Midlife cardiovascular risk factors and late cognitive impairment

Abstract

Cardiovascular risk factors increase the risk of dementia in later life. The aims of the current study were to assess the effect of multiple midlife cardiovascular risk factors on the risk of cognitive impairment in later life, and to assess the validity of the previously suggested CAIDE Study risk score predicting dementia risk 20 years later. A total of 2,165 Finnish twins were followed and at the end of the follow-up their cognitive status was assessed with a validated telephone interview. The assessment of the risk factors at baseline was based on a self-report questionnaire. Relative risk ratios (RR) were calculated and receiver operating characteristic analyses performed. Midlife obesity (RR 2.42, 95 % CI 1.47-3.98), hypertension (RR 1.38, 95 % CI 1.01-1.88) and low leisure time physical activity (RR 2.52, 95 % CI 1.10-5.76) increased the risk of cognitive impairment after a mean follow-up of 22.6 ± 2.3 years. Hypercholesterolemia did not significantly increase the risk (RR 1.52, 95 % CI 0.92-2.51). Overweight individuals who gained more than 10 % weight between 1981 and 1990 had an increased risk of cognitive impairment (RR 4.27, 95 % CI 1.62-11.2). The CAIDE Study risk score combining various individual risk factors had an area-under-curve of 0.74 (95 % CI 0.69-0.79, n = 591), and there was a strong association between an increasing risk score and the risk of cognitive impairment. The results indicate that multiple midlife cardiovascular risk factors increase the risk of cognitive impairment in later life. Also, a risk score including easily measurable midlife factors predicts an individual's cognitive impairment risk well.

Successful ageing for people with an intellectual disability

“…A lack of physical activity during midlife has been associated with a double increased risk of cognitive impairment in old age [21]. In line with this, several studies have shown that physical activity is a protective factor against cognitive decline and dementia [28][29][30].…”

“…Cardiovascular risk factors like hypertension or obesity in midlife can increase the likelihood of dementia later in life [21]. Hypertension is the leading risk factor for global mortality, followed by tobacco use, high blood glucose, and obesity [22].…”

Body mass index in midlife and dementia: Systematic review and meta‐regression analysis of 589,649 men and women followed in longitudinal studies

“…Most studies included men and women, one study included only women [10], and five studies included only men (Launer LJ, personal communication, 2015) [18], [44], [50], [51]. In one study, the first recorded clinical diagnosis of obesity was extracted from hospital admission records [53], in three studies body height and weight were self-reported in midlife [30], [52], or retrospectively in late life by dementia-free participants [48]. Standard, direct measures of height and weight were collected at baseline and used to calculate BMI in the remaining studies.…”

Amyloid-beta and Alzheimer’s disease: the role of neprilysin-2 in amyloid-beta clearance

“…However, there may be a more fundamental explanation. If Aβ is an initiator of the long and complex cascade of pathologic alterations that take place in AD, then a multitude of downstream effectors and modifying factors (including genetics, other medical conditions, and environment) would have a profound effect on the rate and severity of disease progression (Korf et al, 2004; Bennett et al, 2006; Barberger-Gateau et al, 2007; Ngandu et al, 2007; van Vliet et al, 2009; Chang et al, 2010; Rusanen et al, 2011; Reijmer et al, 2012; Tolppanen et al, 2013; Virta et al, 2013). In this scenario one would predict that Aβ would correlate more poorly (but still significantly) with cognitive decline while more downstream effectors (e.g., synaptic loss) would correlate better (Bennett et al, 2003, 2005).…”