Association of change in cardiovascular risk factors with incident dementia

Sedaghat, Sanaz; Lutsey, Pamela L; Ji, Yuekai; Empana, Jean‐Philippe; Sorond, Farzaneh A.; Hughes, Timothy M.; Mosley, Thomas H.; Gottesman, Rebecca F.; Knopman, David S.; Walker, Keenan A.; Guðnason, Vilmundur; Launer, Lenore J.; Sloten, Thomas T. van

doi:10.1002/alz.12818

Cited by 8 publications

(3 citation statements)

References 35 publications

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“… 35 Exposure to cardiovascular risk factors, in particular in midlife and in a cumulative manner, is strongly linked with incident dementia in later life. 36 We and others have shown that the buildup of pathologies at the level of heart and extracranial vessels results in accelerated brain parenchymal loss, cerebral small‐vessel disease, and cognitive impairment. 37 , 38 Although the role of extracranial carotid disease in cognitive impairment has been extensively evaluated, there are limited comprehensive data on the role of intracranial atherosclerosis in brain structural and functional changes.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Atherosclerosis Disease Associated With Cognitive Impairment and Dementia: Systematic Review and Meta‐Analysis

Sabayan,

Goudarzi,

et al. 2023

JAHA

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Background Intracranial atherosclerosis disease (ICAD) alters cerebrovascular hemodynamics and brain structural integrity. Multiple studies have evaluated the link between ICAD and cognitive impairment, with mixed results. This study aims to systematically review and summarize the current evidence on this link. Methods and Results PubMed, EMBASE, PsycInfo, and Web of Science were searched from 2000 to 2023 without language restriction. Cross‐sectional and prospective cohort studies as well as postmortem studies were included. Studies containing data on the link between ICAD, defined as at least 50% stenosis in 1 intracranial vessel, and cognitive impairment and dementia were screened by 2 independent reviewers. A total of 22 (17 observational and 5 postmortem) unique studies, comprising 11 184 individuals (average age range, 59.8–87.6 years; 45.7% women; 36.5% Asian race), were included in the systematic review. Seven of 10 cross‐sectional studies and 5 of 7 prospective studies showed a significant association between ICAD and cognitive impairment. In the pooled analysis, ICAD was associated with greater cognitive impairment (measure of association, 1.87 [95% CI, 1.49–2.35]). Meta‐regression analyses did not show a significant impact of age, sex, and race. All postmortem studies showed that patients with Alzheimer disease and vascular dementia had a higher burden of ICAD compared with controls. Conclusions This study shows that ICAD is associated with cognitive impairment and dementia across age, sex, and race groups. Our findings may underscore the need to develop individualized dementia preventive care plans in patients with ICAD.

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Section: Discussionmentioning

confidence: 99%

Intracranial Atherosclerosis Disease Associated With Cognitive Impairment and Dementia: Systematic Review and Meta‐Analysis

Sabayan,

Goudarzi,

et al. 2023

JAHA

Self Cite

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“…Accordingly, the observed decreasing risk of CV risk factors or diseases for incident dementia with increasing age might be due to the fact that our studied outcome was all-cause dementia and that the presence of multiple pathologies, rather than vascular dementia on its own, seems to be involved in the development as age increase. Fifth, we should have been taking into account the CV risk level in the risk prediction of dementia with longitudinal data since, the improvement of CV modi able risk was associated with a reduction of dementia risk [48][49][50]. Finally, we did not take into account the impact of level adherence of CV medication.…”

Section: Discussionmentioning

confidence: 99%

Association between Cardiovascular Diseases and Dementia among various age groups: A Population-Based Cohort Study in Older Adults

Boivin‐Proulx

Brouillette

Dorais³

et al. 2023

Preprint

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The link between cardiovascular (CV) risk factors or diseases and dementia is documented. There is conflicting evidence whether age moderates the association. We need to study this gap so that research and clinical initiatives target appropriate age groups. A cohort of 320,630 adult patients without dementia was built using Quebec healthcare databases (1998–2010). The CV risk factors were hypertension, diabetes and dyslipidemia, while diseases included stroke, myocardial infarction (MI), chronic heart failure (HF), and atrial fibrillation (AF). Dementia risk and CV risk factors or diseases were assessed using incidence rate ratios and Cox regression across age groups. The cohort presented by mainly female sex (67.7%) and mean age of 74.1 years. Incident rate of dementia increased with age, ranging from 4.1 to 93.5 per 1,000 person-years. Diabetes, stroke, HF and AF were significantly associated with dementia risk, hazard ratios ranged from 1.08 to 3.54. The strength of association decreased in advanced age for diabetes, stroke and HF. The results suggest that prevention of diabetes, stroke, HF and AF are crucial to mitigate dementia risk. The pathophysiology of dementia in younger and older populations seems to differ, with less impact of CV risk factors in advanced age.

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“…CVD risk calculators which incorporate multiple risk factors produce a single risk score and are a standard tool to identify an individual's cardiovascular risk over a specified period. There is some evidence that these CVD risk scores may also be associated with cognitive decline [8][9][10][11][12][13][14][15][16], especially in middle-age [8,9,12,15,16]. Evidence of a relationship between CVD risk scores and cognition in later life (aged >70 years) is mixed [10,11,13], and very few studies have looked at the association between CVD risk scores and the incidence of dementia [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Disease Risk Scores and Incident Dementia and Cognitive Decline in Older Men and Women

Vishwanath,

Hopper,

Chowdhury

et al. 2023

Gerontology

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Introduction: Risk factors for cardiovascular disease (CVD) also increase the risk of dementia. However, whether commonly used CVD risk scores are associated with dementia risk in older adults who do not have a history of CVD, and potential gender differences in this association, remains unclear. The aim of this study was to determine whether CVD risk scores are prospectively associated with cognitive decline and dementia in initially healthy older men and women. Methods: A total of19,114 participants from a prospective cohort of individuals aged 65+ years without known CVD or dementia were recruited. The atherosclerotic cardiovascular disease risk score (ASCVDRS), Systematic Coronary Risk Evaluation 2-Older Persons (SCORE2-OP), and the Framingham risk score (FRS) were calculated at baseline. Risk of dementia (according to DSM-IV criteria) and cognitive decline (defined as a >1.5 standard deviation decline in global cognition, episodic memory, psychomotor speed, or verbal fluency from the previous year) were assessed using hazard ratio. Results: Over a median follow-up of 6.4 years, 850 individuals developed dementia and 4,352 cognitive decline. Men and women in the highest ASCVDRS tertile had a 41% (95% CI 1.08, 1.85) and 45% (1.11, 1.89) increased risk of dementia compared to the lowest tertile, respectively. Likewise, men and women in the highest SCORE2-OP tertile had a 64% (1.24, 2.16) and 60% (1.22, 2.11) increased risk of dementia compared to the lowest tertile, respectively. Findings were similar, but the risk was slightly lesser when examining risk of cognitive decline for both ASCVDRS and SCORE2-OP. However, FRS was only associated with the risk of cognitive decline among women (highest vs. lowest tertiles: 1.13 [1.01–1.26]). Conclusion: These findings suggest the utility of the ASCVDRS and SCORE2-OP in clinical practice, to not only assess future risk of CVD, but also as potential early indicators of cognitive impairment, even in relatively healthy older men and women.

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Association of change in cardiovascular risk factors with incident dementia

Cited by 8 publications

References 35 publications

Intracranial Atherosclerosis Disease Associated With Cognitive Impairment and Dementia: Systematic Review and Meta‐Analysis

Intracranial Atherosclerosis Disease Associated With Cognitive Impairment and Dementia: Systematic Review and Meta‐Analysis

Association between Cardiovascular Diseases and Dementia among various age groups: A Population-Based Cohort Study in Older Adults

Cardiovascular Disease Risk Scores and Incident Dementia and Cognitive Decline in Older Men and Women

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