Risk of dementia evident even at a young age

Press release from the University of Leipzig

The way we live helps determine how our brains age – and this happens much earlier than previously thought. A new study by the Faculty of Medicine at Leipzig University shows that an established dementia risk index is already linked to differences in cognitive performance in young adults aged 20 to 39. Until now, the index was primarily used for risk assessment in middle and older adulthood. The findings have recently been published in the journal ‘Alzheimer’s & Dementia’.

Currently, around 1.8 million people in Germany are living with dementia. For this study, the research team used data from the Germany-wide, population-based NAKO health study, which involved just under 150,000 participants aged between 20 and 75. A LIBRA score was calculated for each person based on health and lifestyle factors – such as smoking, physical activity, depression or cardiovascular disease. The results are clear: higher LIBRA scores, i.e. a higher risk of dementia, were associated with poorer cognitive function across all age groups.

The correlations between risk factors and cognitive performance were then analysed. The Lifestyle for Brain Health (LIBRA) index is an established scientific tool for assessing the risk of dementia. Particularly striking in the current study: younger adults were more likely to exhibit behavioural and psychosocial risk factors such as smoking, lack of exercise and depressive symptoms. In older people, cardiovascular risks such as high blood pressure, coronary heart disease and elevated cholesterol levels predominated. “It is clear that the nature of risk factors for dementia changes over the course of a lifetime. Risk reduction should not begin at the age of 40 or 60, but should start as early as young adulthood,” emphasises Professor Steffi G. Riedel-Heller, Director of the Institute for Social Medicine, Occupational Medicine and Public Health (ISAP). “If we focus on lifestyle factors such as exercise, diet and mental health early on, we can probably do a great deal to promote brain health in old age.”

The study also reveals clear social disparities: individuals with lower socioeconomic status had, on the whole, less favourable LIBRA scores. Differences were also observed between women and men: on average, men had higher modifiable dementia risk factors (LIBRA scores) than women. Negative associations between LIBRA and cognitive performance were particularly pronounced among women with lower socioeconomic status. The results suggest that certain groups may face multiple disadvantages over the course of their lives. Researcher Felix Wittmann: “Our findings clearly show that the risk of dementia is not solely linked to individual factors. If we do not pay closer attention to social inequalities, we as a society run the risk that the most vulnerable groups will benefit least from important risk-reduction measures.”

From a scientific perspective, the study fills a gap: until now, the LIBRA index has only been thoroughly studied in people aged 40 and over. The fact that it is also meaningful for 20- to 39-year-olds shows that established dementia risk models can be applied to younger age groups and that research should focus more closely on the entire life course.

The publication was co-authored by Prof. Dr Susanne Röhr and Felix Wittmann. Prof. Dr Röhr currently holds a post as Associate Professor at the University of New South Wales in Sydney, Australia, and continues to be affiliated with the Institute for Social Medicine, Occupational Medicine and Public Health (ISAP) as a visiting researcher.

More information

Original Publication

Röhr S, Wittmann F, Luppa M, et al. Associations of the Lifestyle for Brain Health (LIBRA) index with cognitive functioning across adulthood: Variation by sex and socioeconomic status in the German National Cohort (NAKO). Alzheimers Dement. 2026;22(5):e71477. http://doi.org/10.1002/alz.71477

Contact

Prof. Dr. med. Steffi G. Riedel-Heller
Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP)
Telefon: +49 341 97 15408
E-Mail: steffi.riedel-heller@medizin.uni-leipzig.de

Felix Wittmann
Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP)
Telefon: +49 341 97 15542
E-Mail: Felix.Wittmann@medizin.uni-leipzig.de

See the article on the University of Leipzig website

Press contact:

Dr. Friederike Fellenberg
NAKO Gesundheitsstudie
Head of Project and Science Communication
Am Taubenfeld 21/2
69123 Heidelberg
Germany
Phone.: +49 6221 42620-62
E-mail: friederike.fellenberg@nako.de

German National Cohort (NAKO)

The German National Cohort (NAKO Gesundheitsstudie) is the largest long-term population study in Germany. Since 2014, over 205,000 randomly selected people have been medically examined and asked about their lifestyle habits in 18 study centres. At the beginning of the study, the participants were aged between 20 and 69.

The German National Cohort (NAKO) is a prospective epidemiological cohort study. The researchers observe a large group, a so-called cohort, of healthy, ill or formerly ill people over a long period of time. The aim is to use scientific analyses of the participants’ data to investigate the frequency and causes of common diseases such as cancer, diabetes or cardiovascular diseases, to identify risk factors and to show ways of effective prevention and early detection.

The research project is supported by 26 organisations. Scientists from universities, the Helmholtz Association, the Leibniz Association and other research institutes in Germany are working together in a nationwide network. The study is being carried out by the NAKO e.V. association. It is financed by public funds from the Federal Ministry of Research, Technology and Space (BMFTR), the Helmholtz Association and the participating federal states.