Can rose coloured glasses really fend off dementia?

Most people who know me well would probably say that I’m deeply cynical. And to be honest, as an engineering professor who likes to think that he’s got most things sorted out (note: incorrectly in many cases), I’ve always worn the stereotypical cynic badge with a degree of self-satisfied pride. After all, to quote George Bernard Shaw, “the power of accurate observation is commonly called cynicism by those who have not got it”.

However, this self-satisfaction recently turned to discomfort on reading a headline suggesting that, “Cynics three times more likely to suffer from dementia”, along with the subtitle, “People who see the world around them in a negative light appear to be at increased risk of cognitive decline in later life”. This and similar headlines appeared widely last week, including in the Telegraph, the Washington Post, and BBC.com, and I was not happy to hear it!

Notwithstanding my disagreement with the idea that cynicism is necessarily the same thing as “seeing the world in a negative light”, what might this research mean for people like me? Does it suggest that I should try to cheer up and put on some rose coloured glasses in an attempt to prevent cognitive decline in my later years? Where does cynicism rank in a list of risk factors for dementia? Perhaps I should cut out the cocktails first and only then try to cheer up?

Luckily my cynicism regarding print media caused me to consult the original scientific study. What I found was a classic case of failure to report the caveats – a favourite media tool used to sensationalize research that is otherwise rather less alarming.

What did the researchers actually do and say?

The original data to which the various media outlets were referring appear in the paper, “Late-life cynical distrust, risk of incident dementia, and mortality in a population-based cohort,” published by a group of neurological researchers at the University of Eastern Finland.

Essentially, the researchers asked a group of 1,449 people, with an average age of 71 (with the youngest being 70.4 years old), whether or not they agreed with statements such as “I think most people would lie to get ahead” or “it’s safer to trust nobody”.

Based on these (and other) responses, the respondents were rated on a 24-point cynicism scale as having low (0-9), moderate (10-14) or high (15-24) levels of “cynical distrust”. The researchers then followed the progress of the respondents over a period of about 10 years to determine whether they subsequently suffered from dementia (46 dementia cases out of a total population of only 622 people), or died (361 deaths out of 1146 people).

The researchers then attempted to statistically account for various “confounding factors” such as age, sex, systolic blood pressure, total cholesterol, fasting glucose, body mass index, socioeconomic background, smoking, alcohol use, self-reported health, and genotype – all of which are already known to be factors associated with dementia and death in elderly populations – and concluded that:

• those ranking high on the cynicism scale (i.e. scoring 15 or more out of 24) had 3.3 times the risk of dementia a decade later, but only after the data were “adjusted for confounders”; and
• higher cynical distrust was associated with 1.4 times higher risk of death; however, the association was “explained by confounders”

Translation please?

What the research is essentially saying is that if you score highly on this particular study’s cynicism scale (which is really measure of distrust in others rather than cynicism in the way that I suspect many people, including George Bernard Shaw, would think of it) when you are (at least) 70.4 years old, then you are, statistically speaking, and with a confidence level of 95%, 3.3 times more likely to develop dementia by the time you’re 80. This also assumes that dementia is defined and diagnosed (often with some difficulty) according to the DSM-IV criteria, and further that you can be considered a representative member of the 622 person population from which the results were drawn (presumably a group of Finnish seniors). It also assumes that you weren’t already suffering from undiagnosed or mild dementia when you joined the study a decade earlier.

That’s rather a lot of caveats… none of which were highlighted in the headlines or the full stories that followed them.

Anyway, back to me… what does this really mean?

The central problem here is that most of the headlines reporting this research failed to note that it was based on “late-life cynical distrust,” rather than general cynicism throughout life, and also that, whatever one’s definition of cynicism, the link to dementia in later life is riddled with caveats and far from clear.

What this really means is that more research is needed, since even the researchers themselves openly acknowledge the need for larger replication studies. Dementia is a serious problem and should be taken seriously (in particular by the media). Alzheimer’s Research UK states that dementia affects 820,000 people in the UK; that 25 million of the UK population have a close friend or family member with dementia; and that dementia costs the UK economy £23 billion a year – more than cancer and heart disease combined.

In any case, the results of the Finnish study are far from conclusive, and they certainly shouldn’t force me to reconsider my generally cynical approach to life. No rose coloured glasses for me just yet, thank you.

Neuvonen, E., Rusanen, M., Solomon,A., Ngandu, T., Laatikainen, T., Soininen, H., Kivipelto, M., Tolppanen, A. (2014). Late-life cynical distrust, risk of incident dementia, and mortality in a population-based cohort. Neurology. DOI: 10.1212/WNL.0000000000000528