Role of cardiovascular health factors in mediating social inequalities in the incidence of dementia in the UK: two prospective, population-based cohort studies

van der Heide, Frank C.T.; Valeri, Linda; Dugravot, Aline; Danilevicz, Ian; Landre, Benjamin; Kivimaki, Mika; Sabia, Séverine; Singh-Manoux, Archana

doi:10.1016/j.eclinm.2024.102539

Cited by 2 publications

References 51 publications

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Race/ethnicity-specific association between the American Heart Association's new Life's Essential 8 and stroke in US adults with nonalcoholic fatty liver disease: evidence from NHANES 2005-2018

Xu,

Lu,

Luo

et al. 2024

Preprint

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Background The Life's Essential 8 (LE8) is a recently introduced assessment of cardiovascular health (CVH) by the American Heart Association (AHA). Nonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease and is associated with an increased risk of stroke. We aimed to explore the association of LE8 with stroke in NAFLD using a national cross-sectional study. Methods Eligible participants with NAFLD aged 20–85 years in NHANES 2005–2018 were included. LE8 was assessed according to AHA criteria and categorized into metabolic and behavioral factors. US Fatty Liver Index (USFLI) ≥ 30 and exclusion of other chronic liver diseases suggested NAFLD. Stroke was diagnosed according to self-report on standardized questionnaires. Results After adjusting for all confounders, each point increase in LE8, LE8 metabolic factors, and LE8 behavioral factors was associated with a 4.4%, 1.8%, and 2.5% reduction in stroke prevalence in NAFLD, respectively. Both moderate and high CVH assessed by LE8 and LE8 behavioral factors were associated with reduced odds of stroke compared with low CVH. Stroke prevalence declined progressively with increasing number of ideal LE8 components, with the lowest odds of stroke at 3 + ideal LE8 components for both LE8 metabolic and behavioral factors. Restricted cubic spline suggested dose-response associations. Race/ethnicity was a significant effect modifier, and this association was present only among non-Hispanic white population and other Hispanic population. FLI as a diagnostic indicator of NAFLD yielded generally consistent results. Conclusions Higher LE8 score, especially LE8 behavioral factors, was associated with reduced prevalence of stroke in NAFLD, especially among non-Hispanic white population and other Hispanic population. The odds of stroke declined progressively with increased ideal LE8 component number. These findings underscore the preventive value of adherence to high CVH for stroke prevention in NAFLD.

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Race/ethnicity-specific association between the American Heart Association's new Life's Essential 8 and stroke in US adults with nonalcoholic fatty liver disease: evidence from NHANES 2005-2018

Xu,

Lu,

Luo

et al. 2024

Preprint

View full text Add to dashboard Cite

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Understanding Racial Disparities in Dementia Prevalence Among Veterans

Arenson,

Bahorik,

Xia

et al. 2024

JAD

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Background: Black and Hispanic older adults have greater incidence of Alzheimer’s disease and related dementias relative to White adults, but factors underlying these disparities are not well understood, limiting the ability to address them. Objective: To determine the impact of demographics, cardiovascular disease (CVD) and risk factors, social determinants of health (SDOH), and neuropsychiatric risk factors on racial/ethnic disparities in dementia risk among Veterans. Methods: We examined a random sample of 1,579,919 older Veterans (age ≥55) without dementia who received care from the VHA from October 1, 1999 to September 30, 2021. All variables were extracted from national VHA data. We used Cox proportional hazard regression models to examine change in variance in risk of dementia across racial/ethnic groups. Results: During follow up (mean 11.1 years), 13% of Veterans developed dementia. Relative to White Veterans, the adjusted hazard ratios (AHRs) for developing dementia in sex-adjusted models with age as timescale were 1.65 (95% CI, 1.63–1.67) for Black Veterans and 1.50 (95% CI, 1.44–1.56) for Hispanic Veterans. In the model examining CVD and risk factors, AHRs were 1.53 (95% CI, 1.50–1.55) for Black Veterans and 1.38 (95% CI, 1.33–1.44) for Hispanic Veterans. In the model examining SDOH, AHRs were 1.46 (95% CI, 1.43–1.49) for Black Veterans and 1.34 (95% CI, 1.29–1.40) for Hispanic Veterans. Conclusions: SDOH and CVD and risk factors accounted for the greatest amount of variance in racial/ethnic disparities in dementia risk. Cardiovascular disease and SDOH are strong possible targets for interventions designed to reduce these disparities.

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Role of cardiovascular health factors in mediating social inequalities in the incidence of dementia in the UK: two prospective, population-based cohort studies

Cited by 2 publications

References 51 publications

Race/ethnicity-specific association between the American Heart Association's new Life's Essential 8 and stroke in US adults with nonalcoholic fatty liver disease: evidence from NHANES 2005-2018

Race/ethnicity-specific association between the American Heart Association's new Life's Essential 8 and stroke in US adults with nonalcoholic fatty liver disease: evidence from NHANES 2005-2018

Understanding Racial Disparities in Dementia Prevalence Among Veterans

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