Dementia, cognitive decline predicted by ideal cardiovascular health index

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Takeaway

  • Ideal cardiovascular health (CVH) index predicts risk for dementia and cognitive decline as well as risk for cerebrovascular disease.

Study design

  • 2750 Framingham Heart Study Offspring cohort participants (mean age, 62±9 y; 45% men), free of stroke and dementia at baseline, underwent measurement of 10-y risks of incident stroke and dementia, and ≈7 y risks of cognitive decline and MRI brain atrophy.
  • Ideal CVH determination was 0-7-points (1 point each for nonsmoking, ideal body mass index, regular physical activity, healthy diet, optimum blood pressure, cholesterol, and fasting glucose).

Key results

  • Recent ideal CVH was associated with lower risk of vascular dementia (HR, 0.49; 95% CI, 0.30-0.81), frontal brain atrophy (P=.003), decline in visual memory and reasoning (P<.05), and stroke (HR, 0.80; 95% CI, 0.67-0.95).
  • Remote ideal CVH (6.9 y earlier) predicted vascular dementia, whole-brain atrophy, cognitive decline, and stroke and was associated with incidence of all-cause dementia (HR, 0.80; 95% CI, 0.67-0.97) and Alzheimer disease (HR, 0.79; 95% CI, 0.64-0.98).

Limitations

  • Findings might not apply to different populations.

Why this matters

  • Following ideal CVH factors and behaviors, especially in midlife, may protect against dementia as well as cerebrovascular disease.