The Cause-and-Consequence Relationships between Domestic Abuse and Alzheimer's Disease: Identification of Five Subtypes.

Domestic abuse (DA) and Alzheimer's disease (AD) and related dementias) are two of humankind's most significant societal healthcare issues. DA is widespread, with one in three women and one in four men experiencing physical, psychological, emotional, sexual, and financial abuse in their lifetime. AD is the most common form of dementia and is expected to affect more than 152 million people worldwide by 2050. Given the incidence and prevalence of these two problems, any causal relationship between them carries profound societal consequences. Herein, we describe five types of overlapping relationships between DA and AD: 1. intimate partner violence (IPV) as a risk factor for AD; 2. AD as a risk factor for worsening ongoing DA; 3. abuse of caregivers by people with AD; 4. abuse of people with AD by caregivers; and 5. reactivation of previous DA behavior in a person with AD. Chronologically, these five types cover the spectrum from occurring decades before the onset of AD symptoms to emerging only after AD symptoms have manifested. Mechanistically, these five subtypes reflect the paradoxical fact that DA and AD may be causes or consequences of each other. Phenomenologically, they encompass the full spectrum of DA, including physical, psychological, emotional, sexual, and financial abuse. Given the challenges in recognizing, managing, and treating both DA and AD, society's need to recognize the DA/AD Problem and to identify and prevent the five subtypes of DA and AD overlap is an emerging healthcare priority.