February 23, 2017

Heart Risks in Middle Age Boost Dementia Risk Later in Life

HOUSTON, Tex -- February 23, 2017 -- People who have heart disease risks in middle age, such as diabetes, hypertension or smoking, are at higher risk for dementia later in life, according to a study presented at the 2017 International Stroke Conference.

“The health of your vascular system in midlife is really important to the health of your brain when you are older,” said Rebecca F. Gottesman, MD, Johns Hopkins University, Baltimore, Maryland.

In an ongoing study that began in 1987 and enrolled 15,744 people in 4 US communities, the risk of dementia increased as people got older. That was no surprise, but heart disease risks detected at the start of the study, when participants were aged 45 to 64 years also had a significant impact on later dementia.

Dementia developed in 1,516 people during the study, and the researchers found that the risk of dementia later in life was 41% higher in midlife smokers than in non-smokers or former smokers; 39% higher in people with high blood pressure (≥140/90 mm Hg) in middle age; 31% higher in those with pre-hypertension (between 120/80 mm Hg and 139/89 mmHg) compared with those with normal blood pressure; and 77% higher in people with diabetes in middle age than in those without diabetes.

“Diabetes raises the risk almost as much as the most important known genetic risk factor for Alzheimer's disease,” said Dr. Gottesman.

Overall, the risk of dementia was 11% lower in women. The risk was highest in individuals who were black, had less than a high school education, were older, carried the APOE-e4 gene, or had hypertension, diabetes or were current smokers at the time of initial evaluation.

Smoking and carrying the APOE-e4 gene were stronger risk factors in whites than in blacks, the researchers noted.

“If you knew you carried the gene increasing Alzheimer's risk, you would know you were predisposed to dementia, but people don’t necessarily think of heart disease risks in the same way,” said Dr. Gottesman.

Because Atherosclerosis Risk in Communities is an observational study, the current study could not test whether treating heart risk factors will result in a lessened dementia risk later in life.

“The benefit is that this is a long-term study and we know a lot about these people,” said Dr. Gottesman. “Data like these may supplement data from clinical trials that look at the impact of treatment for heart disease risks.”

SOURCE: American Heart Association
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