Smoking And Weight Tied To Future Brain Shrinkage, Increased Long Term Care Insurance Need

Smoking, having high blood pressure or diabetes and being overweight during your middle years may cause brain shrinkage and lead to cognitive problems up to a decade later.

According to a new study published in Neurology, the medical journal of the American Academy of Neurology these factors appear to cause the brain to lose volume. Some 38.7 million Americans age 65 and older reported having one or more cognitive disorders according to the 2011 Long-Term Care Insurance Almanac published by the American Association for long-Term Care Insurance.

Health conditions increased the development of lesions secondary to presumed vascular injury, and also appeared to affect its ability to plan and make decisions as quickly as 10 years later. The findings provide evidence that identifying these risk factors early in people of middle age could be useful in screening people for at-risk dementia and encouraging people to make changes to their lifestyle before it's too late.

The study involved over 1,300 people without dementia with an average age of 54. Participants had body mass and waist circumference measures taken and were given blood pressure, cholesterol and diabetes tests. They also underwent brain MRI scans over the span of a decade, the first starting about seven years after the initial risk factor exam. Participants with stroke and dementia at baseline were excluded, and between the first and last MRI exams, 19 people had a stroke and two developed dementia.

Researchers found that people with high blood pressure developed small areas of vascular brain damage, at a faster rate than those with normal blood pressure readings. They also had a more rapid worsening of scores on tests of executive function, or planning and decision making, corresponding to five and eight years of chronological aging respectively.

People with diabetes in middle age lost brain volume in the hippocampus at a faster rate than those without diabetes. Smokers lost brain volume overall at a faster rate than nonsmokers and were also more likely to have a rapid increase in white matter hyperintensities.

"Unhealthy habits come back to haunt millions at older ages," explains Jesse Slome, executive director of the long term care insurance association. "It creates an increased risk of needing long term care in your 80s and 90s a reason why planning prior to retirement is a must especially for those still in good health."