Cardiovascular and cognitive fitness at age 18 and risk of early-onset dementia

Nyberg, Jenny; Åberg, Maria; Schiöler, Linus; Nilsson, Michael; Wallin, Anders; Torén, Kjell; Kuhn, H. Georg

doi:10.1093/brain/awu041

Cited by 94 publications

(81 citation statements)

References 27 publications

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“…46 As previously described, an algorithm developed by experienced cardiac surgeons, cardiologists, and epidemiologists and based on extensive medical record review allowed inclusion of all adults with valid CHD diagnoses. 24 However, misclassification of specific CHD diagnosis, and therefore also CHD complexity, may be present. Furthermore, where the ICD diagnostic code was insufficiently specific to infer CHD complexity, we were not able to categorize adults with CHD according to complexity.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19][20][21][22] In addition, some adults with CHD have poor exercise tolerance, 23 which is a dementia risk factor. 24 In the absence of a disease-modifying treatment for most forms of dementia, the identification of factors with the potential to delay dementia onset is crucial. Based on the increased incidence of neurodevelopmental impairments and associated risk factors for dementia in CHD, we hypothesized that the risk of dementia is higher in adults with CHD than in the general population.…”

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confidence: 99%

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Risk of Dementia in Adults With Congenital Heart Disease

Bagge¹,

Henderson

Laursen³

et al. 2018

Circulation

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Editorial, see p XXXBACKGROUND: More children with congenital heart disease (CHD) are surviving to adulthood, and CHD is associated with risk factors for dementia. We compared the risk of dementia in CHD adults to that of the general population. METHODS:In this cohort study, we used medical registries and a medical record review covering all Danish hospitals to identify adults with CHD diagnosed between 1963 and 2012. These individuals with CHD were followed from January 1, 1981, 30 years of age, or date of first CHD registration (index date for matched members of the general population cohort) until hospital diagnosis of dementia, death, emigration, or end of study (December 31, 2012). For each individual with CHD, we identified 10 members of the general population utilizing the Danish Civil Registration System matched on sex and birth year. We computed cumulative incidences and hazard ratios (HRs) of dementia, adjusting for sex and birth year. RESULTS:The cumulative incidence of dementia was 4% by 80 years of age in 10 632 adults with CHD (46% male). The overall HR comparing adults with CHD with the general population cohort was 1.6 (95% confidence interval [CI], 1.3−2.0). The HR among individuals with CHD without extracardiac defects was 1.4 (95% CI, 1.1−1.8). Adults with mild-to-moderate CHD had an HR of 1.5 (95% CI, 1.1−2.0), whereas the HR was 2.0 (95% CI, 1.2−3.3) for severe CHD, including univentricular hearts. The HR for early onset dementia (<65 years of age) was 2.6 (95% CI, 1.8−3.8), whereas the late-onset HR was 1.3 (95% CI, 1.0−1.8).CONCLUSIONS: CHD was associated with an increased risk of dementia compared with the general population, in particular for early onset dementia. Further understanding of dementia risk in the population with CHD is a potential target for future investigation.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Risk of Dementia in Adults With Congenital Heart Disease

Bagge¹,

Henderson

Laursen³

et al. 2018

Circulation

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“…However, the Million Men Study used a similar case-finding methodology of combining hospital discharge register data with outpatient records. 45 The vast majority of dementia cases recorded on hospital discharge and on death certificates are recorded as generic “dementia” without further information on diagnostic subtype. Hence, it was not feasible to investigate different types of dementia separately, though we report Alzheimer disease models in eFigure 1.…”

Section: Discussionmentioning

confidence: 99%

Geographical Variation in Dementia

Russ¹,

Gatz

Pedersen

et al. 2015

Epidemiology

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Background This study aimed to estimate the magnitude of geographical variation in dementia rates and suggest explanations for this variation. Small-area studies are scarce, and none has adequately investigated the relative contribution of genetic and environmental factors to the distribution of dementia. Methods We present two complementary small-area hierarchical Bayesian disease mapping studies using the comprehensive Swedish Twin Registry (n=27,680) and the 1932 Scottish Mental Survey cohort (n=37,597). The twin study allowed us to isolate the area in order to examine the effect of unshared environmental factors. The Scottish Mental Survey study allowed us to examine various epochs in the life course – approximately age 11 years and adulthood. Results We found a 2-to 3- fold geographical variation in dementia odds in Sweden, after twin random effects – likely to capture genetic and shared environmental variance – were removed. In Scotland we found no variation in dementia odds in childhood but substantial variation, following a broadly similar pattern to Sweden, by adulthood. Conclusions There is geographical variation in dementia rates. Most of this variation is likely to result from unshared environmental factors that have their effect in adolescence or later. Further work is required to confirm these findings and identify any potentially modifiable socio-environmental risk factors for dementia responsible for this geographical variation in risk. However, if these factors do exist and could be optimized in the whole population, our results suggest that dementia rates could be halved.

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“…Physical fitness was measured using a bicycle ergometer,23 but as it was not normally distributed, we created categories of low (0–4), moderate (5–7) and high fitness (8–9). Height and weight were measured and we subsequently calculated body mass index (BMI).…”

Section: Methodsmentioning

confidence: 99%