Risk factors predictive of onset of dementia differ at different ages, according to a new study published in the journal Neurology.¹

McGrath et al examined 4899 individuals aged 55 years (mid-life) and 2386 participants aged 65 or 70 years (late-life) and 75 or 80 years (later-life) to determine the vascular risk factors associated with the likelihood of developing dementia such as aging, hypertension, diabetes, atherosclerosis and stroke. Women comprised the majority participants in both groups (57% and 62%, respectively. For this, data was sourced from the Framingham Heart Study Original and Offspring cohorts and these participants also had available Framingham Stroke Risk Profile (FSRP) data. From the age of 65 years onwards, all the study subjects were tracked to study the 10-year risk of incident dementia. The risk factors were measured at age 55, 65, 70, 75 and 80 years.

The probability of developing dementia was almost four times higher in participants who were diabetic at 55 years of age versus those who did not have diabetes at this age with a hazard ratio of 3.35. Likewise, being hypertensive at this age also increased the chances of dementia in the future with a hazard ratio of 1.17. The risk increased by 12% for every 10 mmHg rise in systolic blood pressure.

Participants who had a cardiovascular disease other than stroke at 65 years of age doubled their risk of dementia (HR 2.12). The most important risk factors for participants in their 70s were diabetes (HR 1.97) and stroke (HR 2.43). Among the subjects who were 80 years of age, history of stroke (HR 1.57), diabetes (HR 1.45) and use of antihypertensive medications (HR 0.68) were the factors most predictive of the risk of dementia.

“No one size fits all”… this study has shown that the vascular risk factors for dementia vary with age suggesting that risk prediction scores cannot be universally applied. At 55 years of age systolic BP and diabetes; at 65 years of age non-stroke cardiovascular disease; at 70-75 years diabetes and stroke and at 80 years of age, diabetes, stroke and antihypertensive drugs were the important risk factors. While leading a healthy lifestyle in general may ward off the risk of dementia, the dementia risk scores should be age-specific and assessment of risk should be individualized with personalized suggestions on lifestyle changes.

Reference

1. McGrath ER, et al. Determining vascular risk factors for dementia and dementia risk prediction across mid- to later-life: The Framingham Heart Study. Neurology May 2022, 10.1212/WNL.0000000000200521; DOI: 10.1212/WNL.0000000000200521.