed psychotic disorders or symptoms.
“Given the robust association observed between psychotic disorders and future dementia risk,” they wrote, “our findings should be reflected in future clinical guidelines for the treatment and care of people living with non-affective psychotic disorders.”
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