Persons who show rapid accumulation of various cardiovascular risk factors such as high BP, diabetes, overweight/obesity, smoking over time are more likely to develop dementia and cognitive impairment compared to those with stable cardiovascular risk, according to a new study from Sweden published in the journal Neurology.¹

Researchers examined 1244 individuals, aged 55 years (mean), who had no apparent heart disease and also had no memory impairment at the time of their enrolment into the trial. The participants were subjected to memory tests and lifestyle questionnaires every five years for up to 25 years, during which they also underwent health examinations. The risk of heart disease was estimated with the help of the Framingham Risk Score. The average 10-year risk at baseline was 17-23%.

The cardiovascular disease risk remained stable or showed only minimal change in 22%, whereas it showed a modest increase in 60% and increased rapidly in 18% of subjects. Seventy-eight participants (6%) developed Alzheimer’s disease dementia, while 39 (3%) developed dementia from vascular disease.

The risk of cardiovascular events increased from 17% to 38% in participants with moderate increased risk, but in participants with accelerated risk, it increased from 23% to 62% over 10 years at the end of the study. In persons with stable CVD risk, the risk of CV event was 20% during the course of the study.

Compared to participants with stable CVD risk, the risk of developing Alzheimer’s disease dementia was 3-6 times higher in persons with accelerated CVD risk. They were also at 3-4 times greater risk of vascular dementia. Their odds of memory impairment in middle age were 1.4 times higher.

Rapid accumulation of cardiovascular risk factors is associated with greater chances of developing dementia and cognitive decline. Instead of just tackling single risk factors, a better approach to reduce the likelihood of developing dementia is to determine all modifiable risk factors and also manage them all as a combination, particularly in individuals who develop these risk factors at a more rapid pace.

Reference

1. Farnsworth von Cederwald B, et al. Association of cardiovascular risk trajectory with cognitive decline and incident dementia. Neurology. 2022 Apr 20:10.1212/WNL.0000000000200255. doi: 10.1212/WNL.0000000000200255