Improving Heart Health at Age 50 Can Reduce Dementia Risk Later in Life

Good cardiovascular health in midlife is associated with a lower risk of developing dementia later in life, according to a new study in BMJ.

Researchers analyzed 7899 patients with data on their cardiovascular health score, also known as Life’s Simple 7. The score is made up of 4 behavioral (smoking, diet, physical activity, and body mass index) and 3 biological (fasting glucose, blood cholesterol, and blood pressure) metrics for primordial prevention of cardiovascular disease, which refers to avoiding the development of risk factors in the first place. Scores between 0 and 6 are considered poor, between 7 and 11 are intermediate, and 12 to 14 are considered optimal cardiovascular health.

The authors sought to determine the association between the Life’s Simple 7 at age 50 and the incidence of dementia over the next 25 years.

“Pathophysiological hallmarks of dementia appear 15-20 years before clinical symptoms, highlighting the need for a long follow-up to identify risk factors and protective factors,” the authors explained.

The patients were part of the ongoing Whitehall II study of 10,308 people in the British civil service in 1985-1988. Cardiovascular data were collected at age 50 and dementia cases were identified using hospital, mental health services, and death registers until 2017. None of the participants had cardiovascular disease or dementia at age 50.

There were 347 (4.4%) cases of dementia over an average follow-up of 25 years, and the average age of dementia diagnosis was 75 years. In the group of patients who developed dementia, there was a higher proportion of women, nonwhite patients, and patients who were in a lower socioeconomic group. In contrast, patients with a better cardiovascular health score were more likely to be male, white, married/cohabiting, and from higher educational and occupational groups.

A higher cardiovascular health score at age 50 was associated with higher whole brain and gray matter volume during magnetic resonance imaging scans 20 years later. The results also suggest that even small improvements in cardiovascular risk factors were beneficial for cognitive health, the authors wrote.

“Our findings suggest that the Life’s Simple 7, which comprises the cardiovascular health score, at age 50 may shape the risk of dementia in a synergistic manner,” the authors concluded. “Cardiovascular risk factors are modifiable, making them strategically important prevention targets. This study supports public health policies to improve cardiovascular health as early as age 50 to promote cognitive health.”

Reference

Sabia S, Fayosse A, Dumurgier J, et al. Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study. BMJ, 2019;366:l4414. doi: 10.1136/bmj.l4414.