Cardiovascular Disease Risk Scores and Risk of Cognitive Decline and Dementia in Older Men and Women

Abstract

AbstractBackgroundRisk factors for cardiovascular disease (CVD) also increase the risk of dementia. However, whether commonly used CVD risk scores are associated with dementia in older adults who do not have a history of CVD remains unclear. The aim of this study was to determine whether CVD risk scores are associated with subsequent cognitive decline and dementia in initially healthy older men and women.MethodParticipants were from a prospective cohort of 19,114 individuals aged 65+ years without prior CVD event or major cognitive impairment. The Atherosclerotic Cardiovascular Disease risk score (ASCVDRS) and the Framingham risk score (FRS) were calculated at baseline, with women and men analysed separately due to large differences in overall level of CVD risk. Dementia was adjudicated by clinical experts according to DSM‐IV criteria. Cognitive decline was defined as a >1.5 SD decline in cognitive score from their own baseline value on any of the four cognitive tests looking at global cognition, episodic memory, psychomotor speed or verbal fluency.ResultOver a median follow‐up of 6.4 years, 4,325 individuals had cognitive decline and 850 individuals developed dementia. ASCVDRS, was associated with dementia and cognitive decline, in men and women, whether considered as a continuous measure and as tertiles. For example, men and women in the highest ASCVDRS tertile had a 41% and 45% increased risk of dementia compared to the lowest tertile respectively (HR [95%CI] men: 1.41 [1.08,1.85], women: 1.45 [1.11,1.89]). However, higher FRS was not associated with incident dementia and only associated with an increased risk of cognitive decline among women (FRS continuous: 1.08 [1.01,1.26]; highest vs. lowest tertiles: 1.13 [1.01‐1.26]).ConclusionThese results provide some evidence for ASCVDRS as a measure of shared CVD risk factors for identifying/predicting risk of dementia and cognitive decline in healthy older adults regardless of sex. Further research is needed to confirm the findings and to validate these results in more heterogeneous populations.