Cardiovascular health metrics from mid‐ to late‐life and risk of dementia: A population‐based study

Abstract

AbstractBackgroundCardiometabolic risk factors in middle age have been associated with late‐life risk of dementia. The associations of cardiovascular health (CVH) metrics in midlife and old age with late‐life risk of dementia need to be clarified in cohort studies. We sought to examine the associations of CVH metrics from mid‐ to late‐life with risk of incident dementia in late‐life.MethodThis population‐based cohort study used data from the Finnish Cardiovascular Risk Factors, Aging and Dementia study. A total of 1449 participants were followed from midlife (1972 to 1987, mean baseline age 50.4 years) to late‐life (1998 to 2005‐2009, mean baseline age 70.2 years, N=744). We defined six CVH metrics (smoking, blood pressure, physical activity, body mass index, fasting plasma glucose, and serum total cholesterol) following the modified American Heart Association’s recommendations. Dementia diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria. Data were analysed with Cox regression models.ResultDuring the follow‐up examinations, dementia was diagnosed in 61 persons in 1998 and additional 47 persons during 2005 to 2008. The incidence of dementia (per 1000 person‐years) was 7.27, 3.76, and 2.00 for those with poor (score ≤5), intermediate (6‐7), and ideal (≥8) levels of CVH metrics in midlife, respectively. Compared with people with poor CVH metrics, those with ideal CVH metrics in midlife had a 48% lower risk of dementia in late‐life (fully‐adjusted hazard ratios, 0.52; 95% CI, 0.20‐0.92). The incidence rate of dementia (per 1000 person‐years) was 9.5, 5.5, and 8.7 for those with poor, intermediate, and ideal levels of CVH metrics in late‐life, respectively. No significant association was found between late‐life CVH metrics and risk of dementia. Compared with poor CVH metrics in both midlife and late‐life, the fully‐adjusted hazard ratio of dementia was 0.24 (95% CI, 0.06‐0.94) for having intermediate or ideal CVH metrics in either midlife or late‐life and 0.29 (0.10‐0.86) for intermediate or ideal CVH metrics in both midlife and late‐life.ConclusionHaving an intermediate or ideal level of CVH metrics in either midlife or late‐life is associated with a decreased risk of dementia.